Dehydration in the Elderly: What To Look For & How To Prevent It

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist
03/25/13  4:10 PM PST
Updated October 25, 2018

The elderly are at increased risk for dehydration. Being aware of the risk factors and complications of this dangerous condition is the first step. Recognize the signs and symptoms of dehydration in the elderly and practice strategies to prevent it.

 Risk Factors

  • >85 years old
  • Institutionalization
  • Dependence on others for feeding
  • Dementia
  • Infections
  • Chronic conditions
  • Medications: diuretics, beta-blockers, ACE inhibitors
  • Normal changes of aging: decreased thirst, decrease in total body water

Signs and Symptoms

  • Altered mental status
  • Dry skin and mucus membranes
  • Fever
  • Decreased urine output/dark or concentrated urine
  • Urinary tract infection
  • Muscle weakness
  • Poor skin turgor/skin “tenting”
  • Severe unintentional weight loss (2% in a week or 5% in a month)


  • Increased falls
  • Urinary incontinence
  • Renal failure
  • Seizures
  • Venous thrombosis
  • Shock

Prevention Strategies

  • Determine fluid needs of at-risk patients and monitor intake
  • Obtain fluid preferences (flavor, temperature, straws, etc.)
  • Make fluids available and easy to access
  • Provide a variety of fluids throughout the day
  • Encourage regular fluid intake with “happy hour” or “tea time”
  • Offer fluid-rich foods, such as jello or fruit

Reference: Collins M, Claros E. Recognizing the Face of Dehydration. Nursing. 2011;41(8):26-31. Link.

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