Why do elderly people refuse to drink sufficient fluid?

For GMIL and GP it's been about ability to get to the loo. As their mobility got worse, getting to the loo became a task (even with walking aids, downstairs toilets, sticks, grab rails ect). Drinking more usually means more trips to the loo. GMIL also started having accidents which then involved more clean up for her so drank less to avoid having to go more often.

There is also habit involved. Drinking water as well do is pretty new. Many elderly people drank only tea or coffee and an odd glass of squash. I remember in the 90s, we had 1 drink at lunchtime and a whole school water fountain. Only on very hot days was the water fountain used. We generally only drank at meal times. My DD on the other hand takes a water bottle to school every day, has a drink with lunch and comes home and has a drink.

I know in GMILs care home they make all residents cups of tea, coffee or hot chocolate every couple of hours and if they don't want a hot drink then they are ordered squash or water instead, there are always lots of jugs of squash about in the general rooms and also most residents rooms have a jug of squash in them. They are encouraged to eat yogurts and there is always a soup served at some point in the day. They also have those hydration sweets. The carers encourage regular toilet trips to reduce accidents and most residents are wearing continence pads to try to reduce embarrassment from accidents. The toilets are well equipped with lots of mobility aids and just to the side of the communal rooms so it's not too long a trip for residents with mobility problems.

This man has kidney failure and gets UTIs.

There are jelly drops that you can buy, intended to hydrate the elderly, but they can be quite expensive.

Oh, I feel your pain, OP. My elderly DF was just the same. He was having chemo and he needed to drink, but he just wouldn't. I bought him a water bottle with markings on the side and suggested he sip it throughout the day, so his main intake would be done by 5pm and wouldn't affect him at night. Nothing worked. Nothing. He did not want to drink. I mean, he drank a bit, but nothing like what he should have been doing. Nothing we did or said and no amount of explanation made any difference.

I did give him some rehydration powders in water, some berry flavoured ones, which helped a little. And if he likes a cup of tea, give him decaf. The Marks and Spencer own-brand decaf in the Tiffany blue box is the best one I've found.

You can get him a water bottle to keep by him, you can give him rehydration powders, you can do the decaf tea, and you can remind him a handful of times through the day, but then you have to accept it. If you don't, that way lies madness and despair. Ask me how I know.

Sympathies xxx

What is all this about HAVING to drink lots of water anyway? We can all check for signs of dehydration (which is not only thirst), google it.

Over consumption of water can be very dangerous, as it can lead to electrolyte imbalance and hyponatraemia - low sodium. That is far more dangerous than not drinking gallons of water a day!

A few glasses of liquid is fine, but unless you are an athlete normal consumption will suffice.

Are the conversations with him a dialogue or simply you telling him what he ought to do? Has he been able to tell you why he won't/doesn't want to increase his fluids? 3 litres a day seems a lot so perhaps you could just look at ways to drink a bit more, even if he doesn't reach that target. If he's already having accidents he will be worried about having more so is there anything that can be done around that - proximity of toilet and ease of use?

3L is a lot, but I too have noticed my mum (approaching 80) not drinking enough. She always used to have regular cups of tea and coffee and an occasional squash or water with some meals. Now she actively refuses drinks when offered at times she’d normally have had one, eg a mid-afternoon cup of tea. It’s not the bother, as I was going to make it for her, she’s not having accidents, and she has a downstairs loo so not the effort of going upstairs. It seems to be a stubbornness and a loss of awareness of normal drinking (that is, what she’d normally have drunk a few years ago).

I’ve tried just making a drink and putting it in front of her, but she only has a sip or two. I’ve tried tempting her with a few salty crisps then offering a drink, but she still refuses. I think her sense of thirst must be affected.

I don't know if you'd class me as elderly (probably, I'm 70) but I don't WANT 3L of water a day. I'd be awash

I can force myself to drink more sometimes, but I'm really not that bothered.

