Dehydration in the Elderly: Signs and Prevention

There are a variety of reasons why dehydration occurs more frequently in elderly populations. Most of these relate to the aging process and its inevitable effects on the body’s function.

Here are some expected age-related changes that contribute to an increased risk of dehydration:

• Reduced sense of thirst. As your loved one ages, their body’s ability to detect and respond to fluid imbalance deteriorates, and it becomes natural for them to drink less water. Essentially, when their sense of thirst is compromised, they won’t think to drink water as much on their own.
• Decreased mobility. Many seniors start to lose their ability to navigate previously familiar spaces confidently and safely. Because they can’t move around as easily as before, they might find it difficult to get drinks for themselves and will be more likely to rely on caregivers to help them stay hydrated.
• Medications. Certain medications, such as diuretics or drugs used for chemotherapy, can increase the risk of dehydration through fluid loss in urine and sweat.
• Cognitive changes. Seniors living with diseases such as Alzheimer’s and other forms of dementia are at even greater risk for dehydration because they’re more likely to forget to hydrate on their own. They’ll need frequent reminders to drink water.
• Existing health conditions. Diagnoses such as diabetes, certain gastrointestinal disorders, cancer, or renal impairment can increase an older adult’s risk of dehydration.
• Common illnesses. Immune systems naturally decline as the body grows older. Elderly individuals are more susceptible to viral conditions, such as the common cold, upper respiratory infections, and gastritis. Such illnesses can compound an already weakened sense of thirst or worsen dehydration through symptoms such as fever, sweating, vomiting, and diarrhea.

If one or more of the risk factors listed above is affecting your loved one, it’s essential for you to monitor their fluid intake and encourage hydration as much as possible.

Read related article:8 Dementia Symptoms to Track in Elderly Parents

Let our care assessment guide you

Recognizing risk factors contributing to elderly dehydration is crucial, but it’s equally important to know how dehydration will manifest in seniors. Symptoms of dehydration in older adults may often be difficult to recognize.

Common signs of elderly dehydration include:

• Dizziness
• Fatigue
• Muscle cramps
• Dry mouth
• Sunken eyes
• Decreased urination or low urine output
• Dark-colored urine

Serious signs of severe dehydration include: ^[02]

• Rapid heart rate
• Difficulty walking
• Fainting
• Hyperthermia
• Disorientation

How to evaluate a senior for dehydration symptoms

Though we may easily recognize problems such as dizziness, nausea, and cramping as symptoms of dehydration, there are other subtle ways that dehydration in elderly adults may show. Lethargy and confusion could indicate fluid and electrolyte imbalances.

Another way caregivers can evaluate when assessing for dehydration in older adults is by checking for the loss of skin turgor. Turgor relates to the amount of pressure or fluid present in cells, so if skin turgor is low, it’s likely that cells are dehydrated.^[03]

The best way to assess skin turgor is by gently pinching and pulling upward on the skin that covers the back of the hand. After a few seconds, let go of the skin and observe how quickly it returns to its original place. If the skin “tents” or takes more than a few seconds to return to normal, this may indicate dehydration.

There are several ways that caregivers can help prevent dehydration in seniors. The simplest intervention is making sure that their fluid intake is sufficient.

Here are some other practical tips to help you ensure that your loved one stays hydrated and healthy:

1. Provide them with regular verbal and written reminders to drink water. Encourage hydration as often as possible, even if your loved one says they aren’t thirsty. Remind them they may not always feel thirsty when their body needs water. You could also post written reminders to hydrate where your loved one is most likely to see them, like leaving a note on the refrigerator or bathroom mirror.
2. Encourage hydration throughout the day. Some older adults do well with visual goals for hydration. For example, using a drinking cup that has marks to help them see how many cups of water they’ve already consumed and how many they have left to drink within a day. However, this might not be the best approach for older adults with memory and mobility issues. If using a bigger container is too much for your loved one, adjust to their needs by reminding them to take a few sips of water anytime they’re eating or taking medicine and at the beginning or end of each day.
3. Make sure they have access to water. For seniors with limited mobility or cognitive impairment, you’ll need to make sure their water access is unrestricted. Caregivers can do this by ensuring seniors always have a glass of water within reach to make it easier for them to hydrate independently.
4. Provide them with options. When it comes to hydrating, water knows no equal. But not everyone enjoys the taste of water, no matter how much it benefits their health. If they prefer something with more flavor, explore other options like coconut water, flavored sparkling water, or milk. Drinks like coffee, tea, and wine can cause increased urination, so these are options to avoid when possible.
5. Use food as a source of hydration.Certain foods can help with hydration because they’re primarily composed of water. Fruits, vegetables, and soups fall into this category. One thing to consider when offering soup is sodium content. Choosing low-sodium options is ideal because high sodium content can have an effect similar to coffee and tea.
6. Use medications as an opportunity. Though most older adults won’t need a full glass of water to finish their medications, this is an opportunity for you to encourage them to drink a whole glass.
7. Monitor their urine output and color. If you notice your loved one is urinating less or see that their urine has a darker tint, prompt them to drink more water and observe to see if urinary output increases and urine color becomes lighter.
8. Keep them hydrated when they’re out and about. Mobile seniors need to hydrate wherever they go. Caregivers should always keep water with them, and older adults must stay hydrated after any physical exertion or when in hot and humid environments.
9. Care for loved ones in senior living. If your parent or loved one resides in a nursing home or an assisted living community, ask their care team about programs and resources available to promote hydration. There may be specific measures or plans that these health care professionals can implement to ensure that residents hydrate sufficiently.
10. Discuss fluid intake with their physician. Certain health conditions and medications may affect an individual’s recommended fluid intake. Older adults and their caregivers should discuss the recommended amount of fluid they need to consume each day to prevent dehydration.

Talk with a Senior Living Advisor

Consequences of elderly dehydration

Dehydration in elderly adults can have serious consequences and contribute to increased urinary issues such as kidney stones and UTIs. In severe cases, it can precipitate a serious injury such as a fall or shock.^[01] Keeping seniors hydrated is one of the most practical ways to prevent unnecessary falls or illnesses.

If you’re concerned about your loved one’s nutrition or ability to stay hydrated, or if your aging parent requires help with daily tasks, consider talking to one of our Senior Living Advisors. They can recommend home care or senior living options that may improve your loved one’s quality of life.