Elderly refusing water? Here’s What to Do

Are you finding it increasingly difficult to get your patient or elderly parent to consume water?

If you’re concerned, you have reason to be. Dehydration is a serious problem for seniors: Dehydrated older adults are more susceptible to urinary tract infections, pneumonia, pressure ulcers, and confusion. The condition can lead to unplanned hospitalizations and even death. 

So, why is it so hard to get elderly patients to drink enough?

Aging research shows it may be all in their head – literally. Over time the hypothalamus, the area of the brain that controls thirst, changes. The area does not produce the same degree of natural thirst response (dry mouth) as a person ages, meaning some older adults do not feel thirsty despite real fluid needs.

If your elderly patient or aging parent is not drinking enough water, here a few steps to take in order to prevent illness or an emergency.

  1. Track the frequency of refusal – In order to understand if the situation is getting better or worse, you need to document how often a person refuses water. If the frequency jumps up from 3 times per week to once per day, you’ll have a better understanding of the severity of the condition. You’ll also be able to trace what could have changed in that time frame to cause further refusal such as a change in medication, constipation, or UTI. 
  2. Explore the situation from the patient’s point of view – It’s critical to find out the reason behind why the patient is refusing drink. Get to know the patient and try to understand why they don’t want to drink water. Common reasons include: being afraid of having to urinate during the night, feeling its too much effort to get up, being embarrassed over a medical condition or lack or coordination and spilling on themselves.
  3. Educate – Try to help the patient understand why it’s important they drink at least some water, and help them work up to drinking larger amounts. Help encourage them by finding creative alternatives to plain water such as fruits, soups, or Jell-O.
  4. Choose an intervention – Discuss the trends found by recording the patient’s activity as well as qualitative information gained from the patient with the entire care team to devise a plan of action.
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One Response to Elderly refusing water? Here’s What to Do

  1. Susan says:

    Excellent information–and creativity definitely has its place. One addition to #3: Flavored water. Flavored water (with no sugar) gave my 86-year-old mother an interest in drinking water again, even though she was rarely thirsty. She knew drinking water was important, she just didn’t find it very tasty. That said, there was an easily accessible cold pitcher of flavored water at the ready (we kept it refilled). Drinking enough water was not a problem after that.

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