Take steps to prevent dehydration in older adults

by Symptom Advice on April 8, 2012

Debby Krzesni is a busy woman. The registered dietitian and STRONG coordinator for Area 1 Agency on Aging travels to senior centers with dining sites in Humboldt and Del Norte counties fielding questions about nutritional health and wellness.

Dehydration is always a topic of conversation. Too many older adults fail to drink enough fluids. Some are not aware that certain health conditions — fever and gastrointestinal illness, for example — increase the risk of dehydration and the need for fluid intake.

”Studies show one in three older adults may not get enough fluid,” Krzesni said. “What they don’t realize is that dehydration can be dangerous and even fatal.”

Fluid helps to carry oxygen and energy to the body and take away waste products.

“without fluids, the body can’t do any of those things. our bodies cannot store fluid, so it must be replaced every day,” she said.

That can be especially challenging for older adults, who often have a decreased thirst sensation.

”they may not even recognize they are thirsty,” Krzesni said.

Below, Krzesni gives some clues to preventing dehydration.

Why is dehydration more common in older adults?

Generally speaking, older adults have less body water than younger adults — 50 percent of their weight is water versus 60 percent for younger adults. also, the thirst sensation isn’t the only thing that declines with age. Kidneys may also function less efficiently.

Changes in physical condition also have an impact. People who have a hard time walking, reaching for a glass or feeding themselves may have a hard time getting to fluids. Then there are the cognitive declines in aging — confusion and deteriorating memory — that can make it hard to stay on top of fluid intake.

What other things affect our ability to stay hydrated?

The environment, medications and physical activity play a role. People perspire more in a hot or humid environment or when they walk, weight lift or garden. sometimes medications, especially diuretics, can result in fluid loss.

Diuretics are used to treat heart failure and hypertension, which are common ailments in older adults. You need to know if your medicines are diuretics as they will make you go to the bathroom with greater frequency. Lasix and Hyzaar, for example, are diuretics. Laxatives are another cause of fluid loss.

What are the signs and symptoms of dehydration?

Dehydration is identified many different ways. Weight loss, increased heart rate and low blood pressure are three symptoms. Decreased skin firmness is another. The skin of a dehydrated person lacks its normal elasticity and sags back into position slowly when pinched up into a fold. Normally, the skin springs back into position.

Other signs are dry mouth and tongue, decreased urination, constipation or fecal impaction, nausea, anorexia, sunken eyeballs and decreased functional ability. In some cases, dehydration can cause weakness, trembling, lethargy or confusion.

Some of these are easily observed. Decreased urination, for example, often results in darker, more concentrated urine that has a strong odor, which can be ammonia-like.

How much fluid does a person need every day?

Contrary to popular lore, it’s not eight 8-ounce glasses of water each day. Fluid needs are based on a person’s body size and health conditions. A registered dietitian can help you figure out your fluid requirement. It’s better to drink too much than too little.

What are the best sources of fluids?

Milk, juice, coffee, tea and water all count as fluids. keep in mind that caffeinated coffee and tea act like diuretics — they increase the need to go to the bathroom. Milk provides protein, calcium and vitamin D. Juice does not have the same nutritional value as whole fruit, but can add significant calories that may not be needed.

Is there fluid in foods?

Yes. Individuals who eat well can get the equivalent of two to three 8-ounce glasses of water from the fluids found in the foods they eat. Fruits and vegetables have high water content. So do soups, gelatin and pudding. Dry foods — think snack foods, cookies, and cheeses — have low water content. If a person is not eating well, they may need additional fluids to make up for the fluids they are not consuming.

How can you prevent dehydration in an older adult?

Given that we can’t rely on feeling thirsty as we age, a good idea is to establish a habit of drinking favorite fluids at every meal and at set times between them. Build habits early in life that encourage fluid intake without relying on feeling thirst.

Give these suggestions a try:

– Include a beverage with each meal and snack.

– keep fluids handy. A pitcher of water with lemon slice in the refrigerator can be very appealing.

– when sitting to watch a TV show, bring a beverage with you to enjoy.

– when you take your medications, drink more water than you need to swallow them.

– If you have trouble remembering to drink enough, pour a half-gallon of water in a pitcher every morning. Use it for any beverage needs during the day. when it’s empty, you’ve likely had enough fluid.

– Eat the recommended 5 to 9 servings of fruit and vegetables each day for essential nutrients and fluids.

– make a healthy soup meal, but look for lower sodium varieties.

– Take a water bottle on outings.

For more information, contact Krzesni at 442-3763, ext. 203 or email .

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