7 Ways to Prevent Resident Dehydration During Winter

Dehydration is a year-round concern for older adults, but the winter months bring unique challenges that can make it harder to keep senior living residents adequately hydrated. While dehydration is often associated with hot weather, colder temperatures can create a false sense of security, making it easier for residents and staff to overlook the risks.

Dr. Mickey Sharma, MD, medical director at United Hebrew Senior Living

Dr. Mickey Sharma, MD, medical director at United Hebrew Senior Living, says people tend to drink less in the winter because they don’t associate cold weather with fluid loss. Meanwhile, dry indoor air from heating systems contributes to fluid loss through breathing and the skin. “Add in medications like diuretics and conditions such as heart failure or chronic kidney disease, and dehydration becomes easy to miss during the winter months,” says Dr. Sharma.

For senior care communities, taking a proactive approach to hydration is especially important during the colder months. These seven strategies can help staff encourage fluid intake and reduce residents’ risk of dehydration throughout the winter.

1. Incorporate Hydration Into Residents’ Routines

Rather than waiting for residents to ask for a drink, United Hebrew Senior Living builds hydration into residents’ daily routines. Staff members offer residents fluids with medications, meals, snacks, activities, and routine caregiving interactions.

Staff also tailor their hydration strategies to each resident’s individual needs and preferences. For example, if a resident drinks very little, staff don’t simply ask why. “We look at what they actually like to drink, whether the temperature is appealing, whether the cup or straw is easy to use, and whether swallowing difficulty, cognitive impairment, mobility limitations, or toileting concerns are creating a barrier,” explains Dr. Sharma.

Visibility and accessibility are also key to incorporating hydration into residents’ routines. At Masonicare at Mystic, staff place filled glasses on dining tables before residents sit down and make hydration options readily available during programs and activities.

2. Offer a Variety of Fluids

Lauren Dubuque, executive director, Masonicare at Mystic

Offering a variety of appealing beverages, rather than relying on plain water alone, can help senior care communities encourage residents to stay hydrated. Lauren Dubuque, executive director of Masonicare at Mystic, says the community offers a variety of choices, including a flavored “Aqua Fresca” that infuses water with flavors like lime or watermelon. The community also offers beverages like lemonade and flavored seltzers when appropriate.

“This is an important point in senior care: sometimes the answer is not telling someone what they should drink,” says Dubuque. “It is understanding what they will actually choose to drink. If we can make hydration enjoyable, social, and part of the experience of living in the community, we are much more likely to see people participate.”

3. Encourage Hydration with Warm Beverages and Foods

Winter provides an opportunity to make hydration more appealing through warm beverages and foods, such as tea, decaffeinated coffee, hot chocolate, soups, and broths. Dr. Sharma says these options can help residents stay hydrated while providing comfort during the colder months.

Foods like soups, broths, and stews help improve overall fluid intake and may be especially beneficial for residents who consciously limit their beverage intake due to concerns about frequent bathroom trips.

“In senior living, dining is an important part of the wellness equation. We should look for opportunities to support hydration through the food and beverage experience, not treat it as a separate clinical issue,” says Dubuque.

4. Make Hydration a Social Activity

Dubuque encourages senior care communities to incorporate hydration into residents’ social activities. For example, communities can offer seasonal or festive beverages during recreational programs to make hydration more enjoyable. “People are more likely to participate when hydration feels like hospitality rather than a health directive,” she says.

5. Encourage Teams to Work Together to Support Hydration

“Hydration is a team responsibility,” says Dubuque. The people who are closest to residents every day are often the first ones to notice a change. Dining staff, housekeepers, receptionists, activities professionals, and clinical staff may notice small changes in residents that can signal dehydration. Working together allows staff to identify potential concerns and intervene early.

“That cross-functional communication is one of the strengths of a senior living environment,” Dubuque says. “We should not think of hydration as belonging to nursing alone. It is part of the entire resident experience.”

6. Continuously Monitor for Signs of Dehydration

Sometimes even the best efforts to keep residents hydrated may not be successful. Staff should continuously monitor for signs of dehydration. Dr. Sharma cautions that initial signs may be subtle and can include dry mouth, decreased or darker urine output, fatigue, weakness, dizziness, or constipation.

“One of the most important warning signs in older adults is an acute change in function or mental status, such as new confusion, lethargy, unsteadiness, or an unexpected decline in mobility,” he says.

Those signs should prompt staff to consider dehydration, in addition to other potential causes. “Waiting for a resident to say ‘I’m thirsty’ is not an adequate monitoring strategy in this population,” Dr. Sharma explains.

7. Tailor Hydration Strategies to Each Resident’s Needs

Dr. Sharma emphasizes the importance of tailoring hydration strategies to each resident’s individual needs and preferences. “Know what each resident actually enjoys drinking and identify barriers like swallowing difficulty, dementia, physical limitations, or fear of frequent urination,” he advises. “The best hydration programs aren’t just about putting more water in front of residents. They’re about knowing the resident, recognizing risk, creating frequent opportunities to drink, and making sure nursing, dietary, medical, and caregiving staff communicate when something changes.”

Dr. Sharma says it may not be appropriate to simply add more fluid for every resident. Residents with heart failure, advanced kidney disease, significant edema, low blood sodium, or a prescribed fluid restriction need personalized targets and shouldn’t be treated with a blanket approach. Tailoring hydration to each resident’s specific needs and preferences can help maximize effectiveness and support their overall health.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.