How to prevent dehydration

What Steps Can Be Taken To Prevent Dehydration?

Fluid intake is key. Families and caregivers need to be cognizant about risks and plan ahead to make sure aging loved ones are properly hydrated. Here are some tips to help encourage fluid consumption and reduce the risk of elderly dehydration:

  1. Offer fluids on a regular basis throughout the day.
  2. Encourage 8 oz. of fluid intake every time the senior takes medication.
  3. Keep water bottles and/or a water cooler available throughout the day wherever the senior is (for example, in bed, on the patio, throughout the house or at the senior living community).
  4. Provide favorite “mocktail” concoctions (see below for some great recipes) or your senior’s favorite beverages (make sure they’re not caffeinated or alcoholic).

Tasty Recipes To Keep Your Elderly Loved Ones Hydrated

Strawberries and Coconut Water

Elderly Hydration: Strawberries and Coconut Water


To make 2 Strawberry Mocktails combine:

  • 1 cup (250ml) of fresh coconut water
  • 1 cup (250 ml) strawberries hulled and sliced
  • 3 T of sugar syrup or agave nectar


  1. To make the sugar syrup, boil sugar and water together in a ratio of 1:3 sugar to water until it thickens to a runny syrup consistency. Store in a jar for all future cocktail making.
  2. Measure 1 cup of coconut water, either directly from a cut-open coconut or from a store-bought container (if you are lucky enough to live in an area that sells fresh coconut water in a bottle).
  3. Combine the strawberries and sugar syrup  and blend with a blender to desired consistency.
  4. Serve with ice.
Get more information on making this delicious strawberries and coconut drink.

Cucumber Lemonade with Basil

Combating Elderly Dehydration: Cucumber Lemonade With BasilIngredients

To make 3 to 4 Cucumber Lemonade treats combine:

  • 1 English cucumber
  • 3 C water
  • 3 lemons
  • 2 T sugar
  • 1 small bunch basil
  • 1 C soda water


  1. Start by cutting your cucumber in half. Peel one half and cut it lengthwise (you can cut it in half again first if need be).
  2. Scoop the seeds out and chop it into pieces.
  3. Put the cucumber pieces in a food processor and puree until smooth.
  4. Put puree in a fine mesh sieve over a container and push with a wooden spoon or spatula, extracting as much liquid as you can from the cucumber puree.
  5. Fill a separate bowl or container with 3 cups water. Squeeze 2 lemons into the water and mix in the sugar.
  6. Pour lemonade and cucumber juice into a pitcher or serving container.  Slice remaining cucumber half (unpeeled) and remaining lemon and add to pitcher. Add basil, too. Refrigerate until chilled.
  7. Serve with ice.

For more great tips, check out A Place for Mom.

Dehydration and the Elderly

Elderly Dehydration

Watching for signs of illness in a loved one can be challenging. Some illnesses show up quite clearly, while others have a more subtle effect on daily living. Dehydration, depending on the severity, sometimes creates only small telltale signs while having a big effect on the body, especially in the elderly.

Dehydration occurs when a person loses more water than they take in. It takes an adequate amount of fluid for the body to function properly; for example, to regulate body temperature through sweating, maintain blood pressure, and eliminate bodily waste. If severe enough, dehydration can lead to confusion, weakness, urinary tract infections, pneumonia, bedsores in bed-ridden patients, or even death. In general, a human can survive for only about four days without any fluids.

Elderly dehydration is especially common for a number of reasons: some medications, such as for high blood pressure or anti-depressants, are diuretic; some medications may cause patients to sweat more; a person’s sense of thirst becomes less acute as they age; frail seniors have a harder time getting up to get a drink when they’re thirsty, or they rely on caregivers who can’t sense that they need fluids; and as we age our bodies lose kidney function and are less able to conserve fluid (this is progressive from around the age of 50, but becomes more acute and noticeable over the age of 70). Illness, especially one that causes vomiting and/or diarrhea, also can cause elderly dehydration.

“Everybody has a normal state of body water that relates to their weight. Anything below that (normal state) is dehydration; everything above it is hyperhydration,” Dr. Larry Kenney, professor of physiology and kinesiology at Penn State University, explains.

That normal level of hydration varies widely from person to person. Contrary to the mantra that everyone should drink eight glasses of water every day, Kenney says there is nothing scientific to back that up. “People misinterpreted that to be, it had to be liquid and it had to be water,” he says.

A person’s diet can greatly affect hydration levels: fruits (especially watermelon), vegetables, and soups are mostly water-based. “Day in, day out, a lot of people get their water from foods, as well as behavioral attitudes towards food,” Kenney explains. “For instance, when we walk by a water fountain, we tend to take a drink, and we tend to drink when we eat.”

