The short answer
- Offer small amounts of the right fluid, oftenWater, milk or a pharmacist's oral rehydration solution, sipped little and often, works better than a large glass all at once.
- Leave out caffeine and alcohol while you do itNHS advice on treating dehydration is to avoid caffeinated drinks and alcohol, since both work against what you are trying to do.
- Know which signs mean call 111 todayA separate, shorter list of signs means 999 straight away rather than waiting to see how the day goes.
- Build in a routine once they have recoveredMost dehydration is prevented rather than treated, with drinks offered on a routine rather than waited for.
Once they are drinking normally again, the target to stay ahead of it is 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.
Before you act
Check what you are seeing looks like dehydration
A few of the clearest signs are worth checking before you start, mostly because some of them, especially confusion, are easy to put down to something else in an older person. If several of these fit, treat it as dehydration and move to the next section.
Does this match what you are seeing?
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Quick checks
If none of this quite fits, what are the symptoms of dehydration in the elderly? has the fuller list, grouped by what it affects. This page picks up from here, once dehydration looks like the right explanation, and it sits inside the wider picture of elderly care more generally.
What to do right now
Offer fluids in small amounts, and keep them coming
The instinct is to hand over a full glass and expect it to be finished. A better plan is small amounts, offered often, over the next hour or two, with a proper check-in partway through.
Offer a drink, in small amounts
Right nowWater, milk or an oral rehydration solution from a pharmacist if you have one to hand. Small sips, offered often, work better than a large glass all at once, especially if they feel sick.
Keep the drinks coming
Next 30 to 60 minutesOffer another small drink every 15 to 20 minutes rather than waiting to see what happens. A carer or family member sitting with them for this stretch makes it much easier to keep track of how much has gone in.
Check how they are doing, and top up
Later the same dayIf they seem brighter and are managing drinks on their own, keep offering fluids through the rest of the day. If there has been little change, or they have barely managed a drink, that is the point to call NHS 111 or ask for an urgent GP appointment rather than waiting until tomorrow.
Watch for the signs that mean 999
At any pointPale, grey, blue or blotchy skin, skin that feels cold, difficulty breathing, sudden confusion, or being unusually sleepy and hard to wake. Any of these means calling 999 or going to A&E straight away, whatever stage you were at a moment before.
A pharmacist can recommend an oral rehydration solution, a sachet mixed with water that replaces salt and fluid together and is absorbed faster than water on its own. If your relative cannot manage a drink at all, water-rich food such as soup, melon or a homemade ice lolly can help in between sips. What is the fastest way to hydrate an elderly person? sets out the full order of what to reach for and why it works faster than water alone. If dementia is part of the picture, getting a drink accepted at all can be its own challenge; dementia care covers the wider day-to-day changes that come with it.
What to leave out
Drinks that work against you while you are doing this
Some of what looks like an obvious choice for fluids slows down or undoes the good you are doing, so it is worth knowing what to reach past as well as what to reach for.
What helps right now
- Water, milk or an oral rehydration solution from a pharmacist
- Small sips, offered every 15 to 20 minutes, rather than a full glass at once
- Water-rich food, such as soup or melon, if a drink alone is not being taken
- A closer eye on them for the rest of the day, even once they seem brighter
What to leave out
- Caffeinated drinks and alcohol: NHS advice on treating dehydration is to leave both out, since they can add to fluid loss
- Fruit juice or fizzy drinks if sickness or diarrhoea is the cause: NHS advice on diarrhoea and vomiting is to leave both out, since they can make it worse
- Sports drinks or coconut water as a stand-in for a proper rehydration solution: neither has the right balance of salt for this
- A large glass forced down quickly if they feel sick, which is more likely to come straight back up
The caffeine and alcohol advice above is from the NHS page on dehydration, and the fruit juice and fizzy drinks advice is from the NHS page on diarrhoea and vomiting. Both are about treating an active episode, not about tea and coffee as part of an ordinary day. Does tea count as water intake? covers the everyday question, where the evidence is that a normal amount of tea hydrates about as well as the same amount of water. Right now, while you are actively bringing the fluids back up, stick to water, milk and a rehydration solution if you have one, and pick tea back up once things have settled.
When to get more help
When this needs more than a drink
Most dehydration in later life is put right at home within a day. It is worth knowing what it looks like when that is not happening, because hospitals take dehydration in older patients seriously for a reason.
16% vs 4%
In a UK hospital study, older patients who were dehydrated on emergency admission were far more likely to die within 30 days than those who were not.
Nottingham University Hospitals NHS Trust, published in Age and Ageing, 2015 (the HOOP study)
That is the reason not to wait too long before asking for help. Dizziness on standing that does not settle, breathing or a heart rate faster than normal, and passing noticeably less urine all mean calling NHS 111 or asking for an urgent GP appointment the same day. Pale, grey, blue or blotchy skin, skin that feels cold, difficulty breathing, sudden confusion, or being unusually sleepy and hard to wake mean 999 or A&E straight away, at any point, whatever stage you thought you were at a moment before. How serious is dehydration in the elderly? sets out the full list of signs by stage and what dehydration is linked to when it goes unnoticed, including a higher risk of falls and sudden confusion.
Once they are better
Building a routine that stops it happening again
Once your relative is back to drinking normally, the job shifts from treating dehydration to making it less likely next time. A few changes to the daily routine do most of the work.
Offer drinks on a routine
Not on request
Widen what counts as a drink
Beyond plain water
Ask about any water tablet or diuretic
At the next GP or pharmacist visit
A regular carer notices sooner
£15–£20 an hour
How can I get my elderly relative to drink more fluids? has practical ways to build this in day to day, and why might an older person be reluctant to drink fluids? looks at the reasons behind a refusal rather than just the workarounds. Nutrition and hydration for the elderly covers eating and drinking well together, and elderly medicine: getting medication right is worth reading if a review of what your relative takes feels overdue. How much does a companion carer cost? sets out what a regular visit looks like, if extra support during the day would help.
Questions
Questions families ask about what to do straight away
Water, milk or an oral rehydration solution from a pharmacist, in small sips offered every 15 to 20 minutes rather than a large glass all at once. If they cannot manage a drink at all, water-rich food such as soup or melon can help in between. What is the fastest way to hydrate an elderly person? covers the full order of what to reach for.
Yes, while you are actively treating the dehydration. NHS advice is to leave out caffeinated drinks and alcohol at this stage, since both can add to fluid loss. This is different from an ordinary day, where a normal amount of tea or coffee counts towards fluid intake without causing a problem; does tea count as water intake? covers that side of it.
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, 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.
Mild dehydration usually settles within a few hours to a day with fluids at home. If there has been little improvement by later the same day, or they have barely managed a drink, that is the point to call NHS 111 or ask for an urgent GP appointment rather than waiting overnight to see.
Pale, grey, blue or blotchy skin, skin that feels cold, difficulty breathing, sudden confusion, or being unusually sleepy and hard to wake. Any of these means calling 999 or going to A&E straight away, rather than trying another drink first. How serious is dehydration in the elderly? has the full list of signs by stage.
Yes, if whatever caused it in the first place is not addressed. A fading sense of thirst, a water tablet or laxative, hot weather, or difficulty reaching a drink are common causes worth working through once the immediate episode has settled, rather than treating it as a one-off.
Yes. A carer who visits at the same times each day notices sooner when a drink has gone untouched, and can build it into an ordinary visit rather than a special effort. Companion carers on PrimeCarers charge £15 to £20 an hour with our fee included. How much does a companion carer cost? has the detail.