I think my FIL is stuck on the eating issue this spring. For weeks, he has been dehydrated probably and now his urine is cloudy. The nurse is checking the urine. She agreed that they should thicken the fluid now so he can drink more. Maybe it is UTI or bladder issue.
For sure, his eating problem this year will be a major issue. From there, he would get sicker and etc.
He does not talk or eat on his own. He may eat on his own one bite or two.
I sure hope he will be fed well. As long as he can finish a whole meal, I guess it is OK.
We leave it up to the nurses/caregivers to resolve this issue. It does not matter which wing he is in.
My FIL got UTI as the nurse told us last night. Well I think it is the dehydration. Hope they will do better.
However, I do know they really cannot provide water like 8 cups a day due to the group care nature. My FIL cannot swallow water properly so they will need to give him thickened liquid.
I don't feel that the NH does give the residents enough water - they only have 3 meals and snack time in the afternoon.
Hydration can be an issue at any point in dementia because the patient doesn't realize they need the hydration, does not know how to get the hydration themselves, or may not be able to intake the hydration. Yes it is up to the staff to make sure the resident receives proper hydration. Many have a hydration program to ensure this happens. Yet there are circumstances that it is very difficult.
UTIs are not caused by dehydration. UTIs are caused by bacteria. The lack of fluid in the urinary system may limit the flushing of urinary system but it does not cause the infection. Not all with dehydration get UTIs and not all with UTIs are dehydrated. It is best to be properly hydrated so that the urinary tract has the best chance of flushing out the bacteria. Hydration also affects many other body functions since we are 60% water. The brain is 75% water so yes it can affect cognition... and our blood is 92% water.
Perhaps ask that your FIL be put on a hydration program with additional fluids during the day. This can be done by his physician. Yes, my Mom had a prescription for water
The Following User Says Thank You to Gabriel For This Useful Post: ninamarc (05-28-2012)
Charrev, with the new unit director it is hit and miss what is done unless it is part of the MAR (Medication Administration Record). I have had prescriptions for all kinds of things.... including water, prune juice, and ice cream!! Yes ice cream. For some reason the kitchen would only send NSA (No Sugar Added) Vanilla ice cream. So I had a prescription for Mom to have Chocolate ice cream every day. It came in a 5 gallon tub so everybody could enjoy it. Later I had it changed to Strawberry ice cream. I also have a prescription for BM logging. If there is something you want or need to be done that it not getting done... have your doctor write a prescription and by law they HAVE to follow his orders. If not they are out of compliance and can be fined!
Deb, could you please tell me how your Mom takes water: is it thickened and how often does she take water? I know for 3 meals, the residents are given drinks for the meal.
If you are not there with her, how do the caregivers manage to give her more water?
I take more water even after or before meal.
In my FIL's generation, he didn't believe in lots of water like what we say today. So his late wife was also taking not too much water (she only drank water if she was thirsty and no lunch.) My theory is that not enough water caused bladder cancer. (Of course there are other reasons.)
The NH where my FIL is gives people drinks at meal time and snack time. It is a small cup also unless the person asks for more.
First you need to know what his urine looks like in order to know if he is properly hydrated. If it is clear and he is urinating 5 or 6 times a day he is getting enough liquids. Second you have to know that not all liquid hydration comes from a glass of water. He gets liquids from his food and everything he drinks. Yes, the old standard was 8 glasses of water a day. Today it is understood that you need that much liquid. If they have soup for an appetizer then that is a liquid. Fruits and veggies also contain liquids. Watermelon is 90% water!
Mom is not on thickened liquids... and truly does not drink just water. Her prescription was actually for flavored water. The staff gave her the plastic bottle of water and let her drink what she would. Then they would stick it back in the fridge and give it back to her later... until it was gone. She had two 12 oz bottles a day. Liquids should be available at all times and the staff should offer drinks during the day other than meal times.
Part of the reason I got the prescription was because she was not drinking at meal time and her urine was dark. She was more preoccupied with the food. Since we have discovered that if they give her the drink before or after the meal she will drink it and eat the meal as well. Presenting both at the same time confused her. She also does better with a straw. She will sip from the glass but if you put a straw in the glass she will slurp it up quickly. Next I am going to try a plastic cup with a lid and a straw that does not come out. It's all about leaving what works best for you FIL.
Yes, most care facilities give them liquids with each meal and snack. If they drink all of what they are offered, plus eating foods such as soup, they should have enough. The problem is when they don't know to drink it all. Then they have to be offered drink when food is not present. I have also pushed for continuous pour at mealtimes. If they drink it all... give them more because they are thirsty
My oncologist told me in 2001 that I need to take more water if I eat apple. Because I would need water to flush it down. So Apple itself is not enough for fiber alone. Prune juice is great for it. In any case, I believe in taking lots of water although it may not be 8 glasses a day. I think the folks in the NH don't have enough water because there is no one on one service. Often the families come to give the loved ones water or drink.
In older generations, the elders don't take lots of water like what we do today. This is a new concept.
Thanks for the post, Deb.
The NH's director just told us that they give my FIL thickened nectar juice as many times as possible. More than 3 meals and snack time. He has UTI now so hope the antibioitcs will clear it up. Not so bad: first time UTI this year.