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H2O for Health: The Critical Importance of Hydration for Elderly
Brenda Peralta

Fact Checked And Medically Reviewed By Edit Lepine, Certified Holistic Nutrition Practitioner

By Brenda Peralta, Registered Dietitian and Health Coach

Last Updated on January 3rd, 2024

Geriatric Nutrition

H2O for Health: The Critical Importance of Hydration for Elderly

Most people struggle with drinking enough water. Older people are no exception. The problem is that older adults are more at risk of dehydration. They have a higher need for water; some depend on their family members to stay hydrated. 

According to research, up to 60%1 of older adults don’t drink enough water daily. 

Not getting enough water can affect overall health, leading to signs of lethargy, rapid heart rate, dry mouth, and severe drop in blood pressure. 

This article will discuss the importance of water in older adults. It will also review how to determine signs of dehydration, practical tips to help older adults drink more water, and what caregivers can do about it. 

Decoding Hydration: 6 Reasons Why the Elderly Are at Risk

The normal water levels in the body are between 45% to 60%. These ranges may vary depending on body composition, age, gender, and other factors. 

Dehydration happens when the body doesn’t have enough fluid in the cells or blood vessels. 

The body normally gets enough water from food and drinks. However, some factors can increase the risk of losing or not getting enough water through diet. Psychological, physiological, or external causes (such as medication) can all affect water levels in older adults. 

So, what causes dehydration in the elderly? 

  1. Underlying medical conditions, such as urinary continence, can result in older adults drinking less liquids to avoid going to the bathroom. 
  2. Mobility problems can make it harder for older adults to get enough water on their own. As a result, they may rely on other adults to get their daily liquid intake. 
  3. Memory problems may cause older people to forget how much water they are drinking or to ask for something to drink. 
  4. Depending on families or staff (in case they live in nursing homes), it can make it more challenging to get all their water intake. 
  5. Older adults struggle to swallow, causing them to drink fewer liquids. 
  6. Some medications (like diuretics) can increase the risk of water loss through frequent urination, meaning their water intake is higher. 

The problem is that hydration plays a crucial role in older people. It helps improve digestion, manage kidney function, maintain urinary health, boost brain function, enhance metabolism, and diminish thirst. This means that keeping adequate hydration levels in older adults is highly important. 

How to Recognize Dehydration in the Elderly

Since water plays a crucial role in the body, it’s important to understand the symptoms associated with dehydration. 

However, keep in mind that research2 shows that the presence of a lack of symptoms is not an accurate diagnosis of dehydration. 

If you struggle or think one of your family members is experiencing dehydration, make sure you speak with a healthcare provider for the correct diagnosis (through blood work and physical examination). 

With that said, these are 13 symptoms that may indicate dehydration in the elderly. 

  • Fatigue and weakness
Fatigue and Weakness in elderly

  • Headache
Headache in elderly man

  • Dry mouth 
Dry Mouth in elderly
  • Dry skin 
joint pain in elderly
  • Dizziness
headache in elderly women

  • Weakness
an elderly is trying to walk
  • Delirium 
Delirium in elderly

  • Sunken eyes 
Sunken Eye in elderly women

  • Less frequent urination 
Less frequent urination in elderly
  • Dark-colored urine 
Dark colored Urine in elderly

  • Low systolic blood pressure
Low systolic blood pressure in elderly

  • Muscle cramps (loss of electrolytes) 
Muscle cramps (loss of electrolytes) in elderly

  • Flushed skin 
Flushed Skin in elderly

Mood may also be affected due to dehydration, especially for people with dementia. They may show signs of anxiety, crankiness, or confusion. 

What Happens When an Elderly Person Gets Dehydrated

The consequences of dehydration depend on the severity and duration of dehydration. The short-term results are the ones previously mentioned as possible symptoms of dehydration. 

But in the long term, it can cause:

  • Problems in bowel movements (constipation)
Problems in bowel movements (constipation) in elderly
  • kidney problems
kidney problems in elderly

  • Urinary tract infections
Urinary tract infections in elderly

  • Cognitive problems
Cognitive problems in elderly
  • Increased risk of falls
Increased risk of falls in elderly

  • Delayed wound healing, leading to more open sores and ulcers 
Delayed wound healing, leading to more open sores and ulcers in elderly

Hydration Help: 6 Practical Tips and Products for Seniors

Before discussing practical ways to help increase water intake, knowing how much water each person needs is important. 

The recommended water intake is at least half your body weight (pounds) in ounces of water. 

This means that if you weigh 200 lbs, you should drink at least 100 ounces of water. 

For a more personalized recommendation, talk to a health professional who can review your medical history and determine if you need more or less water. 

