The short answer
- Older people need more fluid, not less, and often feel it lessThe sense of thirst that should prompt a drink becomes less reliable with age, so a routine of offered drinks works better than waiting to be asked.
- The obvious checks can misleadThirst, a dry mouth and urine colour are all less reliable signs in later life, so it helps to know what to check instead.
- A lower intake almost always has a reason behind itFear of the toilet, a medicine, dementia or a change in taste each need a different fix, rather than one general reminder to drink more.
- Know when it needs more than a drinkSome signs mean call NHS 111 the same day, and a shorter list means call 999 straight away.
Women need at least 1,600ml (about 3 pints) of fluid a day and men at least 2,000ml (about 3½ pints), according to the British Dietetic Association's guidance for older adults.
Why it matters more now
Why dehydration is a bigger risk once someone is older
Dehydration happens when the body loses more fluid than it takes in, and in an older body several ordinary changes work against a full glass of water at the same time. None of this is about forgetting to drink.
The amount of water the body holds falls gradually with age, by around four to six litres between twenty and eighty, and the kidneys become less able to concentrate urine and hold onto fluid when supplies run short. At the same time, the signal that is meant to make someone reach for a drink when fluid is low becomes less sensitive. The Royal College of Nursing lists both changes, a decline in the sensation of thirst and less efficient kidneys, among the reasons older people are at higher risk of dehydration than younger adults. This page is part of our wider guide to elderly care, and fluids are one of several everyday things worth keeping an eye on alongside it.
1,600ml
Minimum for women a day
About 3 pints, British Dietetic Association
2,000ml
Minimum for men a day
About 3½ pints
6–8
Cups or glasses a day
NHS Eatwell guidance, from any ordinary drink
British Dietetic Association, Hydration in older adults; NHS Eatwell guidance.
That target does not fall as somebody gets older, even though appetite and thirst often do. Nutrition and hydration for the elderly covers eating and drinking well together, if food more generally is the wider concern alongside fluids.
Where to look next
Find the part of this you need right now
This page is the overview. Seven fuller guides sit underneath it, each written for one part of the question, and the table below points to the one that matches where you are right now.
You think they might be dehydrated right now
What to do if an elderly person is dehydrated
Small sips of the right fluid, what to leave out, and exactly when it needs more than a drink.
You need to get fluids into them as quickly and safely as possible
What is the fastest way to hydrate an elderly person?
Why an oral rehydration solution works faster than water alone, and what to reach for if you do not have one.
You are not sure whether what you're seeing is dehydration
What are the symptoms of dehydration in the elderly?
The signs grouped by what they affect, and why a dry mouth or dark urine alone can mislead in later life.
You want to know how much this matters, and when it becomes an emergency
How serious is dehydration in the elderly?
The three stages from mild to an emergency, and the health problems it leads to when it is missed.
They just don't drink enough, most days, rather than one bad day
Why might an older person be reluctant to drink fluids?
The seven reasons behind a lower intake, from a fading sense of thirst to a swallowing problem, and which need a GP.
You want practical ways to get more into them, day to day
How can I get my elderly relative to drink more fluids?
What to offer besides water, how to serve it so more of it gets drunk, and what to try if they keep refusing.
You are wondering whether tea and coffee help, or work against you
Does tea count as water intake?
Yes. What the evidence says about caffeine, and why the milk and sugar matter more than the tea itself.
The rest of this page works through the same ground at a lower level of detail: what the signs look like and why some of them mislead, why drinking drops off in later life, practical ways to help, and what a carer can add if watching this day to day feels like one more thing on an already long list.
Spot it early
Signs worth checking, and why the obvious ones can mislead
The signs of dehydration in an older person are largely the same list the NHS gives for any adult, with a catch: several of the signs people reach for first are the least reliable of the lot in later life.
What to look for
0 of 7 ticked
Worth checking
Act on the same day
Thirst, a dry mouth and urine colour are the checks most families reach for first, and research on screening older patients for dehydration has found they can be misleading on their own, present without dehydration, or absent with it. What are the symptoms of dehydration in the elderly? groups the fuller list by what it affects, and how serious is dehydration in the elderly? sets out exactly which signs mean call 111 and which mean call 999, including the health problems dehydration is linked to when it goes unnoticed.
Why it happens
Why fluid intake drops off in later life
A lower intake in later life is rarely a single problem, and it is almost never simply forgetting. Four kinds of change tend to be behind it, often more than one at a time.
A fading sense of thirst
Comes with age, not a habit
Medicines and the kidneys
Common with heart and blood pressure medicines
Worry about reaching the toilet in time
Tends to make things worse, not better
Dementia, and a change in taste
Two separate but related changes
Why might an older person be reluctant to drink fluids? goes through all seven reasons in full, including which ones are for a family to work around at home and which are for a GP to look at. If a new medicine seems to be part of the picture, elderly medicine: getting medication right is worth reading alongside a review with the GP or pharmacist, and if memory or confusion is a bigger part of the picture than fluids alone, dementia care covers the wider day-to-day changes that come with it.
