Dehydration in the Elderly

One of the most common health problems faced by elderly people is dehydration.

Older people are more vulnerable to becoming dehydrated for a variety of reasons, ranging from our bodies changing as we age to environmental and psychological factors that make it more likely that a person will neglect to keep themselves well hydrated.

It's essential for caregivers and loved ones to be aware of the signs and symptoms of dehydration in seniors, as well as how to treat it, as it’s often the case that an older person may not recognise that they are dehydrated.

With this in mind, we discuss the causes and signs of dehydration, alongside treatment and prevention.

Causes of dehydration in the elderly

Dehydration occurs when the body loses more fluids than it takes in. This can happen for a number of reasons, including:

• Changes in body composition and function:
• As we age, our bodies lose muscle mass and our kidneys become less efficient at filtering waste products from the blood. This can lead to dehydration, as the body is not able to hold on to fluids as well as it used to.
• Medications:
• Certain medications, such as diuretics, can cause dehydration by increasing the amount of urine produced. Other medications, such as those used to treat high blood pressure or diabetes, can cause dehydration by causing the body to lose fluid through sweating or urination.
• Illnesses:
• Some illnesses, such as diarrhoea, vomiting, or fever, can cause dehydration by causing the body to lose fluids.
• Environmental factors:
• Hot weather and physical activity can lead to dehydration by causing the body to lose fluid through sweating.
• Mental factors:
• Dehydration is more common in those with cognitive impairment. This can be for varying reasons. They may not recognise the sensation of thirst and associated symptoms of being dehydrated or may have trouble swallowing which makes them less likely to want to take in fluid.

Additionally, incontinence predisposes individuals to dehydration as people may limit their fluid intake to avoid needing to go to the toilet as often.

Signs and symptoms of dehydration

The signs and symptoms of dehydration in older people can vary depending on the underlying cause.

Some of these symptoms would usually be recognised by the person suffering dehydration themselves, however, as mentioned above, in some cases it’s less likely that the patient will realise that they are dehydrated.

Common signs and symptoms include:

• Thirst
• Dry mouth
• Fatigue or lethargy
• Confusion or disorientation
• Dark urine or decreased urine output
• Dry skin
• Constipation
• Dizziness or light-headedness
• Urinating less than four times a day.
• Sunken looking eyes
• Low blood pressure

It’s important for those who are worried about a loved one being dehydrated to be mindful that age related changes can include a reduced sensation of thirst, and this can be even more pronounced in those with dementia, or who have suffered a stroke. Therefore, you may not be able to rely on your loved one to tell you if they are suffering symptoms of dehydration.

Therefore, keep an eye out for external signals that such as dry skin and eyes. If you think someone is at particular risk of dehydration it can be worth monitoring blood pressure and keeping an eye on how often they are going to the toilet.

If you notice any of these signs or symptoms in your elderly loved one, it's vital to seek medical attention right away, as dehydration can lead to serious health complications.

Consequences of dehydration

For the elderly, being dehydrated can be serious and even life threatening. Dehydration is associated with poor health outcomes including increased hospitalisation which is a risk in itself.

Some major complications of dehydration can include seizures, kidney problems and even a stroke.

Common complications which are associated with dehydration include low blood pressure, weakness and dizziness which, in turn increase the risk of falls.

Falls are particularly dangerous for the elderly for several reasons; bones are often more brittle; therefore, an older person is more likely to suffer a more serious injury such as fracture or break when they fall. Additionally, should an older person need it, surgery and the associated sedation is riskier as we get older.

Should a senior fall, it’s vital the help is summoned as quickly as possible, as this leads to better outcomes. Therefore, if you are worried about someone you know and their risk of tripping or slipping due to dehydration or any other condition, getting them to wear a personal alarm with fall detection can give you peace of mind.

This type of alarm will detect that the wearer has fallen, and alert nominated contacts such as family or friends without the need for the person to use the SOS button. Or it can be monitored by our 24/7 response centre who can summon help.

Treatments for dehydration

Treatment for dehydration will vary depending on the underlying cause. In most cases the initial aim will be to replace lost fluids in the body as quickly as possible. Some common treatments include:

• Increasing fluid intake: This can be done by offering fluids such as water, juice, or soup. It's important to avoid caffeinated beverages, as they can increase urine output and make dehydration worse.
• Replacing lost electrolytes: Electrolytes such as sodium and potassium are essential for the body to function properly. They can be replaced with sports drinks or oral rehydration solutions such as Diorite.

• Taking breaks from activity: If your elderly loved one is engaging in physical activity, it's important to take frequent breaks to allow the body to rest and rehydrate.
• Adjusting medications: If dehydration is due to medications, your loved one's doctor may adjust the dosage, type or frequency of the medication.

In some cases, if someone has had to go to hospital for treatment, they may be given their fluids intravenously via a drip to quickly replace lost water and nutrients in the body.

Where dehydration is caused by an underlying condition, other medication may be given such as anti-diarrhoea tablets.

Dementia and dehydration

Those with dementia can be at particular risk of dehydration as they may be unable to communicate that they feel thirsty, or simply forget to drink.

Sadly, this is a vicious circle as some of the symptoms of dehydration include increased confusion and poor concentration, which can make the symptoms of dementia worse. However, if you are caring for a loved one with dementia, it may be harder to pick up on the signs of dehydration.

In the early stages of dementia, it may be likely that the person simply forgets to drink, therefore using a device that sets reminders can be beneficial. The SureSafe Guardian is an ideal way to help to prevent dehydration as you can set reminders and welfare checks.

Additionally, it comes with home temperature alerts. In many cases extreme heat can contribute to dehydration.

For those in a more advanced stage of dementia, swallowing may become more difficult making taking in fluids uncomfortable or difficult.

Preventing dehydration in the elderly

When it comes to dehydration, prevention is always better than cure, and it can be avoided by ensuring that the person you care for is taking in enough fluids.

First, make sure that they are drinking enough fluids throughout the day. Older adults often don’t feel thirsty, so it’s important to encourage them to drink even when they don’t feel like it. Many people (not just older ones) don’t enjoy plain water, so make sure that a range of drinks are on offer such as juices or decaf tea.

Encourage the person to eat food with a high-water content such as soups, vegetables, yoghurt and sauces.

Also take into account their medications. Some medications can cause dehydration or make it worse. If your loved one is taking medication, talk to their doctor about whether it could be contributing to dehydration.

Finally, make sure that they are staying cool in hot weather. Older adults are more susceptible to heat stroke, so it’s important to keep them out of the sun and make sure they have a cool place to rest.

If you are worried about someone you care for and would like to know how our personal alarms can help to manage their hydration, call SureSafe's team of experts on 0800 112 3201 to discuss the available options.