Wednesday, January 13, 2016

Detecting Dehydration in Two Quick Steps

Dehydration is the Enemy

As SLPs, we are continuously watching for problems...after all, that's what we're trained to do. Some signs are easy to see, such as the crooked smile of a drooping mouth or a tongue that deviates to the side. Some troubles are easy to hear, such as coughing while eating or slurring while speaking. Other times, the problems an adult patient experiences are subtle and leave only small, telltale signs of trouble ahead. This is the case with dehydration.


Dehydration occurs when more fluids are lost than are taken in. It's just that simple. Next to oxygen, water is the substance most needed for life. While a person can live without food for approximately 30 days, most people can survive only three or four days with out water. Why is that?

Many important structures are made of water and require proper hydration for proper function. Specifically, water makes up 70% of muscles, 75% of the brain and 85% of the blood.  Additionally, water is present in and around each and every one of our cells. Therefore, when water content is deficient, there are serious consequences throughout the body.

Come to find out, it's no wonder that our older adult patients are dehydrated- the  thirst response decreases with age. In fact, researchers say that adults over 50 are more likely not to experience thirst as intensely as younger people. Additionally, stress and fatigue may also contribute to a diminished thirst response.

Dehydration is a serious problem for the elderly. According to Provider magazine, as many as 75% of older adults are not getting the minimum amount of daily fluids recommended. Yikes! To complicate things, dehydration can be tricky to recognize in the elderly.

Common signs and symptoms of dehydration:
  • confusion
  • difficulty walking
  • dizziness
  • headaches
  • dry lips
  • dry mouth
  • low blood pressure
  • low urine output
  • constipation
  • joint pain

Because so many elderly adults have many of the complaints listed above, it is easy to see why dehydration is often overlooked by caregivers as a contributing factor to a variety of health problems.  Luckily, our bodies signal dehydration is other ways.

Teach patients, family members and/or caregivers to recognize dehydration using two very simple methods.

Two Simple Ways to Detect Dehydration

1.  Urine Color Assessment

Urine color says a lot about our hydration status. Generally, the lighter the color, the more hydrated you are. Conversely, the darker the urine, the more dehydrated you are. Let me explain.

Dehydration is caused when the volume of water in the body is depleted. Our kidneys, which filter out waste, tell the body to retain water. As a result, we have less water in our urine, and it comes more concentrated and darker.

A urine color chart makes dehydration easy to see.

2.  Skin Turgor Test

Assessment of skin turgor can also give clues about a person's hydration status.  A skin turgor test, or a pinch test, can be quickly and easily performed. It's super simple.

Pinch the skin on the back of the hand. If it snaps back to normal in one second or less, it's a good sign that hydration is adequate. If the skin slowly returns,  does not go right back, or remains up in a tent like fashion, it's a sign of dehydration.

Because water comes out in sweat, urine, poop and even breath, it is estimated that the average person loses between 10 and 15 cups of fluid each day. Knowing that water is critical for digestion, healthy weight, body temperature regulation and even mood, encourage your patients to make sure they are getting enough to drink each and every day. If you're not sure they are following your advice, you can use either of these simple tests to help you assess for dehydration.

We never know the worth of water until the well is dry.
Thomas Fuller