It’s easy to overstate how dangerous elderly ailments can be. Senior citizens live under a near-constant deluge of warning labels and fearmongering, fed by the bodily dysfunctions that affect all of us as we age. Sometimes, based on your health, it’s a good idea to heed those warnings. Medical alert systems, for example, can be quite useful if you’re prone to falls or suffer from osteoporosis. But there are many ailments that are best prevented through a combination of healthy habits and thoughtful wisdom.
Dehydration – a severe decrease in fluids in the body – is a great example of this. It’s a problem every senior should be aware of and take reasonable precautions against. It can have some potentially dangerous consequences if left unchecked. But in most cases, there’s no reason to let fear of it rule your day-to-day decisions, so long as you’re proactive and smart about your health.
This guide presents an overview of elderly dehydration: its causes, symptoms and complications, as well as how to prevent it and how to treat it if things get bad. You should always seek the counsel of a qualified, competent physician before following any medical advice you read on the internet, and we’re no exception; remember to speak to your doctor about ways to recognize and prevent dehydration.
Yes, dehydration can be a real problem if left unchecked. Yes, there are reasons why it’s a larger concern for the elderly than it might be for younger generations, especially if you suffer from ailments that restrict your ability to accept fluids in the first place. If you’re an average senior citizen, though, dehydration is relatively easy to prevent. You merely need to develop a few healthy habits and know what warning signs to watch out for.
Elderly Dehydration: Causes & Risk Factors
During their younger years, most people rarely give dehydration a second thought. Consequently, it’s worth understanding why a lack of fluids can be such a concern for the elderly population. As we age, our bodies aren’t as capable of holding on to the water we take in. Water makes up about 60 percent of the average male body and 55 percent of the average female; as we age, that drops to between 50 and 55 percent in men and just 45 to 50 percent in women.
Not only is there less water in our bodies as we age; we also pass it more quickly and aren’t as able to tell when we need to drink – or aren’t as willing to listen to our body’s cues. These are the five chief causes of elderly dehydration:
- Decreased water retention. As we get older, we begin passing fluids more quickly. Our kidneys aren’t as capable as they used to be, which means it takes more water to flush things through our system.
- Decreased thirst. An aging body isn’t quite as good at notifying us when we could use a little more water; we literally stop getting as thirsty. When thirst strikes, it’s that much more important to listen to your body’s signals.
- Medicinal side effects. The older we get, the more likely we are to find ourselves on multiple medications. Many medicines have side effects that can affect your hydration. Some are diuretics, meaning they encourage water to pass through your body more quickly, while others might cause you to sweat more or further reduce your thirst or appetite.
- Common sickness. Nobody likes getting a cold, the flu or food poisoning, but these illnesses can hit seniors especially hard. Vomiting and diarrhea can quickly strip your body of moisture, so it’s more important than ever to drink lots of pure water when you’re sick.
- Inability to accept fluids. Perhaps the most dangerous source of elderly dehydration is the inability to drink water in the first place. This doesn’t necessarily have anything to do with a swallowing disorder, though that can be quite problematic; rather, many seniors don’t get enough fluids because they rely on caregivers who might not think to offer them glasses of water, or understand when their patients are thirsty and in need of a drink.
That last bullet point is worth dwelling on for a moment. There are a lot of reasons why a senior citizen might be unable, or even unwilling, to drink water. Perhaps they’re bedridden and can’t get themselves a drink without help. Perhaps they can’t swallow properly, or have trouble keeping food and water down. Perhaps they’re living in a care facility and can’t communicate well with their caregivers because of a language barrier, a speech impediment or the symptoms of a chronic illness. Some seniors, fearing incontinence, will actually avoid fluids in order to purposefully harden their stools – a very, very bad idea.
If you suffer from these sorts of problems, dehydration shifts from being a mild concern to a cause for significant alarm. If you care for someone in such a situation, it’s vital you ensure they receive enough fluids throughout the day.
Certain people are at higher risk of dehydration than others. Whether you’re a senior citizen yourself or you have one in your care, it’s worth knowing what those risk factors are so you can be prepared:
- Age. This one’s easy: If you’re over 85, there’s a significant increase in the threat of dehydration.
- Weight. It seems like obesity increases your risk for just about any health issue, and that’s especially true in the elderly. Nevertheless, obesity greatly affects your body’s ability to handle its day-to-day functions, and that includes properly taking and passing fluids.
- Mobility. Bedridden individuals are drastically more likely to suffer from dehydration. They’re often reliant on others for their fluid intake, and their general lethargy makes it a lot harder for them to want to drink at all.
- Chronic disease or dementia. People who’ve suffered a stroke, or who have to deal with a chronic illness like Parkinson’s or Alzheimer’s, are significantly less likely to recognize their thirst, much less drink when they need to.
Signs & Symptoms of Dehydration
How do you know when you’re becoming dehydrated, or when someone you care for could use another glass of water? Staving off dehydration and treating it after the fact are both, of course, contingent on knowing when you’re dehydrated in the first place. Keep an eye out for the following symptoms. We’ve listed them in generally increasing order of severity, but all are valid warning signs that warrant a drink as soon as possible.
- Confusion or disorientation in individuals who don’t suffer from dementia or similar ailments. People who are dehydrated can rarely think as quickly or clearly as those who’ve had sufficient fluid intake.