Kenney also takes issue with the idea of not drinking caffeinated beverages because they’re dehydrating. He says the amount of caffeine in a cup of coffee or tea is relatively small, and it’s made of mostly water anyway, so it will hydrate you to some degree. The same holds true for beer, he says, but there is a point at which the diuretic effect of caffeine and alcohol kicks in, so moderation is always the key.

In general, larger people need to drink more water, as do athletes and those who perspire heavily, but that may mean more or less than eight glasses a day. “There is no one-size-fits-all remedy,” he says.

Instead, he recommends monitoring body weight to keep track of hydration levels. To monitor body weight, one should be weighed every morning. If they’ve lost two pounds or more from the day before, and especially if they feel thirsty or have a headache, they’re probably dehydrated.

Mild dehydration is defined as losing 2 percent of your body weight. Severe dehydration occurs with 4 percent or greater body weight loss. Even mild dehydration can affect a person’s health, especially if he already has cardiac or renal problems. “We have measured in the lab cognitive impairment,” he says. “With severe dehydration, it puts a greater strain on the heart. Think of a pump trying to pump with less fluid. That would be one of the primary problems.”

Kenney says an active 65-year-old who exercises probably doesn’t need to weigh herself every day, but a 75-year-old in a nursing home who has had issues with dehydration in the past or has had cardiac issues, should be weighed every day.

But, don’t rely on scales that also claim to measure hydration levels and body mass index. “Their accuracy is very poor; we can’t use them even for research purposes,” Kenney says.

Complicating matters is that signs of dehydration in younger people don’t always show up in the elderly. For example, if a young person was extremely dehydrated, his skin may be wrinkled or sagging. But, that certainly wouldn’t be noticed in most cases of elderly dehydration.

Perhaps because of that delay in diagnosis, elderly dehydration is a frequent cause of hospitalization (one of the ten most frequent admitting diagnoses for Medicare hospitalizations, according to the Health Care Financing Administration), and it can be life-threatening if severe enough.

Other signs of dehydration to look for: confusion, problems with walking or falling, dizziness or headaches, dry or sticky mouth and tongue, sunken eyes, inability to sweat or produce tears, rapid heart rate, low blood pressure or blood pressure drops when changing from lying to standing, and constipation or decrease in urine output. Also check for a decrease in skin turgor-pull up the skin on the back of the hand for a few seconds; if it does not return to normal within a few seconds, the person is dehydrated.

To help make sure your loved one doesn’t suffer from elderly dehydration, make sure he or she consumes an adequate amount of fluids during the day; eats healthy, water-content foods such as fruit, vegetables and soups; checks that urine color is light and output adequate (dark urine or infrequency of urination is a classic sign of dehydration).

Seniors also need to be educated to drink even when they’re not thirsty. Keeping a water bottle next to the bed or their favorite chair could help, especially if they have mobility issues.

If your loved one is in a nursing home or other care facility, make sure that the staff has a hydration program in place, including assisting residents with drinking, offering a variety of beverages (remember, taste buds change with age, so a beverage they used to enjoy may no longer taste right), and providing drinks not only at mealtimes but in between meals. Also make sure that they monitor residents’ weight and assess them if their physical condition or mental state changes. If dehydration is an issue and your loved one takes laxatives or diuretics, speak to his or her doctor about changing medication.

As with most illnesses, prevention is the key. Making sure your loved one stays hydrated now is much easier than treating him or her for dehydration later.

Fingernails: 5 signs that point to bigger health issues

Changes in the fingernails can indicate everything from heart disease to thyroid problems and malnutrition. Here are some nail conditions that might require medical attention.

Nail Separates from Nail Bed

What it looks like: Fingernails become loose and can separate from the nail bed.

Possible causes:

  • Injury or infection
  • Thyroid disease
  • Drug reactions
  • Psoriasis
  • Reactions to nail hardeners

Yellow Nails

What it looks like: Yellow discoloration in the fingernails. Nails thicken and new growth slows. Nails may lack a cuticle and may detach from the nail bed.

Possible causes:

Spoon Nails

What it looks like: Soft nails that look scooped out. In spoon nails (koilonychia), the depression usually is large enough to hold a drop of liquid.

Possible causes:

  • Iron deficiency
  • Anemia

Nail Clubbing

What it looks like: The tips of the fingers become enlarged and the nails curve around the fingertips.

Possible causes:

  • Low oxygen levels in the blood, which could point to heart disease
  • Inflammatory bowel disease
  • Cardiovascular disease
  • Liver disease

Opaque Nails

What it looks like: Nails look mostly opaque but have a dark band at the tips (a condition known as Terry’s Nails)

Possible causes:

If your senior parent has one of these nail problems, and it doesn’t go away, make an appointment with your doctor to get it diagnosed.

