Why do elderly people refuse to drink sufficient fluid?

[Disscombobulated]

I care for my FIL, who lives with us. He has a number of complex medical issues, the most recent being kidney failure and the a UTI.

Despite years of nagging I simply can’t get him to take in sufficient fluids to stay hydrated. He is perfectly lucid (most of the time) but can’t grasp the concept of water improving his quality of life. I have tried literally every angle of discussion… including having pretty brutal conversations about him, his clothes and my house smelling because his urine is so concentrated. He just doesn’t seem to care, or have any respect for me who is dealing with the consequences, such as hospital admissions, clearing up after ‘accidents’ and all the additional cleaning involved.

numerous medical professionals have told him that he must drink 3L a day.

I am now at the stage where I am so frustrated that I don’t know if I can continue to do this.

Any advice would be appreciated, or do I simply let it go and let the worst happen?

You can't make him, unfortunately. Just keep telling him much as you are. Get any healthcare professionals to also speak to him.

If he has had problems such as urinary incontinence or sudden leaks then it could be that he is scared to drink that much fluid. I know my elderly mother probably falls into that category.

You make sure he has water within easy reach. Unfortunately, you can lead a horse to water but you cannot make it drink.

For some people it's fear of incontinence/accidents. Also forgetfulness. Also thirst signals working less well in old age. And bloody mindedness probably plays a part for some people.

With my Gran it helped just to have water around so she remembered to drink it and going to get a glass of water wasn't another task sh ehad to do- carafe by the bed and by her chair etc.

Why on earth does he need to drink 3L of fluid a day? That’s a ridiculously high amount for most people. Can he have a couple of extra cups of tea or something to help sneak it up?

My Nan is 98, in reasonable health but does get frequent UTI’s and they can send her loopy lou for a few days. She says she doesn’t like the taste of water and can’t be assed having to go to the loo. We nag her about it regardless, but it’s in one ear and out the other.

My elderly grandparents do this because it’s takes so much effort for them to get to the loo. They’re unsteady and worried about mobilising to the bathroom so often, especially in the night. So they limit how much liquid they drink. Understandable.

Similar issue with my mum who is 89. I think it stems from a few things. Her generation were not particularly conscious of the need to drink a lot of water. If I give her a glass she drink a few mouthfuls and throws the rest away. Added to this that she sometimes wants to reduce her frequent trips to the WC if we are going out somewhere. I'm not sure there is an easy solution, other than to keep a close eye on fluid intake and make lots of drinks.

In my DM's case she's not very mobile and also has a weak bladder, so doesn't want to keep getting up to use the toilet, or worse, not get there in time.

Not drinking doesn't seem to be doing her any harm though.

Toilet upstairs? My MIL avoids drinking so she doesn't have to go upstairs. She's had multiple UTIs and hospital admissions all down to lack of water. But she will not drink more, we've bought special jugs, lightweight kettles, squashes of every flavour imaginable but she will not drink enough.

It could be he's worried about having an accident and is reluctant to drink because of this??? Also the older they get the more stubborn they become. There is something called jelly drops (I think) they are special hydration sweets. Look and taste like sweeties but are very hydrating

I’m guessing that they try and avoid drinking because it leads to the possibility of having an accident or that going to the toilet is difficult.

Do elderly people have a higher water requirement than younger people ? I struggle with 2 litres and would only get close to 3 during a heatwave.

With mine it’s because they’ve never drunk water and making a cup of tea is too much bother. A lot of elderly people were never brought up drinking plain water due to handed down beliefs (probably from their grandparents who might have witnessed typhoid outbreaks) that it was unsafe to do so.

Everything @Birdist said. Coloured squash, kept nearby at all times helps some older people to remember to drink. As an analogy , if you had a long term minor injury so it was uncomfortable to go to the toilet, plus you don't feel thirsty anyway, would you drink more than your body was telling you to?

Ultimately, I think you need to redefine "nagging" in your mind. Broken record technique might help here - you might say "drinking time!" in a bright and breezy way each time you walk past.

The "accidents" are why he does not drink enough. He does not want to pee himself so restricts fluids.

My parents are not water drinkers it's the running to toilet thing I think , they will drink tea ,and squash with their dinner, my stepfather has kidney issues so he will drink fizzy water but a bottle can last till it goes flat! I don't know the solution sadly my friend works in a care home and they give their residents jelly and hydration "sweets" because of the drinking issues.

Also, high liquid content food like cucumber, ice lollies all count towards water intake.

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!

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

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.

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?

Maybe he doesn't like the taste of water?

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.

What does he drink ?

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.

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.

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.