Winter is officially upon us. And though we have larger Covid related issues wavering above out heads, let us focus on the topic of hydration of the elderly for just a moment.
Tons of research has been done on the effects of inadequate oral hydration, especially occurring sometimes quickly in older adults. Where does this happen at most you may ask? Based on our deeper research, mostly in elderly households without assistance; and sometimes even in a care facility that may lack full time staffing. The elderly in those scenarios, may certainly face a risk of under hydration due to potential reduced drinking. It is a serious issue, the results of which can cause acute confusion, medication toxicity, urinary and respiratory infections, and renal failures. They can all lead to hospitalization, and ramifications of chronic under hydration can even lead to pneumonia. In many cases though, dehydration is avoidable.
Lets focus now on what we can do. Be it as children of the parents who we care after, or as supporting staff of those who are in a care facility. For one, we need to make sure there is a proper procedure in place for this matter at all times. The most important factor we can evaluate is, if you are in fact addressing an individual who is at risk. For example, I myself need daily reminders, even in my early 40s, to have a sip of water, tea or other fluids on the daily. It has always been a task for me, as I absolutely find it to be mundane, and do not gage my own thirst levels properly. So I carry around a massive bottle of water wherever I go. It is a constant reminder for me to drink up, and replenish. When it comes to elderly however, it is our job, or the job of a caregiver to be that planner, that daily reminder to sip away. Something I can suggest for you to try at home, or what we do here at Shalom Home Care facility, is plan for the proverbial “ happy hour” routine. Even tea time activity can be put forward where residents, or your loved one can have a scheduled socialization time where they gather and enjoy additional fluids, get out and mingle and sip away. For those who are truly reluctant to drink and need further intervention, there should be a rule in place where every staff entering the resident’s room, while the person is awake, will offer them at least 2 ounces of beverage of choice. Us humans, at any age, if cognitively intact; can be taught how to monitor and regulate our fluid intake. The most basic and simple way would be to check our own urine, or check on the patients urine color if need be. Here is a chart that will give you an idea of what color and amount is recommended. https://www.healthline.com/health/hydration-chart
The color chart is most effective when a person’s average urine color is calculated over a number of days to determine an individual baseline. If urine becomes darker, additional assessment can be conducted and fluids adjusted to prevent dehydration. Certain medications such as warfarin, aspirin, and multi-vitamins, and fresh fruits and vegetables can discolor urine; the top results have been gained in older adults with sufficient renal function.
Lastly, it is important to keep in mind dehydration in nursing homes has been linked to inadequately trained nurses and insufficiently supervised certified caregivers. When selecting a facility for your loved one, please make sure that the staff members are properly trained in this, and consider it to be a high priority. One should never rush patients when giving them food and drinks. They need to be correctly positioned in bed, and liquids have to be extremely accessible for those residents who drink without assistance. They should also be properly monitored to make sure they meet their daily intake of fluids with all their medical conditions in mind. The bottom line is this; every scenario needs to have its own approach. Please always keep this in mind! Those that get it, will run a more successful homecare, and have happier healthier patients with less health concerns to boot.
During this holiday season, take the time to make adjustments to your own fluid schedule, and to those elderly who you care for. It may save a life!
Yana Smirnov with Shalomhomecare.ca
* In 2004 Xiao H had written Econimic burden of Dehydration among hospitalized elderly patients, and documented the “problem becoming more prevalent: hospitalizations for dehydration in older adults increased by 40% from 1990 to 2000”. (Am J Health Syst Pharm 2004; 61923);2534-40.)