Abstract

Dehydration affects 20% to 30% of older adults. Water is the most essential nutrient required for the maintenance of every body system. It is vital for the removal of waste products as well as the function of the lymphatic, cardiac, gastrointestinal, and urinary tract systems, and more.

Unfortunately, with age, total body Water is the most essential nutrient required for the maintenance of every body system. It is vital for the removal of waste products as well as the function of the lymphatic, cardiac, gastrointestinal, and urinary tract systems, and more.

Unfortunately, with age, total body water naturally decreases, causing these systems to be less effective water naturally decreases, causing these systems to be less effective. The aim of this study was to investigate older adults’ knowledge on dehydration it prevention and the challenges faced in the upper Muea Community.

The objectives of the study were; To investigate the knowledge of dehydration amongst older adults 60years and above in the Upper Muea Community, to find out the knowledge on the prevention of dehydration amongst older adults, To identify the challenges in the prevention of dehydration amongst older adults. this study uses a cross-sectional descriptive study and it employs a purposive sampling technique through the use of well-structured questionnaires to collect data.

The percentages of older adults who had knowledge on dehydration were was 90(90.00%) and their sources of information were as follows follow; Friend2(2.00%) Hospital 84(84.00%) media 14(14.00%).

Meanwhile (57(57%) said not drinking enough because you are sick is a Cause of dehydration whereas 35(35.00%) said Severe or acute diarrhea is a cause of dehydration and 73(73.00%) said they faced challenges in getting good drinking water.

At the end of the study,it was concluded that Most of the older adults in Upper Muea had some degree of knowledge on dehydration demonstrated a good knowledge of the prevention of dehydration in older adults 60 years and above and it was recommended that Health workers should carry community sensitization on the prevention of dehydration in the older adults.

CHAPTER ONE

GENERAL INTRODUCTION

1 .1 Background

For everyone the belief that water is very essential for human life holds true, as our bodies as adults hold up 60% of water to remain functionally healthy as it makes up to 59% of every bodies weight, Also it’s directly involved in all biochemical reactions in our bodies ultimately maintaining the right balance of water is what keeps us alive as humans (Bruise, 2018).

Total body water can be subdivided into two major compartments: intracellular fluids which are fluids inside the cell and extracellular fluids which are fluids outside the cell, like in the blood and interstitial tissues between cells (Lipton, 2018).

For those with the normal 60% of water in their total body weight, 2/3 of that or 40%of the bodyweight is intercellular fluids and the remaining 20% of the bodyweight is extracellular fluids (European Institute of hydration, 2018).

Both inside and out of the cell water acts as an electric transmission, blood osmolality is a good measure for hydration status when blood osmolality is high, a common reason is that there is low water in the blood such as in dehydration when blood osmolality is low the common reason is that there is too much water such as when the is kidney damage (Moses, 2014).

Normally the amount of water in the body is balanced by ingestion and egestion. About 80% of our water comes from drinking fluids and the remaining 20% comes from food such as watermelon, vegetables, and drinks such as alcohol and wine (Murrella, 2018).

As far as water output is a concerned we eliminate water through breathing, urinating and sweating, and bowel movements (Bolore, 2014). In addition to the water we get from food, the recommended daily amount of fluids intake for women is 2.5 liters or 9 glasses, and for men, it is about 13 glasses or 3 liters. (European Institute for hydration, 2020),but this amount of water needed per day can vary depending on many factors such as doing hard work, exercise, and health conditions (Ismael, 2018), plain water is the ideal choice when it comes to hydration but all fluids including caffeinated drinks and teas and juices contribute to water intake, (Nathaniel, 2018). After the water is drink it travels all through to the small intestine where it’s absorbed and sent to the blood where it enters the general circulation.

Then it goes to the kidneys where it’s filtered to produce urine (Albarh, 2014). For a properly hydrated individual, the amounts of water excreted per day is between 800 and 2000meliliters of urine per day which comes out in a pale-yellow color most often (Albarh, 2014). 200Ml/day is also lost through bowel movement, sweat glands also eliminate the smaller amount of water and this amount increases when we are nervous, heat and exercising but the quantity of water loss this way vary greatly on average its between 500ml/day to 550ml/day (Edmonde,2018).

Finally, there is the insensible water loss that is the loss of water which we are not aware of such as when we breathe in the water inside the body humidify the air and water vapor moves out, water also constantly diffuses through the layers of the skin keeping it elastic and nourished it, this is in addition to losing water through our sweat glands. All in all insensible account to an incredible 600ml/day loss which is a lot of water to lose without even sensing it (Kemberlyn, 2019).

Staying hydrated is important because water does so many important things in our bodies such as tears, mucus that lubricate passways in and out of the body for example the eyes, ears, nose, and genitals, peritoneal cavities of the chest and abdomen. It’s also needed at the joints whereas synovia fluids aid in the preventing of bones from rubbing on each other, water is critical for digestion the water in saliva moistens food when we chow, while intestinal juices are enzymes action mediums.

