Category: Dehydration

Drinking Water

Dehydration in the Elderly: Risks, Dangers, Detection, Prevention

As the heat of summer fades away, so might our awareness of how important it is for us and especially our elderly family members to stay hydrated. Dehydration can be difficult to detect, especially in the elderly. However, its effect on health can be dramatic and even life-threatening. Water content in the body decreases with age, especially in women. Dehydration can occur quickly. Depending on overall health, humans can’t survive more than 3-4 days without water. Although knowing the symptoms of dehydration and its damaging effects can be important, having a strategy for prevention is the most important thing for the elderly and their caregivers to focus on. Risk Factors for Elderly Dehydration At 96, my father had difficulty swallowing and easily aspirated liquids, unless they were thickened. Keeping him hydrated was a challenge. He would eat fruit and ice cream, but he refused most vegetables and soup, so he didn’t get a lot of water from his food. Swallowing disorders can be caused by aging, stroke, Parkinson’s disease or dementia. Other risk factors that heighten the chance of developing dehydration include: Not feeling thirsty Memory issues Obesity Beingbedridden Diarrhea,vomiting, excessive sweating Chronic health issues Some medications Diminished drinking due tofear of incontinence Fear of falling anytime they get up Dangers of Dehydration These and other dangerous health problems should cause us to suspect and want to prevent dehydration in the elderly: Urinary tract infections Aspirational pneumonia Severely dry skin and pressure sores Joint pain and muscle cramps Cognitive issues Kidney stones and function Low blood pressure, irregular heartbeat Seizures Early Detection Keeping an elderly person hydrated can require constant monitoring. Some of these signs may indicate dehydration and noticing them might help to prevent other conditions. See if drinking more water helps. If not, check with a doctor to determine

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Elderly Eating

Eating and Nutrition Difficulties with Alzheimer’s and Other Dementias

Eating can be difficult for people with Alzheimer’s disease or other types of dementia. They may have difficulty feeding themselves, resist being fed, don’t recognize food they are given, have trouble chewing and swallowing. They don’t know they are thirsty or forget to drink. They may even try to eat non-food. Many people with Alzheimer’s want to eat only childhood comfort foods. Regular nutritious meals become more and more of a challenge. Unintended weight loss is common. Many seniors develop problems that make them not want to eat or make it hard to maintain good nutrition, even if they don’t have a specific type of dementia. Click to read our blog “Why Seniors Don’t Want to Eat & What You Can Do About it.” It’s not surprising that many of these same challenges are also present in people with dementia: Poor appetite – not motivated to eat; nothing looks good Chewing and swallowing problems; choking and food aspiration Fatigue—too much effort, lack of eye-hand coordination Missing or broken teeth; ill-fitting dentures Medication side-effects Loneliness or depression This  blog also contains strategies for dealing with eating challenges. Below are some challenges experienced more specifically by people with dementia and strategies for their caregivers. Taking Medication Remembering which medications to take and when becomes a problem. In the early stages, putting pills in a pill box marked with the days of the week can help your loved one and a caregiver see that the pills for the day have been taken. At first, my husband who was diagnosed with early-stage Alzheimer’s, could fill the pill boxes himself. I kept a close eye on him and discovered that, before long, he would sometimes miss a pill or put two of the same ones in one day’s box. I started filling the morning and night

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Protein Shake

Why Seniors Don’t Want to Eat & What You Can Do About It

Many seniors are not eating a balanced diet as they age, whether they live on their own, with family or in a senior living facility. Seniors who live alone are at increased risk because there is no one to observe their eating habits. There are many causes for why seniors don’t want to eat, why they’re under-eating, over-eating or not eating nutritious meals. By the time he was 97, my father had multiple problems that made it difficult for him to eat a balanced diet. During the last few months of his life, the only thing he ate willingly was strawberry ice cream. The assisted living center he called home provided 3 nutritious meals a day and snacks in between meals on request. They were very accommodating with his diet–limiting sweets and carbs, cutting everything into small pieces and eliminating foods known to be a choking or swallowing hazard. However, unless a family member was there with him at meal time to encourage him to eat or even help to feed him, he rarely ate vegetables and expended most of his energy and appetite on small bites of protein and the ice cream that easily slipped down his throat. Causes of poor nutrition Some of Dad’s problems could be similar to what’s causing your elderly loved one to under-eat, over-eat or not eat a balanced diet. Watch for these risks and hazards interfering with a balanced diet, and consider what can be done to prevent or get around them: Poor appetite – not motivated to eat: Many seniors’ sense of smell and taste diminish with age. Nothing looks good or tastes good, and often times there’s no one there to direct them toward healthy choices and encourage them to “eat to live.” They often don’t associate what they are eating

