It is imperative to prepare for them and adopt the right practices to protect our elders from dehydration.
High temperatures pose more risks to older individuals for various reasons. The primary danger is dehydration. It's essential to understand that the body continually regulates its temperature. When it exceeds 37°C (98.6°F), the body produces more sweat to preserve natural bodily functions and dissipate heat through water evaporation. Sweating is a protective mechanism, but it must be compensated for by an adequate intake of water. Generally, the sensation of thirst is heightened and encourages increased water consumption. However, older people may not always feel thirsty, and their body's temperature regulation mechanism may not function as effectively. This makes them more vulnerable to heatwaves and extreme heat.
The use of certain medications can exacerbate the effects of heat, and a doctor may recommend adjusting the dosage. It is advisable to avoid antipyretic drugs like paracetamol, which are used to reduce fever but are ineffective in cases of heatstroke and can even worsen existing liver issues. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, can be particularly harmful to a dehydrated person. In all cases, the treating physician should reevaluate medications during periods of high heat. Never stop a medication without consulting a doctor. They can decide to temporarily discontinue a non-essential medication or replace it. Such decisions should only be made by a healthcare professional.
Dehydration results from a lack of water and minerals in the body. The initial signs that should alert families to possible dehydration include thirst, dry lips, slight weight loss, unusual fatigue, and a decrease in strength. Older individuals may not necessarily feel thirsty, even when dehydrated, often leading to a worsening situation. If dehydration is not promptly compensated with adequate water intake, it can become much more severe. A weight loss exceeding 5% of a person's total weight indicates a severe state, and beyond 10%, vital organs are at risk. Signs of severe dehydration include intense thirst, dry mouth and tongue, dull eyes, sunken eyes, the appearance of skin folds, dry, cold, and pale skin, fever, reduced urine output, headaches, dizziness, disorientation, fainting, altered consciousness, and behavioral changes.
Prevention is the safest way to protect our elders. Given that they may not remember to drink water because they don't feel discomfort or thirst, family members and caregivers must be particularly vigilant. Frequent visits or regular phone calls are essential to ensure everything is alright. People with dementia, such as Alzheimer's patients, are especially vulnerable. They may forget to drink and may not realize the severity of the situation. Similarly, individuals with psychiatric and neurological conditions, as well as those with Parkinson's disease, should be closely monitored, especially since they often take medications that increase the risk of dehydration.
Since older individuals may not feel thirsty when their bodies need hydration, they should drink water without waiting to feel thirsty. Doctors recommend consuming about 1.5 liters of water daily, not too cold to avoid quenching thirst too quickly. It is also advisable to avoid alcohol, which can lead to dehydration. Fluid intake can be diversified with teas, soups, highly diluted syrups, fruit compotes, sorbets, fruit juices, or water-rich fruits like watermelon and melon, as well as vegetables like tomatoes and cucumbers. This diversity ensures an adequate intake of water throughout the day. For example, a yogurt hydrates as much as a glass of water. Increased sweating due to heat results in water and mineral loss that must be compensated for.
During a heatwave, it is also advisable to moisten the skin with a damp cloth, use a mister to stay cool, take frequent showers without drying off, if mobility allows, and cool the room. If the outside temperature exceeds that inside, it is recommended to close windows and draw curtains where the sun shines. In nursing homes (EHPAD), healthcare teams are prepared for heatwave episodes and trained to handle them optimally.
If dehydration is mild and weight loss is less than 5% of the body weight, some simple and effective steps can be taken. It is advisable to lay the person down, undress them, cool them down, and compensate for their water and mineral losses by giving them more to drink than usual, including drinks containing sufficient sugar and salt, vegetable broths, or other suitable beverages. Monitor the progress of dehydration and ensure the person's condition improves.
However, if dehydration has reached a more severe stage, and any of the signs listed above are observed, it is then an emergency situation. This requires immediate and specific medical intervention. Call emergency services immediately and provide as precise answers as possible to their questions. The person will be treated at home or transported to the hospital. Water and mineral losses will be compensated for by intravenous infusion if necessary. Afterward, consult the person's regular doctor for follow-up.
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