Post-acute care can be looked on as a stop on the way home from hospital. The carers have a responsibility to the health and well-being of a patient in a rehabilitation center. Included in this, is watching the hydration level of the patient. The joint attention of the patient, the carers, family and friends on this point is required. This is a very important stage in the recovery of a senior.
The Importance of Hydration in a Senior
Water makes up about 60% of the human body. It is needed in the body for regulating the body temperature and many other essential bodily functions. Cells, bodily organs and all parts of the body tissues contain water.
A senior adult is naturally less sensitive to the feeling of thirst. Medications can cause water loss. The kidney functions less efficiently. Illness can cause fluid loss, such as through vomiting. In addition, the body uses up water through body functions, such as, breathing, the digestion process and sweating.
A senior adult’s skin itself stores less water and fat than previously. As a result the skin is thinner and less protective.
In hot weather it is important to drink extra fluids. Even indoors, dehydration can be an indirect effect of air conditioning. Since the AC reduces the level of humidity in the air, over time the dry air can dry out the body.
We see, that the hydration level of a senior adult is especially important.
Well-Being and Hydration of a Patient in Rehab
Does one need to check that the patient drinks?
Yes. A lack of sufficient body fluids in a senior can cause weakness or illnesses. Dehydration in a senior can lead to: UTI’s, pneumonia, bedsores, confusion or kidney injury among other problems.
Remember: Dehydration can be prevented by watching hydration levels!
It is common sense that keeping a patient hydrated helps towards their recovery.
How much water/fluids does a senior need daily?
Eight 8oz. glasses of water or fluid. This is a general rule, to make it easier to keep track of how much has been drunk. The truth is that the amount of water needed for hydration, varies from person to person. A person needs as much liquid intake as is required for them to be healthy and well.
How can a person’s hydration be measured?
Keep track of hydration, says Dr. Larry Kenny of Penn State University. This can be achieved by watching body weight. A patient in a residential home should be weighed every morning. If there is a loss of 2-4% of body weight from the previous day, it should be interpreted as dehydration.
Hydration levels can be estimated easily by checking the elasticity of the skin on the arm, abdomen or back of the hand. Gently pinch the skin on the back of the hand, between the second and third fingers. If the skin does not immediately stretch back to normal, it may indicates dehydration.
How do you Know if Your Loved One is Hydrated?
There are some visual cues to indicate dehydration.
Even a non-medical person can observe/assess if there is proper hydration. Look at yourself or your loved one.
The following may indicate dehydration:
- dry lips
- cold or clammy skin
- roughness or cracked skin
- lack of saliva
- darker urine
- tiredness or lethargy
- anxiety or confusion
Questions to ask yourself or your loved one:
- Does it look like enough water is being drunk? Is there a water pitcher nearby? Do the staff offer a variety of drinks in between meals?
- Room temperature is about right? Can the patient change the temperature? Is the patient dressed correctly for the time of year? Do they have access to a light sweater, that they could wear or take off? Is there a member of staff to help regulate temperature if they need it?
- Do they have access to nourishing snacks (as permitted on their individual dietary plan) such as fresh fruit?
- Do they look as healthy, aware or comfortable as they normally do?
Warning Signs of Dehydration
The first signs of dehydration in an adult are usually thirst and darker colored urine. There are slightly different signs of dehydration in a senior:
- sunken eyes
- can’t produce tears / dry eyes
- dry mouth,
- difficulty keeping balance,
- reduced mobility
- low blood pressure
- small amount of dark urine
We discussed the importance of good healthcare in a post-acute situation. It is a joint effort between staff, patients and their friends and family. The health and well-being of a patient in a rehabilitation center is paramount to all other aspects of the patient’s visit to the center. The effort towards good health, includes watching the patient for signs of dehydration and treating if necessary. This will, in time, lead the patient out of the rehabilitation center in continuation of their journey towards recovery.