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Dehydration and Dementia

Introduction

When I’m home with my Dad, I always make us both a drink and sit down to chat with him. If I ask him if he wants a drink, he won’t know how to answer and will say no or nothing at all.

Keeping dehydration at bay in dementia patients is a constant job for carers. In dementia patients, dehydration is almost a certainty unless you or a carer intervenes.

Dehydration is a health condition that happens when the lost amounts of fluids in the body are not replaced with the new ones. Unfortunately, this fluid imbalance will eventually lead to serious consequences by affecting both the mental and physical well-being of the person. 1

What are the Factors Leading to Dehydration Among Patients with Dementia?

People with dementia become forgetful. This statement refers to routine activities as well. So, those with dementia may simply forget to drink an appropriate amount of water per day. 2

Also, in the later stages of the disease, people with dementia start to experience physical problems. Some of them have difficulties to perform everyday activities. So, they may be unable to stand up from the chair, walk, take the glass of the water, and even drink. 3

Dehydration Signs and Symptoms.

It’s really important to keep an eye on your loved ones when they have dementia, to determine if they might be dehydrated. To be on the safe side is usually best to presume that most people with dementia are suffering some degree of dehydration.

The majority of patients experience dehydration-associated symptoms such as: 1

  • Dry oral cavity
  • Absence of tears
  • Moistureless skin of the face
  • Anxiety
  • Tiredness

How can Dehydration be Prevented?

Since the majority of people with dementia simply forget to drink fluids, you need to actively help them, not just remind them to drink.4

Try to put a glass of water (or any other drinkable fluid) in places visible for them. Try to give them beverages frequently.

Don’t ask them if they want a drink, make one and give it to them.

In order to make the hydration process more pleasant for your beloved ones, give them some tasty alternatives such as fruits and veggies, soups, juices, sauces, and etcetera). 4

It is a great idea to make a habit of drinking beverages together. Adopt some tea or coffee drinking traditions. This will increase their chance of adequate fluid consumption. 4

What Can You Do in the case of Dehydration?

There are different treatment approaches that you can use for dehydrated patients with dementia. The ultimate purpose of the treatment should be normalization of the water balance. Usually, in the late stages of dementia, patients are not able to drink an appropriate amount of fluid by themselves. In that case, three main methods are suggested.5

Fists of all, you need to encourage your beloved ones to drink fluids in little amounts and/or to eat some products that are rich in fluids, like fruit. However, it is important to know that patients who are unable to do those actions, should never be forced.5

Second, if they are in a care home or hospital, try to consult their nurses, they will consider the option of parenteral (intravenous) fluids administration.5

Third, you and/or nurses should be able to recognize the signs of dehydration (moistureless mouth, thirst) and lubricate the oral cavity with specific watered tampons once in two hours.5

Conclusion

Dehydration is one of the most common dementia-associated health complications. It may seriously affect the overall well-being of those with dementia. So, knowing how to recognize, prevent and treat dehydration is essential for caregivers of patients with dementia.

References

1.        Dehydration – Symptoms and causes – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086. Accessed November 5, 2019.

2.        Hooper L, Bunn DK, Downing A, et al. Which Frail Older People Are Dehydrated? the UK DRIE Study. Journals Gerontol – Ser A Biol Sci Med Sci. 2016;71(10):1341-1347. doi:10.1093/gerona/glv205

3.        Dementia. https://www.who.int/news-room/fact-sheets/detail/dementia. Accessed November 5, 2019.

4.        Dehydration In Dementia Patients | Ask the Expert. https://www.bannerhealth.com/staying-well/expert/dehydration-in-dementia-patients. Accessed November 5, 2019.

5.        Arcand M. End-of-life issues in advanced dementia: Part 1: goals of care, decision-making process, and family education. Can Fam Physician. 2015;61(4):330-334. http://www.ncbi.nlm.nih.gov/pubmed/25873700. Accessed November 5, 2019.

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