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Hydration is important for the elderly



August 16, 2012
With the hotter temperatures we have been experiencing this summer, it is more important than ever to drink enough fluids. This is particularly true for children and for the elderly. Not drinking enough fluids can cause unwanted symptoms, complications from existing disease conditions and may account for many hospitalizations with our elders. Water and juices are the best, coffee, tea and colas with caffeine as well as alcoholic drinks, cause the body to lose fluids and are recommended only in small amounts.

Elders are at risk for dehydration for many reasons:

u Age related risks. There is less water in the older body, greater difficulty for the older kidney to maintain fluid balance and less thirst sensations in older folks in general. So they might not realize they are getting dehydrated, as they don't feel thirsty.

u Disease-related reasons for dehydration can range from the complex to the simple. Infections such as pneumonia, chronic obstructive pulmonary disease and urinary tract infections increase the need for fluids due to fevers and overproduction of mucus. Some diseases, such as congestive heart failure, renal disease, stroke or other neurological disorders and diabetes, may cause changes in the function of various hormones that regulate the fluid balance in the body.

u Environmental reasons. A decrease in mobility for those with arthritis, diminished vision or for those confined to bed rest may not be able to easily meet their own needs. Your loved one might be reluctant to bother others for something as simple as assistance in getting a sip of water.

u Medication may cause increased fluid losses through the kidneys. Diuretics, sedatives and laxatives are common, necessary drugs requiring close attention to fluid intake. Other drugs and alcohol can cause the kidneys to work harder, and may damage them, making it harder to maintain fluid balance.

u Psychosocial reasons. This is the elder who is cognitively impaired, and possibly unable to drink without full assistance, or those who may intentionally restrict fluid intake in the hopes of decreasing the risk of incontinence.

u Economic reasons. This may include the lack of financial resources to maintain nutritional and fluid intake, extreme or prolonged weather fluctuations and the possibility of elder abuse.

How to tell if your loved one might be becoming dehydrated? Ask yourself if they have any of the above mentioned risk factors. If they complain of nausea, are lethargic, have headaches, vomiting or dizziness, these could all be signs of dehydration. Call the doctor if these symptoms are apparent.

Keep track of how much one drinks in a day.

A simple way to do this is put two quarts of water in the refrigerator first thing in the morning. Give all fluids for your loved one from this pitcher. This should be consumed by the end of the day. It could be plain water, water with lemon or other fruit juices made with water. Regular tea and coffee do not count because they promote fluid loss.

Decaffeinated teas and coffees are OK, if your loved one will not drink plain water or juices, because they are less likely to promote urination.

Foods that melt at room temperature, such as gelatin or ice cream, also have a lot of water content. Serve foods with sauces, juices and gravies.

There are some diseases for which it is not appropriate to offer so many fluids: congestive heart failure, cirrhosis of the liver and kidney disease. However, for most of us, young and older, the rule of thumb is to drink to keep the body hydrated, and stay away from the hospital and all the tubes and therapy needed if dehydration does occur.

Murphy is a certified senior advisor and the owner of Home Helpers, a non-medical home care business. She lives in the City of Grosse Pointe. Contact her at (313) 881-4600 or tmurphy57@comcast.net. Home Helpers website is homehelpers-mi.com.

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Terri Murphy of the City of Grosse Pointe is a professional geriatric caregiver.
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