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

Scaredtaker, here is a list for dehydration

https://www.agingcare.com/articles/hydration-tips-for-seniors-205594.htm

Dear Diane,

It sounds like you are doing everything you can to help your dad. And I know its hard when our parents won't cooperate with us. I wonder if there is an underlying reason that we just don't know yet about why he doesn't want to drink more water. I wonder if the doctor can do a further evaluation.

I didn't know this but when my dad decided to stop eating and drinking as much it was a sign of heart failure. And he was dying.

As a last resort maybe get him to the hospital to be given fluids through an IV. There is something going of on and I hope you can find out what it is. Thinking of you.

Can anyone please list symptoms of dehydration and or the effects manifested in elderly dementia/stroke persons?

Well, this is how I help my father with his liquids since i am lucky to get a couple of sips of water in him a day. I buy 10 oz packages of frozen fruit at the dollar store. I make jello using this recipe:
2 packages of jello
1 package frozen fruit that has been pulverized by my NINJA (like for snow cones)
1 cup greek yogurt
3 TB chia seeds.

I use two cups boiling water to disolve the jello and then add the chia seeds and yogurt using a hand mixer. Then I add the crushed fruit and stir it all together. Once chilled this is a very nice combo and my father loves this.

Because chia seeds absorb thirty times their weight in water, they help regulate body fluid levels and retain electrolytes, both key in the battle against dehydration. For long workouts in high heat and humidity, chia seeds are a handy way to prolong hydration. (http://www.fleetfeetstlouis.com/news/chia-seeds)

I figure if it can help those in sports, then it can help my father. Since he also prefers pureed carrots, zucchini and other veggies, these also could be added in a jello combo. Here is a list of high water fruit and veggies from SFGate (http://healthyeating.sfgate.com/list-fruits-vegetable-high-water-content-8958.html)
High Water Content Fruits
Watermelon and strawberries contain about 92 percent water per volume. Other fruits with high water content include grapefruit with 91 percent, cantaloupe with 90 percent and peaches with 88 percent water. Fruits containing 87 percent water by weight include pineapple, cranberries, orange and raspberries. Apricots hold 86 percent water, while blueberries and plums contain 85 percent water. The water content for apples and pears is 84 percent. Cherries and grapes contain an average of 81 percent water. And, a banana’s composition includes 74 percent water.
High Water Content Vegetables
On top of the vegetables list are cucumber and lettuce, consisting of 96 percent water. Zucchini, radish and celery are comprised of 95 percent water. Ninety-four percent of tomato's weight is water, and green cabbage is 93 percent water. Vegetables that contain 92 percent water include cauliflower, eggplant, red cabbage, peppers and spinach. Broccoli is 91 percent water by weight. Additional healthy hydrating foods include carrots with 87 percent water and green peas and white potatoes with 79 percent water.

There is a related condition called cerebral salt wasting that can happen with strokes, etc. and those folks need fluids and extra salt too. They can tell if they run simultaneous blood and urine sodium and osmo tests.

My Mother's dr. said the part of her brain that tells the body it needs fluids may have been destroyed by dementia. She has a one year standing order for IV fluids at a nearby infusion center at a hospital-four hours each infusion and Medicare covers. But she is 94 and it would really help if the infusion could take place at the Adult Family Home she is in, but Medicare will not cover. Heard today it could be that the anti diuretic hormone (ADH- brain releases ADH hormone from the pituitary gland) is possibly no longer being released/manufactured by the brain - vaso pressin is the name of the hormone that can be given, but this may be wrong -we are researching.

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.

Thanks for the suggestions. I will suggest fruits and soups as well. I also asked the ALF to monitor her food intake as well. I will check back in and give an update.

What about ice or frozen fruit juice? You can disguise liquids. My mom was diabetic, but hated drinking water. She would suck on ice cubes though. Maybe that's worth a shot.

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!

I'm sorry I posted in the wrong area.

Mom is 81 yrs. old with dementia, had first hospitalization for dehydration, she returned home did very well for the first month. Now we noticed a slow return of the signs (sluggish, weak, slow response, closed eyes, etc.). We urge and beg her to drink more water than what is given with meds (my bro and I split the morning and evening med run) and we give her at least 2 cups with meds. She lives in assisted living. I put up reminder notes to drink water in her apt. UGH!!!! I would really appreciate any ideas to urge her or make her drink the water or any liquid more frequently. Does any one know if people can go in for an IV--similar to patients who go in for dialysis? Forgive me if that sounds totally crazy but we are so frustrated and concerned that something as simple as drinking can be so complicated. Oh by the way, we all agree that liquids should stop by 7 or 8 so as to avoid bathroom runs and not to interrupt her sleep.Thanks

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.

