Dehydration and Confusion in the Elderly

Watching for signs and symptoms of conditions in an elderly family member can be challenging. Some diseases and illnesses show up rather clearly while others have quite a subtle effect on everyday living. Dehydration, depending on how severe it is, sometimes shows only small telltale signs while it actually has a significant effect on the body, particularly when it comes to seniors.

What is Dehydration?

Dehydration occurs when a person loses more fluids than they consume. The body needs an adequate amount of fluid to function properly. For example, the body needs water to maintain blood pressure, regulate body temperature through sweating, and eliminate bodily waste. If acute enough, dehydration can lead to weakness, confusion, pneumonia, urinary tract infections, bedsores in bed-ridden patients, or even death.

Reasons and Risk to Elderly

There are quite a few reasons why elderly people have an increased risk for dehydration. Elderly people may not notice their thirst as quickly as someone younger or their sense of thirst may not be as potent as a younger person. The senior may have extremely limited mobility and might not be able to access a sufficient water supply without help from another person or from an assistive drinking method. Some older adults may have swallowing problems, and older adults that are confused or have dementia may not be mentally capable of drinking on their own.

Dehydration is more likely to occur when an older adult increases activity without increasing fluid intake or in warm weather. Drinking inadequate amounts of fluids is also a common risk factor for dehydration in the elderly. Anything that amplifies urinary output has the possibly to put an older person at risk for dehydration. Having Addison’s disease, diabetes, taking certain medications, or having other chronic conditions can increase a person’s risk for dehydration, as well. Acute illnesses may also increase the likelihood of becoming dehydrated rather quickly, especially if the illness causes a fever, vomiting, and/or diarrhea. If an elder develops diarrhea and/or vomiting, he or she may not be able to adequately rehydrate their body.


Dehydration can occur quickly in senior citizens, especially those who are frail. Symptoms have a tendency to start off as mild but may turn out to be more severe as the body’s need for water intensifies without being met. A few symptoms that may indicate that a senior might be dehydrated include:

  • Thirst. This symptom might be subdued, not capable to determine or verbalize, or absent in elderly.
  • Confusion
  • Decreased sweat.
  • Skin becomes less elastic.
  • Dry or cracked lips.
  • Dry mouth and mucous membranes, such as inside the nose.
  • Sunken eyes.
  • Flushed or rosy look to the seniors’ face.
  • Urine output may be less, dark, concentrated, or absent.
  • A low blood pressure.
  • Fast, weak, and/or irregular pulse.
  • Headache and/or irritability.
  • Loss of equilibrium and/or dizziness.
  • A high sodium levels in the blood.

Dehydration and Confusion

If the elder has dementia or another mental illness, confusion is a dangerous symptom of dehydration that may not be evident. Prolonged severe confusion can cause damage to internal organs, such as the kidneys, liver, and brain. Severe confusion can cause a coma. Confusion may be a strong indicator in a healthy minded senior that the dehydration has progressed to a severe level.

Dehydration is a frequent problem in the aging population due to a vast variety of risk factors. Luckily, dehydration can usually be prevented by drinking the recommended amounts of fluids for a person’s activity level, age, and environmental conditions. Initial warning signs of dehydration might not be noticed or missed in a senior until he or she becomes confused. Most people believe that confusion is a common part of the aging process. If your aging loved one becomes confused or their confusion increases, you should schedule an appointment with their doctor. Many causes of abrupt confusion usually are reversible with prompt and proper treatment.

Prevention Tips

Dehydration is a critical condition that is often overlooked not only in the elderly but in all people. It can turn into a particularly dangerous situation. Here are a few tips to prevent dehydration in elders:

  • Seniors need to be educated to drink even when they are not thirsty. Keeping a water bottle next to their favorite chair or the bed could help, particularly if they have mobility issues.
  • Try to find a healthy drink that the senior actually enjoys. If it does not taste good, it probably will not be consumed. Besides water, try to provide herb teas, fruit juices, broth, and fat-free or low fat milk.

Always provide plenty of high water content foods such as Jell-O, soups, cottage cheese, yogurt, and pudding. A vast number of fruits and vegetables also have a high water content especially apples, oranges, any type of berry, grapes, watermelon, leafy vegetables, and carrots.