Your doctor may tell you to drink only when you're thirsty, or that eight 8-oz. glasses is the recommended amount. When asked "What can I do to help myself?", my standard response is almost always "Drink more water!" I decided to do some research and find out if and why that was good advice for most people.

My search lead me first to the US Army, which knows a thing or two about maintaining health (when it's not putting people in life and health-threatening situations). I found that thirst is not considered a good indicator of when to drink. By the time your brain tells you that you're thirsty, you are already low on water. As we age, this becomes even more true and dehydration is a major cause of ill health among elderly people.

How much is enough?

From US Army News:

1 gallon/128 oz = 3.3 liters

• Sedentary person in cool environment 2 - 3 liters daily ()
• Active person in cool environment 3 - 6 liters daily
• Sedentary person in warm environment 3 - 5 liters daily
• Active person in warm environment 5 - 10 liters daily
  

If this seems like an impossible quantity of water, or you simply don't trust government information, here's another quideline that's easier. Aim to consume a half-ounce of water for each pound of bodyweight. For example, a person weighing 160 pounds would want to drink 80 fluid ounces.
A suitable drinking schedule is to drink 1 liter of water in the morning, 1 liter at each of three meals, and routinely drink small amounts (2 cups every 30 min) throughout the work period. It's better to drink small amounts of water frequently than to drink large amounts occasionally. Cool water (60 - 70 degrees F., NOT ice water) is most easily absorbed, but slightly sweetened, or flavoured water or liquids (milk, soup, lemonade, herbal tea, etc.) are also helpful. Drinks with alcohol or caffeine can increase urination, so are less helpful for hydration but better than nothing.

Dehydration and the Elderly

According to the Royal Society for the Promotion of Health, dehydration can lead to deterioration in mental state resulting in confusion, dizziness and fainting, and has been identified as a major risk factor for falls in the elderly. "The composition of the whole body changes during aging. There is a decline in the amount of lean body tissue, and increase in body fat and a decrease in the percentage of body water. This means that older people can have impaired temperature regulation, starting to shiver later in response to cold. They are thus more vulnerable to hypothermia. The reduced renal function (meaning that urine cannot be as concentrated) and the decline in the thirst mechanism puts an older person at greater risk of dehydration. Older people thus need to drink plenty of fluids even if they do not feel thirsty." Extract from 'Nutritional Care for Older People, A guide to good practice', by June Copeman, Age Concern Care Professional Handbook Series

Not drinking enough water can cause:

• Kidney stone formation and/or kidney damage
• Poor oral health (Saliva inhibits bacteria.)
• Failure to absorb nutrients
• Difficulty eliminating wastes (constipation)
• Deteriorating mental state, mental confusion
• Impaired temperature regulation (less able to deal with extremes of heat or cold)
• Lower immunity to infection
• Risk of falling from dizziness or fainting
• Adequate fluid lubricates the joints and eyes, as well the skin, muscles, and all other structures.

Children also need water. Young children should be taught to enjoy water, instead of always given fruit juice or sodas. Most schools do not offer adequate opportunities for children to drink during the school day, and they may go for up to 8 or 9 hours without a drink. Getting enough fluids is vital for both children's health and their learning capacity.

Getting started

Many people tell me they don't like to drink water because it's boring, or tastes bad. Municipal water often smells of chlorine, and some minerals can give water an unpleasant odor. However, adequate water intake is essential to health, and I suggest doing whatever it takes to ensure a convenient supply of palatable water. Water filters can provide ample, convenient, good tasting water at a low cost per gallon, while some people may find having bottled water delivered is a better option. Drinking 2-3 liters of water in small bottles daily per person will result in a mountain of plastic bottles to be recycled (or thrown away), as well as the labour and energy costs of buying them and bringing them home.
Another objection for people of a 'certain age' may be the inconvenience of having to process all that water on its way out. When we are dehydrated, our highly concentrated urine is very irritating to the bladder, and necessitates frequent trips to the bathroom. Urine that is more dilute is easier on the bladder, so you can go less often, and eliminate more.

So, get yourself a BIG glass, at least 14 oz. Start your day with 2 BIG glasses of water. Have at least another one or two before lunch. If this seems too much, or impossible, just start with one more glass of water a day. To avoid needing to get up in the night, try to drink most of your water before 6pm. Get ready to feel better!