Aging Parents, Thirst, Dehydration– Part 2

Skin turgor

8 Signs of Dehydration and a Quick Test for Dehydration 

Now that we know about the faulty thirst mechanism in older people, shouldn’t we–and they– know the signs of dehydration?
1.  Dark urine
2.  Small amount of urine
3.  Rapid heart rate
4.  Headaches
5.  Dizziness upon standing up
6.  Flushed, dry skin
7.  Coated tongue
8.  Irritability and confusion

Wikepedia elaborates in this definition:

Dehydration symptoms generally become noticeable after 2% of one’s normal water volume has been lost. Initially, one experiences thirst and discomfort, possibly along with loss of appetite and dry skin. This can be followed by constipation.

Symptoms of mild dehydration include thirst, decreased urine volume, abnormally dark urine, unexplained tiredness, irritability, lack of tears when crying, headache, dry mouth, dizziness, and in some cases insomnia.

The Quick Test: Skin Turgor

Skin turgor

A decrease in skin turgor is indicated when the skin (on the back of the hand for an adult or on the abdomen for a child) is pulled up for a few seconds and does not return to its original state. A decrease in skin turgor is a late sign of dehydration.
http://www.nlm.nih.gov/medlineplus/ency/imagepages/17223.htm

Mother normally didn’t drink much water, as mentioned in the preceding post. But she didn’t want problems like the under-disolved pill incident ever again. This skin test became a self-check that she was only too happy to do on herself–she became a converted water, flavored water, and non-caffine beverage drinker.

If these last 2 posts resonate, perhaps the skin turgor test will compensate for the old thirsty switch in your parents (and they’ll want to self-check like my mother did) –as we try to help parents age well.

More about skin turgor:   http://www.nlm.nih.gov/medlineplus/ency/article/003281.htm
…about the dehydration and hot weather:   http://www.homecare.com/dangers-hot-weather

Aging Parents, Thirst, Dehydration, in the Heat of Summer, or Any Time

Dehydration is dangerous, we know this but for most of us it isn’t that real because we’re not old and when we get thirsty, we take a drink. We all learned at some point how essential water intake is for life, but tend to forget unless there’s a drought or we’ve experienced dehydration in an aging parent.

Because of the extreme heat and humidity in certain localities (climate change? global warming? whatever) and because their brains and bodies seem NOT to trigger their thirsty signal very well, we need to remind ourselves again to make certain all the older people we care about are drinking enough. Hot summer days are one thing, but ordinary days are equally important.

(Note:  although caffeinated drinks [tea, coffee, soda] are commonly believed to add to dehydration–along with alcoholic beverages–see September 2017 comment w/ links below).

Since elders don’t experience thirst as intensely as those younger, the dehydration risk to aging parents is more prevalent in hot, humid weather. That said, not drinking enough water in normal weather–especially for those taking medications–  can cause problems as Mother, in her late-80’s learned.

She’d been hospitalized after a bad fall in a dark movie theater. She was never a big water-drinker and no one watched or realized she wasn’t drinking enough water with the pills given her in the hospital. Result: some pills only partially disintegrated. Tiny particles lodged in her throat causing serious irritation and necessitating treatment. Bottom line: taking pills with plenty of water is important. And sometimes a heavier fluid (milk, juice) makes successful swallowing easier.

I’ll conclude with a technique to check for dehydration in this coming Tuesday’s post. Until then, stay cool–and help aging parents stay cool.
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Related: Lack of Strong Thirst Signals Leads Elderly to Drink Too Little,” from a study at the U. of Melbourne, and the comments below provide food for thought.

The work of Egan and his team of scientists from Melbourne and San Antonio, Texas, is one of many studies of thirst in the elderly, said Neil E. Rowland, a professor of psychology at theUniversity of Florida and a thirst researcher. “These studies have had two different results: That elderly people experience less thirst and consequently drink less fluid, or that elderly people experience just as much thirst but still drink less,” he said.
“This paper is important because it’s really the first study that looks inside the brain to try to find out what might be different” about the thirst mechanism in older people, Rowland said.
The study is also interesting because it looked at the cingulate cortex, a region of the brain that hasn’t been studied widely by thirst researchers, he added.
While the findings are important to basic science, they don’t have immediate practical consequences, Rowland said. “The authors suggest controlled drinking programs so that [older people] take more drinks across the day. That doesn’t follow from this particular research. Those sorts of programs have been around for a long time.”
Scheduled drinking isn’t always successful with the elderly, added Barb Troy, a clinical assistant professor of dietetics at Marquette University. Anyone who works with the elderly will say that if you prod them to drink beyond their limit, that can be counterproductive, she said.
“They don’t ambulate as well. In the middle of the night they don’t want to be running to the bathroom, and that catches up with them.”

