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Dehydration in the elderly is a serious health risk. It’s a common cause of hospitalization. Especially during the hot summer months.

As a precaution, most senior living communities have a Hydration Program. Of course, some do a better job than others.

That's why it's important to understand the risk factors, signs of dehydration, and prevention strategies. Then you can assess the program in your loved one's assisted living.

Why are elderly more prone to dehydration?

Assisted living providers understand the risk factors for older adults of becoming dehydrated. You can partner with your mom’s community when you too know what’s involved.

Diminished thirst

As we age our sense of thirst diminishes and we don’t recognize we need fluids. So older adults get severely dehydrated before they even realize they’re thirsty.

Mobility

Frail elders may find it difficult getting out of chairs and recliners. Getting a drink of water doesn’t seem worth the effort.

Overactive bladder and incontinence

Liquid in, liquid out. Many older adults avoid fluids because of incontinence worries. They get tired of frequent and urgent bathroom trips.

Misdiagnosed and undiagnosed

Many early signs of dehydration are easily confused with other medical and natural conditions. Things like dry mouth, fatigue, dizziness, and muscle cramps.

Too many diuretics

Many older adults avoid water and drink a lot of coffee instead. While coffee, tea, and soda are okay in moderation, they shouldn’t be the only fluids consumed.

Medications

Older adults often take several medications. Some of these meds act as diuretics. They may also cause increased sweating leading to dehydration.

Decreased kidney function

Aging bodies have aging kidneys that are less able to conserve fluids.

Illness

Vomiting and/or diarrhea can quickly cause dehydration in the elderly.

What are the signs of dehydration in a elderly?

Caregivers are trained to watch for the following signs of dehydration – especially during hot weather. Collaborate with your dad’s caregivers in keeping him safe by also recognizing the signs.

Confusion
Low energy
Difficulty walking
Dizziness or headaches
Dry mouth
Sunken eyes

Inability to sweat or produce tears
Rapid heart rate
Low blood pressure
Low urine output
Constipation

You can also check an elderly person’s skin for turgor (plumpness of the skin cells). Pull up on the skin on the back of the hand for a few seconds. If it doesn’t return to normal almost immediately, they’re dehydrated.

If you notice these signs in your loved one, call the nurse right away. He or she can assess if your elder should go to the hospital.

What are Hydration Programs in assisted living?

Most assisted living facilities start a Hydration Program during hot weather streaks. These programs prevent dehydration by surrounding residents with opportunities to drink fluids. Here’s what Hydration Programs could include:

Caregiver training

Caregivers should get frequent reminders about symptoms of dehydration. And daily review residents at greater risk – such as loners and those with dementia.

Resident Education

Seniors themselves need education about their risk of dehydration. They should be encouraged to drink, even when they don’t feel thirsty. Urge them to keep several water bottles around: by the bed, easy chair, or dining table. Kick off a Hydration Program with special branded water bottles.

Body weight monitoring

Elders can lose 2-4 pounds of water weight when they’re dehydrated. Daily weight monitoring is critical for folks with renal failure and cardiac issues.

Mealtime choices

Staff should routinely serve water and juices at every meal. Along with encouragement and reminders. Soups should regularly be on the menu. Also, meals should include a wide variety of fresh fruits and vegetables.

Social hours

Activity directors can include popsicles, fruit infused water, and fresh melons at all social gatherings. They can place water stations throughout the building. Especially in areas where residents naturally gather. Meanwhile, encourage your loved one to attend events.

How can you partner with your parent's assisted living?

In case you're rating the Hydration Program at your parent's facility, a high score would include all the above. But keep in mind, your parent’s facility might not need all the above. Every community is different – every mix of residents is different.

Over all, what do you think? Is your facility doing a great job? Wonderful! Be sure to compliment the staff and say, “Thank you.”

On the other hand, could the program use a little boost?

First, encourage your own loved one. Make sure they have plenty of water bottles.

Second, talk to the administrator and ask about their program. They may be doing things you don’t see. Check the Activities Calendar.

Third, ask how you can best help. Perhaps you could volunteer to join the social hours and help serve refreshments.

In conclusion

Keeping our elders healthy and safe is a team effort. It takes collaboration of family advocates and their loved one's assisted living.

The best outcome for your elderly family member is to know about dehydration. Especially the added risks for elderly. Know the signs of dehydration and some prevention strategies.

Leave a comment below. Tell us how you partner with your assisted living community.

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You might also be interested in these articles:

5 Ways assisted livings prevent dehydration in elderly residents

Dehydration in the elderly is a serious health risk. It’s a common cause of hospitalization. Especially during the hot summer

What is Assisted Living?

