Signs and Symptoms of Winter Dehydration in the Elderly and 8 Ways to Avoid Them

Dehydration can kill. It is crucial for anyone to stay properly hydrated but it is even more important for seniors who have other comorbidities as well as dementia like diseases. One of the reasons that the dehydration threat is higher for seniors is because of thinner skin that comes with aging. The thinner skin makes a person more prone to losing fluid. Another issue that makes seniors more open to fluid loss is their medications, some medicines can cause you to become easily dehydrated.

A wide array of medical issues can lead to dehydration. Considering that our bodies are made up of 50% to 65% water, this element is critical to virtually all our physical functions. Every organ and system of the body depends on water, so a shortage of fluid can naturally lead to serious health consequences. Dehydration is one of the most frequent causes of hospitalization among people over the age of 65. Worse, at least one study has found that about one-half of those hospitalized for dehydration died within a year of admission. Older people are at greatest risk for dehydration because the mechanism that normally triggers thirst becomes less sensitive with age. In addition, as we age, a lower percentage of our body weight is water, so dehydration can occur more rapidly. Those elderly individuals most vulnerable to dehydration live alone, especially when they are ill. In addition to fluid lost from fever from flu, or diarrhea from a stomach virus, sickness usually interferes with normal eating and drinking patterns. We lose water in many ways.

* Breathing results in humidified air leaving the body
* Diarrhea is the most common reason a person loses excess water. A significant amount of water can be lost with each bowel movement. Worldwide, dehydration from diarrhea accounts for many of the deaths in children.
* Vomiting can also be a cause of fluid loss; as well, it makes it difficult to replace water by drinking it.
* The body can lose significant amounts of water when it tries to cool itself by sweating. Whether the body is hot because of the environment (for example, working in a warm environment), intense exercising in a hot environment, or because a fever is present due to an infection, the body loses a significant amount of water in the form of sweat to cool itself. Depending upon weather conditions, a brisk walk will generate up to 16 ounces of sweat (a pound of water).
* In people with diabetes, elevated blood sugar levels cause sugar to spill into the urine and water then follows. Significant dehydration can occur. For this reason, frequent urination and excessive thirst are among the symptoms of diabetes.
* Burn victims become dehydrated because water seeps into the damaged skin. Other inflammatory diseases of the skin are also associated with fluid loss.
* The inability to drink adequately is the other potential cause of dehydration. Whether it is the lack of availability of water or the lack of strength to drink adequate amounts, this, coupled with routine or extraordinary water losses, can compound the degree of dehydration.
* One common side effect of many medicines is increased frequency of urination. You need to compensate for these additional lost fluids by drinking more than usual. Medications that often cause this problem are diuretics, blood pressure drugs, antihistamines and psychiatric drugs.
* The aging process can diminish our natural sense of thirst, but if you also suffer from incontinence, you may be reluctant to drink fluids throughout the day. Sipping often in small amounts is essential to avoid becoming dehydrated.

The body's initial signs and symptoms of dehydration are:

* Thirst
* Decreased urine output. The urine will become concentrated and more yellow in color.
* Fatigue
* Headache
* Dry nasal passages
* Dry, cracked lips dry mouth the eyes stop making tears sweating may stop muscle cramps nausea and vomiting lightheadedness (especially when standing). weakness will occur as the brain and other body organs receive less blood.
* Coma and organ failure will occur if the dehydration remains untreated.
* Irritability & confusion in the elderly should also be heeded immediately.

Here are some easy remedies and ways to prevent dehydration:

1. As is often the case in medicine, prevention is the important first step in the treatment of dehydration.
2. Fluid replacement is the treatment for dehydration. This can include: water, juice, soups and clear broths, Popsicles, Jell-O, ice cream, milk, puddings, decaffeinated beverages, Kool-Aid, nutritional drink supplements (Ensure, Boost, Sustacal, Resource and instant breakfast drinks), and replacement fluids that may contain electrolytes (Pedialyte, Gatorade, Powerade, etc.)
3. Reduce or eliminate dehydrating beverages such as coffee, tea and soft drinks (unless decaffeinated). But even decaffeinated drinks can contribute to dehydration. Beware of alcohol intake too. Alcoholic beverages increase risk of dehydration because the body requires additional water to metabolize alcohol and it also acts as a diuretic.
4. If you drink the unhealthy beverages, you need to add even more water to you daily total. The dehydration caused by those drinks must be compensated for by increasing the water.
5. Eat lots of fruits and vegetables. Most have a high water content.
6. Drink water all day long in small amounts. It is not good to suddenly gulp down 64 ounces of water. You can fill a 24-32 ounce tumbler in the morning, refill it by late morning and refill again for the afternoon. Consume that by 5 PM. Most people need to start limiting fluids 1-3 hours before bedtime.
7. Individuals with vomiting and diarrhea can try to alter their diet and use medications to control symptoms to minimize water loss. Acetaminophen or ibuprofen may be used to control fever.
8. If an individual becomes confused or lethargic; if there is persistent, uncontrolled fever, vomiting, or diarrhea; or if there are any other specific concerns, then medical care should be accessed. Call 911 for any patient with altered mental status - confusion, lethargy, or coma.

Remember that the lack of a sense of thirst is not a reliable indicator of the need for water. You need water long before you feel thirsty.

Dr. Thomas is a retired psychiatrist who is in the early stages of Lewy Body Dementia and Alzheimer's disease. He promotes education for senior citizens to maintain good health and about the signs and symptoms of the various dementia-like illnesses. He emphasizes preventative measures as well as treatment options for neurodegenerative diseases. He posts on a daily basis to his blog called "A Diary of a Physician Psychiatrist with Lewy Body Dementia and Alzheimer's Disease." He enjoys knitting, reading, playing number and word games as well as doing other brain training exercises. He and his wife live in Northwestern Pennsylvania. His blog can be read at http://knittingdoc.wordpress.com