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The humble glass of water, an unsung hero of older people’s health

Posted Jan 06 2013 5:24am

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Whatever our age, it is vital that we have enough to drink. The NHS recommends that we should drink 2–3 pints or 1–1.5 litres of water, every day.

Dehydration – something older people can be susceptible to – can cause tiredness and confusion and if unchecked, painful and distressing urinary tract infections. But older people are less sensitive to feeling thirsty. Their kidneys don’t function as efficiently as those of younger people and the risk of dehydration is increased by weather changes and it is hot, humid, or both. 

I observed as both my parents aged, how their water intake diminished. Mum’s dementia both clearly affected and was affected by her water intake. As the dementia increased, she became correspondingly disinterested in drinking anything, even tiny sips of cranberry juice could seemed like a mountain to climb, but if she had a few days when her liquid intake was lower than usual, she became noticeably more confused. In her last few years, (in a specialist dementia unit) a number of distressing urinary tract infections resulted because her drinking wasn't well monitored or facilitated by carers. My dad, who had no dementia, used to sometimes joke, “no water for me thanks, fish have been swimming in it”.

Tea, coffee and squash all count towards the daily recommended total – obviously low-sugar varieties are obviously a lot better. Tea and coffee should be taken without sugar if possible to keep teeth and gum health as good as possible, as the effects of this on dementia symptoms are widely recorded.

In moderation, coffee and caffeine consumption may have a mild diuretic effect, but this is similar to that of water, so in moderation, caffeine consumption does not lead to dehydration. However, as caffeinated drinks may cause jitteriness, sleeplessness and anxiety, water is always the best option.

Dehydration can cause symptoms that may be confused with dementia and can also aggravate dementia. Dementia can cause dehydration and it is an increased danger when dementia is in its final stages, so drinking enough water is key to maintaining good health in people with dementia.

But ensuring that a person with dementia is sufficiently hydrated is very difficult. The importance of care planning for older people in care homes in support of rehydration – and the avoidance of dehydration – cannot be over-stated. Residents who do not have an actively monitored hydration care plan are likely to become dehydrated, with all the inevitable symptoms.

For many older people with dementia, lack of recognition of the water jug and glass or cup can be a problem. Research in hospitals ( more here ) shows that red, blue or green coloured glasses are easier for people to see (and therefore to use) but I’ve never seen them in care homes. However, it is important to stick to routines, familiar objects and surroundings – so although using a non-spill cup might seem like a good idea to a carer, it might well aggravate the problem.

Left unchecked, dehydration can even be fatal, so its importance should never be under-estimated – a simple glass of water is much, much more than a humble servant to our health.

Sources: patient.co.uk; AgeUk; Care Management News

Image: JunkFoodScience

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