How much do you think about the amount of fluids you drink in a day?
Have you been told before about the 8 cups of water a day rule? Well this may not be true, especially for seniors. Hydration is a complex topic and one that may not be thought about often enough.
There are many articles and research studies on thirst, and fluid balance in older adults. A combination of decreased thirst, and changes in regulation of body temperature, sweat production, heart and kidney function all contribute to the changes of how the body processes fluids and increases the importance of understanding hydration for overall health.
Changes in thirst and body fluid regulation can lead to reduced fluid intake even in situations that would trigger increased thirst in a younger adult (being outside in warm weather, exercise, having a fever).
Sense of thirst and lack of it is compounded in this population by other factors. Potentially dry mouth is not a sign of thirst for someone because they have had dry mouth as a medication side effect for a long time. Perhaps, an older adult may be less motivated to drink water if they feel it just increases their incontinence (which is a false belief that I hope to discuss in a future post). Potentially, mobility issues limit their ability to get to and from the bathroom independently so they decide or end up drinking less to not have to get up as often. These reasons along with diseases that impact how your body processes fluid (such as heart failure and kidney disease) can lead to a pattern of low fluid intake and can contribute to dehydration.
So….Is 8 cups a day of fluids the recommendation for older adults?
There is not really one standard recommendation for fluid amount that can be accurate for everyone. This depends on your age, your activity level, medical conditions, and climate even.
The more important factor is drinking water as much as possible. Water is processed by your body more easily because it does not have other ingredients such as sugar of caffeine that your body has to process. Plus, our bodies are made up of 60% water so it is a better replenishing tool than other beverages. Electrolyte beverages, preferably with low sugar may be recommended in warmer weather, with exercise in the heat, or with illnesses that cause you to lose fluids (vomiting, diarrhea); but, it is best to consult with your own physician to see if these are recommended for you.
If you have heart disease or kidney disease these are other situations where consulting with your physician about fluid maximums is a good idea before you make a dramatic change to your hydration habits.
What are early signs of dehydration in seniors?
Dehydration was found in 37% of people over 65 admitted to the ER. I know that I have seen many patients who have had falls and were dehydrated, likely beforehand.
Hydration is so important to overall health and being aware of signs of dehydration can help prevent unneeded medical interventions, falls due to lightheadedness, or other medical complications.
Some of the initial symptoms of dehydration may be darker urine, dry mouth, muscle cramping, dizziness/lightheaded. It is easy to drink some more water and wait 10-20 minutes and see if you start to feel a little better. Keeping an eye on your urine color may seem a little odd but it can be an important indicator of hydration health. The kidneys are responsible for processing fluids you take in and deciding how much is sent to the bladder for output. If there seems to be a large discrepancy in your fluid intake and output, or changes in color these may indicate dehydration or a more serious issue that may need further investigation.
The key takeaway: hydration in older adults matters and is easy to increase with a little planning
Hydration is important for overall health. As a physical therapist who works with patients of varying activity levels and with different medical histories, this is an important topic for me. If I am asking a patient to perform exercise and they are not hydrated enough there can be issues including muscle cramps, they will fatigue sooner, lightheadedness may occur.
Water intake also helps you recover from exercising well and reduce the impact of delayed onset muscle soreness. Water is a powerful tool in your health and can be as simple as bringing a cup of water with you when you sit down to watch a show, or packing a water bottle or two if you know you are going to spend time outside that day.
When you are drinking beverages other than water have a cup of water there as well and intermittently enjoy both drinks. This helps dilute the non-water ingredients in your drink and can prevent ingredients like caffeine from being as irritating to your bladder and may even help prevent bladder spasms. But, like I said earlier, bladder health is a topic for another article. 🙂
So, today’s message is think a little bit more about your fluid intake. Consider your health factors and whether you need to discuss a fluid maximum with your physician. Try to make a plan to bring water with you more places. There are so many great water bottles you can purchase. I have an insulated bottle that keeps my water cold even when it is in the car all day while I work in home health.
Hope you learned something about hydration in older adults and its importance!
Thanks for being here,
Christine
Email me questions or feedback at christine@agingwithability.com