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We are in and out of the hospital with multiple issues mostly stemming from the lack of wanting to drink. UTIs, pneumonia, dehydration, falls from dehydration, low blood pressure issues stemming from dehydration.
The assisted living home will encourage fluids but they don’t sit there to see that they are not being fully used. There’s no explaining the importance of hydration because there are a million excuses as to why she has more than enough (possibly drinks 2-8 ounces a day!) I understand this is her disease making things difficult but does anyone else have any experience with this? Any advice appreciated!

At some point, you have to come to terms with the fact that this is fatal and there is no getting better. Quality vs. quantity. You can't make her drink but you can continue to go to the ER for them to pump her back up. For what? To go through it all over again? I would consider Hospice care at this point. I say this because the same thing would happen with my mother. We'd end up in the ER and spend 2 days in the hospital, which just created more confusion and discomfort for my mom. The last time she went, I had to ask myself who was I helping? I was only ensuring she had more suffering. The kindest thing I could do for her was to let nature takes its course and do whatever I could to keep her comfortable. Hospice was called and there were no more trips to the hospital.
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Reply to Tiredandweary
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Isthisrealyreal Feb 25, 2020
That is the perfect answer to this dreadful disease.

Careblazer, I am sorry that you are facing these difficult choices. I think that tiredandweary nailed the reality of the situation perfectly.
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I don't think it matters how 'advanced' your mother's Alzheimer's is when you ask for a hospice evaluation.............it's about how many times she's schlepping back & forth to the hospital where they are rehydrating her dehydrated body. For what purpose? To drag out a terminal disease and extend her life even further??? At some point, the interventions have to stop, you know? I'm almost there with my mother who's only at the 'moderate' stage of dementia. She has other health issues in place (CHF, AFIB) that make the whole scenario a nightmare to deal with, and all of her issues just make everyone's quality of life non-existent.

So. The next time she goes to the ER for whatever issue is happening, that is when I am asking for a hospice evaluation. So we can end the insanity of the hospitals, the rehabs, the tests, all of it. She deserves comfort care at this stage of her life (93) and disease. She also refuses to drink liquid b/c it 'makes her pee' and she's incontinent on top of everything else.

Leave your loved one alone, get a hospice evaluation the next time she's off to the ER, and let God take over. When it's her time to go, she'll go. Your job is to see that she's as comfortable as possible during the journey.
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Tiredandweary Feb 27, 2020
Totally agree. At some point, you have to decide who is benefitting from keeping someone living through this awful disease that has no cure and no positive outcome. It sure isn't the person going through it or the families that have to watch the process. The Healthcare Industry was making money off of my mother's suffering. To the tune of over $100,000.00 for one year, which was just my mother's out of pocket costs. I have no clue what it cost taxpayers for the medicare coverage when it came to the medical bills. Was keeping her alive at all costs worth it? Not in her condition. If we could have fixed her and she gone back to living a normal, happy, healthy life, sure! We were just spending a fortune to ensure she couldn't die in peace after 91 years. We faced reality and made a decision to do the kind thing. I know she would have thanked me for doing so. I can't imagine anyone wanting to live like she did her last year.
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Hello,Yes,in my line of duty as a HHA since the 1980,s I have seen it till this day.Not only with the Alzheimer's population but even with everyone in my path. It's thru lots of Patience that can be achieved.
The way I do it with my client right now with dementia .In the morning she likes coffee with every Breakfast.I bring one cup with the coffee.Once she finishes I bring her 6 morning pills to the table with water ...IN..the same cup she drinks coffee. WHY?...with clients with brain issues we need First see their necessities. Then make it easy on them.My client DO NOT LIKE to drink water.But with the cup she is comfortable to do so it's with the coffee one. WE BOUGHT 12 of the same cup.When they see different items around the table or different dishes they get confused.So when breakfast is done we start with her meds.Our goal in my 12 hour shift from 9am to 9pm it's...minimum 8 cups. During each hour I bring to her half cup of water.When the first round finishes...THE NEGOTIATION START.
I will bring the Newspaper...and together we start going thru the news paper.I tell her ....I'm bringing a cup of water for me and one for you because we are going to be sitting for long and the kidney needs to work while we are reading.WE start reading and talking and drinking water by11AM she and I had one cup of coffee and two cups of water.Then by close to 1pm I walk her to the bathroom the she finishes and I invite her to walk to the building elevators like a 12 minute walk in total. When we come back another cup of water the same cup...and as days progresses I do my best to assist with such important task.NOT only for the client but for all around them.The aide or visitors can also bring their water.WHY if they see only them have to drink water they might think we are going to harm them.When she needs to drink water...it be nice someone sits with her and also drink water to bring her some kind of security that water it's not POISON.Their brains doesn't funtinon the way we would like for them to funtinon.REMEMBER is their brain and they controle it.We just work around it.It will take a lots of negotiation but it's duable.Little sips on a nice Cup that she can feel comfortable like with beautiful roses of maybe animal print.My client loves Cat's .PLEASE let us know how it's going.Wish you all a very nice journey.Good luck.
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Reply to Sorgalim
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Careblazer310 Feb 27, 2020
Thank you so much!!!!
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This doesn't mean its the end stage of life. This can happen in the early stages. Their brain no longer tells the body that its hungry or thirsty. This is how Dementia is found in some. Its not not wanting to drink its not knowing they need to drink. The AL should be going around every so often with water for residents. They should make sure the residents are drinking at every meal.

