Stay Hydrated

Well June may not have been the sunniest or warmest of months for most of us but, now we are into July we should (hopefully) see some pleasant summers days.

We all know how important it is to stay hydrated, the ‘experts’ bombard us with messages telling us to drink more water – often litres a day – and this is even more important for the older person, especially during warmer weather.

Did you know that the human body is roughly 60% water and that during an average day we can lose 2-3 litres of that water.

Our brains and heart are apparently composed of 73% water, and our lungs are about 83%. The skin contains 64% water, muscles and kidneys are 79%, and even our bones are watery at 31%!

 Water is vital to our good health, it:

• Is needed by our brains to make hormones and neurotransmitters
• Helps regulate our temperature (via sweating and respiration)
• Helps our cells grow, reproduce and survive
• Lubricates our joints (especially important as we age)
• Makes saliva
• Flushes out bodily waste (urine)
• Acts as a kind of ‘shock absorber’ for our brains and spinal cord
• Aids our digestive process
• Keeps our mucous membranes moist

As we age the water content in our bodies does actually begin to decrease, as does our thirst. This means that you may not actually feel thirsty BUT your body STILL requires an intake of fluid in order to keep functioning at optimum efficiency.

Not feeling thirsty (or rather not recognising the feeling of being thirsty) is especially common in people with dementia and other forms of cognitive impairment, so if you are caring for someone with these conditions it is vital you keep prompting them to drink.

Not taking onboard enough water can lead to dehydration, and this can happen more easily and rapidly in older adults.

Effects of Mild Dehydration

We can probably all recognise the feeling of mild dehydration:

• Dry mouth
• Feeling thirsty
• Decrease in urination (wee) and when you do go, your wee is darker than normal
• Headache
• Even muscle cramps

Hopefully upon recognising these feelings we would all act on them and drink some fluid.

However, someone living with dementia (and other cognitive problems) may not recognise that they are becoming dehydrated. Without close supervision it can be very easy for them to slip into severe levels of dehydration.

Effects of Severe Dehydration

• Not weeing at all or having VERY dark wee
• VERY dry skin
• Feeling dizzy
• Rapid heartbeat and breathing
• Sunken eyes
• Confusion
• Fainting

If you recognise these signs in yourself or a loved one, please seek IMMEDIATE medical help. Dehydration at this level is life threatening and requires treatment.

“Urinary Tract Infections” – UTI’s which can lead to confusion, agitation and other changes in behaviour are often exacerbated by dehydration. The sufferer feels the urge to wee more frequently and so limits the amount they drink in order to minimise the need to visit the loo. Unfortunately reducing the fluid intake will only reduce the body’s ability to flush out toxins, which then build up and increase the confused state of mind!

How Much Should You Drink Per Day?

There are so many confusing reports around just how much you need to drink in a day in order to avoid dehydrating.

Some ‘experts’ recommend at least 2 litres of water per day ON TOP of your other fluids (tea/coffee etc).

Others even more.

The problem is that TOO much water is actually BAD for you as it can dilute the level of sodium in the blood!

In a healthy body, your brain will detect when you are becoming dehydrated and will initiate thirst to stimulate drinking. The brain will also tell your kidneys to save water by concentrating urine. Of course, as noted above, a person with dementia may not recognise the signals of thirst, so a carer will need to be especially vigilant.

Studies have also shown that completely avoiding even the mildest states of dehydration – i.e. not even getting to the stage when your brain initiates the thirsty feeling -- could actually support brain function. It’s difficult to see how anyone could guarantee that they ALWAYS keep well hydrated but it is worth trying.

The NHS currently recommends drinking between six to eight glasses of fluid per day, which can include, lower fat milk, sugar free drinks, tea and coffee.

Tips to Staying Hydrated

Assuming you are reasonably fit, healthy and not currently living with dementia or another cognitive impairment, TRUST your body and drink when you feel thirsty, rather than trying to consume vast quantities of fluid to a schedule.

Hunger and thirst feelings are closely linked, so, if you have just eaten but still ‘feel’ hungry, try having a drink.

Although other fluids count towards the NHS recommended 8 glasses per day, plain water is best – if you can drink it.

If you are one of those people who doesn’t enjoy plain water, why not try some of the sugar free water flavourings out there? There’s lots available and being sugar free, they are low or no calorie.

In hot weather consider filling a drinking water bottle with water and adding fruit such as lemons, limes or berries. Keep it with you and sip on it as required.

There is no need to buy bottled water in the UK (adding to plastic waste) but it may be worth investing in a water filter, especially if you live in an area with hard water.

If you are caring for someone and want to ensure they stay hydrated, you will have to remind them to drink and ensure a supply of suitable drink is to hand. Often those living with dementia will not think to ask for a drink so you will need to pre-empt them!

Remember too that people with dementia often experience a change in tastes – some drinks may taste really sour to them, so try to provide flavours they will enjoy and remember tea and coffee can count towards their daily fluid intake. Even an ice lolly will help with hydration and they can be very tempting on hot days!

Find out here how a young man realising his grandmaother was not drinking enough Creates Jelly sweets to help with rehydration  

In care homes, staff are supposed to record fluid intakes in order to prevent situations where dehydration can occur – it may be worth following this protocol at home too – for yourself as well as the person you are caring for. 

Finally…

Staying hydrated shouldn’t be difficult…

• Pay attention to the way you are feeling – if you feel thirsty HAVE A DRINK.
• Keep a supply of fruit at hand to ‘jazz up’ a glass of water
• Have some ice lollies in the freezer
• If you spot any of the signs of dehydration in yourself or others, take action before it gets worse
• Remember you may need to up the fluids on hotter days