Dehydration and the Elderly How to prevent it, how to recognize it and how to treat it

Dehydration is one of the top ten reasons for hospitalization of the elderly.

It is a serious life threatening condition, that is often overlooked.


As the summer continues to heat up, we need to pay extra close attention to older people who are physically frail and/ or have dementia. Some medications add to this problem as they have a diuretic effect- that is they cause the person to pass water- either by sweating or urinating. Many older people’s ‘internal heat sensors’ do not do an adequate job of telling them that it is very dry and warm, and this too can lead them to dehydrate. Often older people with limited mobility might make it difficult for them to get up to get a drink.


I recently had a client, who experienced pain that she believed was due to a urinary tract infection. Without seeing her, her internist called in a prescription for a very powerful anti biotic, (which comes along with a host of side effects ). After a day or two, she decided she felt better, and stopped taking the antibiotic. Several days later, she again complained of similar symptoms. I happened to call her and learned of this. I asked her whether she had been drinking enough water- and she said that she ‘really didn’t care much for water’ and thought she had been getting enough fluid. She agreed to up her intake of fluids, and quickly reported feeling better.


How can you prevent dehydration?

Note that you do not only need to drink water to stay hydrated, and the amount that each person needs varies. It is perfectly fine to offer other types of fluids if the person doesn’t like water, and to remember that soups, fruits and vegetables can also offer fluid- think of juicy watermelon, cucumbers, even leafy green vegetables! Remind the person to drink more when the weather is warm, and if they have a hard time walking to the kitchen, make sure to leave something to drink next to where they usually sit, and at their bedside. Encourage them to drink, even if it is small amount on an ongoing basis.


So, what signs would you observe if the person was dehydrated?

Look for sudden confusion, problems with their walking, dizziness, headaches, dry or sticky mouth and tongue, an inability to sweat or tear, a drop in blood pressure when changing from lying to standing, and constipation or decrease in urine output. Another trick that is sometimes used is to pull up the skin on the back of the hand for a few seconds; if it does not return to normal within a few seconds, the person is dehydrated. The urine of people who are dehydrated is often darker in color.


How do you help an elderly person who is dehydrated?

If they became rapidly dehydrated, they need to receive treatment immediately. Call their doctor, as they may need to go to the emergency room. The outcome of dehydration is that their electrolytes may also be off. Therefore the priority is to restore their fluids and their electrolytes. People with severe dehydration may require intravenous fluids and salt. People with mild dehydration can be treated by increasing their fluids, and beverages that help to balance electrolytes are better than plain water for this.




Again, remember that dehydration in the elderly is a very serious matter that can prevented with close oversight of their fluid consumption, and by encouraging them to drink and stay hydrated.