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She's in a vicious cycle. She's had accidents and peed on herself (while wearing a heavy duty brief), so she won't drink anything, which is causing dehydration, which causes extreme confusion, and then she pees all over the floor, toilet seat and herself. She has dementia and Parkinson's, so it's very difficult to reason with her.


Any suggestions would be greatly appreciated.

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plain gelatin can be added to any liquid and it’s got a couple of grams of protein in it!
jello (thickened)water and jello diluted juice?

broth with meals?

Sometimes ice in the drink ?
(Temperature preference? )

fruit and ice smoothies ? Or puréed and spoon fed?

different cups or sippy bottles? one with a big straw?

Verbal reminders every 15-20 (if applicable)“mom did you get a drink?” “Mom do you need more to drink?” “Mom do you need a sip of water?”

rotate; a bite, a drink; a bite, a drink

sit them with drink by a window? Sometimes they’ll drink without the thoughts and fears with just the calming scene of the outdoors as distraction

Offering drinks on the potty where the immediate fear of an accident is not applicable…? “You won’t have an accident mom cuz you’re on the potty!” And tone of voice helps!

Sometimes making the drink about YOU.. “mom, I need your help! The doctor wants you to drink this much water while I’m here. Will you help me so I can make the doc happy?”

making light of the accidents? “Mom I’m kinda glad you did that! That means you drank your water! Yay! I’m so proud of you for drinking your water! Do you want more water after we get fresh clothes? “
And distract from the cleanup while it’s going on.. talk about the birds outside, the last visit you had at aunt so and so’s.. how to make clean up less traumatic or just a non issue?

Hope you find the magic way for your LO!
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I am in the same situation with my 95yr old Mom, she has been on on home Hospice care for a month now after being hospitalized with Colitis and severe dehydration, they kept her for 2 days on IV's and then sent her home saying she needed to be on Hospice.

She has Alz, Vascular Dementia, Lewy Body, Sundowners and Stage 4 Kidney Disease :( She refuses to drink fluids except coffee in the am, water with pills am/pm then sweet tea at dinner and small sips maybe throughout the day but rarely. She wears depends and can't feel when she poops/pees and doesn't like going to the bathroom due to incontinence. I offer her fruit, drinks, ice cream etc and leave a glass on the table full so she can get it when she wants. She's drinking less than 16oz a day and with the stage 4 kidney disease and dehydration I am beginning to worry how long she can go like this? The nurse comes every wed and checks her over and she is dehydrated again and according to my scale she has lost 19 pounds since being in the hospital a mo ago, she eats really good so don't get that. Thoughts? Am I going to wake up and find her unresponsive from dehydration, it worries me when I am doing all I can.
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Several posters mentioned popsicles and apparently your mom likes them. You can make healthier home-made popsicles with fruit juice, not just the regular juices you can buy in the supermarket but juices you could make yourself at home from fresh fruit, using a juicer or high speed processor. I believe they also sell frozen bars that are made with all fruit/juices.
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I’m a geriatrician. I supervise and care for the patients in the dementia wing at our nursing home.

I say with extreme kindness that dementia patients are adult human beings. There comes a point in late dementia when we have to look at the whole person. When they fight and absolutely refuse to eat and drink, when they cry when their depends are changed, they are saying: “I’m a person! Stop forcing me! Respect my dignity!”

Why are we forcing our nearest and dearest to bend to OUR needs!

People DO die of Alzheimer’s!

Would you like the humiliation of “strangers” (they don’t know who you are!) washing your bum and putting diapers on you? Forcing food, medicine, and liquids down your throat?

These are adults cognizant of what is happening to them. They aren’t babies!

They feel humiliation and embarrassment. I’ve been caring for thousands of such patients for forty years.

Treat then as the adults they are!
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My husband with PD got evaluated for dysphagia. His voice is going as his throat muscles are weaker.
His drinking fluids is not great, suggestions were made for glass of warm water with lemon and honey in the morning.
Papaya juice is supposed to be the best, fresh papaya with watermelon and banana or other fruits make good smoothie.
But not much can be done, sad fact of this horrible disease.
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dear OP :),

does your mother like watermelon? you can cut some small pieces, so it’s easy for her to chew.

