Dehydration and older people (detailed factsheet)

This information has been adapted (with permission) from the 'Essentials in Care' module of the E-Learning for Healthcare Programme.

What is dehydration?

Hydration

We are hydrated when we have enough fluid (water) in our body to be able to function properly.

Dehydration

Dehydration happens when our body loses more fluid (water) than we take in.

The human body cannot function without water. A person can survive up to 50 days without food, but can only survive a few days without water!

Our body needs water to:

• regulate (control) body temperature (through sweating and breathing)
  
  
• lubricate joints (to keep joints moving freely)
  
  
• dissolve nutrients and minerals for the body to use
  
  
• carry nutrients and oxygen around the body
  
  
• prevent constipation
  
  
• protect the body’s organs (like the brain, eyes and spinal cord)
  
  
• moisten tissues in the eyes, nose and mouth
  
  
• help with digestion
  
  
• flush out waste products through urine and faeces (going to the toilet)

Why are older people more at risk of dehydration?   Back to top

As we age, our sense of thirst becomes less sensitive and less accurate. This means that older people should not just rely on thirst as a signal of when and how much to drink.

Our bodies also find it harder to respond to changes in temperature (such as very hot weather) in older age. Having certain illnesses like diabetes and kidney disease can also increase our risk of dehydration.

Storing water in our bodies   Back to top

Most of the body’s water is stored in muscle (about 75% of it). 

But as we age, we lose muscle mass (the amount of muscle we have). This means that older people cannot store as much water in their muscles as they once did (only about 45% of it).

Losing water from our bodies   Back to top

Water is constantly being lost from our bodies through:

• Breathing: Think of how a mirror mists up if you breathe on it. We breathe more often when we’re exercising or if we have a fever.
  
  
• Going to the toilet: We lose fluid when we wee and poo. Diarrhoea and sickness can also cause excessive fluid loss, which can lead to dehydration.
  
  
• Sweating: We sweat more when we exercise, are ill, anxious or when it’s hot.
  
  
• Crying: We lose fluid when we cry. A dehydrated person will have few or no tears when they cry.
  
  
• Salivation: Our saliva (spit) is 98% water. If we are dehydrated, we produce less saliva. This makes it harder to chew, swallow and digest food.

Dehydration happens when the body loses more water than it takes in.

How hydrated are you?   Back to top

Use this healthy wee chart to see how hydrated you are.

Aim for a pale, clear colour.

Dark yellow wee means that you are dehydrated, so drink more to rehydrate.

Concerned about drinking more fluid?

If you’re worried about incontinence. Limiting the amount you drink could make incontinence worse, as it reduces your bladder’s capacity (how much it can hold).

If you’re worried about needing the toilet in the night. Try to increase your fluid intake during the day.

How to prevent dehydration   Back to top

Adults (regardless of age or size), need to drink at least 1.5 litres of fluid per day, to function properly. This is the same as around 6 to 8 cups or glasses, or 2.5 pints.

Fluid can include:

• water
  
  
• milk
  
  
• juices
  
  
• soft drinks
  
  
• soup
  
  
• tea
  
  
• coffee

Preventing dehydration in older people

Most of the body’s water is stored in muscle. But older people have less muscle to store their water in. So older people should drink little, but often. This is better than a few larger drinks throughout the day (which can’t be stored as well, due to less storage capacity).

Ways to encourage older people to drink more

Get creative:

• Offer different types of drinks e.g. squash, coffee, tea (including herbal tea), fruit juice, soup, hot chocolate and milkshakes.
  
  
• Vary between hot and cold drinks.
  
  
• Try new flavours.
  
  
• Add soda water to make drinks bubbly.
  
  
• Ice and a slice? Try adding ice cubes and a slice of lemon or lime.
  
  
• If people are struggling to drink a lot, then offer foods with a high water content e.g. gravy, jelly, ice lollies, custard or fruit like melon.

Make drinking easy:

• Always have drinks available at mealtimes.
  
  
• Use a brightly coloured cup to draw attention. Or a clear glass so it’s easy to see what’s inside.
  
  
• Offer the person the cup. And put it where they can easily reach it.
  
  
• Make sure cups or glasses are easy to use – not too heavy or a difficult shape.
  
  
• Use helpful equipment, like one cup kettles or kettle tippers, to help people to stay independent.

Daily living equipment and technology to help with drinking   Back to top

Daily living equipment and technology can help people to keep their independence. There are lots of affordable products out there that can really help. Some things can even be bought from supermarkets or high street shops.

Take a look at our ‘interactive house’ to find out about the range of equipment that’s available.

Examples of daily living equipment and technology to help with drinking

• anti-spill cups
  
  
• two-handled mugs
  
  
• two-handled china cups and saucers
  
  
• water bottles
  
  
• angled cups
  
  
• weighted cups (for people with tremors), or weighted cuffs (to put on wrists to reduce tremors)
  
  
• straws
  
  
• straw holders (that clip to the cup to keep the straw in place)
  
  
• straws with one-way valves (if people have reduced suction)
  
  
• non-slip trays, non-slip tray liners, and trays with carry handles (to carry drinks safely)
  
  
• trolleys (to move food and drinks)
  
  
• one cup kettles or water dispensers
  
  
• kettle tippers
  
  
• intelligent hydration systems (reminds people to drink using a familiar voice)
  
  
• assistive bottle openers
  
  
• jar and bottle holders