How to get someone with dementia to drink water? Practical Strategies

Dehydration is a common and serious issue among individuals with dementia, with some studies suggesting up to 40% of older adults are affected. [Citation needed]. When you ask, “How to get someone with dementia to drink water?”, the challenge is often rooted in cognitive changes, and solving it requires patience and a thoughtful approach.

Quick Summary

Getting a person with dementia to stay hydrated involves more than just offering a glass of water; it requires understanding their cognitive shifts and adapting your approach. Try offering small, frequent sips, using different colored cups, and incorporating water-rich foods. Consistent, gentle encouragement is key to overcoming resistance.

Key Points

• Understand the cause: Identify if the refusal to drink is due to memory loss, loss of thirst, or swallowing issues before deciding on a strategy.

• Vary presentation: Offer different types of drinks and use brightly colored, contrasting cups to make liquids more visible and appealing.

• Incorporate water-rich foods: Use alternatives like soups, broths, fruits (watermelon), and vegetables (cucumbers) to increase fluid intake indirectly.

• Establish a routine: Offer drinks at consistent, scheduled times to create a habit that bypasses the need to remember to drink.

• Use gentle encouragement: Avoid power struggles and coercion; instead, use calm suggestions and model drinking behavior to encourage participation.

• Monitor for dehydration: Watch for signs like dark urine, dry mouth, or confusion, and don't hesitate to seek professional medical advice.

Understanding the Challenge of Hydration in Dementia

For caregivers, the simple act of encouraging a loved one with dementia to drink water can become a daily struggle. Dementia affects brain functions, including the ability to recognize thirst, forget to drink, or even misinterpret the sensation of swallowing. Behavioral changes, such as refusal or combativeness, can also make drinking difficult. Addressing these underlying issues is the first step toward effective hydration.

Why Hydration Becomes a Problem

• Loss of Thirst Sensation: The brain's signals for thirst can become muted or lost, meaning the person simply doesn't feel thirsty.
• Memory Impairment: They may forget to drink throughout the day, even if a drink is placed in front of them.
• Misperception and Swallowing Issues: Visual processing changes can cause them to misinterpret a clear glass of water. Furthermore, dysphagia (swallowing difficulties) can develop, making swallowing liquids a physical challenge.
• Refusal and Agitation: A person with dementia may resist drinking due to confusion, frustration, or a sense of lost control.

Practical Strategies to Encourage Drinking

Create a Routine

Establishing a consistent routine can help build a predictable schedule for drinking. Offer a drink at the same times each day, such as upon waking, before and after meals, and before bed. This regularity helps form a new habit, relying on familiarity rather than memory.

Make Drinking Fun and Appealing

• Offer Choices: Instead of just water, offer a variety of hydrating options. These could include diluted fruit juices, herbal teas, or flavored water. The novelty can spark interest.
• Use Colorful Cups: Some evidence suggests that using colorful cups, especially red, can help individuals with visual processing issues see the liquid better. A clear cup can be hard to differentiate from the background.
• Serve Drinks in Different Forms: If swallowing is an issue, try serving water in other forms. This could be in the form of a popsicle, gelatin, or even sorbet. Ice chips can also be a manageable option.

Adjust the Environment

• Remove Distractions: Serve drinks in a calm, quiet environment. A busy, loud room can cause sensory overload and make the person resistant to engaging in any activity.
• Use Visual Cues: Leave a water bottle or glass in plain sight. Seeing the drink can serve as a simple, non-verbal reminder.

Hydration Alternatives: Beyond Plain Water

Sometimes, the resistance is to the taste or texture of plain water. Here are some alternatives to consider:

Table: Comparison of Hydration Alternatives

Alternative	Benefits	Potential Downsides
Flavored Water	Variety of flavors; more appealing than plain water.	Some store-bought versions contain high sugar or artificial sweeteners.
Herbal Teas	Can be served warm or cold; calming effects; many flavors.	Can be dehydrating if caffeinated; requires preparation.
Soups and Broths	Hydrating and nutritious; often more appealing than a drink.	May be high in sodium; can be too hot if not careful.
Water-rich Fruits/Vegetables	Adds fiber and vitamins; snack-like format can be easier.	Requires chewing; may cause choking if not cut properly.
Gelatin	Novel texture; fun to eat; high water content.	Can contain high sugar; may be less appealing for some.

Overcoming Resistance and Behavioral Challenges

Approaching a person with dementia requires patience and empathy. When faced with resistance, coercion is not the answer.

• Gentle Encouragement: Use gentle, encouraging language. Instead of "You need to drink this," try "How about a refreshing sip of water?" or simply offer the cup without pressure.
• The "Follow My Lead" Method: If you offer a drink and they refuse, try taking a sip of your own drink. Modeling the behavior can be an effective, non-confrontational way to encourage them.
• Avoid Power Struggles: Back off if they refuse. Forcing the issue can lead to increased agitation. Try again later, or with a different beverage or cup.

Safety Considerations and When to Seek Help

While using these strategies, it's crucial to monitor for signs of dehydration, including dark-colored urine, lethargy, confusion, or dry mouth. If you notice these symptoms, especially if they worsen, it may indicate a more serious issue. You should consult a healthcare professional, as they can determine if a medical condition or medication is contributing to the problem. You can find more information about recognizing and addressing dehydration in older adults from reputable organizations like the Alzheimer's Association. More information about dehydration

Conclusion

Getting someone with dementia to drink water is a complex task that demands a compassionate, flexible approach. By understanding the cognitive reasons behind their resistance, creating a consistent routine, and offering appealing alternatives, caregivers can significantly improve their loved one's hydration. Remember that patience is key, and it's essential to consult with a medical professional if dehydration persists or worsens. A proactive, gentle strategy can make a significant difference in the health and well-being of someone living with dementia.

Frequently Asked Questions

Why won't my loved one with dementia drink water?

There are several potential reasons, including memory loss that causes them to forget to drink, a diminished sense of thirst, confusion over clear liquids, or swallowing difficulties (dysphagia). Behavioral issues and resistance can also play a role.

What are some alternatives to plain water for someone with dementia?

Good alternatives include diluted fruit juices, herbal teas (iced or hot), broths, soups, and water-rich foods like watermelon, grapes, or popsicles. Flavored water can also be more appealing than plain water.

Can colorful cups really help with hydration?

Yes, for individuals with dementia who have visual processing issues, brightly colored cups (especially red) can make the liquid inside more visible. This is because the contrast helps them differentiate the cup from the background, making it easier to perceive.

How do I deal with an agitated loved one who refuses to drink?

Avoid forcing them, as this can worsen agitation. Instead, try offering the drink again later, change the cup or drink type, or take a sip of your own drink to model the behavior. Keep the environment calm and quiet to reduce sensory overload.

How often should I offer a drink to someone with dementia?

Creating a routine is best. Aim for regular intervals throughout the day, such as upon waking, before and after meals, and before bed. Small, frequent sips are often more manageable than large amounts at once.

What are the signs of dehydration in someone with dementia?

Signs include dark-colored urine, decreased urination, dry mouth, cracked lips, lethargy, confusion, sunken eyes, and dizziness. Monitoring these signs is crucial, as they may not be able to communicate their thirst.

When should I consult a doctor about my loved one's hydration?

You should consult a doctor if you are unable to keep them hydrated, if they are showing signs of dehydration, or if swallowing issues are present. A professional can help rule out underlying medical conditions and provide tailored advice.