Dehydration. Does it contribute to a senior's fall risk?

Underlying respiratory issues, like an infection coming on, can cause seniors to fall. Also side effects of medications. Was there a change in medication or has this person been on a medication for while? The ER doctor would've seen right away on the labs if this person is dehydrated - did this doctor actually tell you that this person is dehydrated? It sounds like this person had plenty of fluids. Take a copy of the labs to the person's primary care doctor because there's something else going on.

The dehydration is probably not the primary cause of the fall. They probably were in poor physical condition, having lost most of their muscle mass (it starts as early as our 30's). My mom is gone as of this summer, but she resisted drinking water--because it made her pee! And she wore Depends, and these were expensive, so to her, the solution was to not have so much "input" so as to reduce the "output".

Now that I looked at this again, I'm not going with dehydration as the cause of falling, but the rapid arising from a seated or lying position. Oftentimes an elder is unsteady and gets up too quickly before "getting their bearings."

There are so many possible causes for falls, and usually, it's combos of a few of those.
Very good suggestions here.
Coconut water is extremely good for rehydration. However, there may be a few it's a poor choice for, due to the higher potassium content of coconut water.
Anyone who is too high in their potassium levels on blood tests, might need to use Other options, like simply squeezing a half-lime or half-lemon into water...just enough to flavor it.
Now, too [and I normally do NOT recommend these, due to artificial flavorings and sweetenings, but for some, it's a good option]...those Mio flavored drops to squirt into water. These things are easy to travel with, easy to use, quick. Just takes a few drops in a cup or pitcher of water. I've seen them at most grocers, including Walmart.
Using fresh fruit to flavor water, is best practice for good health.

Eyerishlass is spot on with the hypotension.

This is super common as we age. What can also help is to when going from laying down (or sitting back) to standing up is to pause to do an upright seated pause with feet on floor and have them " pump " their hands a dz or so times to help reset their blood pressure. If diabetic or prediabetic (on metformin), this plus toe curls is good too as diabetics often have low circulation in feet.

Try Boost for more nutrition.

I give my husband Smart Water in a large tumbler with a straw. It is next to him all day.

Watermelon juice!!! Genius!!! Wonderful suggestions! Also, I try to be sure my mom has her walker right by her bed every night before I go to bed. It will help for at least one getting-up... and usually she does leave it by the bed for the next time. No guarantees on that one though. Also, we will be bringing mom back from the NH, and this time, she will go in a carpeted room. If she falls, less injury. I like the idea of nothing being near the bed that she could run into. We also have her pott chair right by the bed for less night-time walking.

Watermelon juice is genius... can't be thankful enough for that idea!

My mother also hates water and has fallen several times due to dehydration. I give her watermelon cubes to eat also. she loves watermelon. MY SIL is a nurse and suggested stale ginger ale is a good rehydrator. coconut water is also excellent for hydration and electrolytes. my problem is mom has dementia and hides the drinks I give her!

I'm glad someone asked this question. My mother was dehydrated and became very weak and needed assistance walking. She has never liked drinking water so upon recommendation from an athletic trainer we decided to give my mom watermelon juice. My mom loves it! We simply by a watermelon, cut it up and blend it in the Nutribullet or even simply the blender. Fresh every time and her fluid intake has increased tremendously !

Just a suggestion regarding falls: My Mom took a bad tumble when she woke during the night to urinate. She fell face-first into the bedroom wall, then hit her head on the bedside table before collapsing, unconscious. Gave my Dad quite a scare! We have since moved the bed away from anything that might harm her if she passes out again. She has dementia, so it's hard to ask her to "remember to sit a few moments before standing." So if you think your senior loved one might be prone to falling, I suggest you fall-proof the area and avoid the week in hospital that my Mom endured. She suffered some mild brain trauma and a resulting loss in speech (aphasia).

Wow! So many great answers. So much to learn! Thank you all : )

My dad drinks a few sips and then dumps the rest of the glass of the water. Older people lose their sense of thirst and therefore are frequently dehydrated. A doctor in the ER told me it is the number one reason for falls/ dizziness and a host of other problems!

Sorry for above typos. Hard to see what I'm writing on my phone.

Dehydration may have been suspected because of lower blood pressure if they were unaware it was his "normal " number. It is confirmed with physical findings of skin tenting, pinch the skin un the back of the hand and it remains tented up, as well as lab findings. The urine specific gravity is elevated(more concentrated urine) and the blood is also more concentrated by multiple available tests available. Besides sitting a bit before rising, pumpint the feet up and down helps as blood can pool in the feet and lower legs with sitting and activating the calf muscles gets it back into circulation helping maintain adequate blood pressure.

potassium is not good for people with kidney problems. Too much is not good. Not enough can cause problems and depression. Talk to his Dr. before u do anything.

