Potential impact of dehydration:
Dehydration reduces the padding over bony points within the body and may lead to pressure sores. Inadequate fluid intake is a common cause of constipation. Low blood pressure: older people’s blood pressure may drop on standing, which sometimes causes them to pass out/fall. If the brain does not get enough water we can feel tired, and if prolonged can impact on other cognitive functions in the brain such as memory and perception. Dehydration changes the amount of electrolytes in the body, which can alter brain functioning. Dehydration activates the HPA Axis, which produces hormones like cortisol which can impact on memory (Johnson, Begum and Madan 2015).
An older person may have difficulty rehydrating because:
They have cognitive difficulties or physical abilities, may forget or lack skills or ability to get a drink. In older people their sense of thirst may diminish. Older people have a higher percentage of body fat. Because fat tissue contains less water than lean tissue, the total amount of water in the body tends to decrease with age. People who experience incontinence may try to minimise their fluid intake. Older people sense thirst more slowly and less intensely than younger people do. Medications, diuretics and laxatives, may compound the problem. Certain disorders, such as diabetes, may increase excretion of urine.
We need to:
Educate and inform people of the risks, prompt people more to drink and offer them foods with a high fluid content. Support people to access the toilet to alleviate their concerns relating to incontinence. Consider the environment, and accommodate for sensory loss. Identify when someone is at risk, observe more for signs of dehydration, dark urine (know what medication a person is on), dry mouth and sunken eyes. We need to give people fluids of choice and sit with people while they drink
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