All You Need to Know About Dehydration in Elderly

Is your loved one dehydrated?

dehydration in elderly

Dehydration can strike anyone, but the elderly are more vulnerable. Dehydration in elderly people is prevalent because of psychological changes that come with aging. There are other risk factors, depending on the person’s lifestyle and physical health.

So, how can you tell if your older loved one is suffering from dehydration? What can cause it? And is there anything you can do to fix or manage it and prevent the consequences that can occur?

Mental Causes of Dehydration

Mental Causes of Dehydration

Some older adults are still as sharp-witted as a youngster. Unfortunately, in others, mental deterioration occurs. Self-neglect is common among the elderly for this reason.

Not only are older people more prone to anxiety and depression, but cognitive difficulties can arise, along with more dire conditions. Sometimes they’re life-threatening, and they can also be a cause of dehydration while they run their course.

Depression

Depression is horrible in general, but in older people, it can be much worse. Depression often goes undiagnosed and, therefore, untreated. But it has a significant impact on a person’s life.

Depression is one of the leading causes of disability. It decreases your quality of life, and it’s a threat to your life. It can cause suicide idealation, and suicide rates are highest among older people.

As suicide idealation increases, and life quality plummets, the tendency to neglect your basic needs skyrockets. In turn, this can lead to dehydration.

Alzheimer’s Disease

Most people know about Alzheimer’s disease and the havoc it can wreak. It’s a disorder leading to the death of brain cells. 

Memory loss and confusion are common symptoms of Alzheimer’s. A person struggling with their memory might forget to eat or drink, or think they already have.

Dementia

Alzheimer’s disease often leads to dementia. Dementia is a syndrome brought on by several conditions, Alzheimer’s included.

A person who has been surviving decently with Alzheimer’s may deteriorate when other conditions come in. The worse that memory, reasoning and other cognitive functions get, the more likely the person is to forget to eat and drink.

Physical Causes of Dehydration

Your elderly loved one can be mentally sound, yet still dehydrated. Maybe they’re frail and unable to get adequate fluids. But sometimes other issues are the cause.

Reduced Thirst

Sometimes the cause is simple. As we get older, we feel thirsty less. By default, we drink less, which may lead to dehydration. So, just because an older person is not thirsty, it doesn’t mean they’re not dehydrated.

Reduced Renal Function

Our kidney function deteriorates as we age. We often associate this with the need to urinate more frequently. That loss of fluid needs replenishment, but that doesn’t always happen.

Incontinence

Incontinence or reduced renal function can also factor into the dehydration equation. The excessive fluid loss which is beyond a person’s control is the culprit. If an older person is suffering from incontinence, make sure they’re drinking enough to replace what they lose.

Medication

Some medications, especially combinations, can cause dehydration. An obvious culprit is if an elderly person is on medication for fluid retention in the body. The frequent expelling of this fluid then leads to dehydration.

These are usually obvious diuretics. But many other medications to treat other issues in older people, like heart failure and high blood pressure, are diuretics too, and you may not realize.  

Other Causes of Dehydration

Unfortunately, a cause of dehydration in elderly people is often negligence. Here, it’s not their fault.

If your loved one is in long-term care, the facility may have undertrained or insufficient staff. People won’t get the individual attention they require, leaving some basic needs neglected.

Pair this with reduced thirst, and busy carers may not think to make sure your loved one is drinking enough. If you can help by visiting and caring for your loved one yourself, it may help combat the problem.

Signs of Dehydration in Elderly People

signs of dehydration in elderly

Catching dehydration in older people can be tough. Many of the symptoms are also typical of other ailments.

Watch out for dryness in the tongue and lips of older adults. Also see if their eyes are sunken, or if their skin is dry and papery. These are clear signs that your elderly loved one or patient is dehydrated. Another sign of dehydration is dizziness because of low blood pressure, but this is present in other conditions too. 

