SECTION 11 Hydration

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► Daily fluid requirements ► Dehydration and stroke ► Hydration and urinary incontinence ► Hydration and constipation 3

The average adult can live for weeks without food, but only for days without water. ► People need at least 6 to 8 cups of non- caffeinated fluids daily to stay hydrated 4 Daily fluid requirements

MeasureAmount Cups68 Ounces4864 Litres1.52 Millilitres

Fluids in common foods FoodServing SizeFluid Content Jellied dessert½ cup120 mL Pudding½ cup100 mL Ice cream or sherbet½ cup60 mL Popsicle1 popsicle90 mL Yogurt½ cup90 mL Canned Fruit½ cup100 mL Soup1½ cups165 mL Simple conversion for daily fluid requirement 1 cup = 250 mL ½ cup = 125 mL 6

Key point Help the survivor stay hydrated. Find out the survivor’s favourite non- caffeinated drinks. Make them available and encourage the survivor to drink during the day. 7

Dehydration and stroke Dehydration is a health risk that rapidly becomes life-threatening. When people are dehydrated they may lose physical, mental, and cognitive function. They have an increased risk of: o Infection o Falls o Constipation and fecal impaction o Urinary tract infection 8

Dehydration and stroke Increased risks for stroke survivors who: ► Have swallowing problems may fear choking and avoid drinking fluids. ► Fear of incontinence may decrease their fluid intake in an attempt to prevent accidents. ► Are on a thickened fluid diet and do not take all the fluids provided ► Refuse fluids at meals or snacks ► Need help with eating and drinking ► Lack the feeling of being thirsty 9

Dehydration and stroke Increased risks for stroke survivors who (cont’d): ► Are unable to communicate that they are thirsty ► Have memory problems or are forgetful ► Have an illness that increases fluid loss, such as vomiting, diarrhea, or fever and sweating 10

Signs of dehydration Watch carefully for these signs of dehydration: ► Decreased urine output ► Dark, concentrated, or strong-smelling urine ► Frequent urinary tract or bladder infections ► Thick, stringy saliva ► Constipation ► Dizziness when sitting up or standing ► Confusion or a change in mental status 11

Signs of dehydration Watch carefully for these signs of dehydration (cont’d): ► Weight loss of 3.5 pounds (1.5 kg) in less than 7 days ► Fever ► Decreased skin elasticity 12

Signs of dehydration 13

► Encourage the survivor to drink enough fluids ► Sip fluids during the day, rather than drinking large amounts at once ► Drink water, the preferred liquid. Consider providing the required amount of water in a container ► Limit caffeine intake to 2 to 3 cups or less ► Provide gentle reminders to drink. ► Try to give them liquids they prefer. ► Offer a variety of liquids 14 How you can help

Key point Dehydration is potentially life-threatening. It is vital to encourage survivors to consume enough fluids. 15

Upon reflection What are three things you can do to help a stroke survivor stay hydrated? 16