I do think it's a generational thing. My FIL has never drunk water- he only drinks coffee or alcohol. My DM only drinks tea, and my DF has a glass of warm water when he gets up in the morning, and will have a glass of orange squash in summer if it is 90 degrees but other than that he sticks to tea and beer. I remember as a child in the 70s we went all day without a drink- we had a drink for breakfast but nothing else at school until lunch-time where water was offered, but rarely did we drink it and then we had a glass of squash after school, a cup of tea with dinner and a glass of milk before bed. I don't remember being dehydrated though!

My mother and my mother in law started restricted their fluid intake when they became less mobile because they were worried about having to keep going to the toilet.

I should add that I would never drink 3L of water in a day. That's a huge amount. I'd maybe drink half of that plus tea.

I think there are a few reasons.
I am in my early 70s. When I was growing up, people were just not aware you had to drink so much water. We just had a drink of water with meals and an occasional cup of tea or coffee. Some people did have quite a few cups of tea and coffee though. Nobody carried a water bottle around with them. You would have got a strange look.
Old people do simply not feel as thirsty or hungry as they used to.
Although some old people like having cups of tea/ coffee they find it a bit of an effort to make it. My mother only has one hot drink a day as her carer makes it for her.
There is also the problem of having to get up and go to the toilet as that can be quite an effort.

3 L sounds like an awful lot. I think I'm doing well with 3 cups of tea, a coffee and a glass of water. My mum never drank a glass of water in her life and still managed to get to nearly 100.

Decaf tea, soup, hot chocolate, squash…

And I find I drink much more when I suck, so try a straw or a beaker with a mouthpiece.

If he’s frail he may struggle with coordination, so the Stanley cups with handles and a lid woul be reassuring.

I also have CKD and I can't drink 3 L of water so I'm like you and get it here and there,

Does he drink tea or coffee? That'll do for liquids, just offer more of it. And yogurt and milk, and ovaltine and lots of stuff. 3 litres a day of water only is not something I would relish either but I drink a lot of tea, coffee, and eat a few yogurts a day.

My father is like this. He had a stroke and as a result is somewhat incontinent, his mobility is poor and, as far as he’s concerned, the less physical activity he does, the better. He would stay in bed all day, every day, if he could get away with it. So drinking less means fewer trips to the loo.

My parents are v mobile and late 70s and are astonished at how much water I drink.

Speaking to my mum, she has never been offered vaginal oestrogen and so might have the urinary issues that come with being post menopausal, whereas most people I know in late 40s use vaginal oestroegen to strengthen the bladder.

My dad had bladder cancer in his 60s and the radiotherapy damaged his bladder, meaning there wasn't enough capacity to drink vast quantities. He needed the loo every 20mins or so until he had an op to deal with this last year.

So there are more reasons than not just disliking the taste of water.

What does he drink ?

I have chronic kidney disease and find it difficult to drink enough fluids. Your fluid intake doesn’t necessarily have to come from water. It can come from things like foods with a high water content such as celery, tomatoes, melons and things like ice lollies. Try upping his fluid intake in other ways. There is lots of advice online.

Maybe he doesn't like the taste of water?

Habit most likely - you’re trying to change the habits of a lifetime. Takes time for the healthiest most motivated people to make a change. Go easy on him.

What can you do to make it easier? Jug or water bottle nearby? Set an alarm to remind him every so often? Habit stacking?

That’s a lot of water. Elderly people aren’t of the generation where you are meant to be drinking water all the time, if at all. My elderly parents never drink water.

Have you tried drinking large quantities when you're not thirsty? I tried when I had a kidney infection and it's incredibly hard.

I think in a lot of cases, it's purely because they worry about getting to the loo in time and so often.

But also consider this is a generation bought up on tea. I know it sounds silly but everyone drank tea, and a cup of tea cures all! They probably hardly ever drank water.

I grew up in the 90s and think I probably lived in a state of constant dehydration! You went out to play and you didn't come back, sometimes if you were playing in the street, someone's mam might call you for a quick glass of squash but otherwise you just quietly died of thirst!