YOUR DIETITIAN: Staying hydrated to prevent a trip to the ER

Did you know that dehydration is a common reason for ER visits among older adults? Approximately 48 percent of the seniors admitted to the hospital after an ER visit suffer from dehydration. Typically, most seniors are unaware that they are dehydrated. During July and August, the hottest months of the year, older adults are at a higher risk for dehydration and heat related illness. Here's why: Reduced sense of thirst A common mistake is waiting until you feel thirsty before getting something to drink. However, as people get older, our sense of thirst diminishes. Thus, thirst is no longer a good indicator of when we need to drink. Experts state that by the time an older adult feels thirsty, he/she is already dehydrated. According to Dr. Dana Cohen, "Many people walk around in a state of low-grade dehydration and don't even realize it." Solution: Drink a glass of fluids every few hours—whether or not you feel thirsty. The Institute for Medicine has increased the recommendation of fluids we should consume per day to 11 ½ cups for women and 15 cups for men. (However, 20-percent of this should come from eating water-rich fruits and veggies. Thus, the amount of liquid to drink per day is about 9 cups for women and 12 cup for men.) Decreased sweating Just because you're not sweating doesn't mean your body isn't overheating. As we get older, our ability to sweat decreases. Sweating causes evaporation of water on the skin which cools off the body in hot weather (or after vigorous activity) to regulate our body temperature. Without adequate sweating, the body temperature may increase—increasing the risk of heat stroke. Possible Solutions: Avoid strenuous activity during the hottest part of the day. Wear light, loose clothing and drink fluids to stay hydrated. If you feel overheated, go into the shade or an air-conditioned building to cool off. Place cool, damp clothes on your neck, forehead and wrists to lower your body temperature. Or take a cool, not cold, bath or shower. Use of Diuretics (water pills) Many seniors take diuretics (water pills) which increase urination. This can lead to dehydration. Few people realize that increasing fluid intake actually helps the kidneys work better—and thus, helps to reduce swelling (edema) in the legs. Fear of incontinence/mobility issues A fear of incontinence is another reason older adults are at risk for dehydration. Many older adults purposely restrict their fluid intake when they have to go out for fear of incontinence. Or, they have a fear of needing to use the restroom in places where one is not readily available or only a low-rise toilet is available (which can be difficult to use due to arthritic knees). Even mild dehydration increases the risk of numerous health problems, such as… Increased risk of falling Our muscles are 75 percent water. When muscles get dehydrated, they become weaker. Weak muscles increase the risk of falling. Reduced ability to concentrateStudies have shown that even with a one to two-percent reduction of water in the body, the brain doesn't function as well. Mild dehydration may cause a change in mood, reduced short-term memory, a longer reaction time, a reduced attention span and reduced ability to concentrate. Impaired kidney function Our kidney function declines as we get older. Dehydration further reduces the kidney's ability to work. Blood circulates through the kidneys to filter out waste products from the blood and excrete them in urine. With less fluid intake, blood volume is reduced and less blood flows to the kidneys. This makes it harder for the kidneys to filter out waste products from the blood -- and may lead to kidney damage and/or kidney stones. Solution: Drinking plenty of fluids to keep your urine dilute reduces the workload on the kidneys and helps to protect your kidneys.Checking the color of your urine is the best way to tell if you are drinking enough fluids. Urine should be very pale yellow (like weak lemonade) -- almost clear. If it looks like apple juice, you aren't drinking enough. Increased risk of kidney stones Dehydration causes urine to be more concentrated. When urine is concentrated (due to less fluid intake), so are the minerals in the urinary tract. This can cause kidney stones to form (from the high concentration of minerals). Solution: Experts recommend drinking 10 to 12 (8-ounce) glasses of fluids each day to prevent kidney stones. Adding lemon, lime or orange juice to water can further reduce the risk of kidney stones. (The citric acid in these juices reduces oxalate stone formation.) Increased risk of Urinary tract infections (UTIs) Reduced fluid intake also increases the risk of urinary tract infections. Without adequate fluid intake, urine stays in the bladder and the bacteria is not flushed out. Untreated, the bacteria may travel up into the kidneys and cause serious kidney damage. Older adults may not experience the usual burning sensation when urinating which occurs in younger people with UTIs. Instead, older adults may experience mental confusion or a headache. Sadly, a urinary tract infection can be overlooked when going to the ER due to these non-typical symptoms. If you or a loved one suddenly has mental confusion, ask for a urine test when going to the ER. Solution: Experts state that you should drink enough to urinate every 2 to 3 hours to flush out the bacteria from your urinary tract. Increased joint pain Synovial fluid cushions and lubricates your joints. The major component of synovial fluid is water. With dehydration, the body may not produce enough synovial fluid—leading to increased friction at joints and pain. Cartilage, which covers the bones at our joints, also relies on water for its structure and function. With dehydration, it can shrink, further contributing to joint pain. Coffee and tea count While large amounts of caffeine acts as a diuretic, small amounts do not. One study found that men who drank up to six cups of coffee were as hydrated as other people who drank the same amount of water. So, drink whatever beverage you prefer, except alcohol — which is dehydrating. Here is a refreshing summertime drink. Seniors at a rec center really enjoyed it. I hope you enjoy it too. Phyllis J. Molnar is a registered and licensed dietitian who writes about food and health for The Chronicle-Telegram and The Gazette. Email her at pjmolnar56@gmail.com. Triple Citrus-Ade ½ cup sugar½ cup hot water¼ cup lime juice (juice from 3 limes, strained) *1 cup orange juice (juice from 3 oranges, strained) *¼ cup lemon juice (juice from 3 lemons, strained) *2 cups cold waterIce cubesSlices of citrus fruits for garnish, if desired*Note: Bottled lime, lemon and orange juice can be used. In a large Pyrex measuring cup, stir sugar into ½ cup hot water until the sugar dissolves.Add fruit juices. Mix. Pour mixture into a pitcher. Stir in 2 cups of cold water. Mix well. Add some ice to the pitcher or add ice cubes to serving glasses. Enjoy! If desired, garnish with slices of citrus fruit. Serves 6 Source: www.marthastewart.com