Ask the Expert: Dehydration in dementia patients

Dehydration in dementia patients

Featuring Heather Mulder

Question: It’s hoMulder_Heather webt where I live, but my loved one with Alzheimer’s refuses to drink water. Should I be worried? How can I get her to drink more?

Answer: A person’s overall risk of dehydration generally increases with age due to a natural loss in one’s sense of thirst, taking medications that promote fluid loss, and the consumption of alcohol and/or caffeinated beverages. The risk of dehydration is even greater for those with dementia, and it becomes more concerning as the disease progresses.

During the early stages of dementia, a person may simply forget to drink because they are less sensitive to thirst and/or cannot recall when they last took a drink. Those with moderate dementia often have difficulty remembering the mechanics of how to drink, such as turning on the faucet, where the glasses are stored, or even how to get fluid into a glass. The risk of dehydration is most severe in the advanced stage of dementia due to not recognizing one’s thirst, having a complete loss of thirst or being unable to express thirst to others.

Signs and symptoms of dehydration
Increased confusion and/or a change in usual behavior are the first signs that someone with dementia may be dehydrated. Additional behavior changes associated with inadequate fluid intake include weakness, fatigue, agitation, muscle cramping in the arms and legs, nausea and dizziness.

Changes in urination such as infrequent urination and/or dark amber or strong smelling urine can also signal dehydration. Certain medications and vitamins can make urine darker, so be sure to look at the overall symptoms. It is important to note that dehydration increases the risk of a urinary tract infection, which can cause an acute phase of confusion.

Tips to stay hydrated
Be proactive and never assume that someone with dementia will ask for a drink. Leave beverages out in visible areas as a reminder to drink up, always take water when out and about, and find fun and tasty ways to slip liquids into the day’s activities. Great choices include:

  • Popsicles
  • Ice cream
  • Hot chocolate
  • Broth-based soups
  • Applesauce
  • Jell-O
  • Fruits and vegetables

When it comes to staying hydrated, drinking clear water throughout the day is always the best choice. However, if your loved one doesn’t have much of a taste for water, try flavored water, juices, or herbal tea.

Sometimes ensuring that individuals with Alzheimer’s disease and related dementias get enough liquid in their diet just requires a little creativity.

Heather Mulder is the outreach program manager at Banner Alzheimer’s Institute. Her office can be reached at (602) 839-6900.

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