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?

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

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.

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.

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.

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.

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 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!

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.

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.

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?

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.

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

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

This man has kidney failure and gets UTIs.

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.

My Aunt has dementia and I know her family struggle to get her to drink anything it's a sip of this or that, she is mobile so pours drinks down the sink saying she's finished,

Three litres a day is bonkers.

Obviously it’s to avoid the accidents.

Fair enough, but does he need 3 litres of the stuff every day? If the hospital/medics think so and he is not doing it, then he should have a drip every so often I reckon to help his condition. I am sure there are ways around it other than forcing an ill man to drink that much if he doesn't feel like it, or doesn't want to. It's one thing drinking lots of water by choice but it's quite another if one feels forced to do it.

I'm in my 70s, active and go out most days but I restrict my fluids unless I know for a fact that there will be public toilets available that are clean and easy to find. I squeeze out every last drop on the loo at home and can then go for about 5hrs without a pee as long as I don't drink anything! Yes, I know it's bad for me. In the evenings I don't drink because I'm fed up with getting up twice in the night to pee - where does it all come from?! I don't know what the answer is tbh 🤷

https://www.jellydrops.com/

3l?!?!? Fecking hell!! Op now I’ve had four kids and am 44. I am rushing to the toilet constantly after one litre and dreading going for the 2! I’d guess when you can’t rush to make it to the toilet life is all forms of hell. Blown away by 3l- surely they can do something better than that?

ps sorry to ‘when I was young’ you, but when I was young everyone just drank the odd glass of tap water, it was mostly milk and tea. There’s got to be a middle ground between the ridiculousness now. (Oh god I’m old and grumpy amn’t I?!?!?)

As you get older, it gets harder to recognise thirst.

You also have the issue of mobility (and getting to the toilet in time) and incontinence - many people would rather not drink than risk having an accident.

I would focus more on foods with lots of liquid - soup, stews, pasta with sauce, roast dinner with gravy etc, or even things like ice lollies. Drinks-wise it doesn't need to be water - tea, coffee etc. are all fine too.

You could get him a urine bottle like they use in hospital if he's afraid to get to the loo in time .

Please don't make him drink water. What does he enjoy drinking? Give him that. Squash, juice, tea, coffee, lollies, soup, salad, sorbets, fruits, milk even a shandy would be great.