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?

Maybe it depends where you lived. I was never brought up to drink loads of water and certainly never carried water bottles around with me. Although everyone brought a packed lunch to school (primary and high school), no one brought a drink with them. If you were thirsty you had a sip from the bubbler and that was it.

Would he drink milk? Milk is better for hydration because it stays in your system longer. You can get those hydration sachets I got some for my daughter after a bowt of vomiting. You can also get jelly hydrating drops for.

We had a rabbit that didn't drink a lot of water. But vet advised to give him lots of veggies that have water in cucumber etc and he got most his fluids from that. Fluid foods like soup and yoghurt as well.

Jellydrops.com. Bloody expensive but designed for people who do t like drinking fluids.

People with an active stoma can have very high fluid losses and do need lots of fluid to make up for that.

Most people don't have stomas though, and have kidneys that are perfectly capable of doing their job of concentrating urine. Anyone drinking three litres of expensive mineral water a day is literally pissing away money.

There was glasses of water available at my infants and junior school. Any other time we had a drinking fountain in the toilets in infants. In juniors it was a tap in the toilets that said drinking water next to it.

This company make a sweet for dehydration. It was developed by someone who was devastated that their Nan ended up in hospital with dehydration. They are 95% water.

I used to buy them for my Dad. They are expensive, but did the trick when I was struggling to get fluids down him. If you do a little research you may find some things on the market that are a bit cheaper.

www.jellydrops.com/

What I also found with my Mum was a small glass that she could gulp down (not the best way to drink water but needs must) and I could make sure she drank it. So she would have lots of little glasses throughout the day. Sometimes a big glass of water they forget to pick it up and sip.

Good luck because it is not fun and a constant battle.

I don't think that is true of all elderly, I drink water all day, always have a glass full and when it's empty, I fill it up again. I love water.

A few glasses of alcohol FREE beer twice a day will do it! Add lemonade for a shandy. Why not try that if he enjoys a drink but is not allowed it because of his illness.

Have been through this with MIL, who lived with us. Same. I was so exhausted with the anticipation of imminent hospitalisation, hospitalisation itself, then discharge after an insufficient course of IV ab, with a subsequent re-admission, because the infection (surprise, surprise, was deep-dwelling and the 5 day IV ab course was not enough) that all I wanted to do was to get a good night's sleep. In the end I just begged, went to her room and begged her to have a drink and my dc helped me with it - when I was away working (I travel a lot), they would make sure they would ask her to have her 2L a day (in addition to coffees, teas, etc.) She was not always able to get to the toilet fast enough not to have a few drips, hence nappies at night. Basically, she would not have done it by herself, myself and my dc ensured she did it, by begging.

Brilliant idea, I wish I had thought of that with my MIL, but I did not.

I think you have to do it by stealth OP and let's face it a swig of cold, plain water isn't all that appealing. I'm not in the UK but are there low sodium versions of Bovril, Cup-A-Soup type things?
I've googled a bit but I'm too tired from my own elderly mother's teeth drama to do deep research tonight. (See elderly parents threads passim - in the style of Private Eye.)
I think you will, through trial and error hit on some way to get fluids into him. Even cooked vegetables? My 84 year old mum has a fascination which borders on a fetish for runner beans.

Good luck and let us know how you get on.

OP I have similar issues with my 87yo DM - she is prone to UTI which may (although no confirmation) stem from dehydration. She has a few cups of strong tea a day, rarely any water more than a few sips. She will drink juice though. When I am with her, I give her squash which she will happily drink.

It is all the reasons pp have said. At that age, it's very hard to change the habits of a lifetime. She doesn't drink much water because ..

