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Caregivers: Know the Signs of Dehydration

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I learned about the serious effects of dehydration the hard way. My father, when in the later stages of Alzheimer’s and in a care facility after breaking his hip, nearly died. Why? The staff was not pushing fluids, nor did they take the time to help him try to drink them. Moreover, the nursing home refused to chart his fluid intake and, making matters critically worse, my father could not communicate his increasing thirst.

Thankfully, we were able to figure out what was wrong before his organs completely shut down. While observing my father’s increasingly strange behavior in the days following his surgery, we became alarmed. After a few days at the care facility, he stopped talking. He repeatedly picked at his gums. He made weird arm movements pointing to the ceiling. The staff, however, seemed to take no notice of these peculiar actions, attributing them, apparently, to his diagnosis of Alzheimer’s disease.

From all the time I spent caring for my father, though, I knew something was desperately wrong. But I didn’t know what it was or what to do. As a last-ditch effort, I took my father’s medicine list to a trusted pharmacist.

The kind pharmacist, after looking over the drugs my father was on, told me none should be problematic or create such a strange suite of symptoms except perhaps for a new one, Lasix, prescribed after his surgery. He advised that I just make sure that the nursing home was “pushing fluids.”

That clue saved my father’s life.

Being on the alert that he was receiving enough to drink, we noted right away that in many cases, there were no fluids on his trays. We began to plead. Our concerns, however, fell on deaf, overworked ears.

So, as family members, we took charge. We visited him around the clock. We brought my father bottled water, cans of Ensure and chocolate milkshakes. We lifted his head to help him drink. Funny thing? My father’s behavior soon turned completely around! Before long, he was able to recognize us again and to speak! The doctor, whom we had alerted and who had run blood tests, said his bloodwork had returned to “normal.” The physician also said something we had already figured out, with the help of our pharmacist: My father had been suffering from dehydration.

My father was one of the lucky ones. We caught the problem before it was too late. Because for seniors, even those without any cognitive disorders and who can fully communicate, dehydration rapidly can become life-threatening and cause organ failure. This is especially a problem when temperatures rise, such in the summer months.

Dehydration, as I came to learn in writing The Gift of Caring with geriatrician Elizabeth Eckstrom, MD, is a perilous problem in nursing homes. Studies show that two out of five patients residing in long-term-care facilities are dehydrated.

What’s worse? If severe dehydration is not diagnosed early enough and the senior begins to suffer organ failure, the mortality rate for older adults is 50%. My father was nearly one of those statistics.

Everyone knows that water is essential for life. Without adequate hydration, the body will shut down and die. What most people don’t know is that in frail, older adults, dehydration is the most common cause of fluid and electrolyte disorders. Once these set in, other problems can quickly follow.

Dehydration is unbelievably common. It is ranked as one of Medicare’ Top Ten Admitting Diagnoses. Persons over the age of 85 years are especially at risk. And, as we saw with my father, who came very close to the edge, if dehydration isn’t not caught early, one out of two seniors will die.

What is the silver lining behind this? Dehydration is entirely preventable! Anyone caring for an older adult or family member should learn to recognize the symptoms and how to prevent it.

What are the key hallmarks that an older person may be experiencing dehydration?

  • Dry mouth.
  • Skin that looks a bit dry.
  • Feelings of dizziness (which can lead to falls).
  • Confusion.
  • Headache.
  • Muscle weakness.
  • Little urine output.

A big part of the problem is that many people don’t realize they are dehydrated! Older individuals lose their awareness of thirst. Even when they are dehydrated, they may not feel thirsty and forget to drink.

There is another problem that many active seniors run into—many worry about always finding a bathroom, so they limit their drinking. This can cause all sorts of health issues. Seniors need to keep in mind that they can incorporate a routine around restroom needs wherever they are!

Because the repercussions are so serious, caregivers need to be on the lookout for signs of dehydration. We need to remind the older people in our lives that they must drink. Geriatricians say most older adults need six eight-ounce glasses of nonalcoholic, non-caffeinated liquid daily.

It’s also true, though, that some older people don’t like the idea of drinking that much water and resist it. If this is your case, don’t give up! Make sure there are options available. And there are lots of them! You can help make drinking fluids more attractive and enjoyable by putting them in a nice glass. Also, be sure to have lots of soups on hands, and yogurt and fruit and juice.

Dehydration can be deadly. I nearly lost my beloved father to it. So, I now encourage everyone who is caring for someone to know the symptoms and what to do to prevent it.

Drink up! Stay out of the hospital! And help save a loved one’s life.

Click here to purchase Marcy’s book, The Gift of Caring: Saving Our Parents from the Perils of Modern Healthcare

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