It is estimated that 1,000 children under the age of five die every day due to lack of access to safe water. Clean drinking water Water is a basic human right and essential to sustain life: without it, death quickly follows. As a rule of thumb, humans can survive without water for three days.Of course, this will vary depending on your age and medical history.
In the Western world, we may be so used to the convenience of being able to turn on the tap and get water whenever we feel thirsty. But what if we can't turn on the tap and have no access to a drink? Nobody in the developed world gets thirsty, right? What is the relationship between dehydration and lack of water? End-of-life care?
Do you have an elderly relative in a nursing home or hospital? Or a relative with a spinal cord injury who is immobile? Or maybe a relative who had a stroke and is confused? When was the last time your loved one had a drink? Do you know? Even if your relative has water nearby, can you reach out and drink it? Don't assume your loved one has had a drink recently or been offered one.
Dehydration can affect people of all ages. Many people with mental illnesses or learning disabilities become dehydrated because they forget to drink fluids. Similarly, people with spinal injuries or broken bones may not be able to reach for a drink without help.
Is your loved one dying of thirst? Is your loved one on the road to “end of life care”? Would they be able to tell you that your loved one is on the road to end of life care?
Many dehydrated patients become confused. When a patient becomes confused or overly agitated, they may not drink or try to drink. To ease the confusion, a sedative may be prescribed. A sedated patient cannot drink or try to drink. When they become too drowsy to drink, hydration is stopped and the patient is diagnosed as “near death.” Many patients die not because of a terminal illness, but because they are left untreated. Could something as simple as a glass of juice or water have saved their lives?
Midazolam
Midazolam Midazolam is a short-acting benzodiazepine used for sedation during minor procedures and surgeries, but it is also considered one of the four essential sedatives. End-of-life care Midazolam is a drug often used in combination with opioids in older adults. Midazolam is often administered with a syringe driver or pump. If your family member uses a pump, ask what medications are in the pump and why. Many experts recommend against using midazolam in older adults because it suppresses breathing. When combined with opioids, it can be fatal.
Who is at risk for dehydration?
First, we need to identify groups in our communities who may not be able to obtain or request beverages themselves and who may be at increased risk of dehydration.
- Babies and Toddlers
- All Ages – Chronic Mental Illness/Learning Disability
- All ages – physically disabled or paralyzed
- All ages – Spinal or hip fractures causing immobility or paralysis
- Unconscious
- Bedridden
- Elderly
- Elderly Confusion/Dementia
It's 2024 and thousands of the most vulnerable members of society in the UK are denied access to water and are literally dying of thirst. study It has been shown that 31% of long-term care patients are dehydrated. 6 times They are more likely to die in hospital than people who are not dehydrated.
What is dehydration?
The human body has many functions, all of which require water. Water is essential for:
- Temperature control
- Eliminate waste
- Nourishes cells and lubricates joints
- Blood oxygenation
- Skin hydration
- Cognitive functions, including memory
Your body is very smart. When it senses that you need more water, it alerts your brain's limbic system to make you feel thirsty. Your body then tries to conserve fluid, and your kidneys also kick into gear to conserve water. You may notice your urine getting darker and thicker. Your body loses water in many ways, including through sweat, urination, and breathing.
Electrolytes
When your body loses fluid, it also loses electrolytes. Electrolytes Electrolytes are minerals such as sodium, potassium, chloride, magnesium, calcium, phosphate, and bicarbonate that are essential to life. Low electrolyte levels can cause muscle weakness, cramps, headaches, confusion, irregular heartbeat, and nausea. Electrolyte replacement therapy is available from most pharmacies. Diora LightMost people can maintain electrolyte balance by eating a healthy, varied diet.
I'm thirsty
When your body is dehydrated, you feel thirsty, but as you age, your sense of thirst weakens. Elderly They drink less water than younger people and often become dehydrated before they feel thirsty. Alzheimer's disease, or, stroke, Thirst and swallowIn most cases, fluid intake will need to be regularly reminded, encouraged, supervised and assisted, and records of all fluid intake will need to be kept.
Diuretics and Incontinence – Diuretics
Diuretics Diuretics, commonly known as “diuretics,” can also be given by injection. Diuretics are drugs that increase the amount of water and salt excreted from the body in urine. Diuretics increase the need to urinate, and many people may feel an urgency to urinate and need help getting to the bathroom. Many people with high blood pressure and congestive heart failure are treated with diuretics because they help reduce the amount of water that accumulates in the body.
