How to Keep Someone with Dementia Hydrated: Essential Tips for Caregivers

According to research cited by Caregiver Action Network, dehydration is alarmingly prevalent in older individuals, especially those with dementia, who may lose the ability to recognize thirst. This makes it a crucial aspect of their care to learn how to keep someone with dementia hydrated to prevent serious health issues.

Quick Summary

Dementia often impairs the ability to recognize thirst, increasing dehydration risk. Practical strategies can improve fluid intake, including scheduled drinks, visual cues, and offering hydrating foods and adaptive drinkware. Recognizing early signs of dehydration is critical for proactive care.

Key Points

• Impaired Thirst Sensation: Understand that people with dementia often lose the natural ability to feel thirsty, requiring proactive hydration from caregivers.

• Create a Routine: Implement a consistent hydration schedule, offering drinks at regular, set times throughout the day to build a habit.

• Offer Variety and Visual Cues: Present different types of hydrating liquids like broths, juices, or flavored water in colorful or easy-to-see cups to encourage drinking.

• Provide Hydrating Foods: Supplement fluid intake with water-rich foods such as watermelon, soups, gelatin, and yogurt.

• Utilize Adaptive Aids: Use specialized equipment like no-spill cups, straws, or cups with handles to make drinking easier and safer.

• Recognize Dehydration Signs: Be vigilant for signs such as increased confusion, lethargy, dry mouth, or dark urine, which can indicate dehydration.

• Model Behavior: Drink your own beverage while spending time with the person to encourage mirroring and increased fluid intake.

Understanding the Unique Challenges of Hydration in Dementia

Dehydration in someone with dementia is a complex issue, often overlooked because the symptoms can be mistakenly attributed to cognitive decline. As dementia progresses, several factors can interfere with proper fluid intake:

• Impaired thirst sensation: The part of the brain that signals thirst may be affected, meaning the person doesn't feel the urge to drink even when their body needs fluids.
• Memory loss: A person may simply forget to drink, especially between meals, or forget that they have just had a drink.
• Difficulty communicating: They may not be able to express that they are thirsty, leading caregivers to miss this important cue.
• Physical challenges: Arthritis, muscle weakness, or poor coordination can make it difficult to hold or lift a cup, leading to avoidance of drinking.
• Fear of choking: Swallowing difficulties (dysphagia) can develop, making the person hesitant to drink fluids.
• Fear of incontinence: Some individuals deliberately limit their fluid intake to reduce the risk of needing to use the toilet.

Practical Strategies for Encouraging Fluid Intake

To effectively keep someone with dementia hydrated, caregivers must move beyond assuming they will drink on their own and become proactive. A multi-pronged approach that incorporates routine, visual cues, and preferred liquids is most successful.

Create a Hydration Routine

Establishing a consistent schedule is one of the most effective strategies. Incorporate hydration into their daily routine so it becomes a habit.

• Scheduled Offers: Offer drinks at regular intervals throughout the day, not just during mealtimes. For instance, offer a small drink every hour or two while they are awake.
• Pair with Activities: Link drinking to other regular activities, such as taking medication, watching a TV show, or during a social visit.
• Mirroring Behavior: Sit with them and drink your own beverage. This modeling can encourage them to drink as well.
• Use Visual Reminders: Place notes or use hydration tracking charts to help create a routine. Some smart bottles can even light up or vibrate to remind the user to drink.

Use Visual Cues and Appealing Options

Making drinks visible and interesting can significantly increase intake.

• Keep Fluids Visible: Place drinks in clear glasses or colorful containers where they are easily seen and accessible. The visual cue serves as a reminder.
• Offer Variety: Not everyone prefers plain water. Offer options like herbal teas, watered-down juice, smoothies, low-sodium broths, or decaffeinated beverages.
• Experiment with Temperature: Some individuals might prefer warm beverages like hot chocolate, while others may prefer iced drinks. Experiment to find what they enjoy most.
• Use Flavorful Ice Cubes: Freezing small pieces of fruit or juice into ice cubes can make a drink more enticing as the flavor is slowly released.

Hydrating Foods and Adaptive Equipment

Sometimes, fluid intake can be supplemented through foods or made easier with specialized tools.

High-Water Content Foods

Approximately 20% of a person's fluid intake comes from food, so integrating hydrating foods is a smart strategy.

