Do people with dementia drink a lot? The truth about fluid intake

While it's a frequent misconception, many people with dementia do not drink enough fluids, with a significant number struggling to maintain adequate hydration due to memory loss and reduced thirst perception. Understanding the reality behind the question, 'Do people with dementia drink a lot?' is crucial for providing proper care.

Quick Summary

People with dementia often struggle with adequate fluid intake due to an impaired sense of thirst and forgetfulness, making dehydration a serious risk, though some individuals may exhibit excessive drinking due to impulse control issues linked to certain types of dementia.

Key Points

• Dehydration is a greater risk: Most people with dementia drink too little, not too much, due to memory loss and a diminished sense of thirst.

• Excessive drinking is possible: Certain types of dementia, like Frontotemporal, can cause a loss of impulse control, leading to excessive fluid intake.

• Cognitive decline affects intake: Memory problems, difficulty with physical tasks, and fear of incontinence all contribute to poor hydration.

• Caregiver intervention is crucial: Caregivers must be proactive in offering fluids, using visual aids, and establishing hydration routines.

• Monitor for signs of dehydration: Watch for increased confusion, fatigue, and dark urine, as these are common indicators.

• Manage excessive alcohol use: If impulse control issues lead to excessive drinking, limit access and consult a healthcare provider.

The Common Challenge: Why Dehydration is a Major Concern

For most people living with dementia, the primary issue is not drinking too much, but rather not drinking enough. As cognitive function declines, several factors contribute to a higher risk of dehydration. It is essential for caregivers to be vigilant and proactive in managing fluid intake.

Factors Leading to Dehydration in People with Dementia

• Impaired Thirst Sensation: Older adults naturally have a reduced sense of thirst, and this is compounded in people with dementia who may not recognize or communicate that they are thirsty.
• Memory Loss: A person may simply forget to drink during the day or forget that they have already had a drink, losing track of their fluid consumption.
• Difficulty with Tasks: Cognitive impairments can make the physical act of getting a drink challenging. This could involve forgetting how to use a faucet or fill a cup, or struggling with the weight or shape of a glass.
• Fear of Incontinence: Some individuals may purposefully drink less to avoid frequent trips to the bathroom, especially if they are worried about incontinence.
• Medication Side Effects: Certain medications commonly prescribed for seniors or those with dementia can increase fluid loss, exacerbating the risk of dehydration.

The Risks of Dehydration in Dementia

Dehydration is not a minor issue. It can significantly worsen existing dementia symptoms and lead to other serious health problems.

• Increased Confusion: Even mild dehydration can cause or worsen confusion, agitation, and disorientation.
• Physical Weakness: Dehydration can lead to dizziness, weakness, and an increased risk of falls.
• Urinary Tract Infections (UTIs): Concentrated urine can lead to painful UTIs, which can further increase confusion and agitation.
• Kidney Problems: Severe or chronic dehydration can put a strain on the kidneys and lead to more serious complications.

The Less Common Scenario: Excessive Drinking

While dehydration is a more prevalent issue, in some cases, a person with dementia might drink excessively. This is often linked to specific forms of the disease or other underlying factors.

Dementia and Impulsive Behavior

Some types of dementia, particularly Frontotemporal Dementia, affect the parts of the brain responsible for judgment and impulse control. This can lead to new or increased patterns of excessive drinking, including alcohol or non-alcoholic beverages. In these instances, the person may not recognize they are drinking too much and may frequently ask for more.

Changes in Taste and Habit

Dementia can also cause changes in a person's taste preferences, making certain liquids, including alcoholic ones, more appealing. A long-standing habit of drinking, even if previously moderate, can become excessive due to a person forgetting how much they have consumed. Addressing this requires a careful and sensitive approach, often with medical guidance.

Comparison: Dehydration vs. Excessive Fluid Intake

To help caregivers differentiate between these two challenges, here is a comparison of their common causes and indicators.

