As we enter the warmer part of the year, it is more
important than ever to drink enough fluids. This is particularly true for
children and for persons 65 and older - which could be both the caregivers
and their loved ones. Not
drinking enough fluids can cause unwanted symptoms, complications from
existing disease conditions and may account for many hospitalizations of
our elders. Water and juices are the best; coffee, tea and colas with
caffeine as well as alcoholic drinks cause the body to lose fluids and are
recommended only in small amounts.
Elders are at risk for dehydration for many reasons:
-
Age related.
There is less water in the older body, greater difficulty for
the older kidney to maintain fluid balance and less thirst sensations
in older folks in general.
-
Disease-related reasons for dehydration range
from the complex to the simple. Infections such as pneumonia,
chronic obstructive pulmonary disease (COPD) and urinary tract
infections increase the need for fluids due to fevers and the
overproduction of mucus. Some diseases, such as congestive heart
failure, renal disease, stroke or other neurological disorders and
diabetes, cause changes in the function of various hormones that
regulate the fluid balance in the body. Also, there are acute reasons
for dehydration such as prolonged vomiting or diarrhea,
over-aggressive diuretic therapy and poor compliance to medication
regimens.
-
Environmental reasons.
A decrease in mobility for those with arthritis, diminished
vision or confined to bed rest who cannot as easily meet their own
needs. Those with diminished appetite or reluctance to bother others
for something as simple as assistance in getting a sip of water are
definitely at risk.
-
Medication reasons.
May cause increased fluid losses through the kidneys.
Diuretics, sedatives and laxatives are common, necessary drugs that
require close attention to fluid intake. Other drugs and alcohol can
cause the kidneys to work harder, and may damage them, making it
harder to maintain fluid balance.
-
Psychosocial reasons. This is the elder who is
cognitively impaired, and possibly unable to drink without full
assistance, or those who may intentionally restrict fluid intake in
the hopes of decreasing the risk of incontinence.
-
Economic reasons. This may include the lack of
financial resources to maintain nutritional and fluid intake, extreme
or prolonged weather fluctuations and the possibility of elder abuse.
How could you tell if your loved one might be
becoming dehydrated? Ask yourself if they have any of the above mentioned
risk factors. If they complain of nausea, are lethargic, have headaches,
vomiting or dizziness, these could all be signs of dehydration. Call your
doctor if your loved one had any or all of these symptoms.
Keep track of how much your loved one actually drinks
in a day. A simple way to do this would be to put two quarts of water in
the refrigerator first thing in the morning. Give all fluids for your
loved one from his or her special pitcher. By the end of the day, they
should have drunk most of the 2-quart pitcher. It could be plain water,
water with lemon or other fruit juices made with water. Regular tea and
coffee do not count because they promote fluid loss. Decaffeinated teas
and coffees are OK (if your loved one will not drink plain water or
juices) because they are less likely to promote urination. Foods that melt
at room temperature, such as gelatin or ice cream also have a lot of water
content. Serve foods with sauces, juices and gravies - every little bit
helps.
There are some diseases for which it is not
appropriate to offer so many fluids: congestive heart failure, cirrhosis
of the liver and kidney disease. However, for most of us, young and older,
the rule of thumb is to drink, drink, drink to keep the body hydrated, and stay away from the hospital and all the tubes and therapy
needed if dehydration does occur.
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