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 think the culture of constantly drinking water, having a water bottle next to you, is a generational thing. Even people in their mid 40s weren't brought up to have bottles of water and to drink two litres a day etc.
My elderly mum finds water very boring but does like tea and soup.
It could be to do with a medical problem with swallowing also?
Not to mention bladder weakness and incontinence which might discourage someone from drinking.
Just offer interesting liquids. Even ice cream is liquid of sorts!

@Disscombobulated is he dribbling in his trousers to make your house smell?? are his trousers stained and does he bathe or shower regularly?

This is extremely common (have worked for years with elderly). The main reason I have found is that they don't want to have to go to the toilet; for various reasons e.g. poor mobility, worried they will wet themselves if they drink more or are just lazy and can't be bothered. Also, they come from a generation where people drank with meals and didnt constantly drink all day long like folk do now. They simply aren't used to drinking all day long - no carrying water bottles around with them when they were younger. They don't realise that they need more fluid as they age. Medications can mean they need to drink more, or their bodies don't metabolise as efficiently and they can be prone to constipation and UTIs. 3L seems excessive though and drinking that much could actually be dangerous and disrupt electrolyte balance.

Because he has had kidney failure through dehydration I guess. Unfortunately he doesn’t drink Tea or Coffee, I can occasionally tempt him with a hot chocolate, but that is rare.

He can get a lot of fluid from food - soups, stews, fruit, herbal teas...

This is a contentious subject.
My late husband's grandfather died because he was not given enough water after an operation.
My parents complained that they were "up all night" going to the loo, after drinking the local mineral water I provided, when they stayed with me.
Where I live, it is normal to drink bottled mineral water, I drink between 2 and 3 litres per day.
If you are in the UK and have to drink heavily chlorinated tap water, I can completely understand why this would not be so appealing.

This is what I thought to be honest. My mum is 94 and has dementia. It’s very difficult to get her to drink water and the advice from continence services is a limit of 1.5 litres a day - which is enough to keep her hydrated, so her urine isn’t concentrated and kidneys are functioning normally. it wasn’t all recommended as water intake either - tea, fruit juice and whatever else she drinks all counted. Three litres is too much in my opinion and it’s no wonder he’s distressed.

So he never drinks anything?

not many older folk at all need 3L of fluid a day. That much fluid (any fluid, but particularly water) could in fact be quite bad for the average older person. Gents of a certain age also suffer with their prostates a bit more than the average MN'er and if you're up to the loo every hour every night because you've drunk what your younger, prostate-less relative thinks you should, then life becomes pretty miserable.

There are ways to get fluids in that don't involve drinking loads of water though. Fruits like watermelon or vegetables like cucumber are good to add in. Juices and flavoured waters would be better than nothing (although obviously not healthy). But I'd try the food route as well. Ice lollies can be helpful, tinned fruit where you serve the juice that the fruit came in with the fruit. Even jelly and ice cream gets some fluid in.

There must be some kind of liquid he likes - cuppa soups, fizzy drinks, fruit juice, squash, sparkling water, flavoured milk? It really doesn't matter what it is.

Unfortunately he does dribble, and have the odd accident - this is no big deal and I always tell him it’s not a problem - the problem is that he is so dehydrated all the time the urine smell is much worse than it should be. He wears incontinence underwear.

The washing is another battle - I expect him to shower every day, he can manage to do this just fine but is profoundly lazy, and sometimes skips it if he thinks he can get away with it, or doesn’t use and soap. Likewise hand washing is a constant battle.

Only whisky I am afraid and he really isn’t allowed that!

He needs to drink at least 1.2 litres of fluids a day - not 3L!

Will he drink a beer a day?

I buy jelly drop sweets for my dad to up his fluid a little. They are 95% water. You will find them if you google jelly drop sweets for the elderly. Dad happily has a couple of packs a day.

Really helpful, thanks hadn’t considered water dense foods although he does have fruit every morning. I guess soup might be helpful too.

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

i'd be questioning that strongly. It is way too much.

So he won't eat or drink anything liquid - at all? No stews, ice-cream, sorbet, salads, roast dinner with lots of gravy, pasta with lots of sauce, casseroles, watermelon, fruit salads, veggies like cucumber? Nothing?

He knows the risks and consequences of not drinking enough. It's his choice what he does. So yes, I'd say let it go and let the worst happen. You can't change him, he has made this choice.

He has had kidney failure….beer would not be wise and the medical staff all say 3L! I suspect that this is in the hope that he might manage 1.5, but the reality is that he often doesn’t.

My grandmother was the same.
She would drink tea ( with milk ) till it was coming out her ears but disliked water.

Why do young people group elderly people together as one amorphous lump?

Nope - right next to his ground floor bedroom.

They are very scared of liquid! In some cases they were told that for example drinking liquids with meals would ruin their absorption of nutrients, almost watering the goodness down. I am 52 and when I was at junior school we were not allowed to have any kind of drink with our lunch.

My father in law cannot understand when we take him for breakfast why they bring a drink out first. We now have it brought after he has finished his food as he will not touch it before.

tea is fine. any watery food or drink is fine.