Dehydration in older adults is both more common than you would think and more dangerous than it might seem. As an example, I have an elderly patient in my dental practice who just spent two weeks in the hospital because she wasn’t drinking enough liquids and she became dehydrated.
It’s mid-summer as I write this – a time when anyone can easily overheat and lose too much fluid through sweating, so it wasn’t a surprise to hear that she’d spent such a long time in the hospital.
Let’s face it – we all need to drink more water, particularly in hot weather or if you are going through an illness. And, just letting you know that alcohol, soda and hot cocoa do not count as a fluid because they actually can contribute to dehydration.
Effects Of Dehydration In Elderly
A crucial part of elderly care for family members and caregivers is to encourage seniors to drink more water. If they wait until they are thirsty before they get serious about drinking, dehydration has already begun.
Many seniors fall prey to dehydration. With their age, their ability to notice changes in body temperature typically decreases, as does their body water content, and they often experience a diminished thirst, which leads to reduced fluid consumptionThedacare.org
But by increasing their fluid intake and keeping them hydrated, you can reduce an elderly loved one’s risk of developing major health conditions, including:
- Lowered blood pressure
- Kidney stones
- Urinary tract infections
- Rapid weak pulse
- Slow metabolism
- Blood clot complications
- Loss of muscle tone
- Organ failure
- Decreased kidney function (in severe cases of dehydration)
If you are having a hard time getting an older person to drink enough fluids, try one a few of the following strategies to increase their fluid consumption.
Here is our video about the dangers of dehydration in the elderly:
9 Strategies To Get Seniors Hydrated
1) Suggest Foods That Have A High Water Content
An article on Healthline says that the top fruits and vegetables that contain the most water are:
- Grapefruit (NOTE: the FDA advises that, often, grapefruit and medications don’t mix. Be careful of grapefruit as eating it or drinking the juice too close to the time of taking medications can block the enzymes needed to break done the drug. This can potentially increase the amount of medication in the person’s system and can lead to an increase in side effects).
- Bell Peppers
Soup is another alternative to plain water for keeping older people hydrated. It not only provides nutrients but also serves as an excellent water substitute. The caveat here is to beware of pre-packaged or canned soups, which usually contain a high level of sodium.
Sodium is dehydrating and should be avoided by seniors who have high blood pressure because it can increase their risk of stroke, heart attacks, kidney damage, and congestive heart failure. If you are using soup as a way to raise fluid intake in an elderly loved one, either make the soup from scratch yourself, so you can control the amount of salt that gets added to it, or buy them low-sodium soups and broths.
2) Offer Their Favorite Beverage
When an elderly person is not too keen about consuming plain water, you can replace it with their favorite beverage. This could include any unsweetened beverage, such as:
- Real fruit juice
- Herbal teas
- Coconut water
- Skim milk
- Milkshakes and smoothies
- Vegetable broth (again, be aware of the sodium content)
Some tips on how to make beverages more enticing:
- Include bits of fruit or create a mocktail of sorts. Try to keep away from drinks with excessive calories, salt, sugar and anything that might contradict with medications. And, again, avoid grapefruit juice, which can conflict with certain prescription drugs.
- Add flavoring to water like Nuun Immunity to encourage seniors to drink more fluids. Several kinds of flavors are now available in small squeeze bottles. Putting a few drops of cherry or grape flavoring into water may stimulate and elder’s thirst sensation.
- Add lemon juice to water to make it more flavorful. If you do this for yourself or a senior loved one, please add it sparingly! Your favorite dental hygienist (me) wants you to know that lemon juice is highly acidic. Using it to flavor water can rapidly lead to tooth decay.
Please limit their intake of caffeine and alcohol, which act as a natural diuretic. Drinking a higher amount of these fluids might cause excessive water loss, resulting in elderly dehydration.
3) Make Water Easily Accessible
Mobility issues could be one of the prime reasons for a reduced water intake in the elderly. For one thing, they may have trouble getting around well, so they may not want to bother with going back and forth to the kitchen to get a drink. For another, they may be incontinent or have concerns about being able to make it to the bathroom in time, so they reduce their fluid intake as a way to avoid the problem.
Some tips on how to make it easier to access water:
- Set up a tray with a container of water on a nearby table so they don’t have to get up to get the water.
- Place cup holders in wheelchairs so water is readily available.
- Give them water bottles with handles for easy grasping with arthritic fingers, as well as the ease of carrying water around with them as they move about their day.
- Encourage your senior to drink a glass of water or their favorite beverage each time they take their medications
- Some elderly people may require special utensils or devices for easy gripping of mugs and cups. If that is the case, you could try a lightweight cup with large handles for easy gripping, such as the spill resistant one in the picture below.
- You could also try wrapping several large rubber bands around a mug or cup to make it easier to hold.
- For seniors who have a hard time tipping their head back to drink, try something like a “nosey cup” . The large cutout on one side makes it easier to tip the glass forward so they don’t have to tilt their head back.
Cups With Large Handles
The Nosey Cups
4) Consider Fruit-Based Popsicles
In the summer, there is a higher chance for dehydration in the elderly. You can beat the heat while providing more fluids by making colorful ice pops, smoothie popsicles, slushies and tasty sorbet from fruit juice and water.
