Dehydration in elderly people – drinking enough and often

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Anyone who looks after an elderly relative is likely to be familiar with the difficulties in trying to get them to drink regularly to stay hydrated.  Dehydration particularly those who live alone or in care homes is a big issue when they are admitted to hospital. This is our guide to avoiding dehydration in elderly people, and tips to drink enough and often.

As we get older, the bladder becomes less able to hang on. One of the problems is the fear of having to get up to go to the loo in the night, or worse, incontinence. The obvious solution is not to drink too much, but dehydration can lead to serious health problems.

Going to the loo at night

needingthetoiletatnightSo, there is a real dilemma and it can be so hard to acknowledge the need to change such a personal habit which has such humiliating consequences, but drinking very little is not a solution to avoiding incontinence.  The refusal to drink enough amongst the elderly is a real problem.  The fear of falling over because of mobility issues or failing eyesight is more than enough to stop someone going to the loo in the night, but here are a few ideas that might help:

  • Keeping a light on in the loo.
  • Plugging in a nightlight may also help.
  • Move the bed to be nearer the bathroom may make the situation easier.
  • Putting a commode in the bedroom is a great solution for people who find it hard to get around.
  • It may also make sense to protect the bed with a plastic sheet
  • Incontinence pads or night-time pants are not quite as depressing or awful as they sound; they make a big difference, and some products really don’t look like “adult nappies”.
Drinking difficulties

Sometimes a sore mouth or difficulty swallowing can put someone off having a drink  – a straw may be a helpful alternative. Or they may simply  forget that they have a cup of tea and leave it.

Physical difficulties such as poor eyesight or arthritic hands make it difficult to make drinks. Lifting a full kettle is almost impossible for those with painful or weak hands and not being able to see when you’re dealing with boiling hot water is obviously dangerous.

Drinking water is an easier option and encouraging your relative to keep a glass by them at all times, particularly at night, should remind them to drink.  But whilst the obvious solution, drinking water is quite a dull option.  So we’ve tried to consider some alternatives below.

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Dehydration has serious consequences – but how much is enough to drink?

Older people can be particularly susceptible to dehydration for various reasons. As we age bladder and kidney function deteriorate, and we usually need to go to the loo more often. Many medicines have a dehydrating effect and need more fluid intake than normal, which is often forgotten. Many elderly people simply do not feel as thirsty as they used to, and believe that they don’t need a drink.

Health problems of dehydration
  • Confusion – if  this seems worse than normal, it could be related to lack of liquids.
  • Dizziness and headaches.
  • Dry mouth, dry eyes and inability to sweat.
  • Low blood pressure.
  • Rapid heart rate.
  • Dark or smelly urine.
  • Sunken eyes.
How to rehydrate

Sickness and diarrhoea dehydrate the body, so it’s important to rehydrate as a matter of urgency. If you fear that the person you care for is seriously dehydrated for any reason you can buy rehydration solutions from a chemist or make your own.

sugarelectrolytesolutions

Sugar/electrolyte solution:

In one litre of water you put a ½ teaspoonful of salt, 8 level teaspoonfuls of cane sugar, which has been proven to be a safe sugar/electrolyte solution[1].

How to get an elderly person to drink enough

Its not easy as already mentioned, but our top tips are as follows:

  • Have regular drinks – water, coffee, tea and herbal teas.
  • Take a glass of water to bed.
  • Eat plenty of fruits, soups, and vegetables which are all water based.
  • Drink more if ill, after vomiting or diarrhoea, or if sweating a lot.

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The caffeine issue

We are a nation of tea drinkers and increasingly coffee drinkers.  Neither are great to drink in the evening because of the caffeine. In addition to interfering with sleep, too much caffeine can cause palpitations and is not advisable for certain health conditions.  Given how keen many of the elderly are on cups of tea it might be difficult to get them to cut down and replace it with another drink – maybe experiment with herbal teas. You never know, they may like one!

Alternative drinks for the elderly

Some people love herbal teas, others hate them and plenty have never tried them. They do not contain caffeine and can be very soothing to the stomach or even improve sleep quality.

  • Chamomile tea can soothe a bad stomach, and it encourages sleep.
  • Peppermint tea is a great digestif and is excellent to drink after a meal.
  • Lemon and ginger tea is particularly good if you have a cold.
  • Green tea has many health benefits, is not acidic, and is believed to keep illness at bay. However, it does have caffeine in it, so it is not a good substitute in the evening.

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Fruit juices and smoothies

These are even better if they are home made – and  blenders and juicers are easily available and certainly more affordable these days.   They’re a great way of using fruit and veg from the garden, or on that odd occasion when either may be lurking a bit unloved in the fridge….

For those with arthritis or digestive problems bottled or packet fruit juices might be too strong – orange, grapefruit and tomato juice are not advisable, but apple juice (and pineapple juice)  is less acidic.

Read our blog: https://www.agespace.org/dying-thirst-6-ways-keeping-elderly-hydrated/

Soft drinks: fizzy drinks are not advisable

As mentioned in  Healthy Elderly Bones, fizzy drinks have an abundance of phosphorus which strips calcium from the body. They are also high in caffeine, and sugar which can cause too much production of glucose and lead to diabetes.  Alternatively, they may contain artificial sweeteners which have a number of side-effects.

Cordials and squashes

For those who don’t like drinking straight tap water, mineral water – still or sparkling – might be a better choice. Squashes and cordials flavour tap water, but it’s always worth checking ingredients because they either have high levels of sugar or artificial sweeteners. A bit of sugar is not a problem if drunk in moderation.

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Alcohol for the elderly

Some people stop drinking as they get older, or they cut it down to the bare minimum mainly because alcohol disagrees with them. The body is less able to deal with the effects of alcohol as we age and it is dehydrating, but some people have their favourite tipples which they want to carry on drinking.

How much is too much?

The government’s recommendations are reduced for the elderly to 11 units a weeks or 1½ units a day.  A unit is equivalent to a glass of wine or half a pint of lager. We frequently hear that a glass of wine can be good for you and, lets face it, a little of what you fancy does you good.  So who are we to pontificate on the subject of booze?

 

 [1] S Afr Med J. 1986 Dec 6;70(12):728-30.  The composition of home-made sugar/electrolyte solutions for treating gastro-enteritis.

Buccimazza SSHill IDKibel MABowie MD.

Frances Ive is a health writer and author who has had over 100 articles published in national newspapers and consumer magazines. She is a member of The Guild of Health Writers.