Being a family physician and geriatrician for more than 38 years, I’m trying to better understand why our elderly patients, and in general, elderly people, suffer from dehydration. For sure, there are many reasons. Some of those are simple, but some of the hidden ones we don’t think about. For example, just by getting older, we end up having less water in our bodies. Living in a humid area and sweating excessively can cause dehydration, as can illnesses with fever, vomiting, and diarrhea. Diabetes, heart disease, and kidney diseases, and medications that are used for those, for sure, contribute to being dehydrated, and most of the time, patients are not aware of that.

Chronic dehydration is usually painless, and we can only detect it by examining the patient and checking blood and urine tests. I’m really surprised that many of my so-called healthy seniors have blood and urine tests that clearly show decreased kidney function. And patients are not complaining and are unaware that they are dehydrated. I tell those patients to drink more fluids, but they usually don’t follow my advice.

I was fortunate to be always healthy, and even now, being 73 years old, I’m still running marathons, and I have completed 34 marathons. For the last couple of years, I’ve been experiencing typical symptoms of prostate enlargement, including urinating more frequently and urinating once or twice at night. My philosophy is that I can take care of all of my health problems for now just with a holistic approach, and I’m not taking any medicine. But, after I consulted my colleague urologist and told him about my symptoms, he recommended that I start a medication called Alfuzosine ER, one tablet a day. I got that medication, and that was unbelievable. The very same day, I noticed that my urination is much better with a good stream, like when I was young.

Now, this medicine is very good for me and I will take it. Also, I’m thinking about all of us in our nature in our human mind. I can see now clearly that, at the subconscious and unconscious levels, almost every senior patient, including me, is drinking less fluid to get secondary gain: to go to the bathroom less. And that way, we end up with many people who are chronically dehydrated. Now that I can empty my bladder properly, I’m drinking more water, and I already feel better. This is just something very important, and I’d like more people to read this article. It is very important to get a neutral opinion from a good urologist, for example, in my case. And I really value his advice. I know this will be an ongoing battle to persuade them to drink more water and eat more fruits and vegetables, which would be the best way to stay hydrated. But we are creatures of habit, and unfortunately, many patients don’t listen to our good medical advice, and they continue to suffer.

Being 65 years old and older could be the most beautiful time of our lives, and for some people, it is. But, I can see more and more seniors now suffering from diabetes and high blood pressure, and it’s like an epidemic in seniors, and obesity is a big problem too. And all those patients should consider whether they are dehydrated. They should ask that doctor to do a simple blood and urine test, which will quickly tell us about kidney function, and whether there are ketones in the urine or not. And my advice would be that we all eat less meat and become more vegetarians and vegans, which would help us maintain a healthy weight, too. The last point is that as we get older, we become more secondary. We should join a good gym, exercise regularly, and always stay well hydrated.

Spasoje Neskovic is a family physician.