Dehydration in the Elderly


Q1. Why are the elderly more prone to dehydration?
The reasons for senior dehydration are myriad. It may have to do with physical changes in the elderly such as decease in body fluid, which diminishes their natural thirst response. Some elderly people may refuse to drink water on purpose for psychological reasons, e.g. being too worried about the inconvenience caused by frequent urination.     
Others simply dislike the tastelessness of water. Sometimes dehydration may happen when the carers fail to take care of the needs of the elderly.   
Q2. How does dehydration affect the elderly?
Dehydration does have an impact on their physical well-being, organs and other body systems. Common problems include urinary tract infection, constipation, indigestion or kidney stones. Seniors may also find it difficult to spit out the phlegm due to increased mucus production in the respiratory tract. And with the blood becoming more concentrated, vascular infarction may occur and increase the risk of heart disease or stroke.
Some seniors may also suffer from delirium as a result of dehydration, with symptoms such as poor concentration, mental confusion, paranoia or hallucination. Severe dehydration may cause coma, even death.
Q3. What are the symptoms of dehydration? How to tell if a senior is dehydrated?
Seniors may feel tired rather than thirsty when dehydrated. When they do feel thirsty, they may not only feel tired but also experience hot flashes or a fever. The urine will turn dark yellow, and urination may decrease in volume and frequency. Other symptoms include less elastic skin, a dry mouth or dry tongue. Severe dehydration can also lead to sunken cheeks or eye sockets, decrease in blood pressure, even coma.
Q4. How much water should a senior drink each day? What can we do if he/she refuses to drink water?
Daily water intake varies from person to person, and it is all about balance. Drinking 8 glasses (250 to 300ml each) a day, or 2 litres in total, is too much for seniors as most of them have heart or kidney conditions and are more prone to edema or swollen feet. Generally speaking, a daily intake of 6 glasses or 1,500ml is adequate.      
To help explain the daily water intake to seniors, try to measure and fill the same volume in the cup and bowl they usually use. Or use water jugs or bottles to make them aware of how much they should drink each day.   
Seniors should drink water at regular intervals throughout the day but not too much each time, or they may feel full. Some of them may dislike the taste of plain water.  To encourage drinking, try to add a squeeze of lemon or other fruits. Dried tangerine peels, red dates and monk fruit also do. Other good choices include nutritional milk, sugar-free soy milk or fresh vegetable juice. Try to avoid too much salt or sugar in soup, fruit juice and sweet drinks. Some foods have high water content, such as soft jelly and panna cotta. They are suitable for seniors that are on soft diet and do not like drinking water.   
Q5. Can drinking water help improve dementia?
While dehydration has no correlation with dementia, it may lead to delirium and poorer memory in seniors with dementia.
Dehydration may also cause multiple strokes and exacerbate dementia. And drinking more water can help prevent deterioration of dementia in senior patients.

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