Water forms the bulk of blood in transportation and also eliminating toxins through urination, water can also help with maintaining a healthy weight by replacing surgery drinks with water lowers calories intake, and drinking water during meals increases the sense of fullness and prevent overeating (Laurencia, 2018).

When water losses are greater than intake it results in dehydration. There are many causes for dehydration starting from vigorous exercise, not drinking enough water, vomiting and diarrhea, excessive sweating and inability to swallow, and sometimes as a result of alcohol intake (Wickney 2019). Dehydration presents with symptoms to include thirst, dry mouth /lips, Nausea, fatigue, lightheadedness, and dark urine (Wickney, 2019). A loss of as little as 20% Body water can leads to irritability, difficulties concentrating, and headaches (Mueller, 2012).

Some groups such as children and adults are at an increased risk of dehydration. Children’s, for instance, have lower stores of water because their surface Areas to body mass ratio is higher so they turned to lose water faster and more, their thirst organs are not fully developed, and given that they depend on caregivers to obtain fluids its harder for them to be hydrated.

Children between the ages of 4-13 years need about 1.7l/day, research has shown that well-hydrated children have improved concentration and ability to focused, infects studies have shown that drinking more water can boost children school performance (Albatune, 2019)

Like children the older adults are also prone to dehydration, they also have a decreased thirst sensation and maybe taken medications that alter their hydration status when oftentimes they have a chronic disease that affects their kidney’s ability to maintain a healthy water balance. Experts have warned that most people especially elderly people could be experienced dehydration unknowingly and that they are not aware of the knock-on impact it brings to their mental and physical health (Albaer, 2017).

New research from the European hydration Institute also suggests that ¼ of the elderly are not paying more attention to dehydration and how much they should drink and lack of knowledge on dehydration is just part of the problem among a number of wrongly believes ideology also surrounds the problem say Bryan et al 2016, they also added that 74% of British wrongly believe that everyone should be taking 8 glasses of water a day. And not knowing that much of our water should be coming from the food we eat and the choices of what we drink not merely from plain water intake.

It should also be noted that as we lose fluids we equally lose electrolytes as well and what happens there is an imbalance between sodium and potassium. That is a serious problem as its complications are far beyond imagination in devastating health and wellness this includes; high blood pressure, kidney stones, kidney failure, coma confusion, heart problems, and even death (Ahrshirahim, 2020)

Very few older people can have the sensation or feelings of thirst of the lifesaving liquid called water and even to complain of dry mouth is never the case predisposing the elderly clients to dehydration and its numerous complications hence this research entitled “investigating home management of dehydration in the elderly ” Sorts caregivers knowledge on dehydration is important as most of them are those to provide care or provide for the needs of the elderly people at home, such as offering a glass of water or reminders for fluids intake.

What is frustrating about this issue of dehydration is that it’s exclusively preventable just by drinking or taking enough fluids. Sadly, in the Muea community too many older adults are less educated on the various ways of hydrating their bodies as a result of poor diet and feeding choices which do not take into account their fluids requirements (personal observation,2020).

1.2 Problem Statement

Globally, more than half the world’s elderly population is not getting enough hydration as recommended, probably because they are not drinking enough. (The European association for hydration, 2018).

They are silently getting dehydrated and this can be a big problem in elderly people as there are not enough fluids for the body as it used to be before aging and the physiological changes sets in and there is a lot of imbalances (Ahrmed, et al., 2008).

A loss of as little as 20% Body water can leads to irritability, difficulties concentrating, and headaches (Mueller, 2012). Like children the older adults are also prone to dehydration, they also have a decreased thirst sensation and maybe take medications that alter their hydration status.

They are also sometimes faced with chronic disease(s) that affects their kidney’s ability to maintain a healthy water balance. It’s been warned that most people especially the elderly people could experience dehydration unknowingly and are not aware of the impact it brings to their mental and physical health (Albaer, 2017).

New research from the European hydration Institute also suggests that ¼ of the older adult are paying less attention to the signs and symptoms of dehydration and how much they should drink.

Despite the fact that dehydration in the elderly can be prevented, it is however witnessed that majority of the older adults at the Muea community still experience dehydration with the extend of them suffering complications as a result of deficient fluid volume/intake.

Some of these complications witnessed by the researcher include an increase in infection, poor body maintenance, a fall in blood pressure, kidney problems, inability to carry out their daily activities, and even death. Investigating the home management and preventive measures of dehydration in older adults (60+ years) will therefore identify the various strategies on ways to prevent and manage dehydration at home within the Muea community so as to limit or solve these complications the older adults face during dehydration.

1.2 Research objectives:

1.2.1 General Objective

The main objective of this study was to investigate on the knowledge on dehydration its prevention and the challenges faced by older adults (60 years and above) in the Muea community.

1.1.2 Specific Objectives

1. To investigate the knowledge of dehydration amongst older adults age (60 years) and above in the Muea community.
2. To find out the knowledge on the prevention of dehydration in older adults.
3. To identify the challenges faced by older adults in the prevention of dehydration.