Symptoms of Dehydration in Dementia Patients

October 13, 2016
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As dementia advances, it’s difficult to ensure that those living with dementia are eating and drinking enough.

Monitoring fluid and food intake, and planning visits around meal times can make sure patients stay hydrated and eat well. Prevention is about knowing the signs and symptoms of dehydration and malnutrition.

Symptoms of Dehydration

The ageing process reduces the ability to sense thirst, and it’s accelerated with Alzheimer’s disease and other forms of dementia.

This is because the kidneys become less active over time, and they are responsible for producing the hormonal response to dehydration.

Monitoring the fluid intake of patients is key to preventing dehydration.

A carer assisting a dementia patient with drinking water

Common symptoms of dehydration are muscle cramps, dry mouth, lips and tongue, sunken eyes, dry, inelastic skin, drowsiness, confusion, disorientation, dizziness, low blood pressure, and darker urine. As a general rule, the paler your urine, the more hydrated you are. Be aware that dehydration symptoms could also indicate other conditions.

Dehydration leads to increased hospitalisation and mortality rates. This is because dehydration leads to lowered blood pressure, weakness, and dizziness increasing the risk of falls in elderly patients.

Even mild dehydration affects mental performance and alertness. Dehydrated dementia patients experience effects on memory, attention, concentration, and reaction time.

elderly woman looks concerned

The following common factors can lead to dehydration in dementia patients:

  • The natural ageing process
  • Living in long-term care facilities
  • Needing help with foods and fluids
  • Incontinence
  • Cognitive impairment and confusion
  • Inadequate numbers of care staff
  • Poor staff training on dehydration
  • Depression
  • Medications particularly diuretics and laxatives
  • Decreased thirst
  • Diarrhoea and vomiting
  • Acute illnesses like colds

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Symptoms of Malnutrition

It’s common to hear families talk about their loved ones losing weight when they go into a care facility. In fact, 45% of people living with dementia experience significant weight loss over a year.

And over half of those living in care don’t consume enough food.

Malnutrition happens when you don’t eat enough or you’re eating things that don’t give your body what it needs.

People living with dementia often forget to eat, lose their appetite or are unable to feed themselves.

Common symptoms of malnutrition in dementia patients include changes in mood, weight loss, frequent colds and infections, tiredness, dizziness, and difficulty keeping warm.

A woman with dementia induced paranoia

A body mass index of less than 18.5kg/m2 or unintentional weight loss greater than 10% within 3-6 month suggests malnutrition.

The definition is a little different if someone’s body mass index was 20kg/m2 before weight loss. Malnutrition occurs if they experience unintentional weight loss greater than 5% within 3-6 months.

It’s important to investigate weight loss because it can indicate other underlying health problems.

High-calorie foods including milk and cheese, avocados, creamy soups, nuts and seeds are a great way to help someone put on weight. Dishes like shepherd’s pie with creamy mash potato are good ideas. And they’re easy to eat for people who struggle.

Finger foods can also be a good idea for dementia patients who struggle with hand-eye coordination.

If the case is particularly serious, a doctor can prescribe fortified milkshakes.

An elderly woman drinking tea and playing cards in a care facility

If you’re worried about someone living with dementia, talk to their GP, healthcare visitor or carer and discuss ways you can make sure they are eating well and drinking plenty.

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