Dehydration in the Elderly
Dehydration is a major cause of high morbidity and mortality in the elderly. It is one of the primary causes of elderly hospitalization, and can be fatal if not treated. Due to a decrease in the fat free mass (73% water) is seen in the elderly due to loss of muscle mass, total body weight, and bone mass making them susceptible to dehydration. Another concern is that the thirst sensation is decreased in the elderly compromising their ability to feel thirsty limits the cognitive function that limits access to beverages. It is important that caregivers and family members are aware of the risk factors that contribute to dehydration in the elderly population (Ferry, 2005).
Risk factors Associated With Dehydration
- Hot Weather
- Reduced water intake
- Increased loss of water
- Medications-(diuretics, and laxatives)
- Acute infections
- Vomiting and diarrhea
- Refusal to drink water- dementia, depression, and swallowing difficulties
- Lack of access to fluid
- Communication Problems
Signs and Symptoms of Dehydration
- Increased weight loss, an indicator of water loss in the body
- Weakness in the elderly in the absence of an illness
- Muscle Cramps and fatigue
- Asthenia (abnormal loss of strength)
Prevention of Dehydration
Caregivers should encourage fluid intake in compromised individuals, like in Dementia/Alzheimer’s by offering fluid regularly. The use of commercial drinks is encouraged, soups and fruit juices if people prefer those instead of water. The elderly population should drink without being thirsty. The average water intake per day is 1.5 liters, and this can be increased in very hot weather as we are experiencing presently. It is recommended to drink 500 mL of fluid more per degree of temperature above 38 degrees centigrade. Other sources of hydration are fresh vegetables, fruits, fresh cheese, and yogurt (Ferry, 2005).
Due to the decrease of the sensation of thirst in the elderly, more frequent amount of eater is encouraged rather than drinking large amount at a time. The role of the caregiver is extremely important in the avoidance of dehydration. It can be more difficult to manage dehydration when the individual lives alone however; family members can call to remind the person to drink as much fluid as possible. Individuals with altered cognitive status pose a challenge in the prevention of dehydration. It is important to identify those at risk for dehydration to help combat dehydration in the elderly population.