There are simple ways to increase the water intake in older adults. Here are some useful tips. 

1. Provide variety. Drinking plain water can get boring after a while. To spice things up, add flavoring, tea bags, or sliced fruits and vegetables to make the water more appealing. One of my favorite recipes is to slice up strawberries, cucumbers, and lemon. 

Variety of drinks for elderly

2. Include electrolyte-rich drinks. Sometimes, offering electrolyte beverages can help reduce muscle cramps. However, opt for a low-sugar version and consume in moderation if you have heart disease.

Electrolyte rich drinks for elderly

 3. Hydration balls. Some innovative options, such as edible water balls, can make things easier. The manufacturers of edible balls created them to help people with dementia increase their water intake.

Hydration Balls

4. Consider setting a schedule. It can be easier to track the water intake of older adults if you set a schedule. This means setting smaller goals with reminders throughout the day. For example, setting an alarm to drink 20 ounces of water before 10 AM.

Tracking water intake by elderly women

5. Use different glasses. Each person has preferences when it comes to drinking. Some older adults may prefer a glass that contains a lid and a straw.  

Different type of glasses for drinks for elderly

6. Avoid alcohol and caffeine. Alcohol and caffeine can increase urination, leading to possible dehydration. If the older adult likes to drink coffee, opt for a caffeine-free option (or decrease the frequency throughout the day). 

Avoid Alcohol and caffeine for elderly

Beyond Water: The Role of Diet in Senior Hydration

Beverages are not the only way to increase the water intake. Foods are also a good source of water. That is why including high-water foods can help older adults reach their water intake without solely relying on beverages. 

Therefore, having adequate fruit and vegetable consumption is crucial. Not only do they provide essential vitamins and minerals, but they are also a source of water. They also contain fiber, promoting good digestion and bowel movements. 

The following foods are 80%–90% water, which can help you reach your water intake. 

  • Watermelon
  • Strawberries
  • Cantaloupe
  • Peaches
  • Oranges
  • Cucumber 
  • Lettuce
  • Zucchini 
  • Celery
  • Tomatoes 
  • Bell peppers
  • Cauliflower 
  • Cabbage
  • Grapefruit 
  • Coconut water

Each fruit and vegetable offers a different nutrient. Instead of relying on just one food, ensure you offer variety in the diet. 

While these foods are high in water, remember that they only account for 20% of the daily water intake. You should still strive for most of the water coming from beverages. 

Supporting the Care Circle: Guidance for Caregivers and Family

Knowing the importance of hydration for the elderly can prevent any possible dehydration cases. Also, knowing the signs of dehydration can allow you to take action and consult a health professional before it develops into more serious symptoms. 

If you’re a caregiver, ensure you have an open source of communication with the older adult you’re taking care of. This will help you create the best action plan that fits their needs without them feeling they have no say. 

If you want to take more actions to help increase water intake, make sure you carry a water bottle around, especially when going out. This can help you stick to the water routine and make reaching it easier. 

For those who still have questions regarding the best sources of hydration or how much water each person needs, talk with a health professional. They can guide you on the best approach to ensure you cover basic needs. 

Takeaway

Hydration plays a crucial role in overall health. Low hydration can lead to symptoms such as mood problems, impaired cognitive function, fatigue, headaches, and less frequent urination. While we all struggle to get our daily recommended water intake, older adults are at a higher risk of developing dehydration. 

Since older adults rely on other people, they may need help to reach their daily intake. Certain medical conditions or medications can also put them at risk of dehydration. 

Knowing the signs of dehydration and what to do about it can help prevent long-term complications and make things easier for family members and older adults. Encourage a safe environment for them to ask what they need, whether food or drinks. 

Sources

1.Li S, Xiao X, Zhang X. Hydration Status in Older Adults: Current Knowledge and Future Challenges. nutrients. 2023;15(11):2609-2609. doi:https://doi.org/10.3390/nu15112609

2.Fortes MB, Owen JA, Raymond-Barker P, et al. Is This Elderly Patient Dehydrated? Diagnostic Accuracy of Hydration Assessment Using Physical Signs, Urine, and Saliva Markers. Journal of the American Medical Directors Association. 2015;16(3):221-228. doi:https://doi.org/10.1016/j.jamda.2014.09.012

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Brenda Peralta

Written By

Brenda Peralta

Registered Dietitian and Health Coach

Brenda is a Registered Dietitian and health coach with over nine years of clinical experience. But besides being a registered dietitian, she has certifications in sports nutrition, precision nutrition, diabetes education, women’s health specialist, fertility advisor, and gut health.

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