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Hydration and Delirium
By Catherine D’Aniello, MSN, RN
How do you know if you are drinking enough?
An older adult, their home caregiver or family member
can take simple steps daily to check hydration status.
First, thirst should not be experienced at any time.
Second, urine should be colorless or straw colored, and
odorless. Being familiar with a urine color chart is
good practice for all ages and critical for older adults
to avoid dehydration. First morning urine should not be
dark, and urination should occur every two to four hours
during waking hours. Some medications and foods such as
asparagus give urine an odor, but normally urine should
Increase daily fluid intake, especially water!
At least half of your daily fluids should be water.
Water significantly reduces older adults’ risk of
becoming delirious. Milk, vegetable or fruit juice, and
soup are also healthy fluid choices. Carbonated and
caffeinated drinks should be limited due to their
diuretic effect. The body needs water to filter
alcoholic beverages from the body. Therefore, increased
water consumption is needed overall as well as to
balance the dehydrating effects of unhealthy drinks.
Drinking healthy fluids is as important as eating
Family members and home caregivers should:
Educate older adults on dehydration risks
Encourage/remind seniors to drink
Teach loved ones not to wait to feel thirsty to drink
Teach loved ones to drink regularly throughout the day
Make fluids easily accessible
Serve fluids at a temperature the individual prefers
Encourage water with ALL meals
Boost the flavor of water by adding drops of lemon/ lime
Limit fluid intake one to three hours before bed
Offer popsicles, juice, gelatin, Italian ice, sherbet
to those who dislike water.
Increased awareness of dehydration as a cause of
confusion and delirium should begin when older adults
are “young-old” (65-74 years) in order to form healthy
drinking habits carrying them into “middle-old” (75-84
years) and “old-old” (85 years and above). Family should
report poor eating or drinking to the primary care
provider so interventions can be initiated to prevent
dehydration and its consequences. Educate your older
family members and their caregivers on the importance of
hydration and ways to facilitate good fluid intake.
Why not reduce your or an older loved one’s chance of
developing delirium by eliminating the dehydration risk
Catherine D’Aniello holds a BSN from University of
Connecticut and MSN from University of Hartford. She has
30 years of geriatric experience and is currently a
Resident Care Coordinator at a skilled nursing facility.