Fluid and electrolyte imbalance pose a threat to the normal functioning of the human body.
When they accompany an underlying pathology or a compromised immune system, fluid and electrolyte problems can be fatal. Dehydration is the most common condition in this regard. While it has a high prevalence in the general population, it is the elderly who suffer from dehydration more often . Therefore, caregivers need to know how to maintain fluid balance in the elderly and how much fluid should an elderly person drink a day.
As most people from the geriatric population have some underlying pathologies, frequent episodes of dehydration can worsen their health conditions. Outcomes of studies conducted across the globe suggest that more than half the cases of dehydration among the elderly require hospital admission and long term care (LTC).
Dehydration As A Medical Condition
A sudden reduction in fluid intake, pathological loss of water, or a combination of both are alarming signals of dehydration that require immediate medical intervention.
The clinical outcomes of severe dehydration can be critical. Dehydration is an independent predictor of mortality. It means that an increased incidence of dehydration in any age group is an indicator of worsening health conditions. When we describe dehydration as a medical condition, then it is essential to understand and distinguish between three types of water depletion mechanisms in the body- hypotonic, isotonic, and hypertonic.
These water depletion mechanisms in the body depend on the sodium levels in the blood. So, hypotonic dehydration occurs when the amount of sodium lost from the body is greater than the water loss. Conversely, hypertonic dehydration involves greater loss of water and higher sodium retention. Both types are harmful to the different organ systems of the body.
This fluctuation in sodium levels that accompany the changes in fluid and electrolyte concentrations in the body are also independent predictors of mortality. In all, the situation is critical when dehydration persists for long.
Dehydration In Elderly
The prevalence of dehydration in older adults is higher than that in the younger populations. Three major factors cause dehydration in the elderly.
- The first factor is that as they age, the water and salt homeostasis in the body declines. It means that the body’s natural ability to ensure ideal concentrations of water and salt does not work adequately. This happens because in old age the fat concentration in the body increases while the lean body mass decreases. Moreover, as we age, the structural and functional composition of the kidneys change. Due to this, there is an alteration in the sodium levels in the body, which cause dehydration.
- The second cause of dehydration in the elderly is that in old age the alteration of the neural mechanisms causes a decline in thirst sensation. So, the elderly do not drink enough water to rehydrate themselves. Even if neural mechanisms do not change drastically, some elders voluntarily reduce water consumption. It is because the urinary bladder muscles become weak and cannot hold urine for too long. Fearing this bladder incontinence and the urge to urinate frequently, they avoid drinking water.
- The third factor that influences the occurrence of dehydration in the older population is the prevalence of chronic illness among these people. Dehydration is a common symptom of several underlying pathologies relating to the kidneys, brain, etc.
While these three factors are the major reasons for dehydration in the elderly, one cannot deny that the side effects of polypharmacy also lead to dehydration. In the elderly population suffering from high blood pressure and cardiovascular diseases, a group of drugs called Furosemides purposefully increase water excretion to manage blood pressure.
How Much Fluid Should An Elderly Person Drink A Day
To compensate for the excess water loss in the elderly, you need to increase their fluid intake. As per research and recommendations of doctors, the elderly should drink approximately 1.7 liters of water per day. If we measure this amount in glasses or cups, then an elderly needs to drink at least seven cups of water in a day.
This value does not account for regional differences in body types and conditions. So, a universal formula was derived to know the ideal water intake for the elderly. As per the formula, the elderly should drink one cup of water for every 20 pounds of their body weight. It is the minimum value, and one can exceed it as well.
People living in a warm climate sometimes need more water than that. Not just the climate, but lifestyle also influences the body’s need for water. Doctors always encourage exercise for the elderly. So, if they exercise regularly, then the fluid intake should be higher than the prescribed minimum intake.
Dry mouth, scanty urine output, headache, fatigue, muscle cramps, constipation, etc. are the cardinal symptoms of dehydration. In severe cases, a drop in blood pressure, disorientation, dizziness, and even death can occur.
Note- We know dehydration can be a symptom of an underlying condition, therefore, if you identify any of these symptoms, then kindly consult a physician as soon as possible. It will help in conducting all diagnostic tests to spot any serious underlying condition.
How To Make Them Drink More Water?
Most elderly people have difficulty in making a routine for drinking more water than usual. To ensure that the elderly drink enough water in a day, you can use these suggestions.
- Keep a water bottle near them so that they can drink water more frequently.
- Encourage them to drink a full glass of water when they take their medicines.
- Give them fruits that have high water content to eat.
- Start giving them soup, tea, protein drinks, and other fluids to bring variety.
- Tell them to decrease their alcohol intake and give them low-fat milk to drink.
- Use supplements like multivitamins that help in proper functioning of the kidneys.
How much fluid should an elderly person drink a day – Conclusion
This article aimed at explaining the different causes of elderly dehydration and inform you about how much fluid should an elderly person drink a day. Dehydration is a common condition in the elderly occurring due to several organic and functional causes. As the thirst mechanism does not work properly, ensuring that the elderly drink enough water should be a goal of the nutrition and caregiving programs.