The importance of hydration for seniors cannot be overstressed. In an older loved one, dehydration can occur rapidly and be life-threatening. Many older people often are not as quick to feel thirst as younger people are, so they may not be drinking enough fluids to begin with. This, combined with health concerns that might cause your loved one to reduce her fluid intake, puts the older person at high risk for dehydration.
When you are caring for an elder loved one, offer a drink of water every time you interact with him or her, and make sure she always has fresh water within reach. However, be aware that even when offered water, many older people will say, “I’m not thirsty” or, “I’ve already had too much to drink today.” You may need to be persistent in encouraging your loved one to regularly drink water.
Fluid Balance
Fluid balance occurs when the amount of fluids a person takes in equals the amount of fluids the person loses. Each day, we lose fluid in the form of urine, sweat, bowel movements and breath vapor. To maintain a state of fluid balance, we must take in enough fluid each day to equal, or balance, these losses. When fluid balance is not maintained, your loved one may develop either dehydration (too little fluid in the body) or edema (too muc h fluid in the body).
Dehydration
Dehydration can result from conditions such as vomiting, diarrhea, fever or severe blood loss. A very common cause of dehydration, however, is simply not drinking enough fluids. Many elderly people have conditions that put them at risk for becoming dehydrated. For example, a person who has problems with mobility or other disabilities may have a difficult time getting up to get a drink. Your loved one may also cut back on fluids because she is trying to reduce the number of times she needs to get up and go to the bathroom, or she is afraid that she will not be able to make it to the bathroom in time. Some seniors who are incontinent may also reduce their fluid intake because they think this will lower their risk for having an episode of incontinence. However, it is important to know that decreasing fluid intake does not decrease incontinence, nor does it decrease trips to the bathroom. In fact, the opposite may be true. As the urine becomes more concentrated, it irritates the bladder and may increase the urge to urinate, resulting in the need to urinate more frequently.
As your loved one’s caregiver, you will play an important role in helping to ensure that she takes in enough fluids. Here are some tips to encourage fluids:
- Frequently offer fluids that your loved one likes at the temperature she prefers.
- Encourage her to drink plenty of fluids with each meal.
- Frequently provide your loved one with a pitcher of clean, fresh water. Encourage her to drink each time you enter the room.
- Be sure she has a clean drinking glass or cup within easy reach. Refill the glass if she cannot do it. A drinking straw or a plastic water bottle with a screw-on lid and a straw may make it easier for some people to drink independently.
- If she frequently refuses beverages, offer fluid-rich foods instead, such as ice cream, popsicles, gelatin or fruit.
If your loved one becomes dehydrated, her physician may give an order to “encourage fluids” or “push fluids.” This means that she should be urged to drink as much fluid as possible. Encourage her to drink each time you enter the room and again on your way out. Keep a record of the amount of fluid your loved one drinks and record the total for the day on the flow sheet for her physician and for your reference.
Be on the Lookout!
Dehydration is a serious condition. If you suspect that your loved one is dehydrated, contact her physician immediately. Signs and symptoms of dehydration include the following:
- Confusion
- Poor skin turgor (the skin does not return to its normal shape when gently squeezed or pinched)
- Passing of small amounts of dark-colored urine
- Constipation
- Drowsiness
- Very dry skin or chapped lips
- Elevated temperature
Edema
Edema, or the state of retaining too much water, can result from medical conditions (such as chronic heart failure or kidney disease) that make it hard for the body to rid itself of excess water. Your loved one’s physician may place restrictions on the amount of fluid she is allowed to have each day.
When you are caring for a loved one and fluid restrictions are in place, the physician will tell you how much fluid she is allowed to have over the course of the day. Offer small amounts of fluid at regular intervals. This will help to prevent your loved one from becoming too thirsty.
Measuring and Recording Fluid Intake
When orders to encourage or restrict fluids are in place, you will need to measure and record your loved one’s fluid intake. A person’s fluid intake includes all of the liquids she drinks, as well as foods that are primarily liquid (such as soups) or that are liquid at body temperature (such as ice cream or popsicles).
Although in everyday life fluids are usually measured in ounces (oz), in health care, fluids are measured and recorded in milliliters (ml) or cubic centimeters (cc). A milliliter (ml) is equal to a cubic centimeter (cc). One ounce equals 30 milliliters or 30 cubic centimeters.
With prepackaged items, printed information on the container indicates how much it holds. For example, a small prepackaged milk container contains 8 ounces, or 240 ml (remember, there are 30 ml in an ounce). In other cases, you will need to determine how much fluid the container holds. When you are caring for your loved one and need to measure fluid intake, you can determine the amount of fluid your cups, glasses and bowls hold by filling them with water and then pouring the water into a measuring cup.
To measure and record fluid intake, observe how much fluid your loved one consumes at each meal and in between meals. For example, if she had 8 oz (240 ml) of milk, 4 oz (120 ml) of coffee and 12 oz (360 ml) of soup with lunch, you would record her fluid intake at lunch time as 720 ml. Then, if she had another 8 oz (240 ml) of tea in between lunch and dinner, you would record her fluid intake as 240 ml.
Sometimes your loved one may not consume all of the fluid in the container. In this case, estimate how much of the total was consumed. For example, if she only drank about half of her coffee at lunch, you would estimate the amount to be 2 oz (60 ml) instead of the full 4 oz (120 ml).
Remember the Importance of Hydration for Seniors – Nightingale Homecare Can Help!
As the top providers of elderly care Scottsdale and the surrounding area offer, our home health care team is always here to provide the resources you need to help older loved ones remain hydrated and healthy. Contact us at (602) 504-1555 for a free in-home consultation to learn more about our professional in-home care services and the importance of hydration for seniors.
