Summer is here again and it’s time to remind you about the hazards of dehydration in your older loved ones and how to prevent it.
Dehydration is a serious problem for older adults that disrupt all body functions including digestion and elimination, temperature control, cellular function, circulation, vitamin and mineral absorption, and detoxification. It is one of the top ten reasons for hospitalization and it is estimated that half of those not treated quickly will die. Bodily water loss of just 10% results in dehydration and 20% is fatal. So what makes your loved one so vulnerable and how can you prevent it?
Normal aging changes contribute to increased risk. As we age, we basically dry up and dry out. Total body water content decreases (especially on the cellular level) due in part to the loss of muscle mass, which holds more water than fat mass. Changes in kidney function contribute to an inability to conserve water and a decreased sensitivity to thirst contributes to not drinking enough. Chronic disease processes add to the risk because of decreased cognitive awareness, limited movement or immobility, isolation, and depression. Medication side effects also increase the risk as well as environmental stresses. People bothered by incontinence or urinary urgency may avoid fluids in an attempt to decrease symptoms.
Dehydration can come on fast and become a medical emergency. Signs and symptoms include fatigue, increased confusion and disorientation, dry mouth and tongue, sunken eyes, sudden weight loss, rapid heartbeat, dizziness, and difficulty speaking. Orthostatic hypotension, or blood pressure that drops when moving from a lying down position to sitting then standing, also occurs contributing to falls. Some of these symptoms may be hard to identify if your loved one has dementia or is taking several medications that cause related side effects.
Prevention is the working word here and there are several proactive measures you can take. Always be mindful of how much your loved one is drinking. Consult with his or her physician about how much should be consumed in a day. A common formula used in institutions to calculate fluid need is 30cc/kg of body weight. But each individual is different and chronic disease will change the need, so please consult with a physician. Offer clear fluids frequently with water accounting for at least half the fluid intake each day. If your loved one will not drink plain water, offer other clear fluids such as cranberry juice, lemonade, decaffeinated iced tea, and apple juice (check first to see that he or she has no dietary restrictions).
I also suggest mixing half water and half-clear liquid. Put it in a sport bottle and encourage your loved one to sip on it frequently. If a loved one has dementia, offer fluids every two hours. Keep in mind that a fluid is any food that melts at room temperature, so ice cream, Jell-O, and sherbet fall into this category. Juicy fruits such as watermelon, oranges, and grapes are also good choices. A word of caution about caffeinated beverages, though, and some diet drinks: they act as diuretics increasing the risk for dehydration.
If a trip out is planned, listen for air quality reports because poor air quality will exacerbate breathing problems. Also try to avoid outdoor activities on those hot and humid days and hot and dry ones as well. If your love one must go out keep it short, moving quickly from one air-conditioned environment to another. The ability to sweat is diminished with age and compromises the body’s ability to cool efficiently. Heat exhaustion or hyperthermia can occur rapidly and is a medical emergency. Signs to watch for include fatigue, dizziness, nausea and vomiting, and confusion. If you suspect heat exhaustion, get your loved one to a cool environment immediately, offer fluids, and call for an ambulance.
For the loved one with mobility problems who is afraid to drink too much, be sure there is easy access to a bathroom or a commode and offer assistance every two hours. A loved one with dementia should be reminded every two hours and assisted if needed. Provide comfortable clothing that is easy to remove avoiding zippers and buttons that can be difficult to manage.
Keep in mind that summer heat puts you at risk, too. Do yard work and outdoor exercise in the morning and add the tips above to your personal health consciousness.
Have a blessed and relaxing summer.
Mary C. Fridley