Practical Strategies to Increase Hydration in a Person with Alzheimer's Disease

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Drinking enough fluids every day is critical for good health. Not getting enough fluids can increase one’s risk for complications such as dehydration and constipation, but getting persons with Alzheimer’s disease (AD) to take in the recommended 64 to 80 oz of total water a day can be difficult. Although much of the water that the body needs is consumed in food, it is important for people to drink water or other nourishing liquid throughout the day.

Here are some practical strategies for caregivers to try:

  1. A good basic approach to caregiving for a person with Alzheimer’s disease is to anticipate needs before they occur. Set a daily schedule for drinking as well as eating. Identify key times during the day that offering fluids fits naturally into other types of activities. For example, before and after taking a walk, sitting down to watch a movie, and enjoying an afternoon on the back porch are all times that offering fluids makes sense.
  2. If your person tends to wander during the day, try offering fluids in a cup with a lid so that s/he can continue to walk but may be cued to take a drink of fluid from time to time.
  3. Consider simplifying the environment at mealtime by removing excess dishes and plates, leaving only the main plate, a utensil and a glass for fluids. Changing the environment in such ways helps to decrease distractions at mealtime.
  4. Try a new flavor to an old drink by splashing some fruit juice in a glass of water, adding a lemon slice or sliced cucumber to water, or serving a flavored, decaffeinated tea. Try adding fruit ices, popsicles, and gelatin desserts to the diet.
  5. Offer and encourage fluids throughout the day instead of only at mealtimes. Keep a glass or bottle of water near a favorite chair or in the car to remind you and your loved one to drink more often.
  6. The World Health Organization (WHO) developed an oral solution containing sugars and salts to improve absorption and prevent dehydration. This solution can be prepared at home by mixing the following:
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    • Table Salt – 3/4 teaspoon
    • Baking Powder – 1 teaspoon
    • Sugar -4 tablespoons
    • Orange juice – 1 cup
    • Water – 1 quart/liter
  7. Treat yourself and your loved one to a milk shake or root beer float as a special activity that is fun and also provides a good source of additional hydration.
  8. Drinks that are too cold may be uncomfortable, so try a glass of fluid that is slightly cooler than room temperature, but is not icy cold.
  9. Eating and drinking are social behaviors, so drink a glass of juice or water with your loved one during the day. S/he may model your behavior and drink. This will also help you stay hydrated!
  10. Offer a small cookie or cracker as an incentive to drink a glass of water or juice.
  11. Sometimes difficulty drinking or swallowing can represent a medical issue. If the problem persists, or if there are signs of dehydration (dry mouth, nose, and skin, light-headedness, low energy, fainting, low blood pressure), take the person to see a physician.
  12. Encouragement, patience, cueing are the keys to keeping a person with AD eating and drinking. It may only be a few bites and a few drinks at a time, but being patient and continuing to try new strategies will pay off!
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