The lack of fluids, especially during hot weather, can pose a serious health threat for anyone, but older adults are at particular risk for heat-related illnesses.
An estimated 700 U.S. heat-related deaths occur each year and adults age 65 and older are more likely to die, often because of underlying comorbidities, including cardiovascular disease, according to the Centers for Disease Control and Prevention (CDC).
Heat-related illness and death among older adults often begins with dehydration, says Dr. Sonia R. Sehgal, a UCI Health specialist in geriatric medicine and a UCI School of Medicine professor.
Aging and fluid loss
As people age, the body's ability to sense thirst changes. When older adults drink less water, they become more susceptible to electrolyte imbalances and dehydration, particularly when it is hot outside.
“This can make it difficult for seniors to adapt to fluctuating temperatures,” Sehgal explains.
By the time an older person feels thirsty, their essential fluids and electrolytes may already be critically low. Other factors can contribute to this vulnerability:
- Medications — including diuretics, antihistamines, laxatives and corticosteroids — can cause fluid loss.
- Chronic conditions such as diabetes, which causes the kidneys to work harder to eliminate excess blood sugar, can exacerbate fluid loss.
- Dementia and Alzheimer’s disease make it difficult for older adults to recognize or express a need for more fluids. They may also forget to eat and drink or have difficulty swallowing.
- Seniors who suffer from incontinence may purposely limit or refuse fluids to avoid accidents.
Recognizing the signs
Become aware of the signs of dehydration and heat-related illness and pay particular attention to the most vulnerable — older adults and children under age 4, Sehgal says.
People who care for seniors, particularly those who have difficulty communicating their needs, should watch for:
- Dry skin, lips, mouth or mucus membranes
- Alternatively, the skin may feel damp from perspiration or warm to the touch
- Difficulty speaking due to a dry throat
- Dark or amber-colored urine
- Frequent urinary tract infections
When temperatures soar during summer, Sehgal advises older adults to take precautions to stay hydrated and prevent heat-related illness.
Start by tracking how much water you are drinking. Although the standard daily recommendation is 64 ounces (six to eight glasses), that may be too much for some people and not enough for others. Heat, humidity, medications and health conditions may also increase how much water we need.
Set yourself up for success:
- Start each day by drinking a large glass of water.
- Set periodic alarms on your phone or watch to remind you to drink.
- Keep a favorite reusable water bottle on hand.
- If you have memory issues, line up full water bottles for the day in a noticeable spot as a visual reminder.
- Consider infusing your water with mint, cucumber, lime, lemon or other natural flavors for variety.
- Eat fruits and vegetables with high water content like melons, cucumber, celery and lettuces.
“Some people may also need electrolyte-rich drinks that can restore optimal potassium and sodium levels,” says Sehgal. She recommends consulting your doctor to find the right fluid balance.
When it's hot outside, use the buddy system — check on a friend or neighbor and have them do the same for you. It’s also best to exercise in a gym or take walks in a mall, Sehgal advises. If you don't have home air-conditioning, consider spending the hottest part of the day in libraries, movie theaters, supermarkets or other places that do.
During extreme heat waves — when temperatures exceed 90 degrees for at least two or three days — many communities sponsor cooling centers. Check with your local city or county government or the California Department of Public Health for additional information and resources.
Other cooling strategies include:
- Wearing light-colored, loose-fitting, breathable clothing made of natural fibers
- Using a mister fan to cool off
- Showering or bathing with cool water
- Resting in a cool place when you feel overheated
Sehgal says it’s also important to keep tabs on vital signs to make sure your blood pressure isn’t dropping significantly or your body temperature isn’t spiking dangerously high.
When to get medical help
If you or a loved one is experiencing confusion, headaches, dizziness or general weakness, these may be the first signs that the body is unable to cool itself.
That, Sehgal says, means you're at risk of heat exhaustion and need immediate medical attention to avoid further complications or worse.