Information compiled from Mayo Clinic

Brain Health: Keeping Your Brain Healthy and Sharp

Maintaining the health of your brain as you age is just as important as staying physically fit. In fact, many studies show that brain fitness can play an important role in warding off dementia. According to the Center for the Longevity of the Brain, more than 24 million people are living with this disease, so the stakes are high. The good news is that there are easy and fun ways to keep your brain sharp. Some simple lifestyle adjustments and engaging activities can make a world of difference in brain health!

Eating a healthy balanced diet is always important, but for brain health, it is essential. A diet rich in fruits, vegetables and lean proteins is an excellent place to start. Eating a healthy diet can also reduce the risk of high blood pressure, diabetes and other health conditions that contribute to cognitive decline.

brain health is importantMartha Clare Morris, ScD, an associate professor of internal medicine at Rush University Medical Center in Chicago, has found that a diet that incorporates one meal a week high in omega-3 fatty acids can slow cognitive decline by 10% each year. Omega-3 fatty acids are unsaturated fats that are also called “good fats.” Our bodies need this type of fat in order to lower cholesterol and reduce the risk of heart disease. Some of the best natural sources of omega-3 fatty acids are fish, nuts and flax seed.

In addition to diet, physical exercise is important for a healthy body and a healthy mind. Two studies presented at the 2011 Alzheimer’s Association International Conference in Paris suggest that that exercise can protect one’s brain against mental decline and promote brain health. Exercising four to five times a week for at least 30 minutes is preferable. Simply going for a brisk walk or even exercising from a seated position will yield measurable benefits. Remember that it is important to check with your doctor before starting any new physical exercise program.

Brain Health Can Be Fun!

Exercising your brain is just as important as exercising the rest of your body. Effective brain exercise includes reading a book (preferably aloud), engaging in a favorite hobby, doing simple arithmetic or learning a new skill. Hosting a game night, doing a crossword puzzle, playing card games, learning to dance or play an instrument are just a few other suggestions. The brain is like a muscle and the more it is used, the stronger it will be! Promoting brain health can be fun.

Interestingly, another important way to support the brain health is through social interaction. Research supports the notion that social interaction plays a positive role in one’s cognitive abilities and overall health. According to the National Institute on Aging, “Several research studies have shown a strong correlation between social interaction and health and well-being among older adults, [while] social isolation may have significant adverse effects for older adults.” In other words, stay in touch. Online social networking has its benefits, but nothing beats the lasting impact of in-person socializing.

Another good way to stay in touch is to volunteer. Meeting new people and starting new friendships can be exciting and may give you a renewed sense of purpose. See how your skills may be a perfect match for local volunteer opportunities at

The trick is to be open-minded and willing to make an effort to stay engaged with your body and your brain. Getting started is often the hardest part of making even minor changes to your daily routine. Stimulating your brain activity to help keep your mind sharp can be as simple as engaging in something that incorporates one or more of your senses such as gardening or attending a concert.

For more information on brain health research, go to the DANA Foundation website  or the National Institute of Neurological Disorders and Stroke . You can also find out more about AARP’s Staying Sharp initiatives at

Brain health can be fun. Keeping your brain fit, engaged and active now can help you maintain mental alertness throughout your life.

Reprinted with permission from  Maine Senior Guide.

Seniors Eyecare Program

The Seniors Eyecare Program ensures that every senior has access to medical eye care and promotes annual, dilated eye exams.  It raises awareness about age-related eye disease, including cataracts, provides free eye care educational materials and facilitates access to eye care.

The Seniors EyeCare Program is designed for people who:

  • Are US citizens or legal residents
  • Are age 65 and older
  • Have not seen an ophthalmologist in 3 or more years

People may call the toll-free help line at 800-222-EYES ( 3937) anytime, for themselves and/or family members and friends to see if they qualify for a referral to a volunteer ophthalmologist or to request free eye care information.

To see if you qualify or for more information you can go



Caregiver Toolkit

The process of caregiving and the process of searching for senior care can be both complex and difficult to organize, and online searches can often yield too much information to parse. That’s why we’ve created the Caregiver Tool Kit for Your Senior Care Search. The Caregiver  is a compilation of checklists, guides and other tools that help you simplify, organize and plan for difficult and complicated aspects of caregiving and finding care for your loved one.

The Caregiver Toolkit conveniently unifies nine essential tools to help you master your search.  These tools help make every stage of your search easier and more efficient. These resources include.

