Dehydration in Geriatrics

Prevention and Treatment

It has been demonstrated that when older adults know that they should not trust thirst but should drink because it is healthy for them, water intake increases above the minimum intake of 1700 ml per day.^[17] For calculating the minimum amount of fluid per day, a formula based on body weight is recommended: 1500 ml is the minimum water intake with 15ml fluid per kg to be added for the actual weight minus 20 kg. This formula can be used for older adults who are normal weight, underweight, or overweight.^[36]

Geriatric nurses and caregivers play a crucial role in the prevention of dehydration, as it has been shown that verbal prompting to drink between meals was effective in improving fluid intake in more cognitively impaired residents of LTCs.^[37] Less cognitively impaired residents increased their fluid intake if they were given the beverages they preferred. The increase in fluid consumption did not occur at the expense of reduced consumption of food or fluid during meals. Participants with higher BMI values showed larger increases in their fluid consumption, but underweight participants (BMI <20) also showed a significant increase in their fluid consumption. Although the fluid intake increased by these feeding interventions, the food and fluid intake of the majority of the participants was still inadequate (≤75%).^[37] Long-term care residents, for example, eat far from 100% of their meals, whereas almost 80% of the total daily fluid comes from fluid intake associated with meals. Patients consuming less than 50% of their meals are at high risk for dehydration. Caregivers should be aware of and anticipate this hazard.^[36]

Other dehydration prevention measures include having water easily reachable throughout the day, encouraging drinking water by repeating self-care actions like brushing teeth, allowing adequate time and supervision during meals, encouraging family members to participate in feeding, and registering fluid intake.^[38] Taking medication with fluid should be promoted. One study showed that LTC residents receiving medication consume significantly more fluid during nonmeal feedings than residents without medication.^[36] For community-dwelling older adults dehydration may be prevented by educating them and their families or caregivers on the importance of hydration and the risk factors for dehydration.^[39]

Geriatrics and Aging. 2007;10(9):590-596. © 2007 1453987 Ontario, Ltd.

Cite this: Dehydration in Geriatrics - Medscape - Oct 01, 2007.