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Tips for Preventing Life-Threatening Dehydration Among Older Adults

Maintaining adequate fluid balance is an essential component of health at every stage of life, yet can become more challenging as we grow older and more vulnerable to shifts in water balance that can result in dehydration.

Why does hydration matter?

In older adults, adequate fluid consumption has been associated with fewer falls, less constipation, better recoveries in orthopedic patients, reduced risk of bladder cancer in men and lower rates of fatal heart disease.

Dehydration can lead to constipation, falls, adverse effects from medications, urinary tract and respiratory infections, delirium, renal failure, seizure, hypo- and hyperthermia. In older adults with other health problems, it can precipitate emergency or repeated hospitalizations and increased mortality rates among older adults.

Who’s At Risk?

• Age and ethnicity. From 1990 to 2000, hospitalizations for dehydration in older adults increased by 40 percent. Adults ages 85 years and older were three times more likely to have a diagnosis of dehydration than younger adults. Among older adults who maintain hydration, physical or emotional illness, surgery, trauma or higher physiologic demands may still increase the risk. Older black adults have higher prevalence rates of dehydration at the time of hospitalization than do older white adults.

• Certain psychiatric medications can cause dryness of the mouth, constipation, or urinary retention that can aggravate hydration status.

• A person’s level of physical dependency and cognitive impairment can cause a person to be unable or forget to drink.

• Nursing homes. According to an article in the June issue of the American Journal of Nursing, nursing home residents have habits that might put them at risk, such as those who “will not drink” due to concerns about controlling their urine or memory problems that cause them to forget to drink.

“If nurses don’t ensure older adults have an adequate fluid intake, we have seriously failed them,” said Diana Mason, RN, Ph.D., FAAN, editor-in-chief, American Journal of Nursing. “For older adults, it’s essential to have consistent fluid intake throughout the day, especially because they should not consume large amounts of fluid at one time.”

As reported in a study conducted by Janet Mentes, Ph.D., APRN, BC, assistant professor at the University of California Los Angeles School of Nursing, the following tips should be practiced for preventing dehydration:

• Identify and treat correctable causes of dehydration such as vomiting and diarrhea.

• Observe the color of the urine: Dark, concentrated urine can be a sign of dehydration.

• Provide glasses and cups that are not too large or heavy to handle, and have straws available at the bedside.

• During hot weather, be especially attentive to replacing excessive lost fluid.

• If you have an older family member or friend in a hospital, nursing home or other facility, make sure water is within reach.

For older adults, it’s essential to have consistent fluid intake throughout the day, especially because they should not consume large amounts of fluid at one time.

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