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Dehydration and Elders

category_bug_journal2.gif Now, don't go thinking this is boring - it's not. It is something that could be dangerous but has a simple, easy solution. How often does that happen in life?

Last Monday la peregrina, who blogs at Santiago Dreaming, made an important health point in a comment on this blog:

“One of the biggest health concerns for older people,” she wrote, “is dehydration. An older relative of my husband was just in the hospital with what was first thought to be a stroke. It turns out she was dehydrated since she only drank coffee and an occasional Diet Dr. Pepper.”

She is absolutely right about it being a health risk for elders. One study found that lab tests revealed 48 percent of elders admitted to hospitals showed indications of dehydration. Another study found that 31 percent of long-term care residents were dehydrated.

Among the reasons elders are more susceptible to dehydration are that as we get older, our bodies are less able to conserve water and less able to respond to changes in temperature. Conditions that make dehydration more likely in elders include hot weather, fever, diarrhea and vomiting. Poorly-controlled diabetes can contribute to dehydration as can kidney disorders and taking diuretics which are sometimes used in the treatment of hypertension.

The most interesting reason for higher risk of dehydration in elders is that as we get older, we often don't realize when we are thirsty.

“Scientists...have warned that elderly people are at risk of becoming dehydrated because their brains underestimate how much water they need to drink to rehydrate...

“Florey researchers...discovered that a region in the brain called the mid cingulate cortex predicts how much water a person needs, but this region malfunctions in older people.”
Medical News Today 28 December 2007

Symptoms of dehydration can include headache, lethargy, confusion, hallucinations, light-headedness and fainting. With mild dehydration, skin and membranes of the eyes and nose become dry. Severe dehydration can lead to such serious effects as falls, dizziness, delirium and drop in blood pressure causing death.

Dehydration is not to be taken lightly.

Caregivers should be aware of these symptoms, be sure there is plenty of water available for those who cannot get around on their own, and they should get their loved ones or patients to a doctor as soon as possible when symptoms appear. Treatment involves replacement of lost fluids orally or via an intravenous tube if necessary.

As it happens, my physician and I discussed elder dehydration just last month during my annual checkup. I tend to not drink enough fluids so la peregrina's comment was a good reminder for me. In most cases, dehydration is easy to prevent: drink more liquids, even if you don't feel thirsty.

Unless dehydration is related to disease needing a physician's attention and if you are otherwise healthy, that's pretty much all there is to it - drink more water. Isn't it a relief to find a simple answer in a modern world where all too often solutions are complicated and cost a fortune.

Most adults should drink about eight glasses of water a day. Physically active people should drink more.

At The Elder Storytelling Place today, Johna Ferguson: A Good Joke


This is especially so here in Australia at this time of the year, particularly down here in the south where it’s hot, damned hot.

I keep a glass of water with me all the time in the house and when I leave in car - water is taken with me. I hear so many older people say they do not like water. I was caregiver for my mother who passed away 10 years ago this month - you would think she was taking medicine when I urged her to drink more water. How can you not like water?

Water = no taste. I seldom see older people drinking water. Even their "coffee" get-togethers often have no beverages.

Also, many believe that when they drink water, that contributes to their incontinence.

When my BIL was in a Nursing Home last year we went to visit him at least three times a week. He was usually in good shape mentally and knew exactly who we were.

One day we went there and he was sitting at a table in his room with his head down in his hands and when we entered the room he had no idea who we were and where he was.

We immediately reported this to the nurse and she called his Doctor in. He was taken into the hospital and given fluids via an IV unit.

As soon as he was hydrated he recognized us and asked what had happened to him. He told us he didn't like the taste of the water there and knew he didn't drink enough.

I went to the store and bought him several bottles of fruit flavored water and he enjoyed that taste and drank them all.

From then on we kept him supplied with flavored water and he was never dehydrated again.

I've been an 8-glass-a-day person for many years, ever since I first read 'Dr. Batman' Just one note of warning though: sometimes it is recommended that we take an occasional pinch of salt to counteract the extra water. I started doing that and over time I was taking too much salt without realizing it, thereby raising my BP. Brought it back down again by natural methods but have been very careful about salt ever since. There is enough sodium in the modern diet without taking extra, even with all that fluid.
Yes, extra water does make you pee more, but so what? It's better than the dozens of potential consequences of dehydration.
(And BTW, the latest thinking is that herbal teas count towards the total, so staying well hydrated is really not a chore.)

I drink a lot of water and it has a side benefit in that it's good for the skin. Someone who doesn't drink enough is more apt to have their skin look more shriveled. I keep water alongside my bed to drink when I wake during the night. If I feel a middle of the night headache coming on, drinking water will often end it. Fortunately I like water. We invested in a filtering system as our particular well water has a lot of minerals that don't make it taste good to anybody but the most hearty. After we started using the filtered water for our cats, their health improved. Small scale and big might not be the same thing but I feel filtered water is easy to have and who knows what those other minerals would have been doing to us longterm. I think even in town it'd be a good idea to filter the water not just for taste but to get rid of the chemicals that we might not need even if the water system did.

I wasn't good at drinking water until a medication the doc prescribed started making me thirsty really. I don't like our city water so I buy a case of bottled water at Big Lots. It costs three dollars a month. I keep a couple bottles in my car so it's always there.

I have been drinking distilled water for many years. I realize that in the process, distillation removes impurities as well as minerals. Hopefully, the minerals I need come from food and supplements. I probably go through 1.5 gallons on average per week.

Drinking water doesn't really make you urinate more. Not drinking enough is what does it. Often elders with dementia who are frequently awake at night to use the BR will do so less when they begin to drink more water during the day. Seems like a stretch, but it works. Dee

To clarify: Drinking water doesn't really make you urinate more during the night.......Dee

I am happy to read Dee's comment because I am guilty of not drinking enough water because I believed that it contributed to the need to urinate frequently.

I'm off to get a glass of water. Thank you for the reminder.

Thanks for doing the research for this post, Ronni. You answered the questions my comment brought up for me, especially the one about not feeling the need to drink as much as I did when I was younger. Good to know it is just a normal part of aging and, now that I am conscious of this fact, it should be easier to keep on top of it now.

Good article. I wound up in the hospital, thought I was having a stroke, but no, it was dehydration.

Our water here is very good, but we also have an under the sink filter to get the chlorine out.
As you say, Ronni, it's great that there are simple things we can do to improve our health. Cutting back the salt, walking, eating food as fresh as possible, getting enough sleep: these are great boons to the health.

The brain is the first to suffer from insufficient water. Think of that first - if your brain is functioning ;) - when brain fog, memory lapses, etc. occur.

Thanks for the reminder Ronni, I was cutting back because of driving long distances and the need to pee is much more frequent than it used to be. I've timed my water consumption today and am struggling with letting go of diet soda due to environment - my inner and the earth itself.

I was so bad at remembering to drink water that a few years ago I started making a simple little calendar thingy on a pad of paper that's always by my desk/computer, where I am sitting every day. Every time I finish a glass of water, I make a mark. I am SO forgetful, that's the only way I've found to remember to DRINK WATER! For ME, it works.

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