Drinking enough, swallowing safely.
When swallowing liquids becomes difficult, people drink less, often without realising it. The body then runs short of water, which causes tiredness and can lead to complications. A few guidelines help you keep up the right rhythm.
- 1.6 litresof fluids a day, as a minimum, for an older woman
- 2 litresfor an older man, unless the doctor advises otherwise
- 8 to 10small drinks spread over the day
Why we drink less.
Fear of coughing
When water makes you cough, it is often aspiration. People end up avoiding drinking. It is often the first sign of a swallowing difficulty.
Thirst that is easy to miss
With age, the sense of thirst decreases. You can be short of water without feeling thirsty.
Real consequences
Not getting enough water causes tiredness and constipation, makes urinary infections more likely and can cause confusion. In an older person, it can lead to a hospital stay.
How much to drink.
The European clinical nutrition guidelines (ESPEN) recommend that older people drink at least 1.6 litres a day for a woman and 2 litres for a man.
Everything counts
Water, herbal teas, coffee, milk and gelled water all count towards the total. Soups and fruit also provide water.
Little and often
A small glass every hour goes down better than a large glass now and then. Keep a drink within reach.
Unless told otherwise
If you have heart or kidney disease, the doctor may limit how much you drink. In that case, follow their instructions.
At the right texture.
A thickened drink goes down more slowly and gives the throat time to protect the lungs.
The one you were recommended
The speech therapist or doctor sets the texture level. Stick to it for all drinks, including coffee and soup.
Gelled water or powder
Gelled water is ready to eat with a spoon. Thickening powder turns your usual drinks into the texture you need.
Checking at home
A simple syringe or fork test lets you check the texture before serving.
Warning signs.
Dark urine
Small amounts of dark urine often signal a lack of water.
A dry mouth
Dry lips and tongue, difficulty swallowing saliva.
Tiredness and dizziness
Unusual tiredness, feeling dizzy when standing up.
Confusion
An older person who is short of water may become drowsy or confused.
Constipation
It sets in quickly when you drink little.
Coughing and fever
Coughing during meals, a wet-sounding voice or a fever can be signs of aspiration.
In older people, these signs are sometimes subtle. It is better to keep track of what is drunk each day than to wait for them to appear. If in doubt, call your doctor.
A diary to keep track.
Note down every drink for three days and show the diary to your doctor, speech therapist or nurse. It helps you see whether the total is enough.
Drinks diary
To fill in for three days and show to your doctor, speech therapist or nurse.
Name:
Date:
Recommended texture: level
| Time | Drink | Amount | Texture | Cough? |
|---|---|---|---|---|
Daily total: glasses
Guide: 1 glass = 150 to 200 ml · 1 cup = 150 ml · 1 pot of gelled water = 120 g. At least 1.6 litres a day for an older woman and 2 litres for an older man, unless the doctor advises otherwise.
BSNUTRITION · bsnutrition.com · A support document for monitoring. It does not replace the advice of a healthcare professional.
See also.
Are you eating as you used to?
The one-minute test, to find out whether you should talk to your doctor.
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Count the chevrons on your supplements. If you are malnourished, the basic guide is 3 chevrons a day.
Malnutrition and cancer
Keep up your strength during treatment, even when your appetite and sense of taste change.
Keeping your muscles as you age
Slow down muscle loss with protein at every meal and a little movement.
Before and after an operation
Be in good shape for surgery and heal more easily, thanks to what you eat.
Pressure sores and wound healing
Dressings protect, nutrition repairs. A simple guide for each stage.
Living with your supplements
Taking them properly, storing them, not getting tired of them and travelling with them.
Helping a loved one to eat and drink
The right steps at mealtimes, with a reminder sheet to put up in the kitchen.
Need advice?
You don’t have to search alone. Talk to your doctor, your dietitian or your pharmacist. Our team is also happy to answer your questions about our products.
Sources
- Volkert D, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10-47. doi:10.1016/j.clnu.2018.05.024
- Volkert D, et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958-989. doi:10.1016/j.clnu.2022.01.024
- Burgos R, et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr. 2018;37(1):354-396. doi:10.1016/j.clnu.2017.09.003
- IDDSI. Complete framework and detailed definitions, version 2.2, harmonised French translation. 2026. Licence CC BY-SA 4.0. Document
Updated: November 2026.
Reviewed by Steeve Roland, physiotherapist, over 20 years in clinical nutrition, founder of BSNUTRITION · Updated on
Publisher: BS NUTRITION SA, Rue de l’Industrie 20, 1400 Nivelles, Belgium. Legal notice