For Ben Carter, his beloved blue sippy cup wasn’t just a drinking vessel, it was a lifeline to years of comfort. According to a report by CNN, Ben refused to drink without his favorite cup, and put himself at risk for severe dehydration that required emergency medical treatment. So when his father, Marc Carter, realized the crucial cup was starting to wear out, he launched a plea online. Thankfully, the manufacturer heard of Ben’s struggle and provided a lifetime supply of cups to ensure that he stays happily hydrated. However, while this story has a happy ending, dehydration is a common yet dangerous problem for individuals with intellectual and developmental disabilities (IDD).
Proper hydration for those with IDD still presents a common problem in terms of maintaining a healthy lifestyle. There are many causes of dehydration that can vary from environmental to medical or dietary factors, the most common usually due to not drinking enough water. Environmental examples are raised temperatures in the summer and spring that can lead to increased fluid loss. Increased physical activities such as sports or outdoor activities may also contribute.
Risks For Dehydration
Parents or caretakers of individuals with IDD are usually well informed about their child’s condition, and know that they may be more susceptible to physical harm or bacterial infections. Their increased risk of harm involves their inability to properly sense danger and how to navigate around it. Bacterial infections cause fever that raises body temperature, which leads to increased fluid consumption. Combined with the body’s need for thermoregulation, these factors contribute to further deplete the internal fluid supply. With inadequate fluid intake, this may lead to the body overly exerting itself.
Dietary lifestyle is also important, as it is adjusted depending on medical conditions that require moderation in their intake of fluids. It is important to note that dehydration affects all age groups but is much more common in infants and children. When combined with illness, the individual is weak and less motivated to properly hydrate themselves. Infants are the most challenging to detect if they are properly hydrated. As they are limited in their ways to voice their needs, infants with IDD tend to have underdeveloped motor and vocal skills that allow them to cry or otherwise indicate that they want something to eat or drink. Elderly individuals with IDD are also prone to dehydration as they are more susceptible to comorbidities, illness, and memory loss.
Symptoms Of Dehydration
Fluids are naturally lost in the body systems by perspiration or urination. It is important to be able to replace those fluids that are lost to keep our bodies properly hydrated. But for individuals with IDD, they are limited in how much they can do for themselves. Parents and caregivers must be able to identify the symptoms of dehydration to properly care for their loved ones. Signs such as thirst, drooling, sunken eyes, dry skin, dry mouth, and dry lips are the most easily identifiable. Muscle cramps and constipation can also indicate dehydration. Vomiting and diarrhea due to gastrointestinal problems can lead to increased fluid loss. Medical conditions, such as diabetes, also have the capability to increase the urinary output. These individuals also tend to feel low on energy and can become lethargic, with accompanying neurological symptoms such as irritability, dizziness, confusion, or cognitive disorientation. In extreme cases, rapid weight with labored breathing may indicate another serious medical problem.
Lack of Sufficient Fluids
Dehydration is defined as the lack of sufficient body water and fluids that occur due to inadequate intake of fluids and/or loss of fluids. Children and adults with IDD are more prone to the harmful effects of dehydration as they sometimes lack the fine motor skills and memory retention that would allow them to simply get themselves a glass of water. According to a study by the Brazilian Journal of Oral Sciences, understanding the impact of oral motor dysfunction interferes in fluid intake, and suggests that greater neurological impairment causes the diminished hydration status. This means that besides their deficient motor skills, there might be a problem at a cellular level that allows them to be more prone to dehydration. In a recent study published in the Journal Age and Ageing, it has also been reported that children with cerebral palsy present increased saliva, leading to dehydration that can be noted in some individuals who appear to be drooling. Mental disabilities also prevent individuals from the ability to simply express themselves when they are thirsty or lack the motor capabilities to get their drinks.
Dehydration Linked to Negative Health Outcomes
According to CPFN, dehydration can lead to negative health outcomes, such as the increased risk of disability, infections, stroke and mortality. Water intake may vary in different age groups and body types, but the most common advice heard is to drink eight glasses of water a day. It also makes it easier for individuals with IDD to remember, and is a reasonable goal that can be achieved by anyone on a daily basis. It is worth remembering that the elderly should make it a habit to drink regularly even when they’re not thirsty, as fluid intake is carefully monitored in those with weak systems or who are prone to weight loss.
According to ANCOR, there are four major common health issues among individuals with IDD: aspiration, seizures, constipation and dehydration, commonly referred to as “The Fatal Four”. Multiple systems and organs are adversely affected by dehydration. It can lead to bowel problems such as vomiting and diarrhea, which increase fluid loss. Diabetes increases your risk for dehydration due to the high levels of sugar in your blood: the kidneys will try to filter these out, which leads to increased urinary output. Severe dehydration can also cause increased frequency of seizures, and in extreme cases, it may also lead to coma and death. Therefore, it is important to help monitor and maintain the daily water intake of individuals with IDD to avoid serious complications.
Overhydration Is Also A Risk
Water intake should also be monitored as there is such a thing as overhydration or hyponatremia, which can occur when an individual is overhydrated during physical exercise. This is due to low sodium levels in the bloodstream that happens when an individual drinks excess water over a short period. As the fluid levels increase in the body, sodium is excreted through sweat and is diluted in the bloodstream, which contributes to the low sodium levels. This mainly affects athletes, but can also be a concern for individuals with disabilities. To detect hyponatremia, symptoms like nausea, vomiting and headaches need to be checked through blood chemical tests. The condition requires proper medical attention immediately, as it may cause confusion, seizure, coma, and in rare cases, even death.
Treatments For Dehydration
Treatment for dehydration may seem as easy as simply increasing your fluid intake, but it is more complicated than that. Especially for infants and elders with or without IDD who show signs of dehydration, it is heavily suggested that you would seek medical help. Infants are more susceptible to rapid deterioration of health since dehydration leaves them more susceptible to other illnesses. For older children, parents can use oral rehydration solutions (ORS) to give small amounts of fluid at a time. Rapidly ingesting ORS can cause the child to vomit or have diarrhea, which will further worsen their dehydration. For severe dehydration, immediate help should be sought by family members, as they will need urgent treatment in a hospital setting to rapidly restore the blood volume by providing fluids intravenously.
Tips For Better Hydration
Parents and caretakers of children with special needs have to be more aware of choosing appropriate beverages that contribute to the overall nutritional needs and hydration. High-sugar and caffeinated drinks should be avoided and replaced with mineral water, sparkling water, or a zero-calorie beverage. They must be mindful of the signs of dehydration, as initial treatment of dehydration in its early stages is shown to be the most effective. Parents and their children should also set a goal on how much water intake they should have on a daily basis, and if possible train the individual to achieve the goal themselves to better integrate hydration into their care. One useful tip work out enthusiasts advise is to use a large reusable bottle that you may only need to refill two or three times a day to meet your daily required fluid intake.
Dehydration is a common problem that can affect all age groups, but it is also easily avoided. Individuals with IDD should always be monitored with their fluid intakes to avoid complications associated with dehydration. Regular daily intake of fluids tends to improve the immune system and nutritional intake, which benefits the overall health of the individual. Parents and caregivers should also be well educated in the adverse effects and complications, and how to properly identify and seek medical attention.