There are several unique factors that make hydration more challenging for someone 65 years or older. Older adults tend to lose muscle mass as they age and so they have reduced ability to store (or conserve) water. There is also a decreased thirst perception associated with age so this cannot be relied upon as a good indicator of whether the body needs more water. There is also the possibility of decreased renal concentrating, so you cannot rely on the color of the urine to determine if there is a problem (typically well-hydrated individuals will have lighter urine than those who are dehydrated). Caring for someone with dementia can add an additional challenge because the person may not be able to express their need for liquids or describe symptoms that may indicate dehydration.
Problems associated with dehydration can be very serious. A dehydrated person frequently experiences severe constipation, decreased functional abilities, fluid and electrolyte imbalance, increased number of falls, increased Urinary Tract Infections (which people with dementia are particularly prone to getting) and in very extreme cases, the body can go into shock and lead to death. Particular risk factors for dehydration include presence of a fever, diarrhea, vomiting, use of diuretics and under-nutrition.
There are several ways you can increase fluid intake if you are providing care for a loved one:
- Determine the person's food and liquid preferences and make sure these options are available on a daily basis.
- Provide encouragement and assistance during meal and snack times.
- Offer beverages throughout the day.
- If it helps, use a straw.
- Use smaller glasses and offer beverages more often if the amount is overwhelming in one sitting.
- If the person you are caring for has a tendency to choke or aspirate liquids, talk to the doctor about using a thickener to make swallowing easier.
- Keep a journal of food and beverage intake--if the person is consistently refusing 25% or more of the offerings, they need to be seen by a physician.
Remember too that you as a caregiver can also be at risk for dehydration as you concentrate of the care of your loved one and sometimes forget your own needs. If your loved one attends the Triple-R Program, we include water breaks 6-8 times in the day to ensure proper hydration. For more information about Triple-R go to: http://www.tripler.org/
