Dehydration in Geriatrics

Question 1

dehydration

Answer 1

loss or removal of fluid from the body, occurs when fluid intake fails to fully replace fluid loss in body
(type of fluid or electrolyte imbalance)

Question 2

why is dehydration not ‘operationalized’

Answer 2

there is a lack of a universally agreed-on method to detect dehydration in this population.
(compared to peds where there is guidelines)

Question 3

Risk factors of dehydration in older adults

Answer 3

1. gender (female)
2. cognitive impairment
3. malnutrition
4. functional: decreased mobility, reduced swallowing
5. environmental: lack of access to clean water, warm temps
6. medications
7. pain
8. social: lack of attention to preferences, inability to communicate
9. institutional factors (untrained staff)

Question 4

Age related changes that increase the risk of dehydrations

Answer 4

1. kidney function declines
2. reduce thirst response
3. reduce body water
4. fear of incontinence
5. reduced lean mass

Question 5

% of 65-74yr olds, 75-84 yr olds, and 85+ not meeting fluid intake recommendations

Answer 5

65-74: 63%
75-84: 73%
85: 81%

Question 6

Dehydration
Causes:
Effects:
Consequences:

Answer 6

Causes:

• Too much fluid out (diarrhea, fever, vomitting, sweating, polyuria, bleeding)
• Too little fluid in (inadequate fluid intake)

Effects

• hypovolemia
• electrolyte balance disruption

Consequences

• medical emergencies
• hypovolemic shock
• delirium
• severe dehydration
• trauma (falls, fractures)
• death

Question 7

Health consequences of dehydration

Answer 7

1. heart disease
2. confusion
3. constipation
4. kidney failure
5. pressure ulcers (poor wound healing)
6. suboptimal rehabilitation outcomes
7. infections
8. seizures
9. drug toxicity
10. reduced QOL

Question 8

Why is fluid balance even more essential to older adults, vs young people

Answer 8

OA have a reduced water body content, so a 6 L loss is a higher percentage of total fluid

Question 9

Signs and Symptoms of Dehydration

- should it be relied on individually?

Answer 9

• fluid intake
• urine specific gravity
• urine colour and volume
• heart rate
• dry mouth, feeling thirst
• should not be relied on individually to assess absence/presence of dehydration in OA individually

Question 10

Severity of Dehydration

Answer 10

1. mild - headaches, fatigue, weakness, dizziness, leg cramps, lethargy, exhaustion and mood changes
2. moderate: sticky/dry mouth, decreased skin elasticity, pallor
3. severe: fever, confusion (delirium), kidney failure, UTIs, low BP, convulsions, severe cramping