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Hydration and Delirium

By Catherine D’Aniello, MSN, RN

(Page 2 of 2)

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 not smell.

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 healthy foods. 

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 juice

  • Limit fluid intake one to three hours before bed

  • Offer popsicles, juice, gelatin, Italian ice, sherbet and pudding
    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 factor?

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.

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