Looking out for signs of illness when you are taking care of a loved one is a challenging thing and it becomes even more challenging if that person happens to be an elderly one. There are illnesses that have very clear signs and you can immediately tell that there is an issue.
Dehydration is one of the issues that come with only small signs. Symptoms of dehydration in elderly people can be overlooked and sometimes missed completely. Dehydration has got big effects on one’s body, especially when seniors are concerned.
Dehydration happens when you lose more water than what you are consuming. When you have enough fluid, the body is able to regulate the temperature through mechanisms such as sweating. Water also helps in the maintenance of blood pressure and also the elimination of wastes from the body.
When dehydration is severe, confusion, weakness, and even urinary tract infections can occur. Illnesses like pneumonia can also occur. That is the pathophysiology of dehydration. Another common thing is bedsores especially in patients who are bedridden.
Death is also a possibility when dehydration is too extreme. Human beings cannot go for 4 days without water. So if you are wondering, can you die from dehydration, the answer is yes.
What happens when blood volume is lost from the body?
If you lose too much blood volume, then you can go into hypovolemic shock. This is treated as a medical emergency because the tissues don’t get adequate oxygen, which can cause organ and tissue damage.
Dehydration in seniors
It is common for seniors to get dehydrated because of various reasons:
- Medications
Seniors have to deal with medication from time to time due to different issues. It is important to note that some of the illnesses that affect the elderly are age-related. Some of the medications that are given to the elderly are diuretic while there are those that tend to cause more sweating.
- Decrease in thirst
As we age, our sense of thirst becomes a bit more acute. It is also common for seniors to be frail and have a difficult time getting drinks when they feel thirsty. There are yet others who require caregivers to assist them. It is not always possible to detect when the elderly person needs fluids.
- Kidney function
As we grow older, the other thing that we lose is kidney function. This means that we are not able to conserve as much water as we want. This becomes a progressive thing, especially starting from age 50. Things become even more noticeable and acute by 70 years.
- Illness
Illness can also cause dehydration. Diarrhea and/or vomiting can cause severe dehydration in the elderly.
More on causes of dehydration
Acute diarrhea, vomiting: acute diarrhea is diarrhea, which starts suddenly and very violently. This can cause a great water loss as well as electrolytes within a very short time period.
When the diarrhea is accompanied by vomiting, then the water loss is even more intense. Dehydration and diarrhea are closely related.
Fever: when your fever is high, then you become more dehydrated. The issue can be made worse if you vomit and have diarrhea as well.
Sweating excessively: water is lost when we sweat. If you are a person who engages in very vigorous activity and you don’t take time to replace the fluid lost, then you will definitely get dehydrated. Usually, humid and hot weather will increase the way we sweat and the amount of fluid that we lose.
Increased urination: increased urination can be an indication of diabetes, which is uncontrolled or undiagnosed. There are also some medications like diuretics as well as blood pressure meds that can make one get dehydrated because they induce more urination.
Eight glasses a day?
We all have a body water state that is normal and it should relate to weight, if you happen to be below normal, then you are dehydrated and when it’s way above normal, it becomes hyperhydration.
The level of hydration is not the same for everyone. Everyone has his/her own level. This, therefore, does not support the mantra that states that we should all take eight glasses of water every single day since there is no real scientific proof for it.
The diet we choose can affect or personal hydration levels. Fruits such as watermelon, soups, and vegetables are water-based. People do get water from the food they eat, not just from drinking water.
What you notice is that larger people generally require more water. Also, athletes and any other group of persons who perspire heavily may require a larger amount of water.
This means that there isn’t a specific amount of water that we should take on a daily basis; everyone has his/her own special needs.
Hydration tracking
The best way to know whether you are taking enough water is to track your hydration. You can do this by monitoring body weight. It means that you need to know your weight once in a while and if possible each morning.
If you find that you have lost more than two pounds from the previous day and if you feel particularly thirsty or your head is aching, then you are most likely dehydrated.
When you lose 2 percent of body weight, then you are mildly dehydrated. When the weight loss is 4 percent or more, then you have severe dehydration.
You should note that mild dehydration can also have negative impacts on your health, especially in people who have renal or cardiac problems. Severe dehydration causes strain in the heart since it is trying to pump blood, but the fluid is not adequate.
This is something that should be done where elderly persons are concerned. If you are an elderly person who exercises regularly, then you may not have to get weighed on a daily basis. You probably take enough water.
However, for those confined in nursing homes, especially those that have had some hydration issues in the past or those with cardiac issues, it is important to take their weight on a daily basis.
It is important to exercise a lot of care when it comes to the machines that are said to also measure the BMI and hydration level. They have poor accuracy and they cannot be relied upon for purposes of research.
One of the things you should also note is the fact that some of the signs that present themselves in younger people indicating dehydration are not always present in the elderly.
