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My Mother is 95 with Dementia. I moved her into my home a month ago. She's never been very good at getting enough to drink, and the last 2 days she's more or less just refusing to drink anything. I gave her Jello at breakfast & she did eat most of that. She really has no sense of taste other than being able to taste sweet, salty, sour & bitter. I've tried numerous combinations of juices, broth & water, hot & cold. She will eat canned fruit & soups. She wasn't interested in popsicles. With most everything she just says she doesn't like it or says "it's too sweet". So, I'm at a loss as to how to get enough fluids down her. There won't be any more trips to ER for hydration. Any suggestions? I do have Hospice coming next week to do an assessment so we can started with services, but in the meantime, I thought I'd explore this forum for answers. Thanks!

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This often happens in the late stages. How far are you willing to go to keep your mother living beyond what is a normal life span? You have offered her everything that you can think of.
As a nurse I can tell you that there is honestly no way to force hydration on her other than putting in a gastrostomy tube surgically, which she would more than likely pull out. Moreover, fluids are not always a friend. While you don't want dehydration, the forcing of fluids onto an elder can lead to choking and fluids entering the lung, causing pneumonia, and too much fluid cannot be processed by the failing heart, lungs, kidneys of an elder. Congestive Heart Failure, swelling of ankles, legs and abdomen can result from a weakened right heart and fluid in lungs with left heart failure.
Your Mother is now 95. Is it not OK to let her be the arbiter of how much fluid or food she takes?
Have you considered palliative care, hospice, or spoken to anyone about end of life decisions? Have you gotten any help with any therapy of any kind (should you want to do this work on grief and loss, a licensed social worker skilled in life change issues is likely even better than a psychologist.
As I said, you have clearly tried everything I think anyone could, to no avail. It may be time to explore, consider, approach what work needs to be done to face the end of a life, the loss and grief.
I am so sorry, and I hope you will find some peace in this. Your Mom is so lucky to have a clearly caring and loving daughter with her now. Enjoy the time you have left with your dear Mom, sharing things that will make her happy, peaceful, comfortable and stress free rather than forcing upon her things that make the end more torturous for her.
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JustJanet Oct 2019
Thank-you for your input. I'm very aware of all the issues you spoke of. I've gotten some good suggestions of things I can offer her that aren't in a "drink" form. Things I knew of, but in all my stressed out moments, had failed to think of.....juicy foods, fruits, veggies, soups, homemade fruit water, etc. We have a consultation with a Hospice nurse tomorrow, & her Doctor & I have talked extensively about the end of life issues, especially since my Mom has Dementia. I've just been wrestling with my feelings of inadequacy as my Mom's caregiver & don't want to be negligent in any way. Thank-you again for your response.
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1.   She may have no sense of taste b/c of meds.  Is she by any chance taking Amiodarone?

2.   Does she have any choking or swallowing difficulty, and if so, has a speech pathologist done a swallowing study to determine if she's aspirating?

3.    Since she'll eat soups, make more soups.   And focus on foods that aren't sweet, since she's definitely taking a stand against that.   Be aware that canned fruits are artificially sweetened, but it may be that sugar levels in other foods are offensive.  

4.  You might try reviewing a diabetic diet to see what foods might be candidates for her tastes.
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JustJanet Oct 2019
Hello....My Mom's loss of her sense of taste may possibly be due to Fosamax that she took about 15 yrs. ago for osteoporosis. She's definitely not aspirating or having any swallowing or choking issues, thank goodness! I've been giving her soups & fresh fruits & veggies, so we're making alittle progress. Thank-you for your thoughts & input!
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I think I might call Hospice back and see if they can come pronto. When we called about my LO, a rep was there that day and she was set up the next day. They seem to know a lot about how to handle things like this. I'm so sorry for you. That must be so stressful.
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JustJanet Oct 2019
Thank-you... Hospice nurse is coming out tomorrow. It would've been sooner but there was a mix-up somehow. Yes, it's been stressful becuz I don't wanna feel neglectful & I don't want my Mom to suffer in any way. I've had some good suggestions as to how to get more fluids in her system, so things are improving alittle! Thank-you!
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I wonder if it might be worth checking that her mouth is okay - sensitive teeth, cavities, ulcers, sore gums could all make sugary or very hot/cold things uncomfortable. So would thrush, but I think you'd have noticed that.

What about tea, does she like any sort of tea? It is a mild diuretic, but very mild and it still counts towards your fluid intake.

