Dehydration in the elderly: Symptoms and Causes

It goes without saying that staying hydrated is very important for the human body to function properly and for us to stay healthy, especially the elderly. And as sixty percent of our body is made of water it is vital that the elderly especially drink enough fluids to ensure that their mind and body work efficiently. 

What is dehydration?

Maintaining proper hydration is very important for overall health, particularly for the elderly. With our body being composed of approximately 60% water, it is crucial that older people drink enough fluids for optimal mental and physical function. 

Dehydration is a result of insufficient fluid and electrolytes in the body, and it happens when more water is lost or used by the body than what is consumed. 

The body’s ability to retain water effectively may decline as age progresses, so many people encounter difficulties in maintaining good hydration levels as they grow older. Renal function starts to decline with advanced age, so excessive loss of body fluids ends up accelerating dehydration. 

What are the signs of dehydration? 

Common symptoms include extreme thirst, dry mouth, tiredness and decreased urination. In older people, dehydration can manifest as cracked lips and sunken eyes. 

Some people may experience headaches and fatigue. A prolonged dehydrated state can lead to dizziness, disorientation, mood swings, and in more severe cases, unconsciousness. 

What causes dehydration in the elderly? 

• Certain medication or health conditions. Underlying health conditions may cause increased water loss through urination, and certain medications can impact how water is absorbed or discarded by the body.  

• Decline in kidney function. More water may be lost through urination as kidneys start do decline with age. 
• Inhibited thirst response. As thirst response becomes weaker with advanced age, older adults tend to go longer periods of time without drinking water or other fluids. 

Prevention and Management of Dehydration

Identifying why the individual is not consuming enough fluids is one of the best ways to prevent dehydration. If there are physical barriers or difficulties in reaching a drink, for example, it is expected that inadequate fluid intake will happen. 

With changes or decrease in physical strength, there can be a fear of frequent urination before reaching the toilet, which makes older people avoid drinking the necessary amount of water. 

These examples can be prevented by providing enough water within reach, as well as ensuring that their mobility can be supported to reach the toilet in time.  

To increase the daily fluid intake and reduce the symptoms of dehydration, it is also important to provide the elderly with fresh and palatable water or other favourite fluids, perhaps by adding a slice of fresh lime or frozen fruit to add flavour.  

Tips to improve hydration

• Track fluid intake to ensure at least 6-8 cups of fluid are being ingested daily 

• Consume water-rich goods like fruits and vegetables 

• Avoid drinks that speed up dehydration such as coffee, alcohol and soft drinks 

• Incorporate flavourful drinks. Fruit juices, cordials mixed with water or non-caffeinated tea are great options to enhance hydration. 

Dementia and hydration challenges

An older person living with dementia may experience more difficulty in managing appropriate levels as behavioural and cognitive changes impact fluid intake. 

Medications that cause a diuretic effect, forgetting to drink or the ability to communicate when they are thirsty, are common aspects of the experience of someone living with dementia. A speech pathologist can help with the more severe issues with dysphagia.  

Being aware of the causes, symptoms and how to manage dehydration, caregivers can make a substantial difference in helping mitigate dehydration-related complications and enhance the wellbeing of elderly people.