Now there does come a time when not drinking or eating means the body is shutting down. They no longer can swallow. Forcing them to do either does more harm than good. This is the "end stage". This is where Hospice can be called in. They will keep the person comfortable.

And they don't decide, they can no longer do that. The brain is dying and losing controll of the body.
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Careblazer310 Feb 26, 2020
Thank you. I understand this. She is not end stage, I agree. I also know she is not purposefully deciding not to drink. So many medical professionals and family have spoken to her about this. She still doesn’t drink so I know it is part of her dimentia.
I wanted to know if anyone has advice for how to deal with this since it is causing a lot of medical issues for her.
we are concerned that it will worsen.
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I agree memory care would be the best placement for her. Another option to consider is palliative care only; no curative measures or drugs to be given. That would mean no more diagnostic tests, blood draws, etc, and she'd go off stations and other meds that try to cure disease. She'd still get treatment for broken bones & illness. While she's talking, someone needs to read Dr Atul Gawande L's book, Being Mortal, and lead her through the question of quality of life. It may be too late, but the family needs to consider this. If it were my mthr, I would not allow the ER to give her fluids but respect her action of not drinking and let her pass on her timetable.
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Reply to surprise
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Is it possible to encourage eating high fluid items.
Popsicle's, jello, pudding, (keep in mind none of these are good if the food has to be thickened.)
Meals like soups are another great way to increase fluids.
Fruits
Between meal shakes like Boost, Ensure or other nutrition drinks might also help.

Is it possible that the AL is not able to monitor enough and the better choice would be Memory Care?
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Reply to Grandma1954
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Careblazer310 Feb 26, 2020
Thank you so much for your reply. Yes, we try our best with soup and high water content foods but she is not really eating well anymore either. She won’t drink Ensure or Boost because she thinks it is for older people. She has her ideas about things which are hard to break through.
I agree that memory care is probably a better option for her at this point but it’s convincing her children to make that move for her that’s stalling the process. I hope they see very soon that it is the safest option.
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Yes; my mom (now deceased) and the mom of a friend (92, mild dementia). It is like pulling teeth to get them to hydrate. No matter how much we explain, cajole, etc. it is a problem. And then there are the health issues by the dehydration.

It's not a complete solution but soups, broths, and other "watery" foods can help.
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Reply to Oskigirl
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The diseased brain is not going to understand that they need to hydrate. They will have to be reminded every day.
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Reply to Llamalover47
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I do my mom suffers from Dementia and she is not drinking enough water so what I do is when she finishes her water I have her put them on the counter then I call her and ask her "how many empty bottles are on the counter" so that I can keep track of it also she has a Home health aide which helps out a great deal.
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Reply to madams44
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My 95 yr old Dad hardly drinks any water.

But he will drink milk and juice and I don't give him coffee, alcohol, sodas.

Find things that he likes to drink because even tho it's not water, it will hydrate

Also, I have a bottle of water sitting beside my Dad 24 7 and try unscrewing the lid and tell him to take a sip. Do this as often as you walk by him.
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