It’s summer, it’s hot outside, and dehydration can sneak up on a person with dementia. Even “mild” dehydration can cause confusion. And urinary tract infections (NO!!!!!!!!) How do you get a person with dementia to drink more water? Check out these ideas.

Offer Small Sips

How do you eat an elephant? One bite at a time. How do you get someone with dementia to drink more water? One sip at a time. Offering someone a huge (to them) 16 ounce or 24 ounce glass of water may trigger a “no way.” So one strategy is to hand the person living with dementia a small “dixie” cup or small juice glass with a couple of ounces of water. Do this every hour or so.

Families (and nursing home staff) often leave a large glass or container of water nearby. But people living with dementia, especially in the moderate to severe stages, do not reach out and start drinking. The nerves in the brain that coordinate the simple (to us) activity of reaching, grasping, moving the cup to the mouth, and then swallowing the liquid are not working properly. Or may be off-line completely. This is why it is important to offer frequent sips.

“But when I do that, she refuses.” Approach is everything. Many of us over-talk and over-explain when we are trying to get a person living with dementia to drink. It may be more effective to simply make eye contact, smile, and place the cup or glass in the person’s hand. Minimal words equal minimal refusals.

Lead by Example

In addition to handing the person water, drink your own water. Humans are social creatures. We like to eat and drink together. I personally feel awkward if I bring my lunch or breakfast to a meeting (even though we were told it was OK to do so), and no one else is eating. Social cues can remain even in the severest forms of dementia. Take advantage of those cues. Drink your water while the person living with dementia drinks his or hers.

It Does Not Have to Be Water

Water is ideal, but not everyone will drink water. Flavored waters with no sugar added are OK. You can add a couple of drops of flavoring to the water. Drinks like iced tea and lemonade can be tricky. Drinks that have caffeine cause you to pee, which defeats the whole purpose of pushing liquids. Drinks with a lot of sugar are not good…empty calories.

If the person has diabetes, sugary drinks will make them pee more. And will cause dehydration. This is because the level of sugar in the blood is already high. Once a certain level of sugar is reached, the kidney tries to “help” by pushing the sugar out of the body. The kidney dilutes the sugar with fluid. The pee looks very pale and there is a lot of it. The vicious cycle begins. The person feels thirsty, drinks more soda, and the kidney “helps” by pushing the sugar out of the body in the form of pee. Bad situation.

Is Soda Ever OK?

Sometimes. This is where you weigh the pros and cons. If my 85-year-old aunt will ONLY drink ginger ale and she does not have diabetes, I’m not going to fight that fight. If she prefers orange soda, I may cheat by cutting her beloved Fanta with some seltzer water. Or lots of ice cubes, which will melt and dilute the soda.

Speaking of ice cubes, see how your loved one feels about cold liquids. Some people have no problem with cold items. No problem. But as we age, the gums in our mouth shrink a bit. This opens the sensitive tooth root to cold liquids and foods. Some people cannot tolerate cold (or hot) liquids because of sensitive teeth. If that is the case, serve liquids that are cooler but not cold.

Popsicles and Freezer Pops

Yes, frozen water is just as good as liquid water. Pay attention to sugar content if the person has diabetes (or is at risk for diabetes). Use popsicles with no added sugar. Or, make your own. I found popsicle molds in several stores. Pour the lightly flavored liquid, such as homemade decaffeinated iced tea, into the molds. Freeze. Serve!

Foods with Lots of Liquid

Another way to sneak in fluid is by eating. Watermelon is the first fruit that comes to mind. And it is delicious! Cantaloupes, tomatoes, and grapes are other options. Jello works, too!

If any of you, my awesome readers, have some of your own suggestions…please share!

Categories: Caregiving

Dr. Rita Jablonski

Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.