Judith John, Consultant Dietitian for Public Health Wales, explains why hydration for older people is an important issue – no matter where you are in the UK.

Public Health Wales’ upcoming Water Keeps you Well campaign is focused on improving the hydration of older people. Good hydration is a basic health need for all, however the impact of poor hydration is greater on older people.

Effects of Dehydration Dehydration can affect mental performance and for an older person who already suffers with a lack of concentration, confusion or memory loss, dehydration can make this worse.

Dehydration can also lead to increased tiredness and cause low blood pressure which can result in feelings of weakness and dizziness. This, in turn, can increase the risk of falls and the effect of a fall on an older person can often be so much worse than with younger generations.

Also, urine infections can be quite common in older people and again, are caused and exacerbated by dehydration.

Older People

Don’t Drink Enough It’s important to realise there are changes with ageing which can reduce an older person’s ability to drink and recognise thirst. Older people suffering from memory loss conditions, such as dementia and Alzheimer’s, may not remember to drink and may not recall if they’ve had a drink recently. Many older people also have a reduced sensation of thirst.

Plus, in older people kidney function can be reduced. The kidneys control fluid regulation in the body so if they’re not working effectively a person’s response to fluid balance and dehydration may not be 100%.

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Then there’s the fact that if you’re frail it is physically harder to get up and about easily which means older people are less able to help themselves to a drink.

Improving Nutrition

in Care Homes Public Health Wales’ is working to support the Welsh Government to consider options for improving nutritional standards in care homes, including hydration. These efforts are aimed at improving the quality of food offered, and to ensure residents have a positive dining experience which meets their needs.

Public Health Wales is also supporting Nutrition and Hydration Week which runs from 14-20 March 2016 and is backed by the National Association of Care Catering.

Encouraging Good Hydration Although around 20%-30% of our fluid intake comes from food we still need to drink. The average person should be looking to drink between 1.5 and 2 litres of fluid a day.

For older people, it’s about encouraging them to think about the best way of having fluid in terms of their preferences. Water is the best drink for hydration but drinks that are mostly diluted with water are fine too, so this includes tea, coffee and squash.

Sugar Impacts Hydration A word of warning though - sugar affects the ability to rehydrate so steer clear of sugary drinks. There’s also the oral health implication of sipping sugary drinks throughout the day. Also, with poorly nourished older people lots of strong tea may not

changes with ageing which can reduce an older person’s

“It’s important to realise there are

ability to drink and recognise thirst.”

be good as it has a negative effect on iron absorption. So it’s important to check any individual needs and see if there is a need for adaptive equipment to help with drinking.

Warning Signs Memory loss and confusion outside of a diagnosed condition such as dementia and Alzheimer’s are signs of dehydration, as are urine infections. Drinks left untouched are another sign that an older person isn’t having enough fluid.

As families, friend and carers of older people in the home, in care homes, nursing homes and in hospitals, we have a responsibility to support older people to drink enough and spot the warning signs when they aren’t.

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