For a young person who is really dehydrated, then they may have wrinkled or sagging skin. In most cases, that is not something that you can tell with an elderly person.
Sometimes dehydration in the elderly is delayed and that is why there is such a high rate of hospitalization among the elderly. When dehydration in the elderly is very severe, then it is a condition that can be classified as life-threatening.
The signs of dehydration in elderly persons
There are many signs of dehydration in the elderly population and they include, but not limited to:
⇒ Low blood pressure
⇒ A rapid heart rate
⇒ The inability to produce sweat or tears
⇒ Sunken eyes
⇒ A dry mouth
⇒ Headaches and dizziness
⇒ Headaches and dizziness
⇒ Walking difficulties
⇒ Confusion
⇒ Constipation
⇒ A low output of urine
If there is suspicion of elderly dehydration, it is always advisable that you check the turgor of the skin so as to know whether it has decreased or not.
This is done by pulling the skin up at the back of the hand for several seconds. If the skin doesn’t return to the normal state immediately, it is a warning sign of dehydration.
Dehydration and high blood pressure
There is a relationship between dehydration and blood pressure. Hydration is very important for bodily functions and it has an important role in the cardiovascular system. When you are dehydrated, the blood volume is decreased, meaning that the body reacts by retaining more sodium.
Because of this, the body closes some capillaries putting more pressure on the arteries and capillaries that remain open leading to high blood pressure. This means that dehydration heart rate is usually high because the heart needs to work harder to pump an already low volume of blood.
If you have high blood pressure as a result of dehydration, taking water suddenly can cause strain on the digestive system and kidneys. It is, therefore, important to seek assistance from a doctor so that he or she can advise you on the safest way forward.
Dehydration prevention in elderly persons
So as to reduce the chance of dehydration in elderly persons, you need to ensure that enough fluids are consumed on a daily basis. Make sure that they eat healthy foods that are well balanced.
Also ensure that there are water content foods in the diet like soups, vegetables, and fruits. You should also keep track of the urine color. It should be light and the output should also be adequate. Kindly note that dark urine or when there is urination infrequency, it is a clear sign of dehydration.
It is important for seniors to note the great importance of drinking even in times when they don’t really feel thirsty. Have a water bottle at hand. Even when going to bed, it is essential to keep a water bottle just near the bed.
If an elderly person has got any mobility issues, then you need to have water situated in the nearest places for their convenience. Have water near their favorite places so they can get it without less effort.
For elderly persons who are within nursing homes or other kinds of facilities, it is important for the staff to have a program or hydration handy so as to assist in the water taking process. It is important to offer the elderly different kinds of beverages so as to encourage them to actually drink.
The elderly should be given drinks while they eat and also in between meals. The weight of residents should also be assessed, especially if their mental and physical condition tends to change.
If there are dehydration issues and if the elderly person is taking diuretics or laxatives, you need to talk to a doctor as soon as possible so as to weigh the possibility of medication change.
The best thing to do so as not to have to deal with the issues that are related to dehydration is to prevent it. Ensure that a loved one is hydrated because it is easier to do that than getting them treatment for the issue when it has already presented itself.
Even when you have conditions that make you lose a lot of water, you need to replace them as soon as possible to avoid dehydration. Also, note that water is an essential part of how our bodies function.
The issues of dehydration can actually affect everyone, but they are more pronounced and dangerous in the elderly and young children. Minor illnesses can lead to dehydration in elderly persons
It is also important to note that this doesn’t always indicate the body’s water needs. Older adults don’t really get thirsty up until such a time that their bodies are already dehydrated. You should, therefore, increase your intake of water when it is hot or when you fall ill.
More on prevention
Take more fluids when you:
Diarrhea or vomit: if an elderly person has diarrhea or is vomiting, make sure that you give extra water or use oral rehydration solutions when you see any illness signs. It is not wise to wait for full dehydration.
If you are planning to engage in any strenuous exercise, ensure you start hydrating a day before. When you produce urine that is diluted and clear, it is an indication that you are indeed hydrated well. Make sure you take in lots of fluids as you work out and continue drinking even when the exercises are over.
Cold and hot weather: take lots of water when the weather is humid or hot so as to lower the temperature and replace any of the moisture that was lost through sweating. Take extra water even when it is cold so as to replace the water lost from the dry air, especially when you are at a high altitude.
If you are ill, you will definitely need to take in more fluids, even for illnesses that are considered minor like bladder infections, bronchitis, and the flu.
When to see a doctor
Getting help when you have different issues is one of the best ways to avoid issues related to dehydration. You should see a doctor when your loved one diarrheas for more than 24 hours.
Also, if the person is less active, sleepier than normal, disoriented, or irritable, medical assistance should be sought out as soon as possible.
