Dehydration - dangerous and difficult to identify in aged care

Many of us this we know what to look for to determine how well hydrated we are: do your mouth and skin feel dry? are you thirsty?

One test that is often used it to pinch the skin on the back of your hand - if it springs back when you let go you are considered to be doing OK, if it stays ‘pinched’ you are overdue for a drink. Other signs include ‘sunken’ looking eyes. In aged care, these are commonly used ‘signs and symptoms’ used to diagnose dehydration among residents.

But do they work? It seems not.

When researchers in 56 Care homes in the UK compared blood tests for dehydration to these commonly used ‘signs and symptoms’, they found them to be of little or no use in diagnosing dehydration. People could be dehydrated despite these signs not indicating it.

Dehydration is a big problem at any age, but more so as people enter their later years: your brain can’t fire on all cylinders when you are even slightly dehydrated, your skin is more likely to tear from even otherwise minor bumps, your capacity to heal wounds is reduced, constipation is more likely, your blood pressure can be impacted and increase your chances of falling. All are absolutely to be avoided.

This study shows that checking the ‘usual suspects’ is not enough when it comes to dehydration in aged care.

The solution lies in prevention. Many aged care menus include soups and casseroles among their options and both of these are a way to get a bit of extra fluid in meals people enjoy. There is fluid also in fruit - especially when its stewed or prepared similarly, in vegetables, juice and milk drinks.

Of course water is a perfect fluid, but its important to remember that many of advanced age have small appetites and filling up on water can mean people end up eating less food because they feel full just on water - in such cases getting fluid and nutrition in together is a great plan. Milkshakes, smoothies, juices and jellies are a good option for these individuals along with good quality soups, stews and fruit based ‘wet’ desserts (such as stewed or canned fruit and custard or ice cream).

Tea and coffee are also fluid sources and for those who enjoy sugar in those drinks, the fluid is vital, at advanced age sugar matters much less if it helps that drink go down!

Its best to aim for some sort of fluid being consumed at every meal as well as in between and older people, their carers and family should always be on the lookout for ways to encourage a bit more.