Dehydration In The Elderly
Dehydration in seniors is a dangerous and common problem. You are considered elderly or a senior once you hit 60 years of age.
A UCLA study found that 40% of seniors may be chronically under-hydrated. That can easily lead to dehydration and cause a variety of serious health problems.
According to Alz Discovery, a study assessing the cognitive function and hydration status of 1,091 people over age 65 found that dehydrated individuals were at higher risk for dementia.
And, dehydration has often been mistaken for early signs of dementia because the symptoms are similar.
All the cells in the body, including our brain cells, depend on water to carry out essential functions. Therefore, if water levels are too low, our brain cells cannot function properly, leading to cognitive problems.
Women of all ages are more sensitive to the effects of dehydration, but elderly women are especially vulnerable. You can become hydrated at an earlier age and if not treated, when you get older it can reek havoc on your body and mind.
Older adults are more susceptible to becoming dehydrated for various reasons, including a reduced sensation of thirst. Our brain receptacles get weak thus do not tell us that we are thirsty, so we drink less because we don't feel thirsty. Our desire to drink reduces, as does the amount of water in our bodies, which makes seniors more at risk for dehydration.
Elderly folks may have fluids nearby, but many have trouble with their hypothalamus, the area in the brain that plays a key role in the regulation of thirst, so they don't get thirsty when they should.
Add this to the fact that seniors often take dehydrating medicines (like diuretics) - and that urinary and bowel incontinence are pervasive, it's not surprising that 40% of older adults suffer from dehydration.
Water makes up about 55-60% of total body weight in younger adults. As we age, it declines to 50-55% and body fat increases.
That means that even when your body is craving fluids, you may be unaware of it, so you may drink less than your body requires to stay healthy.
Persistent dehydration that causes difficulty walking, confusion, rapid heart rate or other more severe symptoms can land seniors in the hospital. Severe or prolonged dehydration can lead to blood in the urine. Not drinking enough water can exacerbate any underlying kidney conditions that contributes to hematuria, such as kidney stones.
Dehydration, if unaddressed, can contribute to bacterial growth, reduce metabolism, and compromise organ function in the urology system.
Medications (Diuretics), which most elderly people take are especially prone to dehydration. Researchers say that as people age, they need to drink more water to compensate for changes in their body temperature regulation.
They urge older adults to drink water even when they aren’t thirsty and to limit beverages such as soda, coffee, and alcohol, which can cause dehydration. These drinks can have a diuretic effect, meaning they can cause you to urinate more, which can then further dehydrate you.
That doesn't mean you can't have a tasty cup of joe in the morning; it might make you urinate more, but as long as coffee is consumed in moderation and the caffeine per cup of coffee is controlled it will not significantly impact your health and hydration over all.
Dehydration Is A Common Problem Among Seniors
Dehydration is the most common fluid and electrolyte - and often not talked about - health problem among seniors. It’s estimated that 40% of older adults are chronically under-hydrated which increases the risk of falls, UTIs, and more severe consequences like organ and brain damage. In fact, dehydration is among the most common form of elder abuse and neglect associated with assisted living facilities.
In one study, the fluid intake of 40 nursing home residents was monitored. Researchers found that nearly all of the patients were inadequately hydrated. Furthermore, the study found that 25 of the 40 patients had illnesses which may have been caused by or related to dehydration.
In another study, 31% of residents in a long-term care facility were dehydrated. In a related study, 48% of older adults who were admitted to the hospital after being treated in the emergency room had signs of dehydration in their lab tests.
Dehydration can come quickly, especially in seniors. Because mild to moderate dehydration can still be reversed, severe dehydration in elderly patients is almost always preventable.
Stages of Dehydration:
Dehydration can be mild, moderate, or severe, based on how much of your body fluid is lost or not replaced. Severe dehydration is a life-threatening emergency. It can cause serious damage to your kidneys, increase the risk of painful kidney stones and even cause kidney failure. It can also damage your heart, and brain. Severe dehydration can be fatal so it is important to notice all of the other warning symptoms and do something to fix them!
Dehydration doesn't just shrivel up your skin like a prune, it shrivels up your internal organs: muscles, kidneys, brain, lungs, gastrointestinal tract, and heart can all suffer from the effects of dehydration.
Moderate to severe dehydration can cause tiredness, confusion, muscle cramping, blood clot complications, passing out, poor kidney function, rapid but weak pulse, little-to-no urine production, lowered blood pressure, and fast heart rate. Severe dehydration can lead to shock, weak pulse, bluish skin, very low blood pressure, lack of urine production, and in extreme cases, death.
