In theory, it's simple: 1.5 litres a day. In practice, in residential elderly care, hydration is one of the biggest daily challenges. The German Nutrition Society (DGE) gives this value as a guideline to maintain physical and mental performance [1].

Causes of fluid deficiency: Why drinking becomes a challenge in later life

Biological hurdles: When the feeling of thirst fails

Normally, our body sounds the alarm as soon as we lose just 0.5 % of our body weight in water. In later life, however, this regulation via receptors in the brain works less reliably. The result: despite a real fluid deficit, older people simply do not feel a sufficient urge to drink [2]. While an infant is 70 % water, this figure in older adults drops to often only 40–50 %. A small loss of fluid can have fatal consequences: confusion, falls and acute health crises. That is why a proactive drinking culture is so crucial.

The consequences of shrinking water reserves

• Lower reserves: This is mainly due to declining muscle mass – our largest internal water reservoir.

• Lower buffers: Due to the lower water content, the body copes much worse with fluctuations (e. g. during infections).

• Greater demand on the kidneys: As the kidneys are less able to produce concentrated urine in later life, paradoxically they need more water to safely flush out waste products such as uric acid.

Cognitive hurdles in fluid provision in dementia: Overcoming visual cues and cognitive barriers

Agnosia often occurs here – the inability to interpret visual stimuli correctly. A clear glass of water on a light-coloured table offers no contrast for the impaired eye. For people with dementia, the water simply does not “exist” there. In addition, the ability to interpret thirst as a signal and translate it into the action of “drinking” is lost [3].

In short: Cognitive deficits mean that the stimulus (thirst) and the object (water) can no longer be linked together.

Logistical hurdles: Overstretched staff who barely find time between documentation and care to accompany individual drinking routines.

The shortage of skilled workers means that hydration is often reduced to “putting down a glass”. If drinks first have to be mixed laboriously in a distant tea kitchen or heavy crates hauled around, there is no time left for the social component of drinking. A decentralised, easily accessible drinks supply is therefore essential in order to minimise staff travel time [4].

In short: Lack of time and physical strain prevent care workers from actively supporting residents while drinking.

Recognising fluid deficiency: the warning signs

What should you do if older people drink little? First you need to know the signs of impending dehydration. Look out for these warning signs:

• Dry mucous membranes: Cracked lips or a coated tongue.

• Dark urine: A clear sign of excessive concentration.

• Sudden confusion: fluid deficiency often leads to dizziness, increased drowsiness or mental absence.

• Physical complaints: Constipation or an increased risk of falls due to circulatory problems [5].

Measures for dehydration prevention: 5 tips for an activating drinking culture

The question “How do I encourage older people to drink?” cannot be answered with pressure, but with smart psychology.

Visibility and colour: The eye drinks too

Beverages should always be placed where they are visible and within direct reach. A decisive hack: offer colourful drinks or coloured glasses. Signal colours such as red or orange catch the eye and create an unconscious drinking impulse (nudging) [6].

Taste variation: Refreshment for the taste buds

For many older people, plain water is simply too boring; the taste buds long for variety, as taste perception declines with age. This is where we come in: a variety of drinks with natural essences offers variety without burdening blood sugar levels with unnecessary sugar. Whether lemon, apple or elderflower – taste is a powerful motivator.

Legal matters & care routines: Is a drinking record mandatory in a care home?

In proper care planning, dehydration prevention is firmly established. According to the DNQP expert standard, monitoring fluid intake is mandatory for risk groups [7]. A drinking record should be kept if residents fall below the recommended amount of 1.3 to 1.5 litres, in order to counteract this objectively and ensure the quality of care.

Conclusion: Efficient drinks provision as a standard for modern care facilities

Drinking in later life does not have to be a mammoth task. With visible incentives, varied flavour and smart solutions, you not only relieve your staff of constant “mixing”, but also directly increase the vitality of your residents.

This is where we come in with ReDrink. We have understood that “encouraging drinking” in a care home must not be an additional task for carers, but must be supported by the environment (infrastructure). Facilities such as the MÜNCHENSTIFT and the Rudolf und Maria Gunst Haus are already setting the example.

References

• [1] DGE (2025): Reference values for nutrient intake: Water.

• [2] Journal of Gerontology: Age-related changes in thirst and arginine vasopressin response to increased plasma osmolality.

• [3] ZQP (Centre for Quality in Care): Guide to eating and drinking with dementia.

• [4] Nursing Prevention Act (2024): Guidelines for ergonomic workplace design in residential care.

• [5] Robert Koch Institute (RKI): Dehydration in later life – symptoms and prevention.

• [6] Thaler & Sunstein (2021): Nudge: The Final Edition. (Concept of choice architecture in healthcare facilities).

• [7] DNQP (German Network for Quality Development in Nursing): Expert standard „Nutrition management to ensure oral nutrition in nursing care“.