Nutrition Tips

Practical Strategies to Increase Hydration in a Person with Alzheimer’s Disease
Drinking enough fluids every day is very important for good health. Not getting enough fluids can increase one’s risk for complications such as dehydration and constipation, but getting persons with Alzheimer’s disease (AD) to drink the recommended 6 to 8 cups of fluid each day can be difficult. At times, persons with AD will refuse to drink, but all difficult behaviors can successfully be managed by using creative strategies.
Here are some practical strategies for caregivers to try:

1. A good basic approach to caregiving for a person with Alzheimer’s disease is to anticipate needs before they occur. Set a daily schedule for eating and drinking. In the case of hydration, identify key times during the day that offering fluids fits naturally into other types of activities. For example, before and after taking a walk, sitting down to watch a movie, enjoying an afternoon on the back porch are all times that offering fluids makes sense.
2. If your person with AD tends to wander during the day, try offering fluids with lids so that he/she can continue to walk but may be cued to take a drink of fluid from time to time.
3. You may need to consider simplifying the environment at mealtime by removing excess dishes and plates, leaving only the main plate, a utensil and a glass for fluids. Changing the environment in such ways helps to decrease the distractions at mealtime.

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Try a new flavor to an old drink by splashing some fruit juice in a glass of water, adding lemon or sliced cucumber to water, or serving a flavored, decaffeinated tea. Try adding fruit ices, popsicles, and gelatin desserts to the diet.
Getting a person with Alzheimer’s disease to drink 8 cups of fluid each day can be achieved if you offer and encourage fluids throughout the day instead of only at mealtimes. Keep a bottle of water near a favorite chair or in the car to remind you and your loved one to drink more often.
The World Health Organization (WHO) developed an oral solution containing sugars and salts to improve absorption and prevent dehydration. This solution can be prepared at home by mixing the following:
• Table Salt – 3/4 teaspoon
• Baking Powder – 1 teaspoon
• Sugar -4 tablespoons
• Orange juice – 1 cup
• Water – 1 quart/liter
Treat your self and your loved one to a special milk shake or root beer float as a special activity that is fun and also provides a good source of additional hydration.
Drinks that are too cold may be uncomfortable, so try a glass of fluid that is slightly cooler than room temperature, but is not icy cold.
Eating and drinking is a social behavior so drink a glass of juice or water with your loved one during the day. He/she may model your behavior and you also need to be sure you are staying hydrated!
Offer a small cookie or cracker as an incentive to also drink a glass of water or juice.
Sometimes difficulty drinking or swallowing can represent a medical issue. If the problem persists, or if there are signs of dehydration (dry mouth, nose, and skin, light-headedness, low energy, fainting, low blood pressure), go see a physician.
Encouragement, Patience, Cueing are the keys to keeping a person with Alzheimer’s disease eating and drinking. It may only be a few bites and a few drinks at a time, but being patient and continuing to try new strategies will pay off!

Core Principles of Care: Safety, Comfort, Respect, Autonomy

For more information about how Alzheimer’s disease affects nutrition, consider purchasing LightBridge Healthcare Research, Inc.’s interactive educational CD-ROM: Volume 1: Managing the Difficulties of Mealtime