JUN 2021: Nutrition and hydration tips for older people

Health

We all know that good-quality food and being well hydrated improve overall physical health and mental health and wellbeing. Good nutrition and preventing dehydration are all the more important as we age, however, and particularly when living with certain medical conditions. Poor nutritional intake and insufficient water intake can have severely detrimental effects on organ function, recovery from injury or illness, and hasten physical and mental decline. Increased risk of urinary tract infections. Inadequate hydration increases the risk of urinary tract infections (UTIs) and can contribute to developing kidney stones or acute kidney problems.

Identifying dehydration is also harder in older people, just when they’re more vulnerable and susceptible to the effects of dehydration. It’s also true that as we age, we’re less likely to feel thirsty, that we store less water in our bodies, while some medications can prompt more frequent urination. It’s a dangerous combination, so we’ve put together some nutrition and hydration tips for older people, to promote good health and better quality of life.

First, though, let’s look at the symptoms of dehydration in elderly people and the signs of serious dehydration.

Higher risk factors for dehydration

  • Acute illness, diarrhoea and vomiting
  • Cognitive impairment/confusion
  • Decreased thirst
  • Depression
  • Hot and humid weather
  • Incontinence
  • Underlying health conditions, such as diabetes or kidney disease
  • Various medications, particularly diuretics.

Symptoms of dehydration

  • Headache
  • Constipation
  • Dry mouth
  • Muscle cramps
  • Increased lethargy and sleepiness.

Signs of significant dehydration

  • Accelerated breathing and heartbeat
  • Cold hands and feet
  • Dark urine colour
  • Dizziness, confusion and irritability
  • Dry skin that remains folded when you pinch it together
  • Low blood pressure
  • Reduced or non-existent urination
  • Weak pulse.

Many of these symptoms are present to a greater or lesser degree in older people generally, and particularly when living with certain conditions. By the time enough have come together to conclude that someone is dehydrated, they may already be suffering serious ill effects. So, preventing dehydration in the first place is infinitely preferable to reacting when seeing the signs.

Tips to prevent dehydration

  1. Try to drink 6-8 glasses of fluid every day (a minimum of 1.5 litres), at regular intervals throughout the day
  2. Drink fluids you enjoy. If water seems dull, choose milk, flavoured water, low-sugar fruit juice or cordial, or simply add a slice of lemon to cold water.
  3. Always make sure fluids are readily accessible at all times
  4. Drink hot and cold drinks; while drinking too much tea or coffee can have a diuretic effect, it’s important to offer variety to promote more frequent hydration.
  5. If mobility is an issue, source aids for drinking, such as straws and cups with supportive handles
  6. When taking medication, always drink a full glass of fluid
  7. Include food with higher water content, such as celery, cucumber, watermelon, soups, ice lollies, yogurt and tinned fruit in juice or jelly in the daily diet, particularly in warmer weather.
  8. Drink extra water before, during and after any exercise classes and if you’re out and about and the weather is warm.
  9. Make sure toilet facilities are always available, especially for anyone with mobility issues or who suffers incontinence; fear of having accidents often deters older people from drinking as much fluid as they should.

Better nutrition for older people

It’s often thought that we need to eat less when we get older. Certainly, our appetite often decreases and we feel hunger differently. But experts think that the decrease in calorie intake should only be between 100 and 400 calories less than for any other adult.

It’s also worth noting that some acute or chronic conditions can actually increase energy requirements: COPD (chronic obstructive pulmonary disease) and Parkinson’s disease are just two examples where energy expenditure goes up. Any sign of weight loss is a sure indicator that you need to eat more food.

Of course, we want most of that food to be healthy and to support bone and muscle strength, organ function and mental health. And since, according to the British Dietetic Association (BDA), as many as one in seven people aged 65 and over has a medium or high risk of malnutrition, it’s important to eat as healthily as possible.

Top tips for nutritious eating

  1. Eat three small meals and at least three small snacks each day, to keep energy levels up
  2. Daily diet should include a mix of protein (eg eggs, fish, meat, tofu, soya), carbohydrates (bread, potato, bread, wholegrain rice), fruit and vegetables
  3. Aim for at least five portions of fruit or vegetables every day (and contrary to popular belief, frozen or canned vegetables still retain most of their important vitamins!)
  4. Aim or two portions of fish every week, one of which should be oily fish
  5. If weight loss is an issue, try more calorific yet nourishing food, such as full-fat milk and yogurt, cheese, bread and butter, custard or rice pudding
  6. Make sure your daily diet features vitamins B and D and calcium, to protect against loss of bone density, muscle strength, metabolism, nerve function and more.
  7. As well as a 10 micrograms (mcg) daily supplement of vitamin D, boost vitamin D intake with oily fish (eg herring, kippers, pilchards, salmon, sardines), eggs, milk and meat
  8. For more B vitamins, eat green vegetables such as asparagus, broccoli and Brussel sprouts and asparagus. Vitamin B6 is found in fish, fortified cereals, milk, peanuts, pork, poultry and various vegetables, while vitamin B12 can be found in fish, meat, eggs, or dairy, as well as fortified breakfast cereals and soya drinks
  9. Calcium is easily absorbed – if you have enough vitamin D – from cheese, milk and yogurt, and can be topped up with fish, spinach, beans and lentils.

The bottom line is that good nutrition and sufficient fluid intake are essential for maintaining health and reducing the risk of injury and disease – and particularly as we age. We hope these tips help you achieve a better balance for you and your loved ones!