- Headaches, dizziness or lightheadedness. This is a classic early symptom of dehydration in people of all ages, and it can often be remedied with a glass of water and a comfortable chair.
- Dry mouth. There are few more obvious signs that you need fluids than a dry mouth. Cottonmouth is a common side effect of medication, but it’s rarely a bad thing to relieve the symptom by drinking water.
- Constipation. A classic early warning sign that you might not be getting enough liquids in your diet, constipation is frustrating and often painful.
- Increased heart rate. If your blood isn’t as fluid as it should be because of dehydration, your heart may beat faster in an attempt to push oxygen throughout your body.
- Low blood pressure. Many senior citizens have easy access to a home blood pressure test, and it’s worth using if you’re at higher risk for dehydration.
- Gauntness. Sallow cheeks and sunken eyes are among dehydration’s few outwardly visible signs.
- Decreased urination or urine output. Try to follow the advice of my old scoutmaster and stick to the Three C’s: Your urine should be clear, copious and frequent. I’m not sure why they’re called the Three C’s, but it’s sound guidance nonetheless.
- Decreased skin turgor. Turgor is a fancy word that refers to your skin’s ability to bounce back after being pinched or pulled. If you try pinching the skin on the back of your hand and it doesn’t settle almost immediately – accounting for age and wrinkles, of course – then you’re unquestionably dehydrated.
- Inability to cry or sweat. If things get this bad, you’re in serious trouble and should seek immediate medical attention. If the body can’t shed heat by sweating or you can’t seem to produce tears to lubricate your eyes, a visit to the emergency room and intravenous fluids are probably in your future.
Complications That Arise From Dehydration
A person can survive up to three days without water, but no longer. Going without water for even a day can severely dehydrate you, leading to a variety of negative effects – some of them quite dangerous.
- If you’re bedridden, you’re more likely to develop bed sores. While this won’t apply to everyone, it’s an important consideration for people who aren’t readily ambulatory.
- Your kidneys could begin to fail. Without water to flush blood through your kidneys, they can quickly become oversaturated. This can lead to a buildup of waste in your bloodstream.
- You could start having seizures. Particularly in the elderly, dehydration can lead to involuntary muscle contractions.
- You could lose consciousness. As the volume of blood in your body decreases, your brain strains for enough oxygen to keep you cognizant of the world around you. Initially, this might feel like the mild confusion or dizziness we mentioned above; eventually, it could mean falling into unconsciousness.
- You could slip into a coma and die. Granted, this only happens after four or five days without fluids, which would be an exceedingly rare case, but it is the ultimate consequence if you don’t keep yourself hydrated.
Preventing Elderly Dehydration
All the complications we just detailed sound scary. If you don’t keep yourself hydrated, or if someone in your care begins to lose fluids, you or they might even risk suffering from some of them. But it’s not difficult to fend off dehydration with four simple precautions:
- Drink plenty of water. This is painfully obvious, but it’s amazing how rarely such simple advice is followed. Drink a glass of water when you wake up. Drink one with every meal. Sip on tea or juice throughout the day. Even if you’re not thirsty, drinking regularly is the best way to stay hydrated.
- Eat water-rich foods. Fruits and vegetables aren’t just healthy for you; they’re also full of water. Soups may be comforting and easy to eat, but that’s not the only reason to cook up a batch of tomato bisque; soups are mostly water.
- Avoid excesses of caffeine and alcohol. In moderate amounts, the diuretic effects of caffeine and alcohol aren’t enough to dehydrate you. If you like coffee in the morning or a glass of wine in the evening, drinking either won’t suddenly leech your body of water. That said, too much caffeine or alcohol can encourage your body to pass water faster, which can make it difficult to stay hydrated.
- Consider weighing yourself every day. Especially if you have a history of dehydration, check your body weight each morning. If you’ve dropped two or more pounds in a day, you probably aren’t getting all the water your body needs.
There’s no magic amount of water that will ensure hydration. You might have heard that drinking five or eight glasses of water a day is enough. If you’ll pardon the phrase, though, neither claim really holds water; everyone’s body is different. Heavier people need more water than lighter people. People who sweat more need more fluids than people who naturally sweat less. Learn to read your body’s warning signs. Push yourself to drink a little more, even if you’re not thirsty. It’ll keep you healthier and happier in the long run.
Treating Severe Dehydration
The treatment for moderate dehydration isn’t particularly difficult: Try to get more fluids, take it slow and steady, and you’ll be back to fighting shape in no time.
Severe dehydration is another matter. In scenarios when some of the more taxing symptoms of dehydration come into play – deeply gaunt features, reduced skin turgor, intense dizziness and nausea, or the inability to sweat or produce tears – you’ll want to seek qualified medical attention right away. It will likely mean an intravenous saline drop to replenish your fluids in a carefully controlled manner. Managed replenishment is key, because oversaturating your body with water after it’s been dehydrated can have some uncomfortable side effects. If the brain hasn’t been getting enough water for a few days, for example, imbibing a lot can cause it to soak up too much at once, leading it to swell and press against the skull.
If you live in or work at a managed care facility, it might be up to you to watch out for the health and wellness of your friends or the people you care for. Look for the symptoms we outlined above, and you’ll be prepared to catch things before they get so bad as to cause some of dehydration’s more severe complications.