Older adults are more susceptible to fluid and electrolyte imbalances due to their declining muscle mass and kidney function. Further, they also have difficulty adapting to things like fluctuating temperatures, declining sense of thirst, and medical conditions that affect the ability to retain fluids. To add to the woes, the presence of Dementia makes them forget to eat and drink, difficulty in swallowing (dysphagia) prevents them from getting the fluids, use of drugs like diuretics, antihistamines, laxatives, antipsychotics, and corticosteroids can cause frequent urination & deplete water and electrolytes. In addition, some adults may also experience incontinence and thus often purposely refuse or limit fluids to avoid accidents.

Dehydration in this population can be diagnosed by looking for initial signs like headache, constipation, muscle cramps, dry mouth and tongue, and sleepiness or lethargy. Urine color is another helpful indicator. It should be clear or light yellow for someone who is properly hydrated.

Severe dehydration can be diagnosed by signs like little or no urination, dark or amber-colored urine, dry skin that stays folded when pinched, presence of irritability, dizziness or confusion, low blood pressure, rapid breathing and heartbeat, weak pulse, cold hands, and feet.

Adults must consume about 64 ounces of fluid every day, but that amount varies with heat and humidity and depending on various medications and health conditions.

Water isn′t the only option to increase fluid Intake. If a senior refuses to drink plain water, they can be given water enhancers, pre-flavored waters, fruit juice diluted with water, or infused waters. Furthermore, warm chicken, beef, or vegetable broth can be a soothing source of fluids and electrolytes. 

Raw fruits and vegetables also aid in hydration. In cases of aversion to fruits and vegetables, particularly uncooked, high water content foods like salads, or vegetable soup may be unrealistic. So, fresh berries can be added to yogurt, cereal, dessert, or slices of tomato, and a few leaves of lettuce can be added to wraps and sandwiches to facilitate hydration. 

Another relatively new food concept is edible hydration "balls" for elderly individuals. These Jelly Drops are 95 percent water, sugar-free, gluten-free, and vegan; however, seniors with swallowing difficulties must not consume them. This fruit gelatin, like JELL-O, can also be used to help promote hydration in seniors.

Leeflang J. Hydration Tips for Seniors. Ageing Care. 2022. https://www.agingcare.com/articles/hydration-tips-for-seniors-205594.htm