I would suggest you get him the product, Boost. This could make him stronger.

Sendme2help, glad you found the information helpful.

Appreciate your wanting to help patients find me, but my small consultative practice is at capacity so I'm generally not able to take on new families for in-person help, sorry!

In an ideal world we'd have enough geriatricians to help all families who need our knowledge, but since there is a very bad shortage of geriatricians, I feel the next best thing is for family caregivers to get better information and support. Everyone needs to learn to get what they need from the medical system, but it's especially important when it comes to frail older older adults.

I follow the forum here because I'm interested in the questions that keep coming up for family caregivers. Dehydration and falls are both very common concerns...I hope the OP and others will be able to get what they need from their doctors.

Dr K, thank you for posting valuable medical advice here today! I did a search for good geriatric doctors in San Francisco and have referred you to my sister who will recommend you to friends caring for their elderly parents. It's so important to get an accurate diagnosis, imop.

Falls in older adults usually have multiple contributing causes. To prevent/reduce them, try to identify as many contributors as possible. It does sound like chronic low blood pressure might be one of them. You can ask the doctor to check his BP sitting and standing (or you can try it yourself with a home BP monitor). If it drops a lot with standing, he may benefit from reducing BP medication, and he certainly should practice standing slowly.

Re dehydration, it generally shows up on labs as
- urine that is more concentrated than usual (but this can be affected by diuretics and other medications)
- elevated blood urea nitrogen and or elevated creatinine
- elevated serum osmolality (not routinely checked w bloodwork but sometimes done)
- elevation of sodium and some other electrolytes. A higher than usual hemoglobin level can also indicate dehydration.

If labs were done, you shouldn't need to speculate as to whether he was significantly dehydrated or not when he went to the ER. Ask his regular doctor to get a copy of the ER labs and to explain them to you, with a special focus on whether there were laboratory signs consistent with dehydration.

This way you'll know whether you really need to get him to increase fluid intake or not. Good luck!

Just because someone drinks a lot, doesn't mean it stays in their body! If he is on a diuretic, he could be losing it. Also, dehyration requires electrolytes also.

I knew a 95 yr old woman who fell down and broke her hip. She was soooo shocked because she was always so careful and always used her walker. The doctor told the daughter that sometimes when seniors are older...their bones just break! NO reason!

My husband liked cranberry juice, and drank at least 6 glasses a day. Wound up in ER, he was dehydrated. Nurse recommended putting a little water in the juice ....that way he was also getting the water and not all juice. He drank even more after I watered it down.

Maybe he should just when arising from a nap or sleeping, sit for a minute or two until he gets his bearings. My mom does that. I think its a drop in blood pressure as soon as you get up, so have him sit for a little bit then get up slowly and move around. hope that helps and IF he is drinking that much water in a day, then he is drinking more than me.

Other things can cause dizziness too like inner ear, vertigo, and medications.

It sounds like he's drinking quite a bit of fluids.

Having just experienced this myself in the ER, it seems whenever hospitals cannot come up with a cause, they blame dehydration (then they can run tests and an IV drip). Sleeping, then awakening and rising may indicate their blood pressure is too low. It does matter what is in those tumblers of liquid relative is drinking. Too much sugar will affect their blood sugars, and blood pressure. Water with a lemon slice is usually the best liquid to be drinking (I recommend 2--3 cups of coffee too). Medications they may be taking will also have an effect.

Did they say he was dehydrated or was this something on a handout on falls in the discharge papers? Six to eight glasses of liquid a day sounds like plenty. (FYI: I was once found to have low blood sodium and was told to drink less water. I was drinking 8-9 glasses of liquid a day.)

OK thanks. I forgot all about bananas...He loves them, too!

Caring, you might also want to see if you can get him to have his decaf later in the morning, after he's been up a while and after his breakfast has had a change to be absorbed.

You might also make sure he's getting enough potassium - bananas are a good source, unless he has specific dietary limitations.

Thanks guys. He's an old school guy with simple tastes. I guess we're lucky he dosent like pop, iced tea, even milk. He drinks mainly water throughout the day (should have specified that, lol). Vodka!! ha. He will have a cup or two of decaf in the morning, and some ensure along with his regular meals. He does have low-normal blood pressure to begin with, so i can see how it might get a bit too low if he got up too fast. I think that's what happened. I'll offer him water more frequently and make sure he takes his time getting up! Thanks again! You may have saved us from more falls in the future : )