Cucumber sticks? Or does she like any salad vegetables that she could crunch on as snacks, such as peppers and tomatoes? You'd have to make sure that her swallow reflex is fine, mind.
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JustJanet Oct 2019
Thank-you for your suggestions of the cucumber sticks! She doesn't have any mouth sores & definitely no thrush, but certainly things to consider in the future! She used to enjoy carrot stix & celery, but since having broken her jaw at age 90, chewing some things isn't as easy. I've been chopping up celery & green peppers in chicken to make a chicken salad. Tomatoes & cucumbers are good ideas....why didn't I think of that? I think I'm just alittle fatigued & have alot on my mind! So, thank-you!!
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keep giving her the things she likes.
Don't focus solely on drinking.
Ice cream, sherbet, pudding, custards, fruit, puree real fruit rather than going with juice, she will get more fiber from the pureed fruit and it would be less sweet than most juices. Soup is another great way to get fluids in. Oatmeal, cream of wheat, cream of rice.
If she does think it is too sweet for her then dilute with a bit of water.
Does she drink tea?, coffee?
Focus on what the color of her urine is.
If it is very dark then she needs to have more fluids, the lighter in color it is the more hydrated she is.
Depending on her level of activity she may not need as much fluids as you think she would.
This is a great question to pose to Hospice as well, they may have some great suggestions.
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JustJanet Oct 2019
Hello, Thank-you for your suggestions. I will try the pureed fruit, tho not sure how she'll feel about the texture. I've been giving fresh fruit instead of the store-bought canned, so that's an improvement in the sugar department! She'll drink hot water, as she has no sense of taste, but still enjoys a hot drink. I've been offering that more, as well as soup. I have Rasberry sorbet, but it's too sweet for her, so I'll try the homemade route, for sure, with your suggestion of the pureed fruit. Oh yes....I definitely check the urine as that's a true indicator of dehydration if urine is concentrated! I have a consultation with a Hospice nurse tomorrow, so will be asking for suggestions, as well. Thank-you again for your answer & suggestions!
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Berries, cantaloupe and watermelon are good too.
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JustJanet Oct 2019
Thank-you!! Good suggestions!!
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Good luck tomorrow. I hope they are able to help keep your mom comfortable.

Hugs!
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JustJanet Oct 2019
Hello....thank-you...Yes, a Hospice Nurse came to do an assessment today & we are getting set up! The biggest issue now is getting the bowels to move!
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It sounds like you are doing a great job already and doing as much as you can. I am glad that you have hospice to help out.

Taste buds change. For some swallowing issues are an issue too. Dental and periodontal issues as well. It’s hard to get old.
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JustJanet Oct 2019
Thank-you....been giving it my best shot! Yes indeed....this aging business is for the birds!
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I use ice pops or sponge soaked in water to keep lips moist, received the sponges from hospice.
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JustJanet Oct 2019
Thank-you for your input. Getting started with Hospice tomorrow!
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you can get sponges at a home care items stroe
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Since your mother enjoys jello give her all she wants. Maybe you could use some high protein water to make it with, something that isn't real sweet. Maybe then she might eventually start drinking some. I would ask her Doctor first if that would be ok. Hang in there, I went through the identical situation with my mother a year and a half ago. It is very hard for me too. My heart and prayers are with you. Sherry.
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JustJanet Oct 2019
Hi Sherry, Thank-you for your idea. I'm sorry you had a similar experience with your Mother & I hope you were able to get thru the situation. I've had a consult & assessment with a Hospice nurse & I have a better understanding about the decrease in fluid intake. I'm leaning more towards juicy fruits & veggies...like cucumbers, etc. & I'm not nearly as stressed out about the fact she isn't drinking a big glass of water or something. It certainly is a learning curve & every day seems to be different when dealing with someone who has Dementia. Quite the challenge, for sure. Thank-you again for your caring thoughts.
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If she will drink a hot drink try senna tea. I believe it is sold as smooth move or a diet tea. This will help her have a bm.

How was your first day with hospice?

Are you doing okay? It's a big step and brings a lot of reality to the situation.

Hugs!
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JustJanet Oct 2019
Hello, Thanks for the tip on the tea. I'll look into it! My visit/assessment with the Hospice nurse went very well. We'll be getting started tomorrow...10/14. It'll be nice to have the extra support & help. Thank-you for asking!
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chia seeds briefly boiled in a few teaspoons of water is a great laxative .
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JustJanet Oct 2019
Oh! Good to know! Thank-you!
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