For the home caregiver, it is vital to understand the importance of proper hydration for the seniors in their care. For many seniors, the effects of aging — including the need for medications, cognitive impairments, physical limitations, increased sensitivity to extremes in temperature, renal function changes, thirst perception changes, and other issues — can contribute to increasing the risk for dehydration. A U.S. based study showed that 6.7% of hospitalized patients age 65 and over were dehydrated as a contributing factor of illness and 1.4% of the study group had dehydration diagnosed as the principal cause of their hospitalization.1
If let untreated or treated inadequately, dehydration in the senior care environment can have devastating effects. Dehydration in seniors can lead to additional health complications including renal failure, thrombo-embolic issues, a variety of infectious diseases, formation or worsening of kidney stones, and obstipation. It is worth noting that mortality rates were in excess of 50% in studies of seniors who received inadequate treatment or were left untreated for dehydration.2
Home caregivers responsible for senior care need to be able to recognize the warning signs of dehydration in seniors and the risk behaviors that lead to dehydration if they want to ensure the health and well being of their clients. In addition, the home care agency needs to work with the home caregiver, family members, and the seniors in their care to provide proper training on the necessity of hydration and methods of ensuring that seniors are staying hydrated.
Signs and Contributing Factors of Dehydration in the Senior Care Environment
As a 1995 American Medical Association warning pointed out, there is no absolute way to define dehydration because the symptoms may be vague or non-existent in the geriatric population. Due to this fact, many adults over the age of 65 may become dehydrated without anyone realizing it. Even so, there are some signs that an individual may be suffering from dehydration and, when these indicators are noticed, it is imperative that the home caregiver responds quickly to further assess and remedy the situation.
Atypical symptoms - Including confusion, constipation, fever, or falls may be a sign of dehydration in older adults. Unfortunately, these symptoms may also be indicators of other problems as well so they are not conclusive proof of dehydration.
Body weight changes- These are often indicative of hydration levels. Due to the fact that the human body is largely moisture, changes in the overall body weight often correspond to increases or decreases in the level of hydration in the aging adult.
Diarrhea or vomiting - These can be both symptoms or causes of dehydration.
Changes in urine color - In older adults, this indicator of dehydration may or may not occur, but if darkening of the urine is observed, further investigation of the cause is warranted.
Increases in urine volume not related to increased fluid intake - Increased urination as a result of illnesses like diabetes or drugs such as blood pressure medication or diuretics may contribute to dehydration.
Fatigue - While many older adults have less energy than they used to, extreme fatigue may be a sign of dehydration.
Dizziness - Resulting from changes in blood volume and pressure, dizziness is sometimes a sign of dehydration.
Lowered blood pressure or O2 levels - Caused by hypovolemic shock, these symptoms are often exhibited in advanced stages of dehydration.
How Home Caregivers Can Prevent Dehydration in Seniors
Encourage Seniors To Drink More Fluids - It may sound like common sense but one of the most effective ways to get seniors to consume more fluids is for home care agency staff to remind them that it is good for their overall health. As their perception of thirst diminishes, many older adults simply forget that they need to drink something even though their body still requires a certain amount of fluid to function properly.
Provide Alternatives To Drinking Plain Water - No one wants to drink the same thing day after day. Provide seniors with a variety of beverage choices such as decaffeinated tea, juice, or other options, and the home caregiver may see a drastic decrease in the incidence of dehydration.
Make Drinking Fun - Consider putting drinks in a cocktail glass or adding straws or paper umbrellas and crushed ice instead of cubes. A mock margarita, made with lemonade and ice run through the blender, can be a fun drink on a warm summer evening.
Set An Example - If the home caregiver is drinking a glass of herbal tea and then tells their client, how good it is and invites them to have one too, it is often well received especially if the caregiver has time to sit and enjoy a few minutes of conversation over the drink. As an added bonus, it gives the home caregiver a chance to catch up on how the client is feeling.
It Doesn't Have To Be Liquid To Count - High moisture foods, such as popsicles, ice cream, pudding, gelatin and soups, can help add to the overall fluid intake for seniors in the home care environment.
By using creativity and being willing to go the extra mile, the home caregiver can be the first line of defense in protecting seniors from dehydration and its related health issues.
Mahowald JM, Himmelstein DU. Hypernatremia in the elderly: relation to infection and mortality. J Am Geriatr Soc 1981;29:177-80.