Dehydration in the elderly

What do you do when you are thirsty? Simple question, easy answer: have a drink. But what if the body needs water without signaling it? This is the case for many older people, whether they live at home or in an aged care facility.

dehydration in old age

Dry mouth , dry mucous membranes or sagging skin are signs of insufficient hydration. Other symptoms such as  constipation , an altered effect of a medication, confusion, weakness and dizziness or increased susceptibility to infections are rarely associated with dehydration but can result from dehydration.

However, other causes such as heart disease or dementia are often wrongly suspected, especially in older people. It becomes life-threatening in the event of unconsciousness, circulatory or kidney failure. Hospital admission is often required. But it doesn’t have to come to that.

Drink enough: little effort, big effect

The German Society for Nutrition (DGE) recommends a regular daily fluid intake of  2.25 liters for healthy older people.  Of this,  1.5 liters should be ingested through drinks and  the remaining amount through food (vegetables, salads, fruit, dairy products, etc.).

For people who are in need of care or live in homes, appropriate offers must be created and the caregivers trained. For senior citizens’ facilities and outpatient care services, the DGE has created key points for practical implementation in order to improve the situation on site.

Older people often drink too little

A lack of habit, fear of going to the toilet at night,  incontinence  or prostate problems (in men) can be important drinking barriers. For people living alone, transporting heavy drinks – whether from the supermarket home or from the basement to the upper floor – can become an obstacle. Patients are sometimes unable to reach their drink, even if it is right next to them. To make matters worse with age, the feeling of thirst often decreases.

If the kidneys lose their ability to concentrate urine with increasing age, more water is excreted and the risk of drying out ( dehydration ) also increases. The same applies to increased protein and electrolyte intake, heavy  sweating  (e.g. in summer, with fever, in overheated rooms, during physical exertion) but also in the event of  diarrhea , vomiting and the use of laxatives or diuretics.

Drink more – how does that work?

If seniors live with their family under one roof, children and grandchildren can help to train the correct drinking habits. It is more difficult in homes and in the care of the elderly. The employees have a special responsibility here. It therefore makes sense for employees or supporting institutions of senior citizens’ facilities and outpatient care services to establish a  beverage  concept.

Important cornerstones of the concept should be:

  1. Offer age-appropriate drinks  : Drinking water, mineral water, still water, diluted  fruit juices  (spritzers) and fruit and  herbal teas are particularly suitable . Different cold and hot drinks should be alternated, and the preferences and habits of the residents should be taken into account. If desired, coffee , black  tea  and, if necessary, beer and wine (spritzers) in the evening can also be served – in moderation  .
  2. Soups, milk and buttermilk drinks as well as fruit, vegetable and multivitamin juices also help to keep you hydrated. The drinks should be offered and drunk throughout the day. It is important that they are available at all times. The range of drinks must be adapted to the metabolic situation and state of health.
  3. Take structural measures  in the facility: In addition to the question of which drinks are offered in old people’s homes, the “how” is also crucial. A drinking plan  accessible to all residents  reminds them to drink regularly at certain times. Drinking logs can be kept for people with unsatisfactory drinking habits. Employee training and individual advice for seniors improve acceptance and implementation.
  4. Setting up self-service options for drinks (for example, drinks oasis) is helpful.
  5. Empty glasses and mugs should always be refilled.
  6. The less someone eats, the more they should drink: If you eat little, eat small meals or eat less frequently, the water contained in the food is missing.
  7. Elderly people in need of help and care need adequate help and support with drinking. Special drinking vessels are recommended for bedridden people and enriching the drinks for those who are weak or have reduced energy and nutrient intake.
  8. Pay attention to the liquid supply of (supposedly) independent residents.
  9. People with dementia reach for a cup more often if it contains a colored or colored liquid.

Hydration schedule for seniors

A possible daily drinking plan for seniors could look like this:

When drinking too much can harm

Limiting the amount of fluid, possibly even balancing, may be necessary in patients with (severe)  cardiac insufficiency  or fluid excretion disorders (e.g. certain kidney damage).

Consultation with the doctor treating you is essential here.

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