Dehydration can also cause dry mouth when the salivary glands in your mouth don't produce enough saliva. This means you don't have enough fluid in your body to produce the saliva you need, resulting in receding gums, tooth loss, and gum disease. As long as you drink lots of water, your gums will stay hydrated, clean, and comfortable.
You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment.
Drinking Water is Not Enough:
When we become dehydrated, drinking water is not enough. During cases of mild dehydration, our body needs a drink that contains a balanced ratio of electrolytes. Electrolytes can help us rehydrate more quickly and retain fluids better.
Water has hydrogen and oxygen, but it doesn't have the electrolytes we need for the body, explains Dr. Fertel. Eating foods like bananas and apples not only help hydrate your body, but also provides the essential electrolytes that help regulate nerve and muscle function, blood flow and brain function.
Water isn't the most hydrating drink. It turns out that honor goes to milk. A 2015 study from Scotland's St. Andrews University looked at various beverages to find out exactly which one is the most hydrating, and which ones humans should skip altogether when trying to quench our thirst.
While they found water - both still and sparkling - does a great job of hydrating people, they also found that it's missing a few key ingredients to really make it work efficiently in the human body. Namely, plain water is missing a touch of fat, salt, and sugar.
Ronald Maughan, a professor at St. Andrews' School of Medicine explained, "when we drink water it empties almost immediately from the stomach and absorbs into the bloodstream. Often, we end up just peeing out the excess liquid."
"If you're drinking water and then, within two hours, your urine output is really high and [your urine] is clear, that means the water is not staying in well," David Nieman, a professor of public health at Appalachian State University and director of the Human Performance Lab at the North Carolina Research Campus, told TIME about a previous hydration study. "There's no virtue to that kind of consumption."
However, other drinks sit and absorb more slowly thanks to their nutritional content. And that's where milk comes in.
Milk's fat, protein, salt, and sugar content helps to coat the stomach when a person drinks it. This allows the water to absorb at a slower rate, thus keeping people hydrated longer. The study tells us much of what we already knew: Electrolytes - like sodium and potassium - contribute to better hydration, which all are contained in milk.
The hydration study concluded Skim milk came in first followed by "oral rehydration" drinks like Pedialyte. Next came full-fat milk, fruit juice, cold tea, tea, sports drinks, still water, and sparkling water. Dehydration must be treated by replenishing the fluid level in the body.
How Much Water And Electrolytes Do Seniors Need?
The average senior should drink at least six to eight glasses of water per day. However since water is not all you need to stay hydrated, and water (to me) is so bland, replace a couple of those glasses of water with milk, or juice or drinks with Electrolytes.
If you like sports drinks, (I LOVE Pedialyte), if you are not severely hydrated drink no more than 1-8oz glass 2 times a week. Too many electrolytes can cause several symptoms, including: Fatigue. Headaches. Weak muscles.
If you are severely hydrated, drink 4-8 servings (32 to 64 fl oz) of Pedialyte or a sports drink per day until your dehydration subsides. Remember, if you are severely hydrated, get medical help fast.
Dangers of Overhydration:
The skin, muscles, kidneys, brain, and heart can all suffer from the effects of dehydration. But very few understand the dangers of overhydration. Because dehydration is more common in seniors, they make special efforts to get enough H2O. (The average senior should drink at least 8 glasses per day.) However, drinking too much plain water can have terrible consequences.
When you drink too much water, you may experience water poisoning, intoxication, or a disruption of brain function. This happens when there's too much water in the cells (including brain cells), causing them to swell. When the cells in the brain swell they cause pressure in the brain. You may start experiencing things like confusion, drowsiness, and headaches. If this pressure increases it could cause conditions like hypertension (High Blood Pressure) and bradycardia (Low Heart Rate), says Web MD.
Consuming too much water too quickly can overload your kidneys and cause a dilution of sodium in your bloodstream. Sodium is the electrolyte most affected by overhydration, leading to a condition called hyponatremia, where you retain water but flush out necessary electrolytes like sodium and potassium. Sodium is a crucial element that helps keep the balance of fluids in and out of cells. When its levels drop due to a high amount of water in the body, fluids get inside the cells. Then the cells swell, putting you at risk of swelling of the brain, having seizures, going into a coma, or even dying.
Symptoms of Dehydration In The Elderly:
Symptoms of dehydration in seniors can be difficult to recognize. Dehydration in elderly people can cause:
• Dry mouth
• Dry skin or tongue
• Sunken eyes
• Decreased urination
• Dark urine
• Fatigue
• Lightheadedness or fainting, especially when standing
• Muscle cramps
• Headache
• Nausea
• Skin that is loose or does not return to its normal position after it is pinched
• Constipation
• Wrinkling of the skin
Mild and reversible dehydration can quickly advance to severe dehydration in older people. Symptoms of severe dehydration in elderly people may include:
• Confusion or disorientation
• Dizziness
• Fainting
• Rapid pulse, heart rate, or breathing
• Low blood pressure
• Difficulty walking or moving
• Decreased brain function
• Memory loss
• Lack of sweating
• Seizures
• Vomiting or diarrhea lasting over 24 hours
How To treat dehydration:
* Try sipping water or sucking on ice cubes.
