Why water matters — preventing dehydration in seniors

BY JA Strom —
A little H2O can go a long way to preventing what can be a dangerous condition.

Dehydration in the elderly can often be misdiagnosed, as symptoms can mimic those of dementia. Confusion and disorientation, which aren’t normal at any age, may be the first clues. And it’s a common problem — one of the 10 most frequent admitting diagnoses for Medicare hospitalization. Certain common medications like diuretics or laxatives can make dehydration worse.

Usually we rely on feeling thirsty to tell us we need to have a glass of water. But seniors, as young as 60, can’t depend on the usual signals, because we have a reduced sense of thirst as we age.

And the elderly have less water content in their bodies. As we lose body mass (muscle mass), water levels decrease. An average healthy 30- to 40-year-old has a total-body water content of 55 to 60 percent. By age 75 to 80 years, the total-body water content has declined to 50 percent, with even more of a decline in elderly women.

Signs and symptoms of dehydration include:

• Mild to excessive thirst
• Fatigue
• Headache
• Dry mouth
• Little or no urination
• Muscle weakness
• Dizziness
• Lightheadedness
• Confusion and forgetfulness
• Deep rapid breathing or an increased heart rate.

The solutions are easy — drink before you feel thirsty (doctors warn that dehydration can creep up on you).

The critical question is how much should you drink

The medical community is no longer recommending eight glasses of water a day. How much water you need to keep hydrated is dependent on many factors — your activity, your weight, the climate you are in, your health, etc. People with heart conditions, high blood pressure or swelling of the lower legs (edema) need to avoid excess water. If you have any health concern, you may want to talk to your doctor about what your ideal fluid intake would
be.

Water doesn’t have to be the only source of fluids. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.

For example, many fruits and vegetables — such as watermelon and cucumbers — are nearly 100 percent water by weight. Beverages such as milk and juice are also composed mostly of water.

How much water is enough is more difficult to ascertain for the elderly

If you have an elderly relative hospitalized, in a nursing home or one who is dependent on others for care, special attention is needed.

Many elderly deliberately reduce their fluid intake to decrease incontinence and eliminate embarrassment. Women are more likely to avoid fluids then men. Inadequate fluid intake, which often results in dehydration, makes the elderly more susceptible to urinary tract infection, pneumonia, pressure ulcers, hypotension, confusion and disorientation.

Because so many factors affect the amount of water or other liquids an elderly person needs — age, weight, overall health — the first step is to discuss the subject with your relative’s doctor.

Then follow up to make sure that he or she is getting that amount, either through meals or making sure that liquids are available during the day and perhaps by the bedside at night.

It’s another case where a little prevention can go a long way to healthy aging.

(Posted September 17, 2008)