I found your site on the internet and thought I’d ask a few questions about my aging mother who lives in a nursing home.
She is 89 and has had mini strokes but still remembers us. Her appetite is poor and she has never been much to drink water — only a little coffee and juice and her Ensure.
She is on a low-dose anti-depressant and a small dosage of Morphine for back pain which is administered only once in the morning.
She has suffered pneumonia twice in two years but managed to recover.
Lately I noticed some more drastic changes with her … her face looked more swollen yet her ankles and wrists and calves and under the arm muscle were not swollen, she was imagining she was holding something in her hands and was trying to put it into her mouth (it was a plastic bib from McDonald’s) and she made rude/mean remarks. Yesterday my sister went to see her and she was yelling at her, “Leave me alone or I’ll kill you, I’ll kill you” and she spat out some food and was really very caustic and then demanding to be taken home and kept saying I’m not crazy.
A friend at work said her mother was acting similarly to this and they tested her blood and found her potassium and electrolytes were extremely low. I have read up on both of these tonight and I do see that as people age they do drink less and less fluids and it ultimately brings about heart congestion, pneumonia, infection and renal failure.
I have asked my sister to get the Dr. to check my Mom’s blood and look into this.
Does my “homework” and “advice” seem correct to you and is there anything else you can suggest?
You describe your mother as: “Her appetite is poor and she has never been much to drink water … only a little coffee and juice and her Ensure.”
Nearly everyone gets about half of their daily water requirement from solid foods and fruit and vegetable juices. But, as you discovered, seniors often have a reduced appetite and sense of thirst. This can lead to dehydration, one of the most common causes of hospitalization after age 65. Early warning signs include persistent fatigue, muscle weakness or cramps, headaches, dizziness, nausea, confusion, forgetfulness, deep rapid breathing or an increased heart rate.
My mother, like yours, had a reduced appetite and drank very little (only small sips) despite having a dry mouth. As a result, she was hospitalized 4 times in 3 years for dehydration.
More Signs of Dehydration:
- Dry or sticky mouth; bad breath
- Low or no urine output; concentrated urine appears dark yellow
- Dry Skin
- Fever and Chills
- Lack of tear drops
- Sunken eyes
- Lethargic or comatose (with severe dehydration)
The treatment? Rehydration via IV fluids for 2 days. After she returned home each time, we did have some success with getting her to drink Gatorade (Tropical Punch) to help maintain a healthy balance of potassium and electrolytes, Ensure to increase her nutrient and calorie intake, as well as apple juice and other sweet beverages. We also encouraged her, with her hearty approval, to have sweet desserts such as ice cream, pie (fruit pies are the best), or cake every day at lunch and dinner.
The most important next step is to have your mother examined by a doctor ASAP. If she is dehydrated, she won’t last long without being hospitalized. With prompt care, many of the drastic changes you’ve noted can be reduced, or eliminated entirely.
More Dehydration Tips:
- Attach a bicycle water bottle holder to your loved one’s walker, rollator, wheelchair, companion chair or power chair to enable them to carry bottled water with him/her. They are available in Walmart as well as bicycle shops.
- If your loved one won’t or doesn’t drink water or Gatorade, try Metamucil. Not only will it add water to help avoid dehydration, but it will also add fiber to help overcome constipation.