Home Health and Hospice patients are prone to dehydration. Let’s explore why that is and the problems that dehydration may cause. You will learn how to recognize signs of dehydration. Then provided below are tips for ensuring your loved one gets enough liquids. Dehyrdation at the end of life will also be discussed.

Is your loved one at risk of dehydration?

Fluids are essential for good health. The amount of liquids required depends on age, climate, health, and activity level. Some individuals must limit their fluid intake because of heart, lung, or kidney disease. If the person has swallowing problems, such as after a stroke or when very weak., they may need thickened liquids.   Most people who receive Home Health and Hospice services are at risk for dehydration because of several factors. Talk to your loved one’s doctor, nurse, or dietitian for individualized guidance.

Common causes of dehydration may include:

  • Fever and sweating

  • Medication side effects
  • Lack of appetite and thirst
  • Hot weather
  • Limited activity
  • Fear of wetting the bed or urinating in their clothes
  • Drinking less to avoid having to use the bathroom due to mobility problems and fear of falling
  • Fatigue and lack of energy
  • Fear of choking
  • Depression
  • Advanced age or being a child
  • Specific illnesses
  • Vomiting or diarrhea

Why it is vital to prevent dehydration

Being thirsty or dehydrated isn’t just uncomfortable. It creates many health issues. Dehydration can be life-threatening when extreme. Dehydration doesn’t just generate a loss of water from the body. Important compounds, called electrolytes, are lost. They play important roles in the functions of organs Electrolytes impact blood pressure, cardiovascular wellness, muscle health, kidney function, and many other processes in the body. Electrolytes, such as sodium, must be precisely balanced for optimal health. Dehydration can contribute to:

  • Skin problems
  • Dry mouth and problems in the mouth
  • Constipation and hemorrhoids
  • Infection
  • Seizures
  • Confusion
  • Shock
  • Kidney damage

Signs and Symptoms of dehydration

Age affects the signs and symptoms of dehydration. Thirst doesn’t always indicate the body’s need to drink water.  Older adults may only feel thirsty when they are already dehydrated.  If you are concerned that your loved one may be dehydrated, notify the Home Health or Hospice provider promptly. Severe dehydration is a medical emergency that needs immediate treatment.

Signs and Symptoms of dehydration in babies and young children:

  • Dry tongue and mouth
  • No tears while crying
  • Three hours without wet diapers
  • Sunken cheeks and eyes
  • Hollow soft spot at the top of the skull
  • Drowsiness or irritability

Signs and Symptoms of dehydration in adults:

  • Dizziness
  • Extreme thirst
  • Urinating infrequently
  • Dark urine
  • Tiredness
  • Confusion
  • Poor skin tone
  • Lack of sweat
  • Dry mouth
  • Headache
  • Low blood pressure
  • Fast heart rate
  • Sunken eyes
  • Fast breathing

Easy Ways to Prevent Dehydration

All fluids add water to the body. Many people do not like the taste of water so provide other fluids. Here are some additional tips that you can employ:

  • Serve juicy fruits and vegetables like cucumbers and melon.
  • Offer frozen pops, ice cream, juices, gelatin desserts, and soups.
  • Create smoothies
  • Encourage the person to establish a daily goal for how much fluids they consume daily. You can purchase or make containers that are appealing and lead to increased consumption.
  • Always have liquids within reach. Make sure the container is comfortable for the person to use
  • Follow the provider’s instructions when giving fluids to people who have swallowing problems or those who are on fluid restrictions
  • Offer lesser amounts of fluids frequently. For example, you may offer 1/3 cup of tea every half hour. Be aware that many people feel overwhelmed when asked to drink substantial amounts of liquids
  • Ask the person what their food and beverage preferences are
  • Ask the person whether they prefer hot, warm, cold, or iced beverages
  • Create a routine for providing beverages
  • Avoid caffeinated beverages, alcohol, and overly sweet drinks such as soda as they can increase dehydration
  • Offer commercial beverages that replace electrolytes along with fluid.

Here are additional tips to help your loved one stay hydrated:

  • Offer help with toileting at least every 2 hours while the person is awake.
  • Take steps to reduce fevers
  • Do not overdress loved ones in hot weather
  • Be proactive- do not rely on the person saying that they are thirsty
  • Remind the person why drinking fluids is essential to them if they can understand. For example, a person with a lot of thick mucus might find it beneficial to drink to feel less congested. A person with constipation may feel more comfortable if they drink more, so because bowel movements are more effortless
  • Consult with your loved one’s health care team with an eye toward identifying the person’s risk factors. For example, a person with poorly controlled diabetes may be at a higher risk of dehydration when blood sugar levels are high. Follow the recommendations of the health care team for managing the risk factors
  • Keep electrolyte replacement products on hand

Dehydration during the final days of life

Consult with a hospice nurse or physician regarding dehydration during the last stages of life. It is treated differently than at other times. Hospice experts recognize that dehydration may help to reduce pain and suffering. The body releases endorphins, which are natural pain relievers. Artificial fluids are not given as they increase strain on the heart and make breathing harder. When people enter the final stage of life, they are not thirsty or hungry. Eating and drinking take too much energy. The emphasis is on comfort, not reversing dehydration or prolonging life. It can be tough to accept that it is normal and even beneficial for a loved one not to eat or drink at the end of life. The previously valuable actions are not appropriate or advised anymore.

Contact Smoky Mountain Home Health & Hospice

Since 1982, we’ve helped thousands of patients in East Tennessee receive high-quality home health care. If you’re interested in our home health or hospice services, call us at (423) 623-0233. You can also use the contact form on our website to connect with a member of our team. We look forward to serving you!