Dehydration in Those with Dementia
While all older adults are at risk for dehydration, this risk increases for persons with Alzheimer’s. Besides forgetting to drink, persons with Alzheimer’s may have challenges in communicating their needs or have difficulty swallowing. If they are incontinent, they may avoid fluids to reduce urinary flow. In addition, as part of normal aging, the sense of thirst decreases.
But it’s not just about how much fluid is coming in. It’s also about what is going out. For example, someone on diuretics can have excess urinary output. Also keep in mind that caffeinated beverages and alcohol promote urination. Fevers or sweating can also lead to fluid loss as can bouts of vomiting and/or diarrhea. Running heaters during the winter months can dry the air and also cause dehydration.
Because the signs and symptoms often mimic dementia, dehydration can be easily overlooked. You know your person with dementia the best and will likely be the first to notice changes in how they behave or appear. Some of the signs and symptoms of dehydration are dry mouth, low urine output or dark yellow urine, constipation, lethargy, fatigue, headache, muscle weakness, dizziness, lightheadedness, confusion, or rapid breathing.
For mild dehydration, drinking fluids is generally sufficient. Start out with small amounts provided frequently. When in doubt, call 911 or your doctor.
The best practice, of course, is to avoid dehydration. Most seniors need at least 7 cups of liquid per day, but this is just an estimate. Actual amounts will vary person by person. Water is not the only source of fluids. Many other beverages are available, as well as some semi-solid foods, such as yogurt. See the table for more ideas. Most fruits and vegetables have high water content. Some good choices are watermelon or other melons, oranges, apple sauce, tomatoes, cucumbers and salad greens. These can supplement fluid intake to meet the persons overall needs.
Tips for preventing dehydration
Sometimes it is difficult to get someone to drink as much as they should. Here are some tips to help you along:
- Offer fluids consistently throughout the day, not just with meals and medications.
- Provide beverages that are well liked and tolerated.
- Make fluids easily accessible.
- Assist those who cannot drink independently.
- Verbally encourage fluid intake.
- Increase social interaction with meals.
- Supervise those who have dysphagia (swallowing problems)while they drink.
- For variation, include solid or semisolid foods with high water content