While dehydration is an ever present risk for the general population, the elderly is part of the high risk group for dehydration for several reasons and preventing them from becoming dehydrated is just as challenging for even several more. This makes it very important to understand how dehydration occurs, the symptoms to watch out for and how to treat it as quickly as possible.
It doesn’t matter whether you are at home doing nothing or are exercising, you have to stay hydrated! Most people assume that lack of activity abates their requirement for water. While it is true that those who spend hours under the sun or are involved in more activity, need more water to replenish their internal systems, even people who are dormant most of the day need to drink water too.
Why Makes Elderly Dehydration Different?
The causes for dehydration in elderly patients are the same as with everyone else (diarrhea, vomiting, illnesses such as bacterial infection, diabetes, burns, bleeding, increased temperature, lack of fluids). What puts them in the high risk group is the increased risk of inadequate fluid intake. The elderly don’t feel immediately thirsty even if their bodies are already nearly dehydrated, some may not like to take in fluids as much as they used to because of fluid restrictions or intake of fluid eliminating drugs and some may have decreased function of the kidneys or experience incontinence. This lack of fluid, when combined with external factors such as elevated temperature, injury or illness, can cause a drop in the body’s fluid volume and cause dehydration faster in older patients compared to young adults.
What are the symptoms of dehydration?
Depending on the severity, there are many different signs and symptoms associated with dehydration: Mild- this is when the thirst mechanism is usually experience. Though with the elderly, this may not be as readily manifested or reliable as it once was. Some may even not experience it at all. Moderate- when fluid loss reaches a certain low point, nausea, weakness, fatigue, dizziness, muscle cramps, palpitations and darker (more concentrated) urine can be experienced. Most patients experiencing these symptoms require hospitalization. Severe- fluid loss at a critical level will cause confusion, loss of consciousness, coma, shock and eventually death unless appropriate interventions are done.
How is Dehydration treated?
Treatment will depend on the cause of dehydration though largely it will consist of fluid replacement interventions. For moderate to severe cases, intravenous fluid replacement therapies may be started. An increase in oral fluids may be prescribed unless contraindicated by other present medical conditions. Aside from fluid management, resolving the underlying cause of dehydration should also be done, especially if it is an infection or a disease that can be treated by medications or an environmental cause that can be modified.
How can it be prevented?
Keeping a close eye on the elderly is the key in preventing and identifying possible dehydration. Monitor the elderly patients’ fluid intake and encourage them to increase their fluids as allowed by their personal restrictions. If it’s possible, incorporate fluids other than water to their diet such as broths, jelly or popsicles to add variety and to encourage compliance. Also keep an eye on the quality and quantity of their urine. Since the body will attempt to save up on water during fluid volume loss, excreting a lesser quantity or producing dark-colored urine can be a sign of dehydration. Finally, if the patient begins to complain of headaches, is nauseous and weak or is noted to be restless and irritable, immediately refer to them to healthcare authorities as prompt diagnosis and treatment is essential for these high risk clients.