For many, the long awaited summer months bring to mind family picnics, cool drinks on the porch, and lazy afternoons at the beach. But, as temperatures soar, warm weather activities can increase the risk for another staple of summer: dehydration.
Not getting enough fluids, especially when it is hot outside, can pose serious health problems for anyone, but older adults are at particular risk for dehydration, which is the most common fluid or electrolyte imbalance among the elderly.
Why Seniors Are at Risk
There are a few reasons why older adults are more susceptible to dehydration. As we age, our body’s ability to conserve water is reduced, causing increased difficultly when it comes to adapting to things like extreme temperatures. Additionally, the sense of thirst also diminishes with age, so by the time someone actually feels thirsty, essential fluids could already be extremely low.
Certain medical conditions and medications can also affect a senior’s ability to retain fluids. Individuals with dementia may forget to eat and drink, which severely reduces their intake, and drugs like diuretics, antihistamines, laxatives, antipsychotics and corticosteroids may also cause frequent urination that depletes water and other fluids in the body. Seniors who experience incontinence may also refuse or limit water in order to avoid accidents.
Signs and Symptoms of Dehydration
As a family caregiver, it’s important to be mindful of the signs and symptoms (both for yourself and your loved one), and to communicate with a doctor or health professional should you notice red flags that could indicate complications from fluid loss.
There are a few clear symptoms and warning signs that all family caregivers should remember to look for if they are caring for an older loved one.
It is important to pick up on the more subtle, early signs that indicate a senior needs to up their fluid intake before they lose too much water. Rather than go by thirst, color of urine is a better indicator of hydration. It should be clear or light yellow.
Keep in mind that thirst is not usually a helpful indicator. These signs include headache, constipation, muscle cramps, dry mouth and sleepiness or lethargy. Urine color is also a helpful indicator and should be clear or light yellow for someone who is properly hydrated.
If severe dehydration goes unchecked, it can cause seizures due to electrolyte imbalance, a reduction in the volume of blood in the body (hypovolemic shock), kidney failure, heat injuries, and even coma or death.
Signs of Severe Dehydration
- Little or no urination
- Dark or amber-colored urine
- Dry skin that stays folded when pinched
- Irritability, dizziness, or confusion
- Low blood pressure
- Rapid breathing and heartbeat
- Weak pulse
- Cold hands and feet
For most of us, drinking plenty of fluids and eating foods with high water content is a great way to keep our bodies properly hydrated in warmer weather. Most adults need about two quarts (64 ounces) of fluids every day, but that amount increases with heat and humidity and can change based on various medications.
A good rule of thumb is to try balancing fluid intake with output. If a senior is sweating or urinating more frequently, then their fluid intake should become more frequent as well.
If a loved one is suffering from an illness that causes fever, diarrhea or vomiting, carefully monitoring fluid intake is crucial. Keep in mind that you can become dehydrated in cold weather, too.
Ways to Increase Fluid Intake
If your loved does not enjoy drinking water, it is good to remember that most fluids count towards the 64 ounces (except for fruit juice, alcohol, soda and caffeinated beverages), and many foods do too.
Sometimes a caregiver must pick their battles, though. If a senior refuses to drink plain water, there are some modifications and alternatives available.
Try using water enhancers, opting for flavored waters, serving a half water half juice mixture, or including plenty of ice in their preferred beverage if they like it cold.
Stur All-Natural Water Enhancer (sugar-free, made with Stevia)
For those who enjoy warm beverages like tea or coffee, hot chicken, beef or vegetable broth can provide a soothing source of fluids and electrolytes that seems more like a “meal” and less like a drink. Even stubborn elders are often fond of sweets, so popsicles, milkshakes and smoothies may be more enticing options that also function as a sneaky vehicle for fluids.
How you serve beverages can have an effect on a loved one’s willingness and ability to drink as well.
Someone with low vision might be able to see an opaque, brightly colored cup more easily and therefore drink from it more often. Particularly resistant seniors may find a beverage more appetizing if it is served in a pretty glass or with garnish. For example, try serving a healthy smoothie in an old-fashioned soda fountain glass with a piece of fresh fruit on the rim.
Sometimes specialized drinkware may be necessary for those with swallowing difficulties, tremors, arthritis, motor skill problems and muscular weakness. Cups with two handles, a no-spill lid, built-in straw, or ergonomic features may simplify the process and prevent spills.
While water is the go-to for most people, keep in mind that beverages are not the only source of fluids. Raw fruits and vegetables can pack a hydrating punch as well. For example, a small plate of cut vegetables, like celery sticks, cucumber slices, cherry tomatoes and carrots served with a healthy dressing or hummus for dipping can be a nutrition- and fluid-filled snack. Use the list below to add foods that will help your loved one stay hydrated.
Foods with High Water Content
|Food||Percentage of Water||Serving Size to Obtain about 4 Ounces of Water|
|Cucumber||96%||1 cup peeled and sliced|
|Watermelon||92%||1 cup diced, or 10 balls|
|Bell pepper||92%||¾ cup sliced|
|Cantaloupe||90%||1/10 (1 small wedge)|
If a senior has an aversion to fruits and vegetables, especially when they are uncooked, high water content foods like crudités, salads or gazpacho, may be an unrealistic approach. On the other hand, sneaking healthy ingredients into foods they already enjoy can yield small victories for a caregiver.
Try adding a cup of fresh berries to a loved one’s yogurt, cereal or dessert, or add slices of tomato and a few leaves of lettuce to wraps and sandwiches. These may not seem like meaningful additions, but every little bit adds up. Incorporating these items on a daily basis can help your loved one prevent dehydration without changing the amount of liquid they drink.
While these helpful guidelines make good health-sense, it is important to stay in communication with your doctor and keep in mind that managing some medical conditions, such as heart failure and kidney or liver disease, may require intentional restrictions on fluid intake.
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