Dry Mouth

One of the main symptoms of dehydration is a dry mouth. This presents as dry, cracked lips and tongue.

Unfortunately, dry mouth crops up elsewhere. Xerostomia is a condition where enough saliva isn’t produced. This can present on its own because of aging or be a symptom of something more sinister.

Dry mouth may also be a side effect of medications or treatments used for cancer. Because of all this crossover, if an elderly person has a dry mouth, it’s a good idea to have them drink more, just in case.

Dry Skin

People of all ages suffer from dry skin. It’s no surprise that aging skin may become drier as it loses elasticity, sags and wrinkles.

Cold weather can make it worse. If the person has used tanning beds in the past, their skin may be leathery. It’s easy to explain away.

A lack of moisture kept in the skin can also indicate a lack of moisture in the body—a sign of dehydration.

Sunken Eyes

Luckily, for diagnosis purposes, the most common cause of sunken eyes is dehydration. This is one sign you’re sure to catch, especially paired with the previous two.

Drowsiness

Drowsiness has an obvious cause, and it’s a side effect of many medications. Dehydration can be a culprit, too.

Even when you’re mildly thirsty, it means you’ve lost some of your required body fluid. Your body needs a balance of fluids to function, so you start to feel less energized.

A lack of adequate fluid intake can cause your blood volume to lower. This is especially prevalent in dehydration. The lower volume of blood means there’s not as much getting to your brain, making you lethargic.

This drowsy feeling can also cause disorientation, dizziness and confusion. The lowered blood volume can lead to low blood pressure.

Decreased Urine Output

This is the most obvious sign of dehydration if it can be assessed appropriately. With decreased urine output, the causes are obvious: less fluid going in, or something’s wrong with the kidneys. Both are serious issues needing attention.

Consequences of Dehydration

Everyone knows organisms need water to survive. But forgoing the worst consequence, some other disorders can occur if the issue isn’t addressed quickly.

Cognitive Complications and Mobility Issues

Mild dehydration can cause mental decline. Drowsiness and confusion are symptoms, and they’re serious ones.

Being drowsy or weak can make an elderly person frail and increase the risk of accidents and falls. It may also make it harder for them to get around.

Kidney Problems

Without proper fluid intake, the kidneys can’t flush solutes out of the body. Solutes are proteins, salts and sugars that our body can’t use.

A lack of water in the bladder leads to concentrated urine. This can lead to other issues, including increased risk of UTI, bladder irritation and incontinence.

Constipation

Constipation is a problem that can lead to more issues down the line, so it’s a problem that needs tackling. Unfortunately, dehydration can cause this domino-effect ailment.

Electrolyte Imbalance

Dehydration can cause electrolyte imbalance. There are electrolytes in the blood that play an essential role in keeping your body functioning. They regulate the water around your cells. Sodium is particularly important.

Low sodium is a threat, leading to hyponatremia. Some symptoms are mild, such as headaches and confusion. Others are more threatening—for example, seizures.

You can restore electrolyte balance by drinking more fluids. There are also sodium tablets or supplements that can help to restore the body’s natural levels.

Hospitalization

If you don’t address and deal with the problem of dehydration, hospitalization may be necessary. Medical professionals can rehydrate the individual through drips, ensuring they get all the fluids and electrolytes they need.

Preventing Dehydration

prevent dehydration in seniors

Some solutions are simple, such as encouraging an elderly person to drink more. If your elderly loved one is still mentally sound but has reduced thirst, perhaps a gift is in order. 

Plain old water is boring, so why not encourage them to drink tea or other pleasant, healthy beverages? There are plenty of tea subscription boxes that could keep them in check.

There are some other, equally easy, solutions to the problem in the early stages.

Remind Them to Drink

If they dislike tea, perhaps encourage your elderly loved one to take a daily supplement. Advise that they drink a whole glass of water with it. This gives them the boost of the supplement and the water.

