Hydration Risks and Tips for Seniors

The hot summer months are the perfect time for most people to enjoy fun in the sun with family and friends. However, as the temperature goes up, so does the risk for dehydration. Although adequate hydration is essential for everyone, older adults may have to take extra precautions to be sure they are drinking enough fluids when the heat is on!

Causes of Dehydration

There are particular reasons why older adults are more susceptible to dehydration. As we mature, it becomes more difficult for our bodies to adapt to temperature shifts, as well as the ability to conserve water. Also, we may start to lose our thirst sensation. Therefore, it is possible that when a senior feels thirsty, they may already be dehydrated. When the body does not have enough fluid to function, electrolyte imbalances occur, which may lead to serious health complications and even death.

In addition to the natural aging process, certain health conditions and medications can also affect a senior’s ability to retain fluids. Individuals with dementia may forget to eat and drink, and in more advanced stages may have difficulty swallowing thin liquids. Thickened liquids may help prevent choking/coughing with fluids; however are often not very palatable. Also, medications that are commonly prescribed for conditions affecting primarily older adults; including diuretics, antihistamines, laxatives, antipsychotics, and corticosteroids can cause frequent urination, which depletes water and electrolytes. Furthermore, those who experience urinary incontinence often intentionally limit fluids to avoid accidents.

Signs and Symptoms of Dehydration

Since thirst is not the most reliable indicator, it is important to pay attention to subtle signs that a senior needs to drink more water. Some early signs to look for include:

• Headache
• Constipation
• Reduced urine output
• Muscle cramps
• Dry mouth
• Lethargy

Symptoms of more severe dehydration include:

• Very little, dark amber color urine
• Dry skin that stays folded/tented when pinched
• Irritability
• Dizziness
• Confusion
• Low blood pressure
• Rapid breathing and heartbeat
• Weak pulse
• Chills

Preventing Dehydration

Balancing fluid intake with output is crucial. While most healthy adults require approximately 64 ounces of fluids per day; excessive sweating, diarrhea, or vomiting may increase fluid needs.

If a senior is resisting water, it may be helpful to infuse with fresh fruit, mix with juice or flavor enhancers or put in an attractive, easy-to-drink water bottle. Although water is usually the best fluid choice, there are sweet or savory, warm or cold liquid options that may be more desirable to seniors, such as warm broth or a cold smoothie. Choosing foods with a high water percentage may also help prevent dehydration. Most raw fruits and vegetables are made up of over 80% water.


Dehydration is a serious health risk affecting seniors, particularly when it is extra hot outside. If severe dehydration goes untreated, it may cause seizures due to electrolyte imbalance, reduced total body blood volume (hypovolemic shock), kidney failure, coma or death. While preventing dehydration is imperative, it is also important to keep in mind that seniors may have certain medical conditions, such as heart failure, kidney or liver disease, which may require fluid restrictions. Therefore, caregivers should stay in close communication with a senior’s healthcare provider to make sure proper interventions are being implemented.

This article was written by Dawn Ortiz (MS, RDN), Registered Dietitian Nutritionist for St. Paul’s PACE.