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confused-elderly-woman

UTIs: Symptoms, Causes & Prevention in the Elderly

The basics about UTIs can be found in one of our first blogs, Health Wise – Urinary Tract Infections in the Elderly. Because UTIs continue to be a very common, serious and frequently undiagnosed illness in the elderly, today’s blog provides additional information about UTI symptoms in the elderly, causes and prevention. Symptoms The most common reason UTIs often go undiagnosed in the elderly is because the symptoms don’t mirror typical symptoms of UTIs. What can be an easy cure (antibiotics) might not be administered, because your first thought could be that your elderly loved one has a much more serious condition, like dementia or other permanent behavioral changes. The most commonly recognized symptoms of UTIs are frequent urination, burning pain, cloudy urine, a fever and lower back pain. Because many senior citizens’ immune systems have been weakened by time and are not functioning at optimal levels, they have increased susceptibility to any infection. Their bodies do not recognize or try to fight the infection; thus, no fever, but producing UTI symptoms in the elderly that can be very different: Disorientation, confusion or a delirium-like state Hallucinations: hearing or seeing things that aren’t real Agitation, depression or other behavioral changes Decreased motor skills and/or dizziness that causes frequent falls Why these symptoms frequently are the result of a UTI in an elderly is something of a mystery. However, as all infections can lead to dehydration which, by itself, can produce these types of symptoms, that may be one reason. Dehydration is common in the elderly for a variety of reasons. If any of these symptoms come on suddenly, an immediate visit to the doctor is called for. Make sure it includes a urine test to determine whether or not a UTI is the cause. A urine test can also help

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End of life signs

Recognizing when Death is Near: Planning for End-of-Life Care

It can be just as difficult to predict the exact time that someone will die as it to predict exactly when a baby will be born. However, there are signs you can watch for that will help you prepare mentally, emotionally and physically for this big change in your family’s life when end-of-life care is needed. As you care for your loved who may be near death, look for normal signs like these: Losing interest in and becoming less responsive to what is going on around them Sleeping or seeming drowsy most of the time Eating and drinking less than usual or not at all Irregular breathing, including noisy or gurgling sounds, sometimes called a “death rattle” Talking to someone who has already died A brief surge of energy and clarity of mind The loved ones of a person who is dying want to know what they can do to make the person more comfortable. Even though a dying person may seem unconscious, many professional caregivers think hearing may still be functional. Continue talking to your loved one. Express your love, hold their hand and reassure them that they can go when they are ready. Take advantage of a brief period of consciousness to say final goodbyes. Even though my father couldn’t talk, we put the phone up to his ear to let out-of-town family members talk to him. He seemed to respond to hearing their voices. Don’t try to force food or water. Going without food or water is not uncomfortable. Swallowing may also be a problem, especially for people with dementia. A conscious decision to give up food can be part of a person’s acceptance that death is near. If the person’s mouth seems dry, just swab it with water and apply lip balm. A “death rattle” may

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Facing a Hard Choice: Saying Yes or No to Artificial Nutrition and Hydration (ANH)

It can be difficult to have a conversation with your family about whether or not an elderly family member should be put on artificial nutrition and hydration (ANH) when he or she is nearing the end of life. However, it’s usually much easier to make that decision while the elderly person can still give informed consent and include their wishes in an advanced health directive. Providers need to be aware of the goals of all concerned and families must be informed as to whether ANH can realistically achieve these goals. Have the Conversation A few months before my 97-year-old father died, he and I sat down with a kind doctor who explained the risks and benefits of ANH. Dad was able to state unequivocally that he did not want ANH or any other extreme measures, including hospitalization, if he developed a life-threatening illness. We made contact with a hospice service that sprang into action immediately when he developed aspirational pneumonia. Within three days, he died peacefully in his own bed. For some families the choice is not so easy. Each situation is different. Some people consider it an ethical matter and feel they must prolong life as long as possible. Others worry that their loved one will suffer needlessly without nourishment or fluids. Your spiritual advisor and doctor can help you make the decision that is right for the patient and family, including informing you of the risks and benefits of ANH and alternative treatments and interventions. Possible Side-Effects of ANH When a person has a curable illness and can’t swallow, ANH can help him or her recover. For a patient who has a life-threatening illness and is dying, ANH may not be beneficial. These patients may live a little longer with ANH, but not always. In either case, there

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