Managing dehydration

Preventing dehydration

Hydrate often

• Sip water frequently throughout the day and maintain a good fluid intake.
• Make sure water and other drinks are within reach.
• Provide a variety of fluids, such as flavored water, juice, tea, or milk. Ice pops and jellies can also be offered.
• If drinking water orally is not possible, sponges or swabs can be used to moisten the mouth.
• Subcutaneous fluids (when fluids are given through a drip into a small needle or cannula under the skin) can also be considered in consultation with the healthcare team.

Diet and daily care

• Limit or avoid things that can cause dehydration, such as caffeine, alcohol, or food that is dry or hard to chew.
• Offer more hydrating foods like cucumber, watermelon, oranges, or soups.
• Maintain good oral hygiene to keep the mouth clean and moist.
• Reduce or quit smoking.
• If dehydration is a concern, review and potentially adjust medications in consultation with a healthcare provider.

Monitor symptoms

• Look out for early signs of dehydration such as dry mouth, sunken eyes, dark or reduced urine, and fatigue.
• A skin pinch on the back of the hand can also indicate dehydration if the skin does not return back to its normal position quickly.
• Regularly check the pulse rate and oxygen levels, low blood pressure can be a sign of dehydration.

Managing dehydration

Address the underlying cause

• Address any specific reason for the dehydration, like diarrhea, fever, excessive sweating, or swallowing difficulties.

Monitor vital signs and other symptoms

• Monitor heart rate, blood pressure, breathing rate, and other vital signs.
• Keep an eye out for related symptoms which may result in added discomfort, like constipation, vomiting, fever, spasms, or rapid weight loss. See signs of dehydration below

Increase fluid intake

• Have small, frequent sips of water and other liquids. Suck on crushed ice or ice chips. Avoid drinking large quantities of fluids at once.
• Oral rehydration solutions can be considered in consultation with the healthcare team.
• Have foods with high water content, such as fruits and soups.
• Puree solid foods to a smooth texture if swallowing is difficult.
• Avoid coffee and alcohol.

Mouth care

• Use moistened swabs or a damp cloth to moisten the mouth and lips.
• Maintain good oral hygiene by brushing teeth with a soft-bristled toothbrush and fluoride toothpaste.
• Use oral sponges for moistening the lips and removing dry or stingy saliva. Replace these regularly.
• To loosen up thick or stringy saliva, rinse the mouth with a homemade mixture of 0.5 liters of water, 1 tsp baking soda, and 1 tsp table salt.

Improve comfort

• Maintain a comfortable and cool temperature to reduce fluid loss from sweating.
• Use a humidifier to add moisture to the air.
• Keep a water bottle within easy reach.
• Address symptoms that might accompany dehydration, when needed.

Managing severe dehydration

Severe dehydration can lead to a significant loss of body fluids which may result in confusion, loss of consciousness, low blood pressure, rapid heart rate, and other complications.

Signs of severe dehydration can include:

• Extreme thirst
• Little to no urination for many hours
• Rapid heartbeat and breathing
• Rapid or weak pulse, low blood pressure
• Fever
• Delirium or unconsciousness

If severe dehydration is suspected, involve the healthcare team as soon as possible. They may:

• Offer oral rehydration solutions, intravenous (IV) fluids, subcutaneous fluids, nasogastric or PEG tube hydration.
• Monitor fluid intake regularly to avoid over-hydration or complications.
• Address the underlying conditions causing dehydration and manage other symptoms if they cause discomfort.
• Prescribe medications for dehydration or underlying causes.

Dehydration is in many cases completely normal and does not always lead to added discomfort, especially in the very advanced stages of an illness. Do not push to drink too much as that can lead to discomfort or complications. If you are unsure about how to manage dehydration, speak to the nurse or doctor, they can advise how to best manage it.