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?

My Mum is ninety five and I am caring for her after a hip replacement, getting her to drink is the work of a whole family! I know why she won't drink, fear of accidents and because it hurts to walk to the loo , even though the doctors have all told her she must walk.
She hates water, so I keep on offering different herbal teas, elderflower cordial, apple juice etc etc, the only thing I can reliably get her to drink is those teeny tiny bottles of yakult ( which she loves) I sneak in one bowl of soup a day, and try and give her lots of milk on her cereal and keep a supply of yoghourt in the fridge, I figure every bit of liquid helps.

Also warming up fruit juices helps.

Cold drinks can be unappealing. Apple juice warmed up with a pinch of cinnamon etc.

There is no need to neck 3 litres of water - no one does that. 3 litres of fluid can be made up from tea, coffee, diluted fruit juices, squash, milk,and any alcohol less than 4 percent proof. Zero alcohol beer is particularly useful as most men will happily drink that! In addition, the liquid component of food, including soup, gravy and other sauces also counts, as does the fluid found in fruits and vegetables. The thirst mechanism works less well in older people and this can be further exacerbated by some medication. Mobility issues and the fear of accidents also makes the issue worse. Forget the water and give him whatever he enjoys drinking or eating instead and make him a cuppa whenever you have one and h is hydration will improve no end!

Does he like Guinness?
Their alcohol free version is identical to the real thing. I wonder if you could get him to have a couple of pints of that? Don't tell him it's not the alcoholic kind!

Also, your husband needs to be the one having words about showering etc not you.

Same, we never had water with meals, and I didn't have a water bottle until about 10 years ago! I definitely didn't take one to school. At primary school you took a flask (maybe with squash) a carton of drink or, if you were really lucky, a capri sun! Definitely didn't drink water in class at school or college.

I don't doubt it, but the responsibility is solely his imo, that's what I meant.

You mentioned he enjoyed a whiskey, would he have water in that? There are plenty of no alcohol substitutes around these days.

Yes indeed - this is a great idea and I will try it.

May I ask why you think my DH should be speaking to him about showering etc?

no sensible health professional will tell an old person to drink 3 Litres a day and it does not have to be water,. Tea coffee any liquid will do, as will soup and watery fruit like melon. How about a beer or Guinness?As people age they just don't get as thirsty and they often don't want water. If he is incontinent get some pads for him to wear.

My grandad gave us all a scare on Christmas Day. I think it’s generational thing as well as him and my nan did not know you’re meant to drink a litre of water a day. I bought them those lite bottles in home bargains that have the time on them and they have been following it religiously. So 8am - get started 10 am keep going…

A friendly but firm word from a doctor or trusted HCP can help in my experience. Unfortunately, if there are memory issues as well it doesn't last for long. My mother is on two types of medication that can cause dehydration if she doesn't consume enough fluids. I find I often have to help her drink the water, holding the glass while distracting her, but your FiL may not like that.

If its the taste of water a few tiny grains of salt or a few tablets of tissue salt called natricum chloratum should help. But the person needs to be willing... If thery are stubborn like my father nothing will help.

I would struggle to drink a litre of water a day and I am not elderly!
Fruit,jellies ,soup etc works to increase fluid intake .

Well this is what I got the last time I was in hospital in France:

Breakfast:

Plain natural yoghurt with a sugar sachet.
Apple compote.
Packet of biscotte (crispbreads)
Pat of butter.
Set sugar syrup in a little plastic box that called itself:
a) Jam
b) Made by a Greek God.
Bowl of hot water with chicory powder.

Lunch:

Beetroot in mayonnaise.
Mystery meat in a sort of Maghreb related lot of sauce with chickpeas and couscous.
More plain yoghurt and sugar sachet.
More Apple Compote.
An individually wrapped triangle of Camembert.
A bread roll.

