Dehydration – What to Watch For

Dehydration – It’s is easier than you think

I always thought that it would hard to get dehydrated.  After all, you get thirst, you drink, right?

Not so.  In fact, in elderly it is very easy.  It occurs when the body has lost too much fluid AND electrolytes (mineral compounds the body needs to keep the correct temperature and maintain the fight fluid balance.

In elderly, they may not want to have to run to the bathroom all the time or wake in the night to go to the bathroom so they limit their fluid intake.  Although it makes sense to them, it can be deadly.  Certain illnesses make elderly more sensitive to this.  For example, Parkinson’s can make it difficult for someone to swallow or hold a glass to drink from.

It can go on for a while without becoming serious but severe dehydration can  be fatal and is a common  reason of hospitalization of elderly.

Dehydration can be caused as a side effect of medications like diuretics or laxatives or illness  such as diarrhea, vomiting, heat stroke, high blood sugar (hyperglycemia) , infections or excessive exercise.

The most common signs of dehydration in the elderly are thirst (although some elderly have a decreased sense of thirst), confusion, irritability and poor skin elasticity.

It is difficult to detect dehydration until the condition is moderate or severe in nature.

Things to watch for:

(The following can also be signs of many other medical problems but it will give you an idea of what to look for)

  • Thirst – some people have a decreased thirst as they age
  • Dry mouth, dry tongue with thick saliva – can be heard sometimes when talking
  • Headaches
  • Difficulty passing urine or reduced amounts that are dark yellow
  • Dizziness that becomes worse on standing
  • Weakness
  • Sleepiness
  • Urinary tract infections
  • Dry, warm skin
  • Flushed face
  • Fever
  • Irritability
  • Malaise
  • Constipation – fluid is used to soften and move stools
  • Cramping in arms or legs

 

Possible Treatments for Mild Dehydration

  • Drinking lots of fluids – make sure there are fluids available wherever they sit and perhaps some on their bedstand.
  • Eat food and drink with sodium and potassium to restore electrolytes: broths or soups (contain sodium); fruit juice, soft fruits, vegetables (contains potassium); sports drinks like Gatorade that contain electrolytes

Caution – Be aware of any dietary restrictions when adding food or drink as certain medications can interact with certain foods/drinks.  Potassium  needs to be monitored  in certain people.

Signs to watch for in severe dehydration

  • Signs and symptoms of mild dehydration become worse
  • Confusion
  • Irritability
  • Lethargy
  • Poor skin elasticity
  • Decreased consciousness/ fainting
  • Lack urine output
  • Shrunken eyes
  • Moist, cool extremities (arms, legs, etc.)
  • Severe muscle contractions in the arms, legs, stomach, back
  • Rapid and faint pulse
  • Low blood pressure
  • Rapid breathing
  • Convulsions
  • Bloated stomach
  • Heart failure

Possible Treatments for Moderate to Severe Dehydration

  • Severe dehydration is a medical emergency and should be treated at the hospital
  • Replenishment of water and electrolytes through intravenous therapy or oral rehydration therapy (solution of salts and sugars taken by mouth; this treatment is most often for dehydration caused by excessive diarrhea)

Tips to Avoid Dehydration

  • Encourage them to drink appr. 6-8 glasses of fluid a day (Water is best).  Of course this depends on exercise and temperature.  If they are reluctant to drink a big glass, try several smaller glasses.
  • Check body weight regularly, fluctuations of 2-3 lbs per day may indicate irregular fluid intake
  • Avoid being in the hot sun for long periods and ensure extra hydration for longer exposure
  • Keep a water bottle on hand and  try to drink often
  • Broths or soups (contain sodium); fruit juice, soft fruits, vegetables (contains potassium) as part of general diet.
  • Make sure the glasses they use are appropriate for them.  Perhaps they need a straw or a cup with a lid to avoid spills.

Bottom line, dehydration can be serious but is usually easy to avoid.  It just takes being aware of liquid intake.

Do you have any tips on how to avoid dehydration in elderly?

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