do any one know how to rehablitate elderly people suffer from dehydration
Diluted down Gatorade with water, the key is electrolytes but you want to avoid the high sugar levels.
It is essential to know the cause & severity of dehydration . The evaluation of plasma sodium would give a clue to etiology of dehydration . 1) If the P.Na is high ( hypertonic dehydration ) , it would suggest water > salt depletion which could be due to excessive sweating & reduced intake of water . It needs to be replaced 0.45% saline or orally with more water with less salt ( hypotonic solution ) . 2) If P.Na is normal , it means water = salt depletion ( isotonic dehydration ) , which could be due to vomiting or diarrhea & needs to be replaced with 0.9% saline or Ringer lactate or ORS . 3) if the plasma sodium is low , it would suggest salt > water depletion ( hypotonic dehydration ) , due to vomiting or diarrhea replaced by only water . This would need 0.9% saline or ringer lactate , or if patient is drowsy would need 3% saline .
This approach is essential because regulation of salt & water mechanism is impaired in elderly & need not coordinate . Salt is regulated by Renin - Angiotensin mechanism & water is regulated by ADH mechanism . Salt depletion can lead to volume depletion & water depletion leads to hypernatremia & water excess can lead to hyponatremia .
The dehydration can be assessed clinically as a) mild : if the patient is thirsty with normal BP , b) Moderate : if patient is thirsty with tachycardia & postural hypotension c) severe : if patient is drowsy with hypotension .
Hyponatremia or hypenatremia present with neurological symptoms such as drowsiness or seizures .
Hi Mustafa, this is a challenging issue for gerontologists and one that I have seen in my practice too frequently. Dehydration in older adults may cause psudo-dementia and much of it is self-imposed. Older adults often have difficulty getting up from a seated position. We estimate that the average adult must get up/down about 70 times daily in the course of a normal day. To avoid getting up/down because it is painful or just difficult to do, older adults often limit their fluid intake. They also may limit fluid intake to limit the number of adult undergarments required daily. That leads to dehydration and that often leads to a diagnosis of dementia. The brain cannot function properly when the body is dehydrated. The Tufts Food Pyramid, developed for older adults, has fluid/water included as essential for optimum health. I have attached the link. I hope this helps.
http://www.nutrition.tufts.edu/research/modified-mypyramid-older-adults
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