Hydration is key for our physical and mental well-being. It is easier for someone with complex care needs, which may include dementia, to become dehydrated because they may forget to drink or may not be able to communicate or recognise that they are thirsty.
Spotting the Signs of Dehydration:
- Increased confusion (compared to typical dementia symptoms)
- Dark and strong-smelling urine
- Dry mouth, lips and eyes
- Headaches or dizziness
- Feeling tired
- Not peeing very often (fewer than 4 times a day)
- Urinary tract infections
If you spot any of the signs above, then encourage the person to drink water immediately. They should sip it slowly but steadily and keep doing so regularly. If the symptoms don’t improve seek medical help and if the condition worsens or doesn’t improve, go straight to the hospital.
Hydration and Thirst
As we get older the sensation of thirst changes, this means we don’t feel thirsty even though we haven’t drunk enough. Some studies have shown that this is because the signals slow down telling us that we need to take on more water, someone with dementia or complex care needs may experience similar changes. They may also be less able or likely to get themselves a drink, because of physical limitations. For instance, someone with dementia may get up to make themselves a drink and forget what they went into the kitchen for or leave the drink in the kitchen.
Making sure some is drinking enough
Putting a drink in front of someone living with complex care needs and or dementia isn’t a foolproof plan either, just because it is in front of them doesn’t mean they will see it or remember to drink it. The person will need to be prompted or reminded, also, if a cup is empty, it doesn’t always mean the person has finished the drink, it may have been spilt or drunk by someone else. They simply may have poured it away because they didn’t like it.
Encouraging a person to drink the recommended eight to ten glasses a day is hard work. Here are some helpful tips to try and boost their fluid intake:
- Always have a drink on hand with food, even a snack.
- Use a clear glass so they can see what’s inside, or a brightly coloured cup to draw their attention instead.
- Don’t just put a glass or cup next to them, tell them their drink has arrived and put it where they can clearly see it. Make sure you have their attention.
- Change it up – Offer different types of drinks throughout the day start with tea or coffee, or perhaps grapefruit, then squash, hot and cold milky drinks, fruit juice or smoothies, soup, and water. Keep it varied.
- They may need a special glass or a bottle, cup, try a few different types to find what’s comfortable for them. It might be that they have a preference for different drinks.
- Foods with a high liquid content should be encouraged, such as melon, cucumber, ice lollies, milk jellies, strawberries, tomatoes, mushrooms, spinach and yoghurt.
- Nutritionists have created sweets called Jelly Drops®, which may help people with dementia consume more water.
- If you have an Alexa or Siri set reminders with a song to encourage them to have a drink.
- Make it a social occasion, like elevenses, sit down together with a drink and a biscuit perhaps and discuss what you’re going to have for dinner or write a shopping list.
These things can help make sure that they stay hydrated, but as we are heading into summer, it’s important to also make sure they don’t overheat as sweating can exacerbate dehydration.
Top tips for keeping cool in the summer
Keep it light
Make sure they have dressed appropriately, if they are dressing themselves, they might follow their usual routine and forget to dress for the weather. You can help by encouraging them to wear light-coloured, loose-fitting clothes made from natural fibres, this will help keep them cool, comfortable and prevent overheating. Make sure they wear a hat or cap when they go out and try and organise trips for the morning or late afternoon when it is cooler.
Keep it cool
Keep their house cool, make sure the central heating is turned off. The curtains and blinds should be closed during the hottest part of the day and buys some fans. Explain what you’re doing to them, it can be disorientating to suddenly have the curtains closed and they may think it is nighttime. In the evening, open the windows to let the warm air out and colder air in. Close the windows at night in case they become concerned about security.
Mad dogs and Englishmen!
The advice is clear we should stay out of the sun during the hottest part of the day (between 11 am and 3 pm), and this is even more important for elderly people with dementia. When your out make sure you keep hydrated, keep applying sunscreen and seek out shade whenever possible.
When someone with dementia is hot and agitated, they often find it hard to express exactly what it is that is upsetting them. They can become angry and exhibit challenging behaviours. when this happens, it is best to get them somewhere quiet and cool, get them a drink and help them to calm down. You can keep a cooling cloth in your bag, they are a cloth that you pour a small amount of water on, flick and they become cool. You can then place these on the back of their neck, forehead, and wrists. Once they are calm help them take a cool bath or shower. Try putting a frozen bottle of water or ice pack next to a fan, for some DIY air-conditioning.
British Dietetic Association
British Dietetic Association is a UK body representing dietetic workers. Also provides a range of information for members of the public.
NHS Choices provides information on eating a healthy, balanced diet.
UK Home Care Association (UKHCA)
UKHCA is the representative body for organisations that provide personal care – including nursing care – to people in their own homes. They have details of homecare providers available on their website.
Vegetarian For Life
Vegetarian For Life is a UK charity aimed at improving the quality of life for older vegetarians and vegans.