Is anybody a fan of the BBC series "Doc Martin"? There's an episode where the doctor deals with an otherwise normal woman who suddenly behaves very strangely. He tracks down the cause as her refusing to drink anything later than mid-morning for fear she would wet the bed at night.

We noticed that my father in law stopped drinking when he began to lose control of his bladder. If he knew we were coming by to visit or to take him somewhere, he would not drink for a whole day before. Wouldn't eat. Nothing. Because he was worried about making it to the bathroom in time. We purchased depends for him, and he was insulted. Only a few short years later, after the accidents happened routinely, we were fortunate enough to get him to a doctor and admitted to a long term care facility. He hates every minute of it, but, at least he isn't in soiled clothes or a danger to himself. Sounds like a new doctor may be in order. Make a list of your concerns: dehydration, won't shower, etc. A doctor should be able to work with you to find a care facility that will help him with his possible dementia issues. Good Luck.

Maybe he wants to avoid having to go to the toilet.

Yeah, dementia seems to make a person's underlying faults or weaknesses all that much more evident. I think it takes a lot of brainpower to compensate for our weak points and tendencies, and those will be the first things to "show" when our brainpower gets weak.

The doctor says he is fine, but make sure that includes blood tests for low thyroid and low B12.

f he has LTC insurance, it might include at-home care. If someone came in to get his pills down him and set up meals and clean up his accidents, he might perk up a little, just for the company. Take him on a visit to a facility. Some of them are nice enough that I want to move in! Not all, but many people report that their parents come back to life in an ALF.

I already have my husband, his mother, his nephew and my five and three year old living with me. yikes... No room for dad. I know we would all feel more relaxed if he was in a facility.

I think it's time for assisted living, too. We are all afraid to suggest it, though. I work full-time, and I have four kids that are 22, 18, 5 & 3 so it's really difficult to handle him. My dad has been really lazy his whole life, too. Even years ago, he would get a cold, and he couldn't even function. It would really frustrate my mom. I swear he got a taste of being totally taken care of in the hospital and that's how he wants to live.

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.

Boy Dianealanalori, I feel for you. My dad was much like your dad. According to my mom, he came from a bad childhood and was never loved, so my mom did everything for him. He was waited on hand and foot for their whole 68 year marriage. Even after he had a stroke and needed to do things for himself to keep his strength up, my mom would do them for him, which really hurt him in the long run.

I am so thankful that my dad passed away before my mom, because I'd be right where you are if mom went first. My dad was lazy with a capital L. He was a very smart man, but wouldn't lift a finger to do for himself. He expected my mom or me to do it for him. If you get your dad checked out and things are OK, I think it's time for some kind of assisted living if you can find a decent facility. If he won't do for himself, let someone else do for him and pay for it.

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.

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...

Yes, he takes depression medication. I actually think he takes more than one. I may ask him if he is still taking them. He is usually pretty good about taking them. Yes, he is diabetic, and takes insulin. Yes, the doctor includes his sugar levels when he says he is "fine." His doctor told him that he is taking an unusual amount of time to recover from the minor procedure. He will make himself simple things to eat, but when it involves fluids, he won't make an effort. Yes, he is a widower. My mother died a little over three years ago. We never realized how much she did for him. My fathers' sister also told me that he was completely babied growing up, and that my mother kept it going. He says that he doesn't have any energy, but I honestly just think he doesn't want to do anything for himself. I think he really liked being waited on at the hospital, and never went back to trying to do things himself. He actually has long term nursing home coverage, but all of us are chicken to ask him to go.

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.

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.

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.

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?

My Dad 89 lives with me ever since mom passed last year.my Dad doesnt drink enough water slso. He also has been to ER for lack of drinking. Lately I got him a bottle of water and I set it on table next to him. I tell him that he and I are going to drink water together today. Also Dr put him on 40mg celexa for depression when mom passed and Hospice has him on steroid pill fot energy. When my mom was here she was also bed ridden. The hospice nurse told us that when she quite drinking that she was near her time. Dont let that scare you that was just my mom. The nurse was right mom would not eat either. Fill free to email me anytime.