watermelon is very nutritious AND full of water :).
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TammyN Jun 2022
Thank you for the suggestion, she dies not like watermelon.
I took another posters suggestion about Popsicles and she lives them. She is doing well with eating them and getting some hydration.
I also tried milkshakes but she didn't care for them.
Thank you so much.
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Oops, I meant to say your "mom"
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I experiment with different protein drinks: Orgain, Glucerna, Ensure. Try different flavors and put a colorful straw in. Mom likes bananas and chocolate, so these flavors seem to work. She also loves iced tea, so that's around too. And she hates being told to drink :-( but she will drink if I leave it out and she "finds" it. Perhaps your wife is further advanced and some of these other suggestions would be better. But hope something helps.
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A swallow evaluation could be in order. Parkinson's in latter stages does cause swallow difficulties. If this is the case for your wife she is almost certain to avoid thin liquids by instinct. I would recommend thicker juices such as nectars save for the fact too much juice isn't a good things for our younger OR older in that large uptake in sugar occurs with them. I would discuss this with doctor; a swallow evaluation can be arranged with OT. Sadly, if this IS becoming a problem there are few answers. As an RN I seldom saw a senior admitted who was not dehydrated. The drive to take fluids does go down markedly with age.
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In late stages of Alzheimer's, patients reduce intake of food and water. This is a bad omen, Thirst is a survival instinct that even animals never lose.
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bundleofjoy Jun 2022
hugs :)

actually many elderly people just don’t feel like drinking (although they’ll eat). dehydration is very typical.

it’s not a strong instinct to drink (unless you haven’t drunken for many days). and people with dementia (or parkinson’s with dementia) often don’t feel thirsty.

you have to force/remind them to drink.

many people in general (even us here on this forum) should actually be drinking more water, stay more hydrated.

i myself force my LO to drink water (we toast together, “cheers!”). i drink water at the same time, so i’m not hypocritically forcing only my LO.
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I give my husband popsicles and fruit pops . He loves them and they provide the fluids as well
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Give her "juicy" snacks and treats in addition to thickened liquids. Consider frozen and chilled snacks like jello, ice pops, sorbets, and ice cream. Consider warm food like soups, thinned sauces, thin custards or puddings. Sometimes just adding thickeners to liquids is enough to get folks to drink more. Look online for Thick-it and other dietary thickeners.
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TammyN: Reasoning with an individual with dementia will always be a futile effort. Try to add liquid into her system by other means, e.g. soups, popsicles, et al.
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Make the drinks look as appealing as possible with a little cordial, cut up fruits and a straw, you can also give her foods that liquify such as watermelon, yogurts, custards, ice creams, soups and foods that have lots of juices in them such as grapes, oranges, mandarin. Good luck & all the best 😊
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"Drinking" is not the only way to increase fluids.
What can she eat without aspiration? If thin fluids need to be thickened then she may not even realize she is consuming what was a "liquid". If aspiration is possible then avoid things like jello and even ice cream. As these will liquify before they are swallowed.
Soup, pudding, cream of wheat, cream of rice, oatmeal. Any food placed in a blender with a bit of broth or other liquid that will allow the food to be pureed.
I would strongly suggest that you have an evaluation done for Hospice. They can be of great help and will provide you with supplies and equipment that you need.
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why haven't you requested an assessment for Palliative or hospice care for your mother? At least if the assessment finds her in need you will be able to have CNA, nursing visits, and possible assistance from other resources.
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billydhodges Jun 2022
Christine, I'm just curious. Is there a reason you assume she hasn't requested an assessment for Palliative or Hospice Care for her mother? I'm sorry, but your reply to her seems a bit snarky. I've been primarily responsible for my sweet mom who is now in advanced stages of Alzheimer's and she is in a great skilled nursing facility...however, I've experienced battle after battle over the last 4 years with ALF, Memory Care, and Rehab Centers as I constantly and consistently advocate for my mom since she can no longer advocate for herself.

There's no 'manual' for going through these types of diseases with a loved one. Each day is literally a new chapter in learning and becoming wise in what to do, what to ask, and who to ask.

TammyN simply asked a VERY pertinent question...one that even though my mom is in a 24/7 professional, very good facility...I have had to ask as well. The way people respond/reply is a KEY FACTOR in whether or not a person will continue to ask questions while on their particular journey.

Perhaps a more sensitive reply like "Have you requested an assessment for your mom for Palliative or possibly Hospice Care? Those agencies could be of great help," would go a lot farther when trying to help guide individuals.

Just my opinion...but I know I've been dismayed after asking a truly honest question but had people insert their 'assumptions' or just flat out reply negatively or with a "tone" literally for no reason at all.
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She may accept foods with liquid content, as described in some of the other responses, such as soups, fruits and vegetables, smoothies, ice cream, puddings, jello, etc. Don't try to reason with someone who has dementia. Try to find foods she will accept that are good for her.
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So my mom is on another UTI/confusion track and she does not want to go back to ER for the IV, and I’ve said “mom it’s fluids or ER”. We use Tennas for her to avoid the accidents. I’ve been making vegetable soup several times a week and giving her lots of fruits. Part of not drinking is they don’t want to keep running to the bathroom.
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Give her her favorite drinks. To avoid accidents, take her automatically to the toilet every 2 hours, allowing her to urinate and check for wetness and underwear change. My mom hates drinking plain water, so I give her different flavored waters. She loves it. Every 2 hours or so, we take her to the toilet as she cannot express when she needs to go.
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Try popsicles or watermelon.
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Hi Tammy, that’s a tough spot you’re in!! The first thought that came to mind was to bribe her. Thinking back to my childhood when I had to eat dinner before I could get dessert 😊. Those things that she loves to do( and I hope they’re still present) like certain foods or activities. Tell her we can do this or that but, first you have to drink ( maybe a hall cup of water but fill glass up though.. she may drink it all). Hopefully it will work.. fingers crossed😊. Also speak with her medical team for advice as well.
It is a truly new journey “parenting our parents” and navigating through new waters can be stressful but, hang in there and be creative!
My best you you💕
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Try Watermelon and soups. Many other fruits and veggies are 90% water. Just google "water rich foods".
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i hope others have great advice for you! i just want to say: i feel for you, and for your mother!!

