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Common Questions About Dehydration in the Elderly

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Common Questions About Dehydration in the ElderlyWhat is dehydration?

Dehydration is a state where the water volume in the body is significantly lower than normal. It is not just water that is lost. Essential salts known as electrolytes are also passed out along with the water. Collectively the water and electrolyte loss affects the various processes in the body, leading to a host of complications and even death if it is not treated.

Who is at risk of dehydration?

Dehydration can occur in any person of any age in certain situations. However, it is more likely to occur in the elderly for various age and disease related reasons. Dehydration occurs when the water loss, either through sweating, urination, profuse vomiting or severe and prolonged diarrhea, exceeds to water intake and retention in the body. This fluid loss can be rapid or slow and dehydration will occur if fluid replenishment does not at least match the fluid loss.

Why are the elderly more at risk of dehydration?

As a person gets older and especially with the onset of certain chronic diseases, the body’s ability to signal thirst and retain water are impaired to varying degrees. Debilitated patients may also experience difficulty in regulating fluid intake without the help of an attentive caregiver. This gradually leads to a point where the overall fluid volume in the body is lower than normal resulting in a state of dehydration.

The greater risk occurs in hot weather and particularly with a heat wave. Here the normal thirst mechanisms may not signal the need to consume more water as is appropriate for the change in weather. If a senior is not attentive in this regard and drinking fluids constantly even if not thirsty, dehydration will rapidly set in. Medication is often another factor as some drugs more commonly used by seniors can increase water loss.

What are the symptoms of dehydration?

The elderly should be vigilant about the signs and symptoms of dehydration. These features include :

  • Dry parched mouth
  • Cracking lips
  • Dry skin
  • Fatigue and sleepiness
  • Headaches
  • Constipation
  • Dizziness
  • Thirst
  • Reduced urine output
  • Less sweating than would be expected.

More severe and serious symptoms arise as the dehydration worsens. This can cause a noticeable difference in physical appearance, changes in heart rate and blood pressure, fever, delirium and unconsciousness.

Will I feel thirsty when dehydrated?

Thirst is also a symptom of dehydration but the elderly especially should not depend on the lack of thirst to ignore the possibility of dehydration. It is often misleading as the elderly may often have the symptoms of dehydration but since they are not feeling thirsty they tend to look at other causes for these symptoms. Age, disease and medication can affect the thirst mechanism.  A person should rather consider the amount of fluid lost, the setting such as hot weather and the signs and symptoms of dehydration as a more accurate indicator of dehydration.

How to prevent and treat dehydration?

Water is the main component in treating and preventing dehydration. The water content in the body has to be replenished. However, water alone is not sufficient. Electrolytes also need to be replenished. Many people opt for soft drinks but the caffeine, preservatives and colorants in some of these beverages can increase water loss. These substances are therefore referred to as diuretics. The same applies to tea , coffee and alcoholic beverages.

The more reliable solution in preventing and treating dehydration is to use oral rehydrating solutions (ORS). These are usually available in sachets which can be added to water and is easily available at most supermarkets and pharmacies. It contains the correct electrolytes in the right quantities for proper rehydration. A person who is vomiting profusely or is not conscious to drink fluids cannot be rehydrated orally. Instead an IV drip needs to be set up so that saline can be administered through the vein.


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