The Most Common Signs of Dehydration in the Elderly

Kenneth Knowles, MD
Medically reviewed by Kenneth Knowles, MDSeptember 29th, 2020
woman helping dehydrated senior

Some symptoms of health issues come on suddenly: severe pain, shortness of breath, and fainting, to name a few. Others are slow and sneaky, creating serious health complications before you can even recognize the problem. The biggest culprit? Dehydration. Dehydration is the most common electrolyte and fluid concern among seniors thanks to its often-undetected symptoms. Don’t let these signs of dehydration fly under your radar; read on to learn what to look out for.

Top Signs of Dehydration in Seniors

In most adults, urine can tell a lot about hydration levels: not only the amount produced, but the color, too. Clear urine signifies that a person is well hydrated, while darker urine usually signifies dehydration. The other big sign of dehydration? Thirst, of course. Most adults are well acquainted with the sensation of thirst, but the elderly often dismiss or simply do not to notice this early symptom, which means it’s essential to keep an eye out for other indicators, such as:

  • Muscle weakness
  • Lethargy
  • Dry mouth
  • Headaches or dizziness
  • An inability to sweat
  • Low blood pressure
  • Rapid heart rate
  • Fatigue
  • Confusion

Severe dehydration is marked by shriveled skin, a sunken look in the eyes, low blood pressure, and delirium. Severe dehydration is a serious risk for the elderly; caretakers, it’s essential that you address signs of dehydration before these symptoms start to manifest themselves. Luckily, there’s a simple test you can perform on your elderly loved one to check for dehydration. Pinch the skin on the back of their hand and observe how quickly it returns to normal. If it snaps back immediately, it’s not likely they’re dehydrated. If it maintains a tented shape for an extra second or two, that’s a sign of dehydration. [availability_widget]

Common Causes of Dehydration in the Elderly

The root causes of dehydration are loss of bodily fluids and not getting enough water. Healthy adults can become dehydrated because they neglect to drink water throughout the hustle and bustle of daily life. For seniors, it’s often a different story. Many seniors with dementia or Alzheimer’s literally forget to drink water frequently. Mobility-impaired seniors who live alone might have a hard time accessing water. Seniors with diabetes might have a hard time keeping up with frequent urination, a common diabetes symptom. The flu can also lead to dehydration due to symptoms like diarrhea and vomiting; seniors have a tougher time bouncing back from the flu than healthy adults, which means that hydrating is essential during and after a flu bout. Different health issues pose unique risks of dehydration in the elderly, so it’s a good idea to take a minute and ask yourself these questions: What might be preventing your loved one from getting enough water? And what can you do to reduce that risk?

Risk Factors

As we age, our body’s water percentage naturally decreases. Since seniors already have less body water to work with, staying hydrated is critical for them, especially when paired with a complex health issue like Alzheimer’s or diabetes. People who live in high altitudes are more subject to dehydration since there’s less oxygen available, which can lead to water loss through rapid respiration. So are those diagnosed with chronic illnesses, such as an adrenal gland disorder, alcoholism, kidney disease, or cystic fibrosis. Regardless of problems that can stem from complex health issues, hydration education is one of the biggest risk factors for the elderly. In one study, more than half of the elderly population surveyed reported that they didn’t know that dehydration could lead to seizures, confusion, and death. The majority was also found to overestimate the amount of fluid loss that shows as a symptom of moderate dehydration, and more than half also admitted to drinking fewer than six glasses of water per day.

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Potential Complications of Dehydration

Here’s the thing about dehydration: as a healthy adult, serious complications due to dehydration seem unlikely at best. But for the elderly, complications pose a much bigger risk, if only because signs of dehydration are often much harder to catch in a senior than they are in a younger adult. Often, elderly loved ones struggle with dehydration without their caretakers or themselves realizing, which makes potential complications more likely. These complications can include:

  • Seizures
  • Kidney problems
  • Low blood volume
  • Heat strokes

Tips to Prevent Dehydration in the Elderly

  • Educate seniors on the importance of hydration. The elderly still have agency and want to do everything they can to stay in good health. Seniors with Alzheimer’s or dementia might struggle to remember to drink water, but you should still prioritize hydration education.
  • Encourage taking small drinks throughout the day. Large glasses of water can be intimidating to some seniors. Instead, make sure they always have a water bottle handy for small sips.
  • Fill the fridge with foods high in water content. Fruits, veggies, and even yogurt can help seniors stay hydrated.
  • Mind the weather. Sweating in hot weather can lead to dehydration, and so can moisture loss from dry air in the winter or at high altitudes.
  • Discourage diuretic beverages. Alcohol, coffee, and some protein drinks can increase urination, which can exacerbate dehydration.

Treating Dehydration in the Elderly At Home

Noticing symptoms of dehydration in the elderly can be scary for both seniors and their caretakers, especially if symptoms are advanced. And traveling to the emergency room or urgent care clinic with a symptomatic senior can pose challenges: confused seniors might not want to get in the car, dizziness might require them to stay planted on the couch, and hot weather might exacerbate dehydration symptoms. DispatchHealth can help. We’ll send our qualified medical professionals to treat dehydration in seniors within the comfort of their own home. We can treat almost everything the emergency room (ER) can, including testing electrolyte levels, administering IV fluids, and prescribing anti-nausea medication if appropriate. We’ve also partnered with the majority of insurance companies, including Medicare and Medicaid, to ensure we can provide in-home care at one-tenth the cost of an ER visit. After treatment, we always send a detailed report to each patient’s primary care physician, home health agency, or living community—plus, we can electronically send prescriptions to the patient’s preferred pharmacy. If you’ve noticed non-life-threatening symptoms of dehydration in a senior, request a visit from DispatchHealth via phone, our mobile app, or online—we’ll be there within a few hours. If you are experiencing a life-threatening emergency, please call 911 or go to the nearest emergency department.


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