Last November when my sister and I were called in as they felt my mother was at end of life, we found that she was very dehydrated. The reason for this? When the drinks were brought around, if she was sleeping, they didn't leave one for her as she can not reach for it or drink it herself and they didn't wake her up to drink.
If she was awake, they would give her something to drink, but didn't have the time to stay with her while she finished a full glass of anything.
Once I was coming in every day and making her drink juice and/or water – a full glass, she recovered and is still going strong at 100. She is 2 months short of her 101st birthday now.
There have been reports that many of the seniors who died during this Covid pandemic have also been dehydrated.
One of the most terrible findings of the final report of Ontario's independent commission into long-term care is that some residents died, not of COVID-19 but of neglect and dehydration.
“Apart from fatalities due to COVID-19, residents died as a result of neglect due to staff shortages,” the commission wrote in its final report, released Friday. “For example, the commission was told that malnutrition and dehydration occurred due to a lack of available staff to tend to resident needs. As a result of these conditions, some residents spent their final hours in complete isolation and ultimately died alone.” https://www.qpbriefing.com/2021/05/03/we-have-to-move-forward-minister-responds-to-ltc-report-finding-that-seniors-died-of-dehydration-and-neglect/
Signs And Symptoms Of Dehydration
Symptoms of dehydration in elderly adults may sometimes be subtle, but not drinking enough water and fluids can have a big effect on the body, especially in the elderly. Severe dehydration can lead to confusion, weakness, urinary tract infections, pneumonia, bedsores in bedridden patients, and other serious conditions.
If you do not drink enough, sweat too much, or have severe diarrhea, you can become dehydrated. Mild to moderate dehydration isn’t that dangerous and can be corrected by drinking more fluids.
If the dehydration worsens and becomes severe dehydration, you may need to have IV fluids to correct the condition.
Here are some signs and symptoms of mild to moderate dehydration:
- Having a dry mouth
- Feeling fatigued or sleepy all the time
- Having increased thirstiness
- Having a decreased urine output with urine that is more yellow than it usually is
- Having dry or flaky skin
- Being dizzy
- Having a headache from low blood volume in the brain
- Crying without having many tears
If the dehydration is allowed to worsen and you continue to lose body water, you may see the following signs and symptoms:
- A severe reduction in the output of urine or the absence of urine at all. If there is any urine produced, it will be scant in amount and a deep yellow color or amber/brown color.
- Lightheadedness or severe dizziness that is worse when you stand up or get up from a reclining position.
- Orthostatic hypotension. This is a severe drop in blood pressure that occurs when you try to get up after sitting or lying down.
- Rapid heart rate from the heart trying to compensate for a low blood volume.
- Fever, which is usually low grade in nature
- Seizures, which are usually grand mal seizures
- Poor elasticity of the skin. When you pinch it, the skin tents up and doesn’t go back to its normal position.
- Being lethargic or confused
- Going into a coma
- Suffering from extreme shock, which can be life threatening.
Dehydration has a way of sneaking up on you, especially if you are otherwise occupied with other things, such as the activity you are doing or are wrapped up in being sick with vomiting and diarrhea.
As soon as you start to feel the symptoms, you need to be thinking about hydrating yourself.
Treating Mild To Moderate Dehydration
If the symptoms are mild and you can still drink, try to step up the amount of fluids you are taking in. Water is perhaps the best choice for treating dehydration. Other good choices include Gatorade or PowerAde, which provide liquids plus electrolytes, which can be lost in sweating, vomiting, or having diarrhea.
If the problem is due to vomiting or diarrhea, you can buy some Pedialyte or your doctor may prescribe anti-emetic (anti-nausea) medication. These can be prescribed for you from your doctor.
Over the counter anti-diarrheal medication is another choice as long as the diarrhea isn’t from food poisoning. (In such cases, it is best to replace fluids only and allow the bacteria causing the diarrhea to flush out of your system).
Treating Severe Dehydration
If the dehydration is severe and you are suffering from some of the severe dehydration symptoms listed above, you need to consider checking yourself into a hospital and receiving IV fluids.
IV fluids have not only the water you need but contain sugars and salt solution that will restore your normal electrolyte balance. It can take as little as a liter of fluid to turn around the dehydration or as many as five or more liters of IV fluid.
Consequences Of Severe Dehydration
Besides seizures, one of the main consequences of severe dehydration includes damage to the kidneys. If the kidneys do not have fluid to flush through the tubules, you can actually suffer from acute kidney failure.
The kidneys can shut down and will only return to normal functioning with careful replacement of fluids and time. Replacing the fluids too fast, however, can result in cerebral edema and electrolyte disturbance within the brain.
To avoid these horrible consequences drink water regularly. This is easy when you always have access to water, by keeping a bottle of water in your car, and on your desk or near you wherever you work. You can even keep a small bottle in handbag and refill it throughout the day.
You can keep track of your water intake in a number of ways – put 64 oz of water in the fridge and be sure you finish it by the end of the day. Put 8 pennies on your counter and as you drink an 8 oz glass of water you move one penny. When you have moved all the pennies, you have had 64 oz of water.
Many seniors forget to drink water. I know that my mom for years had to be coaxed to drink water on a regular basis and my partner does not drink enough water. He drinks liquids – coffee, milk, iced tea, but not just plain water except in really hot weather.
How about you? Are you staying hydrated? It's especially important on these hot summer days.
Stay well, stay safe, and please pass on these words of warning to others you may know.
P.S. Here is something that may help you keep track