• Fruits: Watermelon, oranges, berries, peaches, and grapes are excellent choices.
• Vegetables: Cucumbers, celery, tomatoes, and leafy greens are high in water.
• Other Foods: Yogurt, popsicles, gelatin, applesauce, and broth-based soups are also great ways to increase fluid intake.

Adaptive Drinking Aids

Specialized tools can help individuals who have difficulty gripping or swallowing.

• Specialized Cups: No-spill cups, cups with handles, or weighted cups can prevent spills and make drinking less frustrating.
• Straws: Using straws, especially one-way straws that keep liquid level high, can assist those with swallowing difficulties.
• Hydration Syringes: For advanced dementia, a medical professional may recommend hydration syringes to safely deliver fluid to the back of the mouth.

Comparison Table: Dehydration Signs vs. Dementia Symptoms

Symptom	Mild-Moderate Dehydration Sign	Dementia Symptom	Key Differences
Confusion	Increased or sudden confusion.	General, long-term cognitive decline.	Dehydration causes a sudden worsening of confusion, unlike the gradual nature of dementia.
Agitation/Irritability	Unexplained irritability.	Can be a part of behavioral changes.	Dehydration can cause a rapid, unexplained shift in mood; resolving it can improve behavior.
Sleepiness/Lethargy	Appearing unusually drowsy or vacant.	Can be a symptom of later-stage dementia or depression.	Lethargy due to dehydration is often accompanied by other physical signs like a dry mouth.
Constipation	Often caused by lack of fluids.	Can be a digestive issue linked to reduced activity or diet.	Dehydration is a common and direct cause of constipation, but other factors can contribute.
Dry Mouth/Lips	Visibly dry, sticky mouth and chapped lips.	Can occur, but less distinct from other issues.	A very reliable sign of dehydration that is less likely to be caused by dementia alone.

What to Do If You Suspect Dehydration

If you notice signs of dehydration, start by gently encouraging fluid intake using the strategies above. However, certain severe symptoms require immediate medical attention.

For mild to moderate symptoms:

• Increase fluids using their preferred methods.
• Track their intake with a log to monitor progress.
• If symptoms don't improve, consult their doctor.

For severe symptoms:

• Seek immediate medical attention for symptoms such as worsening confusion, extreme weakness, rapid heart rate, low blood pressure, or a lack of urination for eight hours.

Conclusion

Maintaining proper hydration for someone with dementia is a cornerstone of their health and well-being. By understanding the reasons they may not drink and implementing proactive, creative strategies, caregivers can significantly reduce the risk of dehydration. Creating consistent routines, offering a variety of appealing fluids, using adaptive equipment, and incorporating hydrating foods are all valuable techniques. Staying vigilant for early warning signs is also critical. Ultimately, patience and persistence are key to ensuring your loved one stays healthy and hydrated. For more specialized advice, caregivers should consult their healthcare team.

Dementia and Dehydration: The Critical Caregiver's Guide

Frequently Asked Questions

What are the early signs of dehydration in someone with dementia?

Early signs of dehydration include increased confusion, agitation, tiredness, dry mouth and lips, and infrequent, dark-colored urine.

Why do people with dementia stop drinking fluids?

People with dementia may stop drinking due to an impaired thirst sensation, forgetfulness, difficulty communicating thirst, challenges with coordination, or a fear of choking or incontinence.

Are there certain drinks to avoid giving to someone with dementia?

It is generally best to avoid or limit caffeinated beverages like coffee and tea, as well as alcohol, as these can act as diuretics and worsen dehydration.

How can I get my loved one to drink if they refuse water?

If they refuse water, offer a variety of other appealing liquids such as juice, smoothies, herbal tea, or low-sodium broth. Experiment with different temperatures to see what they prefer.

What kind of cups or straws are best for people with dementia?

Adaptive drinking aids such as no-spill cups, cups with large handles, or straws (especially one-way straws) can make drinking easier for those with poor coordination or swallowing difficulties.

Can hydrating foods be a substitute for drinks?

While hydrating foods like watermelon, soups, and yogurt can supplement fluid intake, they are not a complete substitute for drinking liquids. A balanced approach combining both is best.

When should I call a doctor for a dehydrated person with dementia?

You should seek immediate medical attention if you observe severe dehydration symptoms, including extreme weakness, rapidly worsening confusion, rapid heart rate, low blood pressure, or a lack of urination for eight hours.