Indicator	Dehydration (Common)	Excessive Drinking (Less Common)
Thirst Sensation	Decreased or unrecognized thirst.	May have an intense, persistent thirst for more.
Fluid Recognition	May not recognize a cup of water or how to drink from it.	Often actively seeks and demands drinks, sometimes forgetting they just had one.
Behavior	Reduced appetite, fatigue, increased confusion, dizziness.	Impulsive behavior, mood swings, increased need to urinate, frustration when denied refills.
Urinary Habits	Infrequent urination, dark-colored and strong-smelling urine.	Frequent urination, especially at night.
Caregiver Strategy	Proactively offer fluids, use visual cues, and create a routine.	Monitor and manage access to fluids, consider alternatives, consult a doctor for a behavioral plan.

Practical Tips for Managing Fluid Intake

Regardless of whether the challenge is too little or too much fluid, caregivers play a crucial role. Here are some strategies to help.

For Encouraging Hydration

1. Establish a Routine: Offer drinks at specific times throughout the day, such as with meals and medications.
2. Make it Visual: Use clear or brightly colored cups to make the liquid more visible and enticing. Ensure drinks are always within sight and easy reach.
3. Vary the Offerings: Provide a variety of fluids beyond just water, including fruit juice, milkshakes, herbal tea, or soups. This can help with changing tastes.
4. Use High-Liquid Foods: Incorporate fruits like watermelon and oranges, as well as yogurt and ice lollies, to increase fluid intake through food.

For Managing Excessive Drinking

1. Reduce Access: Keep beverages, particularly alcohol, out of sight and reach. For non-alcoholic drinks, use smaller or non-transparent containers to reduce the visual cue.
2. Redirect and Distract: Offer an engaging alternative activity to a person who is seeking another drink due to boredom.
3. Seek Medical Advice: If excessive alcohol consumption is an issue, discuss it with a healthcare provider, especially as alcohol can interact negatively with dementia medications. The Alzheimer's Society provides further guidance and resources for hydration challenges in dementia.

Conclusion: Navigating Fluid Intake for Dementia Patients

Ultimately, understanding the true nature of fluid intake challenges in dementia is the first step toward effective care. While the phrase 'Do people with dementia drink a lot?' points to a concern about excessive consumption, it’s far more common to address the risk of dehydration. Tailoring strategies to the individual's specific needs, whether that means encouraging more fluids or managing impulsive behavior, is key to maintaining their health and well-being. Regular monitoring and communication with a healthcare team are essential for providing the best possible support.

Frequently Asked Questions

Why do people with dementia forget to drink water?

People with dementia may forget to drink water due to several factors, including a reduced sensation of thirst, short-term memory loss that causes them to forget when they last drank, and a general decline in cognitive function that can make initiating a simple task like getting a glass of water difficult.

What are the signs of dehydration in someone with dementia?

Signs of dehydration in a person with dementia can include increased confusion, agitation, dizziness, fatigue, dry mouth, and infrequent urination with dark, concentrated urine. These symptoms can often be mistaken for a worsening of their dementia.

Can dehydration make dementia symptoms worse?

Yes, dehydration can significantly worsen dementia symptoms. It can increase confusion, cause hallucinations, and impair cognitive function. Preventing dehydration is an important part of managing the condition.

How can I encourage a person with dementia to drink more?

Encouraging a person with dementia to drink more involves setting a routine, offering fluids throughout the day, providing a variety of appealing drink options, using bright or clear cups, and incorporating high-liquid foods like fruits and soups into their diet.

Why would a person with dementia suddenly start drinking a lot of alcohol?

In rare cases, a person with dementia may start drinking excessively, often linked to a loss of impulse control caused by certain types of dementia, such as Frontotemporal Dementia. This is not a typical symptom for most forms of dementia and requires a careful medical evaluation.

Can dementia cause a change in a person's taste for drinks?

Yes, changes in taste are not uncommon in people with dementia. They may develop a stronger preference for sweeter or more intense flavors, which can influence their drinking habits and potentially lead to excessive consumption of certain beverages.

Is it true that dementia patients might drink less to avoid incontinence?

Yes, some individuals with dementia may consciously or unconsciously reduce their fluid intake in an attempt to manage incontinence. This is a counterproductive strategy that increases their risk of dehydration and urinary tract infections.