Dinner:

Grated carrots in vinaigrette. Amusingly named as if they had been a victim of SA.
Mystery meat with mushrooms in a lot of sauce that might have been bourguignon.
More plain yoghurt with sugar sachet.
A very frightened looking refridgerated banana.

I was in there for quite a while but that's just a typical day's menu. From what I remember.

It was the ever present plain yoghurt with sugar sachet and apple baby food compote that really made an impression on me.

I always love the rose-tinted idea that people in the 50s/60s/70s ate great wholesome food. My working class grandparents existed on Fray Bentos tinned suet pies, tinned potatoes and tinned sweetcorn, with Angel Delight for afters.
Lunch was meat paste spread or cheap jam on spongy white bread with the crusts cut off, a pack of Golden Wonder and a Blue Riband biscuit. For special occasions a box of Mr Kipling fruit pies would be procured (and for something really special, the fondant fancies).

They literally ate this day in day out for decades! Never a fresh veg or a piece of fruit passed their lips! This was the standard diet on their estate and all of it was processed and tinned. Plus a pack of fags each per day. No wonder they all had horrible health problems to be honest. It really wasn’t the case that people didn’t eat processed food — more like the opposite. As today, fresh food was expensive and you needed the time and expertise to cook well. Poorer people in particular ate a terrible diet in postwar Britain — less Hovis ad and more Kwick Save!

It might also be that drinking equals peeing and if getting to the toilet is a chore they avoid that too.

Food with lots of fluid like cucumber, watermelon etc can also help x

I work in a care home and lots of the residents use something called jelly drops. They help replenish fluids and people think they are eating sweets https://www.jellydrops.com/?utm_source=google&utm_medium=cpc&utm_campaign=21816760558&utm_content=&utm_term=&gad_source=1&gclid=CjwKCAjwnPS-BhBxEiwAZjMF0vywKgdaSOnZWmySHnbhF0rnVtjpghfNknwyFEKGyX16b2NnA9eCWhoCPh4QAvD_BwE

I’m assuming you are British. Only in the UK have I ever heard anyone say they don’t like water. Or that it’s ‘boring’. It’s SO strange to me. Water is like air. It’s just what one drinks.

My grandma worries about leaks and getting up to go to the loo is a huge effort for her.

Poor her!

Being on my way to being old i can tell you it's because the more you drink the more you wee and when you are old you can't hold on for 2 minutes never mind 5 and wetting yourself is embarrassing. I have just been on holiday and really had to limit my fluid intake, less than a litre a day, if i hadn't done that i wouldn't have been able to explore the area as there was a massive lack of public toilets in the towns and of course the coast and countryside have no toilets. Once you are old this is just part of normal life, you have to plan travel and daily life around the loo.

I know people mean well, but some of the suggestions are unsuitable for someone with recent kidney failure or kidney disease. You need to take the advice of the renal nurse or your GP, OP. There are probably suggestions if you google too. My father was a renal patient for many years and was quite strict about what he ate and drank. No coffee was served on the renal ward, for example. He loved a proper cup of coffee, so that was a tough thing to give up. Barleycup is a good alternative though if your FiL enjoys coffee.

I could no way drink 3L of water a day.

6/8 cups of tea is plenty for me.

@Disscombobulated - how much does your FIL actually drink each day?

I hate drinking water, it's not like air because you (generally) breathe without having to make any effort to do so!
I started trying to drink more water (my aim is 1 litre/day) last year and it still feels like a effort!

I guess maybe if all I had drunk in childhood was water, maybe it would seem easier...

I can’t help but wince at you having “brutal” conversations with an elderly relative about him, his clothes and your house smelling of wee.

Why liters a day? Thats generally way too much for anyone, let alone for an old person who is not used to drinking enough. It needs to be upped slowly.

Agree
I thought it was 2litres
The same for all of us

Nevertheless a lot of people are concerned they won’t get to the loo quickly enough.

Do you have a downstairs toilet OP, one tha5 he can use without difficulty that’s nearby.