  • The Senior Care Calculator: a tool that compares the costs of care in your area to the current actual costs living and care.
  • Best Kept Secrets to Financing Senior Care : Little known info about financing senior care.
  • The Assisted Living Checklist: a checklist to help you access and choose an assisted living community.
  • The Document Locator Checklist: A list of important documents regarding your older loved one that you should have access to in an emergency.
  • Memory Care Checklist: A checklist to help you access and decide on a memory care provider.
  • Senior Home Safety Checklist:  A comprehensive checklist to assure seniors who live at home are as safe as possible.
  • A guide to VA Benefits: A detailed guide to veteran’s benefits for seniors.
  • A guide to Pet Friendly Assisted Living: Tips for finding senior communities that accept cats and dogs.

The Guide to Senior Housing: Simplifies the complex lingo of the world of senior housing and senior care, and discusses the various types of senior care and housing.

Click on the various links below to access the Caregiver Toolkit.

Beware Scammers Posing as the IRS

Watch out for con artists posing over the phone as representatives of the IRS.  It’s an old idea,but treasury and IRS officials say thousands of people have fallen for increasingly sophisticated phone scams designed to steal money or identities.

The IRS recently issued a fresh warning, saying the scams may come in various forms.  In recent months people have reported “a particularly aggressive phone scam,” the IRS said.  In some cases, callers tell victims that they are “entitled to big refunds, or that they owe money that must be paid immediately to the IRS”.

The IRS says it “will always send taxpayers a written notifications of any tax due via the U.S.Mail”.  The IRS “never asks for credit-card, debit-card or prepaid- card information over the phone.

If you receive such a call, just hang up- and consider the following advice from the IRS.

  • Call the IRS at 800-829-1040 if you think you owe taxes, or think you might.
  • If you are sure you don’t owe taxes, or have no reason to think you might, report suspicious calls to the Treasury inspector general for tax administration at 1-800-366-4484.
  • Contact the Federal Trade Commission ( and use its “FTC Complaint Assistant” on that site. “Please add IRS Telephone Scam” to the comments of your complaint,” the IRS says.

For more information, go to and type in “scam” in the search box.


Maine Senior Farmshare Program

Maine’s Senior FarmShare program has embarked on another season.  Eligible seniors are again able to get free fresh, fruit,vegetables and herbs from local Maine farmers.

The program provides $50 worth of produce to each participant.  Qualifying seniors contract directly with local farmers for pickup or delivery.  Participating farmers offer a variety of methods for providing produce.  Seniors pick it up at a specific farmers’ market, or at the farm or farm stand.  Some farmers offer home delivery.

To qualify for a Senior FarmShare, a participant must be a Maine resident, at least 60 years old and with a household income of not more than 185 percent of the federal poverty income guides.

Seniors may contact the Area Agency on Aging at 877-353-3771 to find participating farmers.  The list is also available at  Information is also available at Maine Senior FarmShare Program at 207-287-3491, or e-mail at


Letter of Instruction: The Most Important Letter You Will Ever Write

“Where is Mom’s Social Security card?” It’s a common refrain when someone can’t help with their own affairs. Confusion and uncertainty compound the difficulties of dealing with a family emergency. There is a way to help those who will have to act in a family emergency. It’s called a “letter of instruction.”

How an Hour Now May Eliminate Uncertainty in Times of Family Emergencies

The letter of instruction is NOT a legal document. It does NOT replace a will or trust, a Health Care Power of Attorney or Living Will, or a Durable Financial Power of Attorney. On the other hand, the letter of instruction offers practical guidance usually not contained in any legal document. It’s a good way to let to those trusted to take care of your affairs know what you would want them to know.

letter of instructionSince the letter of instruction is not a legal document, it does not need to be notarized or signed in the presence of witnesses or with any other special formality.

It is also different than the “Separate Writing” that lawyers sometimes recommend accompany a Will or Revocable Living Trust. That document directs the distribution of your personal property after your death. [For example, Aunt Sally's watch goes to my daughter Amanda; and Grandpa's shotgun to Billy.]

Who should write the Letter of Instruction?

A husband and wife should prepare one together. The person who handles the family financial affairs should write one for the person who will have to take over in case of death or incapacity.

When is it used?

A Will is usually not read until some time after the person’s death. The letter of instruction should be readily available and in a place where a family member or other friend can find it in the event of emergency. For example, my family knows ours is in the top left-hand desk drawer in my study.

What’s in the letter?

The letter should give the contact information for the people to be notified in the event of a family emergency, and should also tell the location of all important papers . . . and passwords! It could even spell out personal preference in how various matters are to be handled, including funeral arrangements.

It should contain the specific locations of items mentioned in the letter, such as: “My insurance papers are in my safe deposit box,” or “My Social Security file is in the bottom left-hand drawer of the living room desk.”

Who should have the letter?

You should consider making the letter available to someone outside the household. If you choose to provide a copy to the person who would most likely take over if something happened, you need to remember to send them updates when you change the letter. Mostly, however, it is important that someone be able to find the Letter in the event of an emergency.

Reprinted with permission from Maine Senior Guide.