It’s difficult enough to get most people to stay hydrated. Many people live in a perpetually dehydrated state.
Dehydration can cause cognitive sluggishness and fatigue, and lead to weight loss, constipation, diarrhea, and in extreme cases, death. It can also prevent pressure injuries from healing properly.
What is a concern for the broader population can become dire for people living with cognitive decline, such as dementia. This population, often physiologically diminished to begin with, commonly have sensory and motor challenges that make proper hydration difficult. In fact, figures presented at a Royal Society of Medicine (RSM) conference in 2014 showed those with dementia were six times more likely to be dehydrated.
“Some common physical and cognitive issues create challenges for maintaining hydration for those with dementia,” says Dana Fillmore, Gordon Food Service Healthcare Segment Manager. Those issues include the inability to recognize beverages; difficulty with coordination and swallowing; the inability to recognize thirst; taste and smell changes that can affect food and beverage preferences; and just forgetting to drink.
The extent of those issues depends on the state of dementia, Fillmore says. Medications—for instance those that correct edema (swelling due to fluid accumulation)—are diuretics and exacerbate dehydration and increase the need for fluids, she adds.
Late in 2016, Fillmore conducted a presentation and asked Gordon Food Service healthcare customers to brainstorm ideas for hydration. The group’s ideas fall into two basic categories—at meals and between meals. The recurring theme: More is always better, and staff plays a crucial role in persuading residents to consume hydrating foods and beverages.
Mealtimes present a good opportunity, three times a day, to make sure residents are consuming enough liquids. Most residents are in one place, and staff can circulate the room to provide beverages and offer assistance in serving and consuming them.
The course of the day also offers ample opportunity to persuade residents to drink up. Among the options:
Overall, then, the message is clear. Suggest and offer liquids and hydrating foods to memory care residents whenever possible. Help them consume these foods, if they need help. Whatever extra time and care it takes is worth it in order to help avoid the devastating effects of dehydration.
Signs of dehydration are subtle even in healthy people. In those with dementia or diminished health, the signs of dehydration can be even more difficult to spot. According to the Cleveland Clinic, here are the major signs of dehydration:
Left unchecked, dehydration can cause urinary tract infections, skin breakdown, confusion, fatigue and even death. The lesson: The best time to hydrate is well before these signs appear.
In addition to offering hydrating fluids and foods, caregivers can use additional methods to help memory care residents stay hydrated, says Amy Gautraud, Gordon Food Service Nutrition Resource Center Manager. Among those options:
Several cognitive and physical challenges can prevent those with dementia from drinking and eating enough fluid-containing foods, says Fillmore. Among the reasons:
As a result, staff assistance in reminding memory care residents to drink and offering help where needed, can be crucial in keeping this population well hydrated.
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