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Avoid dehydration


Dehydration is a top issue for older adults and their caregivers. This article explains the causes and signs of dehydration. It then suggests ways for the caregiver to help the older adult stay hydrated.

What is dehydration?

Dehydration is a top issue for older adults and their caregivers. Dehydration happens when a person has too little fluid in their body, either because they are not drinking enough liquids or because they are expelling more fluid than they are taking in. This deficiency in water content makes the body unable to function the way it is supposed to.

While dehydration can and does happen at every age, the problem is more common and more serious among older adults. It can lead to hospitalization and death. In addition, even when it is not fatal, it can have serious health outcomes, including:

  • Urinary tract infection
  • Loss of consciousness
  • Kidney stones and kidney failure
  • Seizures
  • Reduced effectiveness of medications
  • Shock caused by a dangerous drop in blood pressure and oxygen

Causes of dehydration

Some common causes of dehydration in older adults are as follows:

  • Incontinence problems that make a person worried about having fluid in their bladder
  • Mobility problems that make a person reluctant to need to go to the bathroom
  • Forgetfulness and not remembering to drink
  • Effects of aging such as getting less thirsty and lowered ability to retain water
  • Conditions such as diabetes that cause the body to lose water
  • Medications such as those used for constipation, cancer, and migraines. These medications can blunt the thirst mechanism, cause diarrhea and/or vomiting, and/or cause the body to flush water1
  • Use of diuretic medications and supplements, often called “fluid pills,” to treat edema (fluid build-up) in the lower body; this is especially common among heart-failure patients.

Signs of dehydration

Signs that might indicate dehydration can also be symptoms of other conditions, including stroke and liver disease, and so it’s important to consult a medical professional if dehydration occurs, even if symptoms resolve. There is no surefire way for a family caregiver to know if an older adult is dehydrated; only blood tests can tell for sure whether the problem is or is not dehydration.2

However, since dehydration is a common and potentially serious problem among older adults, any signs that it is happening should be addressed immediately. Dehydration may be mild to moderate or severe.

Mild to moderate dehydration

One way to check whether someone has mild to moderate dehydration is to give them fluids and see if they seem more alert and energetic within 10 minutes.3 If they do, dehydration could be the culprit.

Signs of mild to moderate dehydration include the following:

  • Thirst
  • Dry or sticky mouth
  • Dry skin
  • Headache
  • Reduced urination
  • Darker urine
  • Weakness and fatigue

Severe dehydration

Severe dehydration is a medical emergency and can lead to death. The caregiver should call 911 if any of these symptoms are present. They should not try to treat the dehydration themselves.4

Signs of severe dehydration include:

  • “Tenting” of skin on the back of the wrist when pulled and released
  • Dizziness or fainting
  • Delirium (confusion, hallucinations, altered consciousness)
  • High heart rate (over 100 beats per minute)
  • Dry mouth or dry armpit skin
  • Sunken eyes
  • Loose skin 
  • Little or no urine, or small amounts of very dark-colored urine

Treatment for dehydration

The treatment for dehydration depends on how severe it has become.  

  • Mild dehydration: Can usually be corrected by having the person drink more fluids. The fluid should be at room temperature, as hot and cold liquids can stimulate the urge to urinate and also lower the amount of liquid absorbed in the stomach. Fluids containing electrolytes, such as sports drinks, juice, or water with rehydration powder mixed in, are ideal.5 However, plain water, milk, and tea are better than nothing.
  • Moderate dehydration: Can be treated with intravenous (IV) fluids. This can be done at an urgent care center or hospital.
  • Severe dehydration: Requires emergency treatment, which may include short-term dialysis.

Ways to avoid dehydration

Fortunately, there are many simple ways to help older adults stay hydrated. The first step is to inform the older adult about the dangers of dehydration. Knowing about the importance of adequate hydration and the signs of dehydration increases the chance that they will adopt good hydration habits.6

Additional steps to keep hydrated include the following:

  • Set daily hydration targets (usually at least 7 cups of fluid a day, unless a medical professional says otherwise7
  • Invest in an attractive, lightweight, spillproof water bottle
  • Measure the amount of fluid that a person’s favorite water bottle, mug, or glass holds, and make sure that the person drinks it fully the required number of times each day to meet the hydration target
  • Track urine color until good hydration habits are formed
  • Make water and other fluids easy to access, including ensuring that the water glass or bottle is light enough that the person can lift it easily and drink it without spilling any water
  • Use water-flavor drops, fruit pieces, or berries to make water better-tasting 
  • Give the person fluids at the temperature they like best—for instance, cold water or warm tea
  • Set up a regular bathroom schedule for people with continence or mobility problems
  • Make sure the person has meals that include plenty of food with high water content, such as fresh fruits, vegetables, soups, broths, and popsicles

Related information

Dehydration: Drinking Extra Fluids

Dehydration Caused by a Medicine

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