How to get fluid into dementia patients? Creative techniques and essential tips for caregivers

People with dementia often lose the ability to recognize thirst or remember to drink, putting them at high risk of dehydration. Learning how to get fluid into dementia patients requires a strategic and compassionate approach that adapts to their changing needs.

Quick Summary

This guide provides caregivers with practical methods for encouraging fluid intake in individuals with dementia. It covers creating consistent schedules, making drinks more appealing, incorporating hydrating foods, and using specialized drinking aids to address issues like memory loss and swallowing difficulties.

Key Points

• Create a routine: Offer fluids at regular, predictable intervals throughout the day rather than waiting for the person to ask.

• Use visually appealing cups: Choose brightly colored or transparent drinkware to attract attention and encourage drinking.

• Offer a variety of fluids: Provide different options like broths, fruit-infused water, or milk to prevent flavor fatigue.

• Incorporate hydrating foods: Add foods with high water content such as watermelon, soups, and yogurt to increase overall fluid intake.

• Try adaptive drinking aids: Use cups with handles, lids, or specialized straws to assist with coordination and reduce spills.

• Consider thickeners for dysphagia: If swallowing is difficult, a speech-language pathologist may recommend adding thickeners to liquids for safer consumption.

• Track fluid intake: Keep a simple log to monitor how much liquid is consumed daily, helping identify potential dehydration early.

• Model drinking behavior: Sit and have a drink with the person, as this can encourage them to mirror your actions.

• Avoid caffeinated drinks: Caffeinated beverages and alcohol can have a diuretic effect and should be limited.

Understanding the challenge of hydrating dementia patients

Dehydration is a common and serious problem for individuals with dementia. As the condition progresses, a person's cognitive function declines, affecting their ability to regulate thirst and remember to drink. This can be compounded by other issues, including reduced mobility, poor coordination, and difficulty swallowing (dysphagia). Recognizing the signs of dehydration, which can be mistaken for worsening dementia symptoms, is the first step towards effective management.

Signs of mild to moderate dehydration

• Increased confusion or agitation
• Fatigue or lethargy
• Dry mouth and lips
• Headaches or dizziness
• Dark, concentrated urine
• Constipation

Creating a fluid intake routine

Establishing a consistent hydration schedule can help bridge the gap created by a weakened thirst signal. Rather than relying on the person to ask for a drink, caregivers should proactively offer fluids throughout the day.

• Offer drinks frequently: Proffer small cups of fluids every hour or so. This is often more manageable than presenting a large glass at once.
• Tie fluids to existing routines: Pair a drink with established daily activities, such as medication times, before and after meals, or during a favorite TV show.
• Use visual cues: Place a visible and accessible drink in the person's line of sight. Consider using brightly colored cups to make the drink stand out and be more appealing.
• Stay consistent: Routines provide a sense of stability. Offering a drink at the same time and in the same way each day can become an ingrained habit.

Making fluids more enticing and accessible

Plain water isn't always the most appealing option. Diversifying the types of fluids and making them easier to consume can significantly increase intake.

• Experiment with variety: Offer a range of hydrating options such as herbal teas, diluted fruit juice, smoothies, and low-sodium broths.
• Incorporate hydrating foods: Many foods have a high water content and can supplement fluid intake. Good options include watermelon, cucumbers, oranges, berries, yogurt, popsicles, and gelatin.
• Customize the temperature: Some people prefer warm drinks like tea, while others might prefer cold or frozen treats like fruit-infused ice cubes or popsicles.
• Utilize adaptive drinkware: For those with reduced grip strength or coordination, special cups with handles or lids can prevent spills and make drinking less frustrating. One-way straws are also a useful option.

Comparison table: Drinking aids for dementia patients

Feature	Lidded "sippy" cup with handles	One-way straw	Specialized hydration jelly (e.g., Jelly Drops)
Best for...	Preventing spills and offering stability for shaky hands.	Allowing fluid to move in one direction, preventing liquid from dropping back down.	For individuals who refuse drinks or have advanced swallowing issues, as it feels like a sweet treat.
Key benefit	Increases confidence and reduces mess, encouraging independent drinking.	Eases the physical effort of drinking and can prevent accidental inhalation.	Provides hydration in a solid, appealing form, bypassing resistance to drinking.
Best used with...	A variety of beverages, served at mealtimes or throughout the day.	Thin or mildly thickened liquids.	As a standalone snack or supplement to regular fluid intake.
Limitations	May be perceived as childish, which can lead to refusal.	Can be challenging for some to manage and may require assistance.	Only provides a small amount of fluid and can be expensive.

Addressing swallowing difficulties (dysphagia)

Swallowing problems are a significant hurdle to proper hydration. If you notice coughing, choking, or a gurgling voice after drinking, it's crucial to consult a speech-language pathologist for a full assessment. They can provide tailored recommendations, but here are some common techniques.

• Use thickening agents: Commercial thickening powders can be added to liquids to increase their consistency, making them easier and safer to swallow. These are available in different levels of thickness, from nectar to pudding-thick.
• Try spoon-feeding fluids: In later stages of dementia, offering fluids by the spoonful can be more successful than using a cup.
• Use hydration gels or jellies: Products like Jelly Drops are specially designed for people with dementia and come in bite-sized, colorful pieces that provide a high water content.

Conclusion

Maintaining hydration for a person with dementia requires ongoing vigilance, patience, and a flexible, creative approach. By establishing a consistent routine, offering appealing and varied fluid options, and adapting techniques for any swallowing difficulties, caregivers can make a significant difference in their loved one's health and well-being. Tracking daily intake is also a valuable tool for monitoring progress and identifying potential issues early. When faced with persistent challenges, consulting a healthcare provider or speech-language pathologist can provide further guidance and support.

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Alzheimer's Society: Drinking, hydration and dementia

Frequently Asked Questions

What are the early signs of dehydration in a dementia patient?

Early signs of dehydration include increased confusion, dry lips and mouth, fatigue, headaches, dizziness, dark urine, and constipation.

What kind of drinks are best for hydrating a person with dementia?

Offering a variety of options is best, including water, diluted juices, herbal teas, smoothies, and low-sodium broths. Variety can make drinking more appealing.

How can I encourage someone with dementia to drink when they refuse?

If they refuse drinks, try offering fluids in different forms like popsicles, gelatin, or specialty hydrating jellies (e.g., Jelly Drops). Serving smaller amounts more frequently can also help.

What is dysphagia and how does it affect hydration in dementia?

Dysphagia is difficulty swallowing, which is common in advanced dementia. It can make drinking thin liquids unsafe due to the risk of choking or aspiration.

Are there special cups for people with dementia who have trouble drinking?

Yes, adaptive drinkware such as cups with two handles, lids, or specialized one-way straws are available to help people with coordination issues drink more easily and with less spilling.

How can I make drinks more appealing visually for a dementia patient?

Using brightly colored cups, adding colorful fruit garnishes, or presenting drinks in an attractive way can make them more noticeable and enticing.

How do I know if my loved one is drinking enough fluid?

Monitoring their intake is key. Keep a daily log of the fluids they consume. Also, pay attention to signs like urine color (it should be pale yellow) and overall energy levels.