* Try drinking water or sports drinks that contain electrolytes.
* Do not take salt tablets. They can cause serious complications.
* Ask your provider what you should eat if you have diarrhea.
Untreated severe dehydration may cause:
* Death
* Permanent brain damage
* Seizures
What To Do To Combat Dehydration:
For mild dehydration, drinking plain water may be all you need. However, if both water and electrolyte losses have occurred, electrolytes (especially sodium and potassium) should also be replaced. There are a number of flavored commercial drinks or oral rehydration solutions that have been formulated to replace the electrolytes (salts) lost during vigorous exercise or in times of illness. These drinks can be used to prevent dehydration or to treat mild dehydration.
Salt tablets are not recommended, as they can cause serious complications. If you have heart or kidney problems, consult your doctor about safely replacing fluids before exercising or during acute illness.
• Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising.
• Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration.
• Include more milk. According to a study by McMaster University, milk is more hydrating than water or sports drinks due to its source of protein, carbohydrates, calcium, and electrolytes. Milk has a similar electrolyte content and carbohydrate concentration to commercial sports drinks.
• Sip smoothies. Between the yogurt and all the fresh fruit, smoothies are a great, and tasty, way to stay hydrated. Not sure what fruits and vegetables to pick? Strawberries, peaches, cucumbers, spinach, applesauce, apricots, asparagus (cooked), bananas, blackberries, blueberries, broccoli (cooked), cauliflower (cooked), cherries, grapes, raspberries are all excellent options.
• Consume drinks with a lot of electrolytes, like coconut water and eating fruits and vegetables with a lot of fiber to combat these losses.
• Pedialyte or Gatorade not only contain electrolytes, which are lost through sweat and gastrointestinal losses, but are absorbed more readily within the body.
• If you feel thirsty, try to increase your intake of hydrating fluids, like water, milk, fruit and sports drinks, and cut back on beverages that contain alcohol, coffee, and soda's as it may have a diuretic effect. They rid your body of salt (sodium) and water.
What Are The Side Effects Of Diuretics?
Usual side effects of diuretics include:
* Peeing more than usual.
* Dizziness.
* Tiredness.
* Headache.
* Gout.
* Low potassium (unless you're taking a potassium-sparing type of diuretic).
* Muscle cramps.
Adults over the age of 60 who drink only when they are thirsty probably get only about 90% of the fluid they need.
The Harm Of Drinking Water All At Once:
If you wake up and chug a gallon of water each morning, you may be doing more harm than good. Overloading your system with water will only cause your body to eliminate any excess through your urine, taking vital electrolytes with it.
Start your day off right by drinking a glass of water each morning before breakfast. This will jump start your mind and body. Keep a bottle of water near you at all times and keep a running total of how much you've consumed - And sip throughout the day.
Drinking water gradually throughout the day is important. Too much water at one time may increase the risk of a condition of hyponatremia.
As the Mayo Clinic - states, hyponatremia may be life-threatening.
Being hydrated is also very important for certain medications to work properly.
Aim to stay hydrated throughout the day.
For older adults, staying hydrated can take more effort. In addition to monitoring water intake, they need to ensure that they consume enough electrolytes for their body weight.
So maybe your new drinking habits will lead to a couple more trips to the bathroom. But you'll be happier, healthier, and more efficient with a properly hydrated brain.
Plus you'll be amazed at how soft, smooth, nourished, and healthy your skin will be when you drink 6-8 glasses of fluids a day.
It will improve your blood flow, flush toxins out of your body, and hydrate your skin cells. It will hydrate your body from the inside out.
So, Drink up and stay hydrated.
Resources:
Health Line - As You Get Older, You Need to Drink More Water. Here's Why.
Sharp Homecare - Dehydration In The Elderly Is A Serious Health Risk
Health Line - Chronic Dehydration - What Does It Mean When Dehydration Becomes Long-Term and Serious?
Cleveland Clinic - Why Are You Dehydrated?
Travel & Leisure - Water Is Not The Most Hydrating?
Mount Sinai - Dehydration
Medical News Today - What happens if you drink too much water?
Health Line - Is Pedialyte Effective for Dehydration?
The Urology Group - Dehydration: 4 Conditions Made Worse by Thirst.
|