Is assisted living right for you or your parent? Yes…or maybe No.Yes! Because today’s assisted living isn’t like the dreaded

Is assisted living right for you or your parent? Yes…or maybe No.

Yes! Because today’s assisted living isn’t like the dreaded “old-folks home” of yesteryear.

And No! Because not every assisted living matches you, your needs, or preferences. They all seem to offer the same things.

Look below the surface and compare the details. This article looks “under the hood” of assisted living. What it is and what it isn't.

Here are the 5 basics that professional referral agents know. You should know them too.

1. Assisted Living is a social model – not medical

You often hear assisted living described as the “alternative to a nursing home.” This is only somewhat true. Assisted livings are not medical facilities.

Assisted living is more like independent retirement. Both offer a “hotel-style” of living. But, assisted living facilities hire in-house staff to provide hands-on help with daily living.

Think of assisted living as a bridge. They span the gap between independent living and nursing homes where complex medical care is provided.

Older adults choose assisted living when they want independence but have help available if needed. These residents can direct their own care, value autonomy, and like having choices.

2. Each facility is licensed by the State

Assisted living facilities are licensed by the State Department of Human Services. They’re inspected every two years for compliance with Rules and Regulations.

Inspection reports are public information. Every community must keep their report in a binder, on-site, and easily accessible.

If you’re a consumer, don’t be shy. Ask to see it.

In between inspections, any complaints of abuse or neglect are inspected within 24 hours. You can check Complaint Records online.

3. Floor to ceiling care

Imagine a building. There’s the floor and the ceiling. Some buildings have low ceilings and some have tall ceilings.

In assisted living, the State sets the minimum requirements of care. That’s the floor or foundation. But each facility sets its own ceiling of care.

State-mandated basic services include:

3 meals + snacks per day
Private apartments with full ADA accessible bathrooms and basic kitchenette
Care assistance with bathing, dressing, personal hygiene, transfers, mobility, toileting, transportation arrangements, medication management, etc.
24-hour awake staff
A social and activities program that meets life engagement needs of all residents

Each facility determines how much care they’re able or willing to provide.

Examples:

Example 1 - Community “A” will assist or guide residents with transfers from bed to walker, if no lifting is needed. Community “B” will assist with transfers when 2 caregivers are needed, lifting is required, or a mechanical device is necessary.

Example 2 - Community “A” will pass oral medications on a regular schedule. They’ll also provide regular diabetic glucose testing and give regular injections. But, they’ll require residents use pre-measured insulin pens. Community “B” will provide full sliding scale diabetic injection care.

Also, a community’s “ceiling” can fluctuate. Fluctuations are based on overall acuity of care at any given time.

For instance, a community that typically provides sliding scale diabetic care, may decline any new diabetic applicants. The nurse or administrator may decide there’re too many current residents needing a lot of care. They want to ensure their ability to meet the needs of residents.

Please note: the State restricts many medical care tasks in assisted living. These care tasks require licensed nursing. Residents in assisted living must be medically stable with predictable care.

4. Staffing ratios are not mandated by the State

The State sets minimum requirements for care, but it doesn’t mandate staffing ratios (as of this writing). Each assisted living community is expected to staff according to the total acuity of care in the building.

Oregon does not require caregivers be licensed CNAs. Front line caregivers or personal attendants must pass criminal background checks. And facilities must provide on-the-job training and regular ongoing education related to aging.

Please note: residents share 1 caregiver with 13-20 other residents. The average staff to resident ratio is 1:15 (hopefully).

5. Culture

Every assisted living community has its own “culture” or personality. The mix of residents, their backgrounds and interests, the current administrator, and team determine the culture.

Before moving your parent to an assisted living, visit several times. Meet the staff, residents, and resident families. Attend events and social gatherings.

Consumer-Driven Services
Assisted living services continue to evolve. Many communities strive to meet today’s consumer expectations of choice, amenities, and aesthetics. Flexible dining and expanded menus are examples.

But don’t be fooled. Lovely surroundings, fancy amenities, and extra services don’t always equate to five-star care.

Consumer-Driven Services

Assisted living services continue to evolve. Many communities strive to meet today’s consumer expectations of choice, amenities, and aesthetics. Flexible dining and expanded menus are examples.

But don’t be fooled. Lovely surroundings, fancy amenities, and extra services don’t always equate to five-star care.Each facility determines how much care they’re able or willing to provide.

Find the right assisted living, work with a local referral agent

Professional referral agents have experience and insider knowledge. They network and build relationships. Referral agents know a community’s history, staff turnover, compliance, and culture. Agents preview and pre-qualify communities. They’ve done the research, so you can relax.