When it comes to dehydration in the elderly people, the science of the signs and symptoms of are a mine field of misinformation. Most of what is wrong is repeated based on opinion and conjecture and not research and science. Many times what you hear is the regurgitation of what people have been taught and have been lead to believe. Rather than science, it is science fiction.
Thirst is a poor indicator and a late indicator of dehydration, contrary to what you will often hear.
Consider what the ABC Chief Medical Correspondent, Dr. Richard Besser said on the topic of hydration and a woman who claimed to cut years from her looks by drinking several bottles of water a day....
"If you are not feeling thirsty, you are probably not dehydrated." Dr Richard Besser 11/1 2013.
This is so wrong! Unfortunately, the doctors opinion was not based on the current science, understanding of dehydration or even common sense. Think about it.
Both at risk for dehydration
because thirst is a poor indicator.
The skin on the back of the hands can be an indicator of dehydration.
Use your common sense and decide. It is a fact that elderly dehydration is common, affecting over 80% of our grandma's and grandpa's.
Doctors do not agree on the definition of what exactly hydration is. So to say if you are not thirsty you are not dehydrated, ask, what does dehydrated mean? When someone says dehydrated, do they mean slightly, moderately, or severely dehydrated?
Another way to ask if it is severely, acutely, or chronic dehydration?
What are the degrees of dehydration?
Thirst is a late indicator of dehydration,
thus a poor indicator.
While thirst is an indication of dehydration, science shows it is a late indicator. Since it is late, it is a poor indicator for any dehydration, especially mild or moderate.
Doctors agree that thirst sensation fails as we get older.
As Dr. Elson Haas, MD, author of Staying Healthy with Nutrition says,
"A lot of what we think about water is sheer guesswork."
He adds that due to the lack of research, there is a lack of knowledge.
Doctors believe that about 75% of people don’t consume enough water.
If this is true for the majority of us, how much more so for dehydration in the elderly and the very young.
To put an end to adult dehydration, we have to change the way we think and the way we educate and train heath care workers. We also have to change the way we think about the water we drink. Dehydration in the elderly is a serious problem. Using thirst as an indicator is obviously not working.
At some point there we need to balance common sense with the evidence. When the evidence is biased by the potential for profits, less weight should be given to the evidence. When there is no profit incentive in the research in common elderly hydration, more weight should be given the common sense and then the evidence based science.
Although TV doctors may say otherwise, at Water Cures, we feel they have done a great disservice to the viewers and our neighbors. Although over-hydration can cause problems as the show indicated, drinking too much is rare compared to not drinking enough. This is especially true of dehydration in elderly people.
More importantly, what the doctor said, is not even accurate based on the medical science and we have to admit, it is wrong according to Dr. G**gle too, which has this one right on. Consider what some other doctors say...
Using the water cures protocol, many have ended their dehydration. By making the water cure protocol a life change, it is possible to prevent dehydration. Using the protocol solves many of the problems the elderly have that causes them to not drink. Using the salt will help them prevent the need for extra trips to the restroom.
"Unfortunately, thirst is not a very poor gauge of your body's requirement for water. This is especially true in children as well as older adults. The better way to determine dehydration is urine color. Light-colored it means you're well hydrated. Dark yellow or amber color is often a sign of dehydration.
Unfortunately, this too is incorrect. All urine color shows is the timing of the water you drink. Lets assume I do not drink for 24 hours. Lets assume I also do not eat much, knowing that water, although very little, can be locked up in a piece of dry toast. To further make this bad, lets say I either do not eat a lot of vegetables or I am self restricting salt because doctors say it is bad for you. What would my pee look like at the end of the day? Dark naturally.
Lets say this is my routine for several days. My urine is still going to be dark. So, a family member comes in and encourages me to drink. I do. My pee is now light. But just because I drank a glass of water, it does not mean the water has been shared with all my trillions of cells in my body. I may still be severely dehydrated.
Thus the color of you pee is only an indicator of when you last drank fluids or ate foods with a lot of moisture in them.
Below are the health challenges related to dehydration that the elderly face. Next are just a few of the Titles of peer reviewed medical journal articles pulled from PubMed, the website of the National Institute of Health.
Decrease sensation in the bodies thirst mechanism. Decreased total body water in proportion to body weight due to loss of lean muscle mass. Age related functional decline of kidneys. The elderly are vulnerable to dehydration due to atmospheric conditions such as like exposure to hot humid weather and extreme cold. The elderly are vulnerable to dehydration due to health challenges such as diarrhea, vomiting, fever and numerous prescription medications. Physical and neurological impairment from stroke can alter the way the hypothalamus and pituitary gland work, which can have a negative effect on the thirst sensation and fluid regulation. When neurological impairments such as dementia and depression exist, the elderly are at increased risk of dehydration due to their inability to seek water.
Preventing Dehydration in the Elderly
-------Seasonal Weather Changes, Risk of Dehydration Dehydration in elderly people is due to an increased susceptibility than younger people. This is partly because of a lack of thirst sensation and changes in the water and sodium balance that naturally occur as people age.
-------Hydration, Morbidity and Mortality in Vulnerable Populations
Considering the number of people that are dehydrated, the risk factors of dehydration and the number of people who who have health related problems due to a lack of consumption of water, we need a better way to educate and help prevent dehydration.
To prevent dehydration in the elderly, we need to change the way we think. We need to change the way we treat and educate people in the prevention of dehydration.