A quick, easy recipe for fruity ice pops is to fill a Dixie cup or other wax-coated cup one half to two thirds full with the elder’s favorite fruit juice. Partially freeze the juice, and then insert a craft stick (popsicle stick) into the cup. Continue freezing until solid. Remove the cup to eat the treat.
You can even eliminate the cup and stick by freezing the fruit juice just until it is slushy, then scooping it into a bowl. Serve it with a spoon.
Adding pureed fruits or vegetables to the juice is an easy way to add fiber and foods to your senior’s diet.
Older adults are more prone to becoming dehydrated for a number of reasons, including a diminished sense of thirst.National Council On Aging
5) Use Treats Like Hydrating Candy
Hydration candies may be a medical hydrating solution for seniors. Look for one that is comprised of an appropriate ratio of salt, sugar, and potassium. This is essential for the formula to work effectively and keeping electrolytes in balance while optimizing fluid absorption in the body.
Medically proven hydrating candies are clinically known to prevent dehydration more effectively than plain water. However, it is critically important to consult with a physician before offering hydrating candies to a senior with certain medical conditions, such as high blood pressure, diabetes, thyroid, and congestive heart failure.
6) There’s Always Room For Jello
Sugar free is one way to go depending on your senior’s health. Another are a new product called Jelly Drops which are an excellent way to boost hydration in someone with dementia or Alzheimer’s.
7) Use A Marked Pitcher To Designate How Much They Should Drink Daily
When I took care of my dad, I was always concerned about how much water he was (not) drinking. We could literally spend all day together and he might drink 8 – 10 ounces of water, in spite of my prodding him to drink more. He would shrug his shoulders and tell me, “I just don’t get thirsty anymore.”
When he began having trouble with painful leg cramps that got him up at all hours or the day and night, I finally convinced him they could be a side effect of dehydration. I am a runner, so I am well aware that my own legs cramp in the middle of the night if I haven’t drunk enough during the day.
To get him to drink more water, I dug out the large mug he had gotten during a prior hospital stay. It was marked with ounces (32 oz.). I told him he could reduce the number of times he had leg cramps if he drank one full container daily, in addition to his regular cups of coffee in the morning and his lunchtime iced tea. (I know, they can be dehydrating, but at least he was drinking something!).
He now had a goal and could keep track of how much water he was drinking. As promised, when he increased his fluid intake, his cramps all but disappeared.
Marked containers let the senior see just how much they are drinking daily. Additionally, if you are caring for an elder and are worried about dehydration in your loved one, marked containers can help you keep track of how much water they are actually taking in.
Some, like the Hydr-8 water bottle even come with markings for the time of day, so an elderly person knows they should drink the morning level by lunchtime, and so on.
8) Offer Support Whenever Needed To Encourage Them To Drink More
As I mentioned above, the fear of incontinence is one of the main reasons that some elderly people reduce their water intake. The mere thought of having an “accident” because they could not get to the bathroom in time could diminish a senior’s urge to drink voluntarily.
When it comes to elderly care, it is best to help them overcome their fear. Try encouraging them to use adult incontinence products rather than to avoid drinking water. They might also experiment with drinking more water during the day, but limiting their intake of liquid immediately after their evening meal and through bedtime.
They may find that sipping small amounts of water all through the day might help, as well.
9) Electrolyte Drinks for Elderly
We suggest keeping a commercial rehydration solution handy all the time. This is the best way to improve electrolytes in a senior, which are lost when they become dehydrated.
You may be wondering is coconut water good for the elderly? Absolutely – in fact, unsweetened coconut water and tomato juice are both excellent sources of potassium and electrolytes that can help to replenish lost nutrients and fluid.
Another kind of electrolyte drink to try is something like Pedialyte or Ensure, which also contain needed electrolytes and potassium. You might also try sodium free bouillon or Diet Gatorade. In the case of Gatorade or other sweetened drinks, we recommend the diet version (without added sugar) if the senior can tolerate it.
How Much Water Should An Elderly Person Drink A Day?
When it comes to elderly care, ensuring adequate hydration is critical. Studies recommend determining a senior’s water requirement based on different factors, such as their overall health and their gender, plus their activity level and environment.
In general, experts agree that a senior should consume at least 1.7 liters of water in a 24 hour period. This is about 6-8 glasses of water per day.
What Are The Symptoms Of Dehydration In The Elderly?
Dehydration symptoms can look different, depending on the degree of severity. For example, in the early stages, it can hide behind the crepey-looking skin that you see in normal aging. Seeing someone with skin that “tents” when you tug on it (an early sign of dehydration) is going to look so similar to normal skin that it is easily overlooked.
If you are caring for a senior loved one, it is a good idea to familiarize yourself with the following signs of dehydration:
Mild Dehydration Symptoms
Severe Dehydration Symptoms
Headache, fatigue, feeling unwell
Dry mouth, dry cracked lips, and/or dry skin
Dizziness and confusion
Rapid breathing, weak and rapid pulse
Reduced urine output or dark urine
Low blood pressure
No sweating and/or no tears
Loss or consciousness or delirium
If you spot any of the symptoms or sign of dehydration or if your senior becomes confused, take them to their doctor, an urgent care facility, or to the emergency room right away. Untreated dehydration can be fatal.