Getting more in
Practical ways to get more fluid into an ordinary day
None of this needs to be exact, and it is rarely about persuading somebody to drink something they dislike. It is closer to removing the small obstacles that get in the way of a habit they would otherwise keep up on their own.
What tends to work
- Offering a drink at the same points each day, alongside meals and tablets, rather than waiting to be asked
- Widening what counts as a drink: tea, milk, juice, soup and water-rich food such as melon all count
- A favourite mug, at the temperature they prefer, left within easy reach
- Small amounts offered often, rather than a full glass offered rarely
What tends to fail
- Waiting for thirst as the signal to offer a drink
- Pushing plain water when a warm drink or a milky one would be taken more readily
- A drink left across the room, which older hands and knees may not manage to fetch
- Cutting back because of worry about the toilet, which tends to make that problem worse
Tea and coffee are worth a specific mention, because the old worry about caffeine cancelling out the cup does not hold up at ordinary drinking levels; does tea count as water intake? sets out the evidence in full. How can I get my elderly relative to drink more fluids? goes further into serving, variety and matching the fix to the reason behind a refusal.
Extra care at certain times
When the everyday risk goes up: hot weather, illness and winter too
Fluid needs do not stay level all year, and a routine that works most of the time can fall short exactly when it matters most.
Times to watch more closely
0 of 5 ticked
In hot weather
During a stomach bug, a fever or an infection
In winter
Getting an older relative through winter safely covers dehydration in cold weather in more depth, alongside the flu jab, hypothermia and keeping the house warm, and the NHS's guide to coping in hot weather has the fuller advice for a heatwave. If dehydration has already set in, whatever the season, what to do if an elderly person is dehydrated and what is the fastest way to hydrate an elderly person? cover exactly what to do.
If everyday help would ease this
What a carer visit can add to hydration through the day
Family and a good routine cover most of this. A regular carer is another way to make sure a drink is offered and noticed, especially on the days nobody else can be there.
- 1
Write down what a good day of drinks looks like
TodayNote when your relative usually has a cup of tea, water with tablets, or a bowl of soup. This becomes what a carer works from rather than a guess made on the day. - 2
Search carers near you
FreeLook for an hourly or companionship carer by postcode. Every profile shows the carer's rate, experience and reviews, and every carer has interviewed online, with identity, right to work and an enhanced DBS checked, before they appear. - 3
Ask specifically about hydration, not just visits
This weekA carer who knows to offer a drink with each visit, and to notice if a cup goes untouched, does more for this than an occasional reminder from family. - 4
Book a visit built around mealtimes
Week 1A lunchtime or afternoon visit fits naturally around a drink and something to eat, and the pattern can change once you see what helps.
Keeping track of somebody else's fluids, medicines and moods, on top of everything else, is its own kind of tiring. Caring for the caregiver is written for the person holding all of this together, not the person being cared for.
Questions
Questions families ask about elderly hydration
At least 1,600ml (about 3 pints) a day for women and 2,000ml (about 3½ pints) for men, according to the British Dietetic Association's guidance for older adults, from ordinary drinks and water-rich food together. How can I get my elderly relative to drink more fluids? has practical ways to reach it.
Tiredness, a headache or a dry mouth tend to appear before thirst does, because the sense of thirst is often the first thing to fade with age. What are the symptoms of dehydration in the elderly? has the fuller list, grouped by what it affects.
Tea and coffee count fully towards the daily total. NHS guidance treats them the same as water, and research comparing tea against water at ordinary drinking levels found no meaningful difference in hydration. Does tea count as water intake? covers the evidence in full.
Usually one or more of a handful of reasons: a fading sense of thirst, worry about reaching the toilet in time, a medicine's side effect, a swallowing problem, reduced mobility, dementia, or a change in how a drink tastes. Why might an older person be reluctant to drink fluids? goes through all seven and which ones need a GP.
Call 111 or ask for an urgent GP appointment if dizziness on standing, a faster heart rate or breathing, or dark urine do not settle. Call 999 for pale, grey or blotchy skin, skin that feels cold, difficulty breathing, sudden confusion, or being unusually sleepy and hard to wake. How serious is dehydration in the elderly? sets out the full list by stage.
An oral rehydration solution from a pharmacist, mixed with water and taken in small sips often. It replaces salt and water together, which the gut absorbs faster than plain water on its own. What is the fastest way to hydrate an elderly person? sets out the full order of what to reach for.
Yes, to both. New or sudden confusion is one of the signs of dehydration in later life, and it is also one of the signs most often mistaken for something else. Dehydration is also linked to a higher risk of falls, partly through dizziness and low blood pressure on standing. How serious is dehydration in the elderly? covers what it is linked to when it is missed.
Yes. A carer who visits at the same times each day gets to know what is normal for your relative and notices sooner when a drink has gone untouched. Companion carers on PrimeCarers charge £15 to £20 an hour with our fee included. How much does a companion carer cost? has the detail.