Is this dehydration?

[Linbrusco]

Maybe 2 or 3 times a week, from approx 4pm onwards Mum looks absolutely dreadful.
Glassy eyes, a bit more confused, slow in her actions and movement.
She does have Chronic Lymphocytic Leukemia which makes her very tired and has a nap every afternoon. Her blood tests from a week ago are fine.
Some afternoons she will nap for 10 mins other days an hour.
She sleeps well at night now, due to taking Nortriptyline at night for bladder spasms ( a condition shes had for 10 yrs).

Despite her insisting she is drinking enough during the day ( which I know you can take with a pinch of salt) I do wonder if the above symptoms could be more dehydration than fatigue?

Mum & Dad live behind me, and I work 4 days a week, so I can't always monitor what shes drinking and when, but wondered if by filling a jug of water with at least 3 glasses of water and putting it in the fridge and insisting she drink it, might help?
I would have to write a reminder on her white board.
I could also enlist Dads help to encourage her to drink enough but Mum won't listen to a word he says, only me or my sister.

 

[jenniferpa]

It might be the CLL. My husband (who doesn't have dementia but has had treatment for CLL) does now take an afternoon nap, and he's only in his 60s doing a desk job. He's also well hydrated.

Which doesn't mean that your mum's issue might not be down to dehydration of course.

Could it be a form of sundowning do you think?

 

[Linbrusco]

That was another thought Jennifer.
Such a guessing game isn't it. But then I don't want to rush Mum off to the doctor unnecessarily.

 

[Mamsgirl]

Good on you Lin for looking beyond the obvious. My first thought was Sundowning, like dementia's the class troublemaker who gets the blame for things they didn't do because they're usually the culprit.

If your Mum's had blood results back as recently as last week it sounds like she's getting close enough medical attention as it is, and probably won't welcome another appointment. Something that did occur to me though is whether it's hard to get a good vein.

My daughter has psoriatic arthritis and needs regular bloods. This kid would feel hydrated by walking past a tap (!) and the monthly blood test was our own little piece of hell on earth (poor daughter, poor, poor pathology nurse), until we hit on the hydration issue. We developed a system to get her overhydrated and overheated, found a cooperative vein and stuck to it, and never looked back.

So I wonder if this might be a clue. While it's harder to