Aged Care Insite Issue 98 | December-January 2017 | Page 30

clinical focus Those pauses that refresh Helping clients stay cool and hydrated is a matter of vigilance and tailoring drinks to their preferences. By Linda Kilworth Someone who is well hydrated will have pale yellow urine. FLUID GOALS There is no recommended daily fluid intake for older people, although the accepted minimum is 1500 millilitres. Commonly, 6–8 glasses of water a day is recommended, but this is not evidence-based. There are several methods to calculate the exact fluid intake for older people. An accredited practising dietitian (APD) can help. TYPES OF FLUIDS S ummer is here and whilst most people enjoy the warmth, a common recurrent issue it causes for older people is dehydration. The risk for this problem is higher in older adults, due to physical changes in body water composition, renal function and thirst perception. These risks are exaggerated in summer’s prolonged periods of hot weather, and can be fatal. It is important for care teams to work together and, with the family, encourage adequate fluid consumption to minimise complications in this at-risk population. The body loses fluid as we age. Until age 40, the proportion of body fluid to body weight is about 60 per cent in men and 52 per cent in women. Muscle cells hold water and men generally have more of them than women. As we age, we lose muscle mass. After 60 years, fluid makes up just 52 per cent of body weight in men and 46 per cent in women. Concurrently, the kidneys become less able to concentrate urine, so water loss is greater in the elderly. In addition, kidney function declines with age. Older adults are also less aware of thirst, due to deterioration of osmoreceptor sens