If the elderly person has Alzheimer’s, dementia, or another disease, this ritualistic reminder may not be enough. Here, it’s a better idea to use a talking alarm clock.

A good battery-powered alarm clock talks in a friendly female voice, up to four times daily. It also reminds them of the date and displays the day, date and time on the screen.

In this case, the medication would be a glass of water, a supplement, or other medication they’re on. Unfortunately, you can’t set it to announce the name of the medication, so you must get more involved.

If you can visit even once a week and organize their medication until you come again, it’d be fantastic. Perhaps make a chart they can mark off through the day.

“WATER” can be a medication itself on this chart. It keeps the body functioning well like one. The chart, paired with the talking alarm clock in the same place, should help to keep your elderly loved ones hydrated.

Improve the System

If your loved one is in a care facility and ends up dehydrated, you, unfortunately, know who to blame. But it’s not as easy as it seems to make sure everyone in a care facility is getting their recommended daily intake.

Extra staff training is a smart idea, but individualized attention isn’t always possible. With so many residents, keeping tabs on each person’s daily intake goal is a difficult task. 

Instead, suggest they change the system. Encourage the facility to implement new activities and foods. 

Liquid Foods

Soup is variable and easy to consume. Suggesting they serve a different soup every day to help residents take in more fluid, while keeping things interesting.

Custard, pureed fruit and yogurt are also handy snack ideas for increasing fluid intake.

Keep Water Available

Suggest water coolers or a table with water jugs. A mini-freezer containing ice by the table could be helpful, to make it more palatable. 

Lemon, lime and orange slices would also be a nice idea to have on the water table. This keeps things from getting boring.

Provide Varied Beverages

treatment for dehydration in elderly

Tea and coffee breaks are another strategy they can use to get daily fluid intake up. Low fat creamer and sugar-free sweetener can add to the enjoyment. Perhaps provide nutritional (but tasty) biscuits with the drink.

Natural (low-sugar/sugar-free) fruit juices may also be preferable to some residents. Suggest a money-free vending machine, or a regular one with the necessary funds next to it for convenience.

If this won’t work for them, propose they make kitchens clear and approachable so the residents can find them and ask staff for their preferred beverage.

Fluids With Medication

It’s no secret that older people are often on a list of medications. Make sure the facility provides full glasses of water at medicine times, not just however much they need to take the pills, and that they encourage them to drink the whole glass.

If there are residents on no medication, consider getting staff to offer supplements, or suggest residents drink anyway.

Activities

Staying active is essential as we grow older. It helps keep our bodies, or our minds fit, depending on the activity. Encourage the facility to have some engagement among residents; it can energize them and work up a thirst. Alternatively, a sedentary activity is a perfect excuse to have something to sip.

Here are some activities you could suggest, and drinks to go with them:

Book Club

Whether their eyes are working or they need someone to read for them, nothing beats a book and a warm drink. This could be a leisurely afternoon activity, enjoyable for staff and elderly residents alike.

Ballroom Dancing

Nothing says recapturing your youth like ballroom dancing. An evening class can tire residents out before bed and give them a reason to hydrate one last time before lights out.

Games

Puzzles, cards or even an old-fashioned game of charades are better enjoyed with a beverage and a friend. Encourage them to have residents to pair team up, get energized, have some fun, and accompany it with something to drink.

The Takeaway

Dehydration can occur because of several factors, mental or physical. Luckily, if you know the signs, you can recognize it, correct it and take steps to avoid it. A supplement, varied beverages, or even a talking alarm can do wonders.

Please comment if you have any questions regarding dehydration in elderly people. It’s an important subject that should be discussed.

Yes, dehydration in the elderly is a prevalent problem. But it’s one with an array of easy, even enjoyable, solutions.

Cherry is the editor-in-chief of Mobility With Love. She obtained a bachelor's degree in Kinesiology and a master's degree in Adapted Physical Activity. Her expertise includes biomechanics, biochemistry, nutrition, disability studies, and so on.

Leave a Comment