Dehydration and Dementia

By: Gary LeBlanc

Throughout the long and often frustrating campaign of caring for a loved one living with dementia, odds are you will eventually deal with the issue of dehydration.

Fortunately for me I didn’t have to deal with this with my dad very much. However, in Mom’s case it was a different story. I even remember it as a daily battle.  It got to the point where the only time I could get her to drink fluids was in order to swallow her pills. “One more sip please,” quickly became my refrain.

First, let me point out the symptoms of the mild to moderate stage of dehydration. Here are some signs to look for:

  • Dry or sticky mouth and tongue
  • Long periods between urinating
  • Urine darker than normal
  • Cool skin temperature
  • Headaches
  • Confusion
  • Muscle cramps

If the dehydration becomes severe, the symptoms will most likely include:

  • Not urinating at all and color of urine extremely dark
  • Sleepiness, substantial confusion and irritability
  • Dizziness, fainting
  • Eyes sunken in their sockets
  • A rapid heartbeat

At this point a trip to the emergency room becomes necessary. An I.V. will be inserted in order to administer fluids for swift re-hydration.

When caring for Mom, an easy test I would often use at home was checking her skin for elasticity. This was achieved by gently pinching then pulling up the skin on the back of her hand. This showed me her skin turgor, or hydrostatic pressure. I personally called it the “pop tent test.” If her skin remained tent-like then I knew she was dehydrated.  Mild dehydration will cause the skin to be slightly slow in its return to normal uniformity. The longer the skin remains raised, the more dehydrated the body is.

My advice? Be creative. Clear liquids will help the most, but if the person is not cooperative, you may have to take a different route.

When I discovered the value of soups this became a huge blessing for my mom and relief for me. I may not have been able to get her to drink a glass of water, but I could easily get her to sip down a cup of soup, especially if I told her I slaved over the stove and made it from scratch (Thank you, Campbell’s Soups!). Other options may include ice pops, Jell-O, fruit and cereal. These may not be the most ideal solutions, but remember, some fluids are better than none. (If you do get them to drink, Gatorade is perfect.)

Another red flag for possible onset of dehydration is if they are running a fever, experiencing diarrhea or they are sweating profusely for no particular reason. And what about their medication side effects or warnings? Do they contain a diuretic? This would have them urinating more often than normal and, ultimately, become quite a concern.

As I stated above, be creative when dealing with dementia. Be patient but persistent. In my case with Mom and Dad, I lost count a long time ago how many times I heard the words, “I already drank a cup.”

Gary Joseph LeBlanc, CDCS

Director of Dementia Education

Dementia Spotlight Foundation

CAREGIVERS YOU ARE NOT ALONE