1 - she doesn't move a lot and doesn't get warm (always cold) so doesn't often feel thirsty
2 - she has always drank tea primarily
3 - poor mobility and energy, so reluctant to have lots of toilet visits
4 - she doesn't really believe it's necessary (different from your case)

I am 49 and grew up drinking Ribena - consciously drinking water became a thing in mid 90s when I was at uni (and had dozens of fillings by then!). But I think carrying around water bottles came later really.

you need to get your husband involved here. it is his father after all. what about the chair he sits in, does it have a waterproof covering on it and is it washed every day. does his bed have a waterproof matress protector on it? get him a load of trackie bottoms and make him change in the middle of the day, dh has to force him into the shower and just tell him he is stinking!! I had a patient that refused to take a bath, stating that he had one last month! we had to force him into the bath to give a good wash and put clean pyjamas on him before letting him into the hospital bed! he stank to high heaven!

This is great - the 0% Guinness is great, and I know he would enjoy it.

It’s often the case that they’re anxious about leaks, and/or getting to the loo on time, or at all, if there are mobility problems.

Hardly any of the residents in my DM’s care home would drink plain water, so in addition to tea and coffee they were given small glasses of weak squash throughout the day. Plus there were plenty of ‘watery’ foods - soup, stewed fruit and custard, jelly and ice cream, etc.

In the 90s, are you sure? There wasn’t any water fountain at my school, so we all brought our own big water bottles (in the massive Head sports bags that were in fashion then); and there were vending machines all around the school flogging drinks cans and water bottles! All the girls’ magazines went on and on about drinking 2L of water every day for your skin so you didn’t get spots. There was definitely a water bottle culture in the 90s. Some girls took to bringing water in giant 2L fizzy drink bottles wrapped up in plastic bags to keep it cool. And this was a Northern comprehensive in an area that wasn’t noted for being particularly fashion-forward 😆

Anyway, the poor OP’s relative doesn’t care about all that, sorry for derailing the thread!

They don't want to pee and the amount of anti diuretic hormone decreases as you get older so you are less aware of not drinking enough, frustrating I know!!

You can also get alcohol free shandy as well, which he might like. And the idea of warm/hot Ribena is a good one too.

it really depends on the 'kidney issue though' -there is no such thing as a 'standard' fluid intake. Acute and chronic renal impairment have different needs. Pre-renal, post-renal and renal causes of impaired kidney function have different needs. Patients with really naff kidneys may in fact be fluid restricted to around 1L a day.

3L/day is a starting point quoted in basic medical text books for an average sized healthy man, but in reality a person's fluid requirement is based on their weight, other co-morbidities (heart failure often goes with renal impairment in older folk and that can really complicate things), electrolytes, medications and fluid output (which is where your stoma is clearly significant). In reality, 3L of water a day would be enough to render a lot of elderly people hyponatraemic, fluid overloaded and really unwell.

I'm fairly old now, always been an under drinker and recently passed a very painful kidney stone. I need to drink more. What I've found works for me is one of those large glasses with a lid and wide straw in it. When the water is room temperature I can drink a fair bit without too much trouble at all, much harder when it's chilled.

The lid stops the cat sticking her head in, not sure if she ever uses the straw though.🐱

I think I've just had an epiphany here. Is this why so much hospital food is sloppy? Were they trying to get fluids into us without us noticing it in our weakened state?

Habit. My b. 1933 mum drank four to six cups of tea a day. That’s all. She (TMI) pee’d maybe twice a day.

I recall her laughing about a prospective buyer for the house next door she watched from an upstairs window; got out of his car to greet the agent, walked to the door- then raced back to his car to get his waterbottle. For a 20 minute visit.

In the 60s we had 1/3 pint of milk to drink between 9-3.30 at school, and maybe one glass of water with lunch.

Older people just aren’t accustomed to modern water intakes.

Can’t say I noticed it being sloppy when I was in for 3 weeks a couple of years ago. In fact, with the exception of some seriously mushy broccoli, I was very pleasantly surprised at how palatable it was - that is when I felt like eating again. Alas I have put back on the 5 or so kg I lost. 😟

Agree with a PP that an extra cup of tea might be preferable to drinking cold water.

That generation often didn't even drink water with meals...it was somehow frowned upon (guzzling)!

Great idea about the alcohol free drinks.

Also, think of foods which have a high water content:

• soups/broths
• risotto
• stews
• cucumber, melon, watermelon, oranges