There are also other instances when the elderly person is not able to hold fluids. If they have a black or bloody stool, get assistance immediately.
Dehydration can be caused by very simple things such as not drinking enough water or when you are sick. You could even be too busy to get a drink or you may not have any access to water that is safe like when you are camping, hiking, or traveling.
The risk factors
When you are learning about dehydration, it is important to appreciate that it is not only the elderly and children that can be affected by the issue. However, there are people who are at a greater risk of getting dehydrated and they include:
Children and infants: this is an age group that is at a very high likelihood of getting severe vomiting and diarrhea. Children are very vulnerable to dehydration.
This is because they have a high surface area as compared to volume area so they lose a higher amount of fluid when they have a very high fever or even burns.
When they are especially young, children may not be able to tell when they feel thirsty and they are not in a position to get drinks without assistance.
Older adults: when we start to age, the fluid reserve that is within the body gets smaller and also the water conservation ability reduces. The way we sense thirst is also made acute. These are problems that can be brought about by different chronic illnesses such as dementia and diabetes.
By using certain medications, the issue can also get worse. There are still older adults with mobility issues and who are not in a position to get them any water without assistance. This is what makes dehydration in the elderly very common.
Chronic illnesses: when diabetes is uncontrolled or if it is not treated, then you happen to be at a very high risk of dehydration. The presence of kidney disease also tends to increase the risks that are associated with dehydration.
Also, medications that tend to increase urination make it worse. Having a sore throat or a cold can also make you more likely to get dehydrated. This is due to the simple fact that you do not feel like drinking or eating anything whenever you are feeling sick.
Working and exercising outdoors: when the weather is humid and hot, there is more risk of dehydration. There is also more incidence of illness increase. This happens because when the humid air does not allow sweat to evaporate so as to cool the body as it normally does.
This leads to increased temperature in the body and therefore, one needs to take in more fluids. If this is not done, then dehydration is may occur.
Complications associated with dehydration
There are many complications that can be caused by dehydration, some of which are very serious. They include:
Heat injury: if you happen to exercise in a vigorous manner, leading to heavy perspiration without enough fluids, then you may get heat injury. This can be mild or severe.
The mild form can represent itself as heat cramps. When severe, you can suffer from heat exhaustion or heatstroke which is a life-threatening condition.
Kidney and urinary issues: when you have dehydration every now and then, or when it is too prolonged, then you may have issues with urinary tract infections, kidney failure or kidney stones.
Seizures: our bodies have electrolytes such as sodium and potassium. These are responsible for carrying different electrical signals from one cell to the next.
When these electrolytes aren’t in balance, the normal messages can easily get all mixed up. This can cause muscle contractions that are involuntary. It is also possible to lose consciousness.
Hypovolemic shock: this is also called low blood volume shock. This is a very serious issue and it can also be life-threatening. It happens if the volume of blood leads to a decrease in blood pressure. This translates to a decrease in the oxygen that is circulating within the body.
If you are wondering how long it takes to recover from dehydration, it depends on the extent of the dehydration, the cause, and the damage done.
Diagnosis
A doctor can make a dehydration diagnosis based on the physical signs and symptoms that are portraying. It is also possible that the patient can have low blood pressure, especially as they move from a lying position to a standing position. This can be seen through a heart rate that is faster than the normal and a reduced flow of blood to the extremities.
So as to make a diagnosis confirmation and also to confirm how far the dehydration has gone, there are many other tests that can be conducted. Such tests include:
- Blood tests: a blood sample can be taken so as to check different things such as the electrolyte level especially the potassium and sodium. A blood sample can also tell how the kidneys are working.
- Urinalysis: these are tests that are carried out on urine and it can show the doctor whether you are dehydrated or not and to what level. This is a good time to check for any infections in the bladder.
Treatment
Treating dehydration is done very effectively if you are able to replace all the lost electrolytes and fluids. The best way to carry out rehydration actually depends very heavily on the age of the person in question. It also greatly depends on how severe the dehydration is and what caused it in the first place.
When children and infants are dehydrated fever, vomiting, and diarrhea, an over the counter ORS can be used. This is a solution that has water and salts in given proportions that assist in the replenishing the body with electrolytes and fluids. An older child can be given a sports drink that has been diluted.
For adults who have mild or moderate dehydration due to vomiting, fever, and diarrhea, the condition can be improved by taking drinks such as water. Diarrhea can be made worse by soft drinks and fruit juice that is full-strength.
When you are exercising outdoors and the weather is humid and/or hot, take cool water. The sports drinks have electrolytes but ensure that they do not have caffeine. A carbohydrate drink is also one of the best drinks for dehydration.
When dehydration is very severe, the person needs to be taken to the emergency room. In such a case, fluids and salts are usually delivered intravenously so as to encourage quick absorption and quicker recovery.
