Dehydration and Dementia

July 2017

Hot enough for you?  I don’t know about you, but it was hot enough for me back in May. Now that we are in the grips of a heat wave with no end in sight, it is dangerously hot. While dehydration is a real risk for people of all ages, it is especially dangerous for seniors. Did you know that older adults are at a much greater risk of becoming dehydrated? There are multiple reasons for this, and together they create a perfect storm. 

As we age we lose the ability to realize that we are thirsty. What a lousy trick, courtesy of Mother Nature.  As a result, our brains are not getting the signal that we are running low on fluids.  Add to that the many other causes of dehydration in older adults, and before you know it you are in trouble. 

Medications such as diuretics cause the body to rid itself of fluid, and this can result in the body losing more fluid than it takes in. In addition, folks who are on diuretics may limit the amount of fluids they drink because what goes in must come out.  In other words, the bladder will be working overtime and into the night, resulting in interrupted sleep. In an effort to avoid this aggravation, people on diuretics may limit their intake and find themselves with the unexpected consequence of dehydration.

Older adults struggling with urinary incontinence may limit their fluid intake in an effort to avoid accidents. While this may seem like a good idea, it can result in dehydration as well and create more problems than it solves. 

For people with dementia, the risk of dehydration is even greater.  Short-term memory loss leaves them unable to remember when to drink, how much to drink, or what they may have already had to drink earlier in the day. The task of taking in the appropriate level of fluids simply involves too many steps. 

Dehydration is also made worse by excessive sweating, vomiting, diarrhea, and fever. 

Caregivers (who may also be older adults) should look for these signs and symptoms of dehydration:  

  • dark, concentrated urine
  • decreased urine output
  • confusion
  • weakness
  • reduced skin elasticity
  • headache
  • dry mouth
  • fatigue
  • dizziness
  • rapid pulse
  • muscle cramps

A good formula for how much fluid is needed per day is to take one-third of a person’s body weight and drink the equivalent number of ounces of fluid daily. For example, a 150-pound woman would need 50 ounces of fluid daily, or about six 8-ounce glasses of water.

Here are some tips on being proactive. 

  • Prefill bottles the night before, measuring out the amount of liquid that should be consumed by day’s end. This will help you keep track of how much has been consumed.
  • Add a twist of lemon, lime, or orange to the water to tickle the taste buds.
  • Have a helping or two of juicy veggies and fruits such as watermelon, strawberries, honeydew, celery, and tomatoes;
  • Enjoy popsicles or other frozen desserts such as lemon ice.
  • Avoid caffeine and alcohol, as they can hasten dehydration.
  • Avoid being out in the heat of the day.

Remember, an ounce of prevention is worth a gallon of cure. Dehydration can become very serious very quickly.  The time you spend hydrating yourself and the person you care for could save you a trip to the emergency room or worse.  Chill out and take care.

Barbara Garwood is director of community services for Lutheran Services Carolina. Email her at

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