Now, with the arrival of sunnier skies and rising temperatures, people are spending more time outdoors. Although it benefits physical and mental health, being outside also brings an elevated risk of dehydration, heat exhaustion and heatstroke if we fail to drink sufficient water.
Healthcare providers and caregivers must be doubly diligent, ensuring proper hydration not only for the people they care for, but also for themselves. It can be all too easy to neglect the requirements of one’s own body while busily caring for others. The key is for hydration to become second nature, like brushing your teeth.
Multiple factors can increase the risk of dehydration among older adults. As we age, our bodies experience a decline in their ability to regulate their temperature, as well as a decline in kidney function, making us more susceptible to dehydration. Our bodies’ water composition can change from about 70% to below 50%. Side effects of medication can increase our need for water. Decreased mobility can make us less likely to make that long trip to the refrigerator or the sink for a drink. Dementia or other cognitive challenges can decrease our awareness of thirst, the ability to communicate that thirst, and possibly our ability to swallow. And many of us, caught up in our daily activities, simply don’t think about hydration as often as we should.
Older adults who are not in residential care are generally reported as having much higher rates of hospital admissions or ER visits due to dehydration. In one study involving 200 older adults in long-term care, 37% of the participants admitted to the hospital were diagnosed as dehydrated.
In a typical year, extreme heat causes more deaths than hurricanes, floods and tornadoes combined. More than 80% of Americans who die of heat-related causes are over age 60. Unfortunately, symptoms of dehydration in seniors often go unrecognized, increasing the potential for a more serious medical event.
Early identification of the signs of dehydration, heat exhaustion and heatstroke can help older adults stay healthy and hydrated. Healthcare providers and caregivers should be alert for signs of dehydration, which can include dry mouth, infrequent or darker urination, muscle cramps and headache. Prolonged dehydration can lead to other symptoms, such as dry, “papery” skin, irritability, increased heart rate, or confusion.
Signs of heat exhaustion can include heavy sweating; cold, pale and clammy skin; muscle cramps; tiredness or weakness; dizziness; headache; nausea or vomiting; or fainting. In responding to such cases, caregivers should move the affected person to a cool place, loosen their clothes, lower their temperature with a wet cloth or a cool bath; and give them water to sip.
Signs of heatstroke can include high body temperature (above 103 degrees Fahrenheit); red, hot or dry skin; rapid, strong pulse; throbbing headache; dizziness; nausea; confusion; or loss of consciousness. Heatstroke is a medical emergency that can cause death or permanent disability. Caregivers should seek immediate medical attention for the affected person.
At Brookdale Senior Living, we take a comprehensive, proactive approach to our residents’ well-being, and that includes giving special attention to hydration. Recognizing its importance, we integrate it into every aspect of daily life in our communities, striving to make it second nature for our residents.
Beyond our evidence-based clinical understanding of the importance of hydration, we also understand the human behavior piece of the equation. It’s generally easier to shape human behavior by making the desired behavior more pleasurable or enjoyable rather than tedious or boring. We know it’s not easy to get excited about drinking water, especially in large amounts, and we have accepted the challenge of generating a little excitement about it.
We employ preventive strategies to mitigate the risk of dehydration among our residents. For example:
An integral part of our customized care is taking the time to understand each resident’s life story, daily habits, norms and customs. Really knowing our residents helps us identify risks, including insufficient hydration. If we know that Sheila loves to sit outside in the sun when it’s warm, we know we need to be intentional about offering her extra hydration during those times. Brookdale communities have people on hand who not only remind residents to stay hydrated but also to watch for signs of dehydration and help prevent unnecessary hospital admissions.
We provide ample hydration options for a variety of lifestyle needs, beginning with our dining programs, where residents receive plenty of water and other beverage options at each meal. Convenient hydration stations make it easy to grab a cool drink of water, and choices of flavor packets and fruit infusions help make plain water more appealing. We also offer snack options with high water content, as well as water bottles for on-the-go hydration. And we often plan fun social events around our inventive drink options.
In our Clare Bridge® dementia support program, we take every opportunity to verify our residents have water. Proper hydration is an essential element of our evidence-based dining program, and we have hydration stations throughout our Clare Bridge® communities to make it part of our residents’ daily path. When we feature a flavor, we often create a program around it. If the flavor is watermelon, for example, we may talk about growing watermelons to generate interest and excitement, while encouraging residents to drink the water. We also strive to enhance hydration stations’ visual appeal, focusing on the enjoyment aspect of hydration.
Our Brookdale HealthPlus® communities use an electronic tool called Stop and Watch. If we notice changes in a resident’s health or behavior, we can immediately enter those observations into our electronic health record to notify a nurse to administer an appropriate intervention. The issue could be something as simple as hydration, and the tipoff could be dry lips, a change in skin tone or a sudden shift in cognitive status.
Finally, we also remind our staff to stay hydrated. We know that their well-being is crucial to the well-being of our residents. That’s something we can drink to!
Contact us to learn more about Brookdale’s commitment to healthy hydration and how it’s part of our overall approach to supporting our residents’ well-being.