Dad (80) refuses to drink fluids even though he's been in the hospital several times for dehydration. How do I handle.this?

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My father had a kidney stone two months ago and had a procedure to have it removed. After the procedure, he's been told over and over by everyone that he needs to drink fluids, but he refuses. He has been sent back to the hospital several times for dehydration. I am at a loss at what to do. I can't make him drink fluids, and he just lies in bed all day, and won't even take a shower. He is already on medication for depression. My siblings and I are just so tired of trying to get him to do the things he needs to do to take care of himself. I feel so guilty, because I want to give up on him. We use so much energy trying to talk to him and get him to do things, and he won't do anything for himself. All three of us have "caregiver burnout."

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As much as I hate to bring this up, it is unfortunately very possible that it is not just depression and dad won't do what he needs to do for himself because he can't. Can't remember the sequence, can't remember the steps, can't judge the necessity. In other words, dementia has set in and he can't care for himself any more. He is going to need someone to do those things for him, i. e. full time care. He is not going to want to admit this and almost certainly does not understand what is happening to him. I was stunned to learn from the subacute rehab my mom was in that she could not be expected to remember the sequence of steps to put her own hearing aids in, it was not so much unwillingness as inability. Getting facility staff willing to do that for her was another story too. Shortly after that she became unable to place phone calls. I felt very sad and we left the phone at her bedside anyways, for fear she would worry about what happened to it. She would just compain that it wasn't working (though it was working fine.)

Another possibility with the fluids is that he is coughing and choking or having a hard time swallowing. so he just avoids the problem, and that can be evaluated medically and all options considered.

As hard as this is, you may realize the problem is you are hitting your head on a wall that is not going to budge and a totally different approach is going to be needed not because dad is just acting bad but because he needs a lot more help. Sorry you are facing this, it is hard, and it is sad, but dad needs others to take over the things he can't do.
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Will he eat fruit like watermelon? Lots of fruits, salads, cucumbers, anything packed full of water. I know it is not ideal, but what about decaf tea or coffee, juices, ice pops, flavoured waters. This in addition to any water you can encourage him to drink often, salty snacks?
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We've tried so many things with my father to get his fluids. We've tried fruits, but if they take any effort to prepare (cut) he won't bother. We've bought bottled water, and flavored water. I've made jello, but he will only eat it if I drive to his house, and put some in bowl and hand it to him. My dad has never been the type of person to drink very much. (hence the kidney stones). The whole thing is just weird to us. He won't take showers, change his clothes, and if he has an accident, and just leaves it. None of us want to take our kids to his house, because we are so afraid of them touching something that might be contaminated. I know that is terrible, but he just doesn't care about anything. Even the physical therapist quit coming, because my dad wouldn't do anything for him. In one thought, I go from feeling angry and selfish to feeling quilty. The doctor's keep telling him that he is fine, so we can't figure out why he is acting this way.
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Same situation with my wife, advanced MS, UTI's were common. Could not get her to drink enough water. Put together a drinking tube in a gallon jug, similar to what runners use, velcroed to her neck pillow, then put a sports watch on her wrist, that vibrates every 10 minutes. When it vibrates, she takes a drink. No more UTI's!! Solved the cognitive issue. Hope this helps.
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This is a psteigman quote from another post: "Dementia can creep up slowly without anyone noticing. Ten years ago mom stopped reading novels, stopped getting news papers. Gave up sewing after five different sewing machines "didn't work". Five years ago she stopped twirling spaghetti and started cooking other pasta. Dinners became simpler, more often things got burned. Nobody noticed the dings on the corners of her car, the crushed ladder in the garage. Appliances "didn't work", the bread machine failed. The cupboards began to fill to overcapacity, and so did the closets. Payments for bills were all the fault of the water dept or the gas company. Finally she screwed up her medications and landed in the hospital. We overlook too many small signals until it reaches crisis point.."

Soiling oneself and not taking care of it kind of crosses the line as far as crisis point. Surely he took care of that himself in the past and did not depend on his late wife for it...
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You are right. It's only been in the last three months that he isn't taking care of himself. I never thought about "dementia, " because I thought that was only a memory issue. I just looked it up on the internet, and there is way more to it than that. Although a part of me knew that you can't be "in your right mind" to allow yourself to soil yourself and not take care of it.
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Does he actually take the depression medication? Perhaps he needs the dose changed or a different med. But if he isn't taking it, no medication will work. If he won't get himself a bowl of jello, is he eating regularly? I think your profile says he has diabetes. How is that being managed -- pills? insulin? When the doctor says he is fine, does that include his blood sugar levels?

Is he a widower? If so, for how long?

I think your fluctuating feelings about this are normal and to be expected. Keep reminding yourself that this is not your fault, you are doing the best you can to deal with it, and try to give up the guilt.
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I see, it seems to be a matter now of you educating yourself to dementias, alzheimers being one form. I originally came to this site stating "caring for my mother with general age related decline." Well, it is not and she has Alzheimer's disease. It is heartbreaking to go through and rough to learn what is going on, you aren't living with your dad so you don't see the day to day play out of the disease. I guess you must get your legal paperwork in order, make a decision to move him in with you, you with him, or use that long-term care policy. I have been told by professionals the sooner the person adjusts to residential care the better their adjustment as the disease progresses.
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vhope, have you talked with the staff at the facility where Mom is? Do they have any suggestions that they could help with?

Does Mom like fruit? That is a good way to get additional fluid -- watermelon, peaches, grapes, oranges, pineapple, just about any fruit will help with hydration, fresh frozen, or canned. Does she like milk-shakes/smoothies? Could she use the extra calories/nutrition from these items? Does the ALF serve soup often? Does she eat that?

She doesn't need to get all her fluid by drinking water. In fact, if she is drinking 4 cups of water a day, that is about 3.5 cups more than my mother gets! My mom drinks coffee, tea, eats soups, loves fruit, and generally gets much of her fluid from food.

If your mother is showing symptoms you've associated with dehydration in the past, perhaps having her checked by the ALF's nurse would be a good idea. Maybe those symptoms are about dehydration, and maybe something else is going on.

Good luck! Come back and let us know how this works out!
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Well, for an update on my mom. We took her to the hospital this week-end in an attempt to be proactive, as she is displaying the same symptoms that landed her in the hospital previously , with the exception of passing out. The ER doc said she is only a little dehydrated, sodium level is low but couldn't find anything else wrong with her. We have a follow up with her primary doc next week. SIGH. My bro wonders if her meds should go back to the levels when she was discharged from the hospital since she was doing well. So incredibly frustrated and sad for my mom.
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