Professional Comment

The Importance of Hydration in Adult Social Care

By Sarah Scotland – BSc Nutrition, Exercise and Health(Hons) (

Dehydration in the elderly is very com- mon and can have serious consequences. When the elderly are dehydrated, they can become dizzy, weak and suffer from wors- ened memory loss. These are all factors that increase the likelihood of falls, and in turn, a rise in hospitalisations of the elderly. Making some simple adjustments to your care to prioritise hydration could make a real differ- ence to the overall health and wellbeing of the elderly.

Firstly, what causes dehydration? The human body is made up of 65% water, which is used by the body for lots of reasons, such as breathing, sweating, and going to the loo. However, this is not an endless supply. The body’s water must be replenished regularly so that we can keep functioning properly. When water levels in the body have not been maintained, dehydration sets in. In a young and healthy individual

the first indicator of dehydration is thirst, reminding the body that it needs to drink. Unfortunately, the sense of thirst is diminished in old age, so the elderly must be constantly reminded to drink or offered food and drinks with a high water content. This is particularly important in hot weather, when the body sweats out more water. Another reason the elderly are more vulnerable is that they have a lower percentage of water compared to when they were younger (about 50%).

Dehydration creeps in gradually and is not always easy to spot. Many old people can seem confused, tired or listless when really they are just dehydrated. Headaches are a key sign of dehydration, often resulting in irritability. A good way to determine if someone is dehydrated is to examine the colour of their urine: the lighter in colour it is, the more hydrated, the darker, the more dehydrated.

Due to many different illnesses in old age, like dementia, how drinks are offered to the elderly must be given more consideration. For example, think about the choice of cup. Brightly coloured plastic cups are a good option as they are easily seen, especially if poor sight is an issue. As they are plastic it doesn’t matter if the cup is dropped, as breakages can be avoided. Depending on the illness, feeder cups with lids are often a great idea. Two-handled cups are a must for elderly who suffer with trembling hands or from dementia. For those who have lost coordination, cups with straws work well.

There are other reasons why drinks cannot be consumed aside from the inability to hold cups. It might be that drinks are placed too far away and cannot be reached. Although this is never done intentionally, it must be given thought. Are there side tables within reach for the cup to be placed up and down easily? Is there a way for hot drinks to remain hot? Tea and coffee are not nice to drink when cold, and this might well be the case if they forget to drink them. Invest in a thermal cup – you can even find these with two handles.

It is often difficult to convince people to drink water, so try to find alternative ways to encourage hydration. Tea and coffee do hydrate, but they are also diuretics, so offer these in moderation. Drinking chocolate or hot Ribena are great drinks to offer (these are high in sugar, so be careful if there is a weight issue). Dilute food and drinks to increase the water content. For example, you can easily dilute fruit juices and soups. Certain foods contain lots of water. This can be a useful way to introduce water into the diet. Fruit and vegetables are an excellent choice as they provide a variety of vitamins and minerals as well as water. Carbohydrates such as rice and pasta are good choices and mixed together with some protein and vegetables can make a nutritious and water replenishing meal.

Many old people dislike eating by themselves. Even if they are able to look after themselves, they can find preparing and cooking food hard. Eating together in a group where there is stimulation and socialisation is key to old people eating and drinking well.