Wednesday, October 22, 2014

Sunday, December 14, 2008 mommy828599, Community Member, asks

Q: How to get a person to drink fluids?

My grandma is late or end stage alzheimer's, she has been hospitalized twice in the last 6 months for dehydration. she is total care, she has to be fed but she will eat 90 to 100 % of every meal but she wont drink fluids. We are lucky if we get a 6 oz cup of liquids in her a day, and that is by holding the cup to her mouth and basically forcing her to drink. We don't like to do this as we are afraid that she will get choked and aspirate. How can we get her to take enough fluid to keep her hydrated?

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Answers (2)
AFA Social Services, Health Guide
12/16/08 3:44pm
Your concerns about your grandmother’s health are very significant.  Dehydration is serious and can lead to other complications.  Alzheimer's disease affects the ability to coordinate the tongue, lips and jaw.  It is very common for individuals with Alzheimer's disease to develop swallowing disorders, or dysphagia.  It is important to assess your grandmother’s overall situation to determine if any new medications or changes in her level of consciousness could be affecting her ability to swallow.  In addition, her body and head position are essential when engaging her to take a drink.  Forcing her to drink could be distressing to her, which may prevent her from being able to relax and successfully complete the task.       
One option is for your grandmother to have a speech pathologist conduct an assessment.  A Videofluoroscopic Swallow Study may help determine the source of the problem.  Also a speech pathologist can help make recommendations for a new swallowing program to improve the fluid intake for your grandmother.  There is a stage of Alzheimer's when swallowing becomes too difficult entirely.  Many individuals with Alzheimer's will become candidates for some form of tube feeding, either nasogastric tube through the nostril or a PEG tube into the stomach.  There are certain risks with such interventions, and so the people making health care decisions need to be very careful in choosing the best course of care. 
It is highly recommended that you seek consultation with her physician.  There could be medical reasons apart from the Alzheimer’s disease that could be causing difficulty for your grandmother.  The longer the issue is not addressed by a medical professional, the more precarious the situation could become for your grandmother and the family.     
Connie Moore, Community Member
12/14/08 7:41am

Hi have you tried spoon feeding her liquids? I don't mean force but if she allows you to feed her will she let you spoon feed her broths, jello, gatorada and slip some water in there? I hope you find a way. Does she have any at home medical care maybe they just flat need to use an IV. Do you know her wishes, does she want her life supported with force if necessary to keep her alive. If you know her wishes it will help you make a decision on IV fluids. I am sorry I hope this helps some. Connie

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By mommy828599, Community Member— Last Modified: 12/24/10, First Published: 12/14/08