Why are fluids important?
Our bodies are between 5O and 7O per cent water. Water is in blood, digestive fluids, muscle, fat and bone. The body needs water to function normally. You need to replace fluid every day because you lose it from the body through breathing, your skin, urine and faeces.
If the amount of fluid going in and out of the body is not balanced, the body may not function properly.
What happens if someone doesn't drink enough fluid?
- If the amount of fluid a person drinks is less than the amount they lose every day, they can become dehydrated.
- Signs that a person is dehydrated include:
- passing less urine than normal
- dark-coloured urine
- mood changes or confusion
- a dry nose and dry cracked lips
- feeling tired and sleepy
- feeling weak
- hallucinations (they see or hear things that aren't there).
Dehydration can be dangerous.
If you think the person you support is dehydrated, you need to talk to your supervisor, their care coordinator or to their general practitioner (GP). If you are out in the community and you don't have any other support, take them to a hospital emergency department straight away.
What happens if someone drinks too much fluid?
- If a person drinks a large amount of fluid over a short period of time, the kidneys might not be able to process the fluid quickly enough.
- This can cause hyponatraemia (water intoxication). This is when the amount of sodium (salt) in the body is too low because there is too much water in the body.
- This is rare because the person would need to drink a lot of water quickly. However, it can happen with some disease, such as diabetes, or with mental health conditions including some types of schizophrenia.
- Signs of hyponatraemia include:
- blurry vision
- convulsions, seizures or 'fits'.
- If not treated, a person's brain can swell, leading to a coma and death.
Hyponatraemia can be dangerous.
If you think the person you support has hyponatraemia, you need to talk to your supervisor, their care coordinator or GP. If you are out in the community and you don't have any other support, take them to a hospital emergency department straight away.
How much fluid is enough?
- For most people, drinking 1-1.5 litres (6-8 glasses) of fluid a day is enough to stay healthy. However, some health conditions require people to drink less or more. Check the person's care or mealtime management plan for any special needs, including thickened fluids or fluid restrictions.
- Some foods we eat also have fluid in them and this fluid adds to the daily total. Some foods have more water in them than others, such as grapes, watermelon, yoghurt and ice-cream.
- The amount of fluid we need to drink depends on:
- a person's size - bigger people need more fluid than smaller people
- metabolism - how well someone's body makes energy
- how active a person is - people who exercise lose fluid through sweat
- the environment a person is in - a warm room, too many blankets or wearing too many clothes can make a person sweat more
- how any physical disability or condition impacts a person
- the weather - a person loses more fluid through sweat in hot weather.
Record how much the person you support drinks and passes urine.
- Write down each time they have a drink and how much they drink. Add this up at the end of the day.
- Write down how many times they go to the toilet during the day. 4-6 times a day is normal. Less than this can mean that they are not drinking enough.
- Pour 1.5-2 litres of water into a jug or water bottle at the start of each day and then pour from that into a glass for the person to drink. You should aim to empty the jug by the end of the day.
- The best guide to work out if a person is drinking enough is to look at the colour of their urine.
How do you help someone who isn't drinking enough?
- Put drinks where they can easily reach them, for example in a water bottle next to them.
- Make sure fluid is given to the person in a cup, glass, or bottle that's easy for them to grip and drink from comfortably, e.g. a cut-out cup, or bottle with built-in straw. Offer to help them if needed.
- Ask them what they like to drink or think of different ways to give them fluids:
- the person may have a favourite cup or drink bottle
- try flavouring their drinks, e.g. add some lemon juice to water or orange slices
- offer different types of fluids but avoid soft drinks, which are high is sugar, salt and calories
- avoid suger-free soft drinks because they can irritate the bladder and cause bladder and bowel control issues.
- make sure they don't have too much mineral water or energy drinks because these are high in caffeine, salt and sugar. Energy drinks can also cause bladder control issues.
- limit coffee, tea and alcohol as these can irritate the bladder
- try fresh fruit juice or fruit smoothies
- in very hot weather, offer ice-cream or frozen fruit juice
- make sure any fluid you offer meets the person's mealtime management plan, if they have one
- if the person has a percutaneous endoscopic gastrostomy (PEG) tube, make sure you follow their feeding routine.
- Make drinking time a social time - sit with the person, focus on them and encourage them. Don't rush them when they are drinking. Try to give them a drink when they are doing something they enjoy, e. g. while they are watching TV or after eating lunch.
- If the person is on fluid restrictions, don't give them more fluids than they are allowed.
- If the person has a toileting plan, make sure that you follow it. If the person is afraid of being wet, they may not want to drink.
Need more help? Call the National Continence Helpline on 18OO 33 OO 66 and talk to a continence nurse advisor.