Hydration & Dementia

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ASK DR. MINDY™

MINDY KIM-MILLER, MD, PhD
to learn more about Dr. Mindy click here

Question:

Sometimes my mother does not want to drink water with her meals, and she often seems to forget to drink during the day. How important is it for her to drink more water, and how do I get her to do it?

–Victoria, 47, Chicago

Answer:

Drinking enough fluids every day is very important for good health. Not getting enough fluids can increase one’s risk for complications such as dehydration and constipation.

Elderly people are more prone to dehydration. They have less water content in their bodies (about 60% as opposed to 70% in younger adults), a lowered thirst response, and the kidneys concentrate urine less well with aging. Swallowing problems, poor food intake, and long periods between drinking fluids can increase the risk of dehydration. Some elderly may also be taking medications (such as diuretics or laxatives) that increase fluid loss. Dehydration can have serious medical complications including kidney and heart problems. When dehydration is mild, the skin and insides of the mouth, nose, and eyelids become dry. Persons with dementia may act more confused and sluggish if they are dehydrated. Standing up may make them feel light-headed and they may faint. As dehydration becomes more severe, the body makes less urine, and the urine becomes dark. Severe dehydration can lead to low blood pressure that can be life-threatening. It is very important to maintain a safe level of hydration.
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In the United States, constipation results in about 2 million annual visits to the doctor and is the most common gastrointestinal complaint, especially among the elderly. In someone with dementia, constipation can worsen confusion and often irritability or aggression as well. A major complication of constipation is fecal impaction, which can result in intestinal obstruction, colonic ulceration, overflow incontinence (leakage of stool around obstructing feces), or even diarrhea. Urinary incontinence, urinary retention, urinary tract infections, and fever can also result from constipation. Too much straining during bowel movements may cause problems with blood circulation to the brain, heart, and extremities, which can lead to fainting, strokes, and heart attacks. A rare but serious complication of chronic constipation is megacolon (enlarged, dilated colon), which can lead to pain, fever, shock, and even death.

You can help prevent constipation and dehydration in your mother by encouraging her to drink every 2 hours during the day (such as water, juices, decaffeinated drinks, clear soup) and eat fruits, vegetables, bran and other whole grains each day. Encourage her to drink something before bedtime. If appropriate, a glass of water should be available by the bedside in case she wakes up thirsty at night. To encourage fluid intake, try adding flavored fluids to the diet such as fruit juices, popsicles, and gelatin desserts. Try to establish schedules for increasing fluid intake and gradually build up to a safe level. Exercise can also help maintain regularity. Remember that with exercise and sweating, the person needs to increase fluid intake to prevent dehydration.

Dr. Mindy Kim-Miller is a trained medical physician who provides useful, but general answers to questions provided by online visitors. While Dr. Mindy can not provide specific medical advice or services, we hope you find her responses useful in your personal education. All information is provided for informational and educational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. If you suspect you have an illness or disease, or a health related condition of any kind, seek professional medical care with an appropriate health care professional immediately. Do not postpone or delay seeking treatment or disregard professional advice based upon the general answers provided by Dr. Mindy. Dr. Mindy’s advice is not intended to substitute for a visit to your personal physician or other qualified health provider. Any specific medical concerns or questions you may have should be directed to your personal physician or other qualified health provider.

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