By Lauren Mahakian Contributing writer. Originally published in Palos Verdes Peninsula News on 10/21/2021

Many dementia patients do not consume enough fluids, leading to dehydration and other complications. And, because the symptoms of dehydration are similar to those of dementia — confusion and fatigue — the condition is easy to miss.

Dehydration is dangerous at any age.

But, among the elderly, however, dehydration can lead to complications that may include headaches, urinary tract infections often with hospitalization, constipation, kidney stones and even kidney failure. Low levels of potassium and sodium can even lead to seizures. And many medications, including the use of diuretics, only make this worse.

Here are the common signs of dehydration:

  • Increased confusion or change in usual behavior
  • Weakness or fatigue
  • Agitation
  • Muscle cramping in the arms and leg
  • Headaches, nausea and dizziness
  • Changes in frequency of urination and/or color or odor. While certain medications and vitamins can make urine darker, do not dismiss the possibility of dehydration

Here’s why someone with dementia may easily become dehydrated:

  • They’re unable to communicate a desire for fluids
  • Not recognizing they’re thirsty or unable to associate drinking with calming thirst
  • They forget to drink fluids
  • Fear of water is not uncommon and may cause high anxiety and agitation with water-related tasks such as drinking water, bathing and showering. Even the sound of water may cause fear
  • Difficulty swallowing or dysphagia leading to fear of choking
  • If they do not eat, especially when reducing the consumption of foods that may help process fluidsif mobility issues prevents or discourages someone from reaching for a drink or walking to get a drink
  • Side effects of medications
  • As people get older, the feeling of thirst and desire for fluids changes. This can mean they don’t feel thirsty even though they’re not drinking enough

Once you determine which of these may be concerns for your loved one, you can better approach the issue.

Here’s how to help a person with dementia consume more fluids:

  • Encourage them to drink throughout the day. The recommended amount of fluids is 8 to 10 glasses, or 10 to 13 cups per da
  • Ensure they have a drink on hand whenever they are eating something or performing any kind of activity
  • Use a clear glass so the person can see what’s inside; or try a variety of brightly colored cups to draw attention and visual enjoyment
  • To keep easy count of number of drinks consumed, label BPA-free water bottles with numbers 1 through
  • Ensure the drink is easily within reach.
  • Offer different types of drink throughout the day to add variety, make it fun, and “new.” Try flavored water, cranberry juice cut with water, other fruit juices or teas.
  • Ensure the flavor, consistency and temperature is to their liking. Carbonated water or drinks taste differently than flat and may appeal to different preference
  • Drinking is the priority. Unhealthy or “empty calorie” drinks are still fluid
  • Make sure the cup or glass is suitable — not too heavy or of a difficult shap
  • Add flavor, color, texture and nutrients: For those with a sweet tooth, offer hot chocolate, with marshmallows! Add mint!
  • Add vegetables, including leafy greens, celery, cucumber, spinach, colorful bell peppers and broccoli. Clear soup and bone broth are other good choices. Add asparagus for stirring
  • “Double-dip” in the benefits by choosing high liquid content foods, such as watermelon, celery, jello, ice cream, popsicles and yogurt
  • Remember alcohol and caffeine can increase dehydration

In the early stages of dementia, many may not recall when they last took a drink.

In moderate dementia, some may forget the mechanics of how to drink, such as turning on the faucet, the location of cups or glasses or the ability to serve or pour.

In advanced stages, the risks can be even worse without the ability to identify or express thirst to others. At any of these stages, considering someone is dehydrated and seeing their lack of drinking is frustrating.

If someone is dehydrated, they may require IV fluids. Prevention is key until medical assistance is required.



Lauren Mahakian is a certified care manager. Check out her free podcast, Unlocking the Doors of Dementia™ with Lauren and Free Support Groups on Zoom.


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