parkinson's...dementia...it's all very hard. and you're extremely kind, loving to be helping your mother.

so i'm just writing as 1 daughter to another: you're awesome! i hope in the middle of all this, you can also relax, have good times.
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There is a new product called Jelly Drops. They are like a candy but are designed for exactly this purpose. They are 95% water and sugar free. You can order them online and can subscribe to get them on a regular basis.
Good luck!
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Kimbof Jun 2022
Oh that’s a great idea! Thanks
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Is there any chance she won't drink because she has developed dysphagia and needs her fluids thickened? Periodically choking/gagging on water was the first thing that plagued my mom.

https://www.thickenupclear.com/
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My mother loves Lactaid mixed with Muscle Milk and a drop of vanilla flavoring. I also frequently hand her a water bottle and tell her to drink, which she will do most of the time. About every month I have a nurse from a company that provides hydration come to the house and give her IV fluids just to stay on the safe side.

She also takes a cranberry capsule and D-Mannose supplement for bladder health. She wears depends but almost never soils them.
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Kimbof Jun 2022
D Mannose is good. I add it to the cranberry powder and make drinks from it. I am going to look into the nurse with IV. That’s a great idea. I keep having to take her to ER.
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If she herself says that she doesn't want to drink because she is afraid of bathroom accidents, explain that keeping her system well flushed works much better and continue to offer. But generally don't attempt to reason with her. You might as well ask her to run a mile in battle dress as to grasp and retain a reasoned strategy for good urinary tract health.

Regularly offer her small, fresh, palatable drinks of types which you know she prefers, or juicy, appetising snacks such as jello, ice cream, fresh fruit.

If her Parkinson's and/or dementia symptoms are troublesome, she may need extra help such as lidded beakers or hydration bottles for drinking, adapted spoons for eating, and also support with the physical task.

To illustrate the last example: you ask her if she would like some ice cream, she agrees to try a little, you place it by her, nothing happens. She may just have changed her mind (or not like vanilla - did you ask?), but another possibility is that her brain has lost an ability called initiative - she can't take the first step, that key link in the process is broken. If you place the dish in her one hand and the spoon in the other (going gently and checking that she's comfortable at each step) you may find she then eats it all up without stopping.

As a rule, regular supported toileting will be better than heavy duty pads during the day; and I hope to goodness any accidents are sympathetically handled (I'm sure they are, but such accidents are mortifying enough without anyone commenting). Are you dealing with this or is your mother in residential care? - sorry, I should have checked your profile, I know.
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My mom didn’t drink but she had dry mouth so she would suck on mouth lozenges. She was using about 14 a day. I found Propel (electrolyte drink or vitamin drink) for her. It is sweet and I open 2 of them and put straws in them. She drinks more with a straw. She now drinks 2 a day which is all I wanted her to drink. She has not had a UTI since she started drinking more and I also got her Cranberry pills to assuage the liquids. When I am with her, I pick up the bottle with the straw in it and hand it to her. She is like a baby bird in that she will take it and drink it. She can down a lot with the straw.
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Popsicles & watermelon are both good ideas, along with the small water bottles which you can flavor with Crystal Lite. Milkshakes are also another tasty idea that she might like and also offer hydration.

I have to tell you, my mother who also had dementia refused to drink liquids too.........for years, b/c she didn't want to have to pee. This went on pre dementia and post dementia............and she managed to live to the ripe old age of 95 and did not die of dehydration. She said she never felt thirsty, so it wasn't like she was ignoring a need, either.

I'm sorry you are going through such a difficult situation; I know how hard it is to want our mother's to do certain things & having them refuse to. Sending you a hug and a prayer for peace, no matter how things turn out.
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When people begin to ignore natural survival instincts, it means that they are close to dying. Thirst is a survival instinct. Even animals don't forget it. The ER can't save her. They will hydrate her and will send her back home where she will refuse to drink, again. She needs hospice care. Not every problem will have a happy solution.
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