If your loved one with dementia seems confused or tired, you may chalk it up to their condition. But there’s another possible cause — dehydration. It’s common for people with dementia to become dehydrated. There are many reasons for that:
- They may not know when they are thirsty. This is common in older adults, who are less sensitive to thirst.
- They might not remember to drink enough fluids since they have memory loss and difficulty thinking.
- They may not remember where the glasses are, how to use the faucet, how to fill a cup or how to open a bottle or juice box.
- They may be unable to tell others they are thirsty.
- They may take medications that make them lose fluids.
- Physical problems could make it hard for them to get drinks themselves.
- They may have difficulty swallowing and be afraid of choking.
- They may struggle with incontinence and think drinking less will help.
- Other health conditions, such as congestive heart failure or a fast breathing rate, could make them dehydrated more easily.
Signs of dehydration in dementia patients
Along with confusion and fatigue, other signs of dehydration include:
- A dry mouth
- Dark urine
- Strong-smelling urine
- Sunken eyes
- Dizziness
- Weakness
- Agitation
- Constipation
- Bad breath
- Changes in how they usually act
- Feeling sluggish
- Muscle cramping or weakness
- Headache
- Nausea
It’s important to watch for these signs. If you notice them, encourage your loved one to drink water or other fluids and ask other caregivers to do the same.
“Keep in mind that dehydration can come on quickly. Your loved one could have symptoms after just a few hours without fluids,” said Angela Allen, clinical research program director of nursing research with Banner Health.
You’ll want to take your loved one to an urgent care center or emergency room if you notice these more serious symptoms:
- Confusion that is getting worse
- A temperature of 101 F (38.3 C) or higher
- Difficulty breathing
- A rapid heartbeat
- Diarrhea or vomiting
- Pain in the chest or abdomen
- No urination for eight hours
Untreated, dehydration can lead to urinary tract infections and other problems with the urinary system, kidney problems, seizures and heat exhaustion or heat stroke.
Here’s how to help your loved one get the fluids they need
“Most people need two to three liters (eight to 12 cups) of fluid per day, unless they have certain health conditions such as congestive heart failure,” Allen said. “Be proactive and never assume that dementia patients will ask for a drink.”
With these hydration strategies for dementia caregivers, you can help make sure your loved one has enough fluid intake to prevent dehydration:
- Offer fluids throughout the day, even if they don’t say they’re thirsty.
- Keep a fresh bottle of water or juice in sight or out on the counter.
- Bring a water bottle along when you’re out and about or stop to get a drink as a treat.
- Along with water, give them choices like flavored water, seltzer or club soda, juices, herbal teas, hot chocolate, smoothies and nutritional shakes. They may be more interested in drinking if they have choices.
- Offer warm, cool and room-temperature drinks.
- Offer drinks when you socialize, since seeing you and other people drink fluids may encourage them to drink as well.
- Offer something to drink with every meal.
- Give them plenty of time to finish their drinks.
- Offer foods that contain a lot of water like fruits, vegetables, yogurt, popsicles, ice cream, Jell-O, broth-based soup and applesauce.
- Give them a four- to six-ounce glass of water when they take pills and encourage them to drink it all.
- Take a drink break as part of activities, like working on craft projects.
- Put labels on water bottles or use hydration charts to help remind them to drink. You can also try smart bottles, which vibrate when it’s time to drink and have lights to track progress.
- Use glasses that aren’t too heavy or awkward. If they have trouble with coordination or motor skills, use straws or sippy cups so it’s easier for them to drink.
- When they are awake, try to make sure they are drinking something about once an hour.
- Remind them to drink when they are physically active or it’s hot outside.
- Have a consistent routine for drinking water and other fluids.
- Make sure your loved one’s environment is calm and comfortable.
- Avoid caffeine and alcoholic beverages, which can make them lose fluid.
- Recognize that they may not have finished drinking from a cup that is empty. They might have spilled it or poured it out.
- If they struggle to get enough fluids, try rehydration solutions or powders such as Hydration Multiplier. “They provide faster hydration than water alone,” Allen said.
If your loved one is having trouble drinking enough fluids and staying hydrated, talk about your concerns with a health care provider such as a doctor, nurse or dietitian. They can offer tips for managing difficulty with swallowing or other limitations that could make it hard to take in fluids. They can also help you learn to monitor fluids, create a care plan and adjust medications that can affect hydration.
The bottom line
It’s important to make sure your loved one with dementia gets enough fluids. Preventing dehydration is vital for their overall health and well-being, including their cognitive health. If your loved one is struggling to drink enough fluids and is at risk for dehydration, contact their health care provider for guidance and support.
If you would like to connect with an expert who can evaluate your loved one’s situation and provide tips and strategies to help them get the fluids they need, reach out to Banner Health.