Diuretics help reduce the amount of fluid in your blood vessels, lower your blood pressure, and reduce fluid retention in your body. However, it's important to note that many elderly people, people who are immobile, and people taking diuretics often worry about taking in fluids and therefore don't want to drink. incontinence They have various problems, such as not being able to go to the toilet right away. Many people feel that they are a burden or a nuisance to their caregivers and family members. If they don't want to drink water, they will quickly become dehydrated.
Nursing Homes and Hospitals
Many people in nursing homes and hospitals become dehydrated because they rely on carers and nursing staff to give them fluids, which, if not addressed, can lead to confusion and a rapid deterioration in their health. Cognitive functionEven people who are mobile and able to drink fluids can forget to drink. Keeping a record of fluid balance is very important. Many care homes have policies for monitoring fluid intake, but relatives and visitors can request this information.
Many medical conditions that require hospitalization can cause dehydration, such as diarrhea, fever, and diabetes, which can further worsen fatigue, headaches, and constipation. Dehydration can also: Urinary tract infection or acute kidney injury.
Digitalization has eliminated the need for paper fluid balance charts to measure fluid intake and output. Previously, these charts were hung at the end of the patient's bed or at the door, making them easy for family and visitors to monitor without asking staff. It remains the responsibility of staff to regularly check that drinks are offered, received and recorded.
Signs of dehydration in elderly and vulnerable people
- Dry or cracked lips
- Dry mouth
- Poor pronunciation of words
- Dry skin
- Infrequent urination/dark amber urine
- Strong smelling urine
- Muscle spasms
- confusion
- headache
- Irritation
- Poor memory
- dizzy
- headache
- syncope
- Increased heart rate
In elderly or frail people, dehydration can progress quickly and requires urgent treatment. Fluids often speed recovery, and symptoms often start to improve within 15 minutes of drinking fluids.
A quick test for dehydration: pinch the skin on the back of your hand.
There are blood tests to determine dehydration, but the only reliable and quickest way to determine whether you are dehydrated is to Skin on the back of the hand If the skin bounces back quickly, that's a good sign you're hydrated. But if the skin stays at its peak and is slow to return to the surface of your hand, that's a sign of dehydration.
Treating dehydration
How to treat dehydration HydrationDepending on the situation, intravenous infusions are often used if drinking becomes difficult. Check the chamber to see how fast the drops are flowing. Is the flow too slow? The majority of patients who require intravenous infusions also have a urinary catheter connected to a catheter bag. How much urine is in the bag and when was it last emptied? For those who are able to swallow, encouraging, supervising and helping them to give a drink every two hours will improve both their physical condition and their brain cognition.
How to prevent dehydration in the elderly and vulnerable
Public awareness of dehydration is the only sure way to prevent it. Knowledge saves lives. No one should ever be thirsty. Dehydration causes confusion, which may be treatable with sedatives. A sedated patient cannot consume liquids and becomes further dehydrated. A vicious cycle continues, leading to death. Dehydration is easily reversible and does not need to become serious. Be vigilantask questions and share messages.
Fresh water should always be available and easily within reach of everyone. Milk, orange juice Commercially available electrolyte drinks are known to help prevent dehydration.
How to encourage someone who doesn't want to drink
Sometimes it can be difficult to encourage others to drink. Some people may have difficulty holding a glass, in which case a beaker or straw may be necessary. Freshly chilled water with a slice of lemon and ice is often more appealing and easier to drink.
Frozen flavored popsicles are also an attractive alternative for those who are feeling ill or nauseous, and fruit and soups can also help with daily fluid intake.
Drinks should be in suitable containers (beakers or water bottles) and kept visible at all times. There should be no excuse for forgetting or not being able to reach a drink. Regularly encouraging drinks can be helpful, for example pouring drinks with meals and ensuring they are drunk, drinking a glass of water or juice when taking medicine, or having a drink or tea at the same time.
Regular monitoring and record-keeping are the only surefire ways to know if your loved one is drinking enough water.
An essential resource for relatives
please note:
The symptoms of dehydration in older adults are not always obvious – for example, some medications can affect the color of urine. Dehydration can also cause older adults to hallucinate, but cognitive changes due to dementia and side effects of certain medications can also cause them to perceive things that are not there.