 

Aging Parents: The Practical, Important Foundations for Aging Well Function 4 –pictures added

4 Fundamentals–Fundamental #4
Nutrition and Hydration

Food and water are essential. We know that. We covered diet choices in previous posts, listing 98-year-old Sr. Advisor R’s favorite foods for breakfast, lunch and dinner. We also followed R’s shopping trip to Trader Joe’s for some of her favorite foods.

#4a.  Food  If you haven’t already viewed this post, click https://helpparentsagewell.com/2012/03/13/help-aging-parents-the-food-a-98-year-old-buys-to-cook-for-herself/ for sensible, tasty food ideas and shopping strategies that, no doubt, have contributed to keeping R healthy during her older years.

R worked out some dietary changes for herself, without a doctor telling her she needed to adjust her diet. For example, she watches salt intake–buying low-sodium products when available as explained in the aforementioned posts. She realized that while her taste-buds enjoyed rich food, it wasn’t agreeing with her 80-something-year-old body chemistry; so she eliminated rich foods from her daily diet.

She also decided to buy “low fat” products when they were an option and tasted decent. This isn’t to say R never enjoys treats like candy, dessert, or quiche; rather she rations rich foods, never overdoing because, she says, “it’s not worth paying the price. Why make yourself sick? It’s hard enough to be old.”

Bodies age. Metabolism and who-knows-what-else changes. Recognizing what doesn’t’ agree with us, probably checking with our doctor to rule out a more major problem, then making changes is no doubt proactive and preventative.

#4b. Hydration  On the other hand, we may not realize we aren’t drinking enough. Inadequate hydration causes problems. Most studies have found that older people don’t experience thirst like younger people do. When I mentioned this to R, she acknowledged she didn’t often feel thirsty, but didn’t know it was age-related. She added that her systems function better when she drinks more water. We talked about how much water older people should drink.  Click Mayo Clinic’s link,  http://www.mayoclinic.com/health/water/NU00283, for hydration information.

Mother experienced a consequence of not drinking enough water. She was in the hospital. In her late 80’s she took a bad fall in a darkened movie theater. It did a lot of damage, but she could eat and take medications by mouth. Not drinking enough water when taking pills, however, caused them to lodge somewhere in Mother’s throat. I learned this a day later, after significant throat irritation was traced to the partially dissolved pills. Pills need ample water to dissolve and do their job. Wish I’d known about this NIH link: http://nihseniorhealth.gov/takingmedicines/faq/faq13.html before the unpleasant incident.

After that, Mother was mindful about drinking enough. She didn’t like water much, so I bought flavored water. We lined up the bottles to be consumed each day and adjusted for juice and soup. Result: Mother felt a sense of achievement upon finishing the last bottle each day–and no more hydration problems. Setting goals and accomplishing them–always a plus!

Good vision, good hearing, good food, plenty of fluids, and keeping the body moving provide a strong foundation for aging well. And the more we know–and aging parents know–about supporting these important functions, the better the chances of helping parents age well.
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Seems like I’ve always heard about this simple way to test whether we’re drinking enough liquids–but I only read it this once in a naturopathic doctor’s work: The skin on the back of the hand–if gently pinched (remember old people bruise easily)–should go quickly back into position when the body has sufficient hydration. Returning slowly into position is an indication of insufficient hydration.

For additional hydration information:  http://www.europeanhydrationinstitute.org/files/EHI_Key_Tips_on_Hydration_Elderly.pdf

http://www.drugs.com/news/lack-strong-thirst-signals-leads-elderly-drink-little-10383.html

Yes, I know this isn’t Tuesday or Saturday, but my wireless access is “ify” while I’m cleaning our sold/soon-to-close-home, which no longer has internet access….and my iPhone just can’t do it! Anyway, don’t they say flexibility is a good thing?

Aging Parents: The Practical, Important Foundations for Aging Well–Fundamental 4

Yes, I know this isn’t Tuesday or Saturday, but my wireless access is “ify” while I’m cleaning our sold/soon-to-close-home, which no longer has internet access….and my iPhone just can’t do it! Anyway, don’t they say flexibility is a good thing? Note: I have reposted/reblogged with photos I’d wanted to add so please go to the May 4th version. This version will soon disappear.  Thanks.