December 19, 2014
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With heat, staying hydrated especially important for elderly

It’s important to stay hydrated during the heat of summer. This fact is especially true for senior citizens, as age can lead to dehydration, as well as falls and fractures.

According to Kathleen DeCristofaro, a registered nurse with 15 years of experience, dehydration can be avoided by following a few simple rules. Through the years, she has cared for many elderly patients who have been hospitalized because they weren’t properly hydrated. Several of them had to be admitted to a nursing facility, as they lived alone and were unable to care for themselves until they regained strength.

“It can be prevented if they know how to prevent it,” said DeCristofaro, who has worked at Cherry Hill Manor Nursing and Rehab Center in Johnston for 10 years. “People are falling and getting fractures and it’s all because they didn’t drink or they went out in the sun. If they had a little more information, it wouldn’t have happened.”

The most obvious defense against dehydration is drinking plenty of fluids. Water and Gatorade are prime options.

“As we get older, our thirst mechanism decreases,” said DeCristofaro. “As a result, many elderly do not drink enough. Every two hours or so, drink a bottle of water. If you’re out in the sun, maybe more. In addition, elderly people are more likely to have chronic illnesses or to be taking medication that can lead to fluid and electrolyte imbalances. If you’re not drinking enough, you won’t be able to urinate. Your body is going to hold onto that water because you’re not giving it anything.”

Another way to combat dehydration is by restricting sodium intake and omitting diuretic beverages like coffee, tea and alcohol during outdoor activities. Aside from bringing hydrating drinks to the pool, beach or cookout, items like sunglasses, large umbrellas and sunblock are key accessories. Limited exposure is also crucial.

“They can’t stay out in the sun the way a younger person would,” DeCristofaro said. “They don’t feel the dehydration.”

But there are a few telltale signs to watch out for. One of the most common is confusion or a change in mental status. DeCristofaro said typical quotes from a dehydrated senior include, “I just didn’t feel right today,” or “I just couldn’t concentrate today,” and “I keep thinking I have to go to the bathroom but couldn’t go.”

Having a low-grade fever of about 99 degrees or being constipated are other hints.

“Usually by the time you’re constipated, you’re dehydrated,” she said.

Other clues, said DeCristofaro, are postural hypotension, a dizzy, light-headed sensation when changing position from sitting to standing, increased pulse rate, and a new onset of fatigue and/or generalized weakness, which often leads to falls and fractures.

She also said changes in daily weight are indicators of fluid loss or excess.

“A liter of water weighs approximately 2.2 pounds,” DeCristofaro said. “Therefore, a weight change of one pound corresponds to a fluid volume change of approximately 500 milliliters. An easy way to keep track of what you are drinking is to keep track of your fluid intake. Pre-fill a 32-ounce pitcher of your favorite hydrating fluid. Just remember, if you are on a fluid-restricted diet or other structured diet, speak with your primary care physician to verify any fluid restrictions.”

It’s also critical to keep in mind that certain medications require users to stay of the sun because they may cause sunburn. Medications for high-blood pressure lead to photosensitivity, or a sensitivity to light, as do anti-depressants, anti-psychotics and prescriptions for high cholesterol.

Yet, that doesn’t mean seniors can’t have fun in the sun.

“That’s where the sunblock comes in,” said DeCristofaro. “Wear a lightweight shawl over your shoulders. Let’s stay healthy and enjoy our families and summer together this year.”


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