Good – Gooood – Goooood – Good Hydration …..
One of the more frustrating aspects of caring for someone who has dementia is ensuring they keep well hydrated. It can seem like a 24 hour job just trying to keep our loved one well watered.
- Signs of dehydration are:
- Dry skin
- Postural hypotension
- Increased heart rate
- Lack of energy
- Lack of concentration
- Dark urine
- Dry mouth
- Compromised immunity
- Less elastic skin
- Urinary tract infections
- Worsening cognition especially when severely dehydrated.
- Tiredness, shortness of breath and pain are other signs of sever dehydration
There may be some very good reasons why it is so difficult for someone to stay well hydrated:
- They may forget to drink
- They may forget any one part of the process in taking a drink
- They may not have the capacity to initiate the drinking process-They may be unable to make sense of thirst & if they can, may be unable to know what to to when they are thirsty
- They may have a hang-up about drinking and needing to go to the loo …. Indeed going to the loo and any part of going to the loo may hold any number of reasons to put someone off wanting to drink. I have often come across people afraid to drink for fear of “having to go to the loo all the time.”
- They may no longer like the sensation of drinking.
- They may find handling the drinking receptacle difficult or be frightened of being clumsy afraid they might break a glass or worry about embarrassment
- They may have difficulty drinking and swallowing and the fear may be about choking or coughing and making a fool of themselves.
There may a combination of some or all of these or none of these; understanding their difficulty can help you hone your approach to suit.
- Keeping your loved well hydrated is probably one of your most important tasks though. Here are some tips that may help make the road a little less bumpy:
- Keep a jug of water at hand and encourage good habits
- Squeezing some fruit juice in can make it more appetising
- Tell your loved one you love them want them to stay well and they need to drink to keep well. Maybe even that you want them to stay out of hospital
- If the brain is 4% dehydrated it can work at 40% less capacity. For some reasoning can be all someone needs to encourage them to drink more.
- Use repetition in patient, gentle tones to encourage drinking.
- Put a sign up to remind the person to have a drink, words and pictures can be helpful.
- Use a brightly coloured glass (typically hot colours are best) to serve the drink …. Maybe a brightly coloured jug too to highlight where the jug is in a person’s environment
- Serve drinks with a smile
- Vary drinks
- Try and avoid sugar, caffeine and alcohol as these can dehydrate especially alcohol and fizzy drinks.
- Drink with the person and use verbal prompts like, “cheers”, “bottoms up” and “down the hatch”
- Use humour – with mum we joke it’s a G&T, or that I will be badgering her because I love her to finish the jug
- Set goals with your loved one e.g. the jug needs to be finished by the end of the day, or when we‘ve finished our cuppa we can go and do …. (something the person likes)
- If reminders don’t work, hand them the drink, even if you have just given them a verbal prompt and remember …. Smile, we don’t want to make the experience become a programmed negative one.
- Sneak in extras with watery soups like leek and potato soup, or juices and smoothies
- Use little and often prompts and use mime to reinforce a clear message
- When you go out take a water bottle and drink together. Make this a life habit, when going to GP, walking the dog, visiting relatives etc.
- When you go out make going for a drink the key part of your trip.
- Use drinking vessels that make sense to the person, e.g. one lady I knew would only drink out of a china cup and saucer
- Use ergonomically designed cups
- Ask others to get involved to provide a consistent approach of care. Whether it be friends, family members, professionals, medical support and anyone involved in your loved one’s care, ask them to help and remind your loved one to drink there and then and in general. This can help support you so you don’t feel like the bad one always going on at the person and show your loved one that everyone wants what’s best for them. A professional can often give impetus to your case.
- Know this work is vital good work!
This is not an exhaustive list and not all of these will work all the time for everyone, but it’s about using what works for your loved one. You will have some wonderful tricks up your own sleeve that will work for you.
Please feel free to share away and send me your comments and top tips to keep that good hydration vibe going
Warm wishes Nicolle