Navigating health and aging: Hydration is important for everyone, particularly for the elderly

In my last column, I talked about brain health and ways to keep the brain healthy. One of the most forgotten forms is hydration. It’s also one of the easiest things to do! Our bodies are made up of two-thirds of water and our brains 77-78 percent water. When we drink less water than we lose, we become dehydrated.

During these hot summer days and high humidity, our bodies lose water even when we are inactive. We lose water through sweating, through our skin, urine, vomiting, diarrhea and even breathing.

When we do not replace lost fluids through normal body functions or in times of illness or extreme heat, we can become dehydrated. Dehydration can disrupt normal functioning and can be extremely dangerous and even dangerous to the lives of very young, aging people and those who are working or exercising in extreme heat and not replacing fluids.

The aging of the population is especially susceptible to dehydration. In fact, dehydration is one of the 10 most frequent diagnoses reported for hospitalizations of people over 65 in the United States. The reasons for the high incidence of dehydration vary.

As we age, our kidneys are less efficient in urine concentration to store water during times of dehydration. In addition, as we grow older we experience a decreased thirst that makes us drink less. Add decrease in mobility and desire not to be interrupted to urinate frequently and is a set-up for chronic dehydration. Those taking diuretics, such as Lasix (Furosemide), to control congestive heart failure or fluid retention are at risk of dehydration when they do not balance fluid intake.

The following information about dehydration comes from the Mayo Clinic.

Mild to moderate dehydration is likely to cause:

  • Dry and sticky mouth
  • Drowsiness or tiredness – children are likely to be less active than usual
  • Thirst
  • Decreased urine production
  • There are no wet diapers for three hours for babies
  • Few or no tear when crying
  • Dry Skin
  • Headache
  • Constipation
  • Dizziness or lightheadedness

Severe dehydration, a medical emergency, can cause:

  • Extreme thirst (often altered and diminished in the elderly population)
  • Drowsiness or drowsiness in infants and children; Irritability and confusion in adults
  • Very dry mouth, skin and mucous membranes
  • Little or no urination – any urine produced will be darker than normal
  • Hollow eyes
  • Dry and wrinkled skin that lacks elasticity and does not “bounce” when pinched in a crease
  • In infants, sunken fontanelles – soft spots on top of a baby’s head
  • Low blood pressure
  • Fast heartbeat
  • Fast breathing
  • Do not cry when you cry
  • Fever
  • In the most serious cases, delirium or unconsciousness

In the aging population – which in my experience is notoriously under hydrated – dehydration can cause confusion, delirium and even kidney failure. Dehydration is often the cause of a change in mental state.

It is common for me to see aging people who do not like water, and just drink any liquid. It is also common for me to see people aged in assisted living and nursing homes with drinking glasses through the room where they can not reach them. Research has shown that more than 30 percent of the elderly are dehydrated and that between 50 and 90 percent of the residents of the residences are dehydrated.

What are some simple rules you can follow to ensure proper hydration?

First, be sure to drink plenty of fluids even when you are not thirsty. Do not wait for thirst to guide fluid consumption. While water is best in normal situations, the taste of water or drinking a drink you like is better than not drinking at all. Keep in mind that caffeinated beverages cause you to lose water, so consider adding additional water to account for those losses. Recommendations for fluid consumption are at least 57 ounces to 91 ounces per day for women, and more for men.

Exercise and sweating cause loss of water, and as a result there may be a loss of sodium and electrolytes. In times of extreme heat, water and sodium are lost through the skin even with little effort. Dr. Rengen, a kidney specialist, reminds us to hydrate and replace electrolytes with liquids like Gatorade or G2 in the case of diabetes. Keep in mind that replacement with high sugar drinks should be avoided when you experience diarrhea or loose stools as it will make it worse.

Eat fruits and vegetables! They have high concentrations of water and help keep you hydrated. Watermelons, cucumbers and lettuce are excellent sources of extra fluids.

Check your urine for color and odor to assess hydration. The clearer the color, the better it will be hydrated. If your urine is dark yellow, or even amber, it’s time to start drinking. Look at your tongue, is it dry or wet? Pinch the skin on the back of your hand, if it recovers quickly, large. If you get pinched appearing and it takes time to bounce then moisturize!

It’s amazing how much better you’ll feel if you’re hydrated. At first you may not notice the difference. However, if you consistently moisturize, you will begin to notice more energy, less lethargy, mental clarity, more regular bowel habits, better skin and many other benefits.

It is important to discuss the parameters of fluid intake with your doctor, especially if you have conditions such as congestive heart failure, kidney problems or fluid retention. There may be limitations in your consumption in order to create a healthy balance for you.

And lastly, remember that hydration is important throughout the year … not just during the heat!

Jill Rosner is a registered nurse, certified geriatric care manager and owner of Rosner Healthcare Navigation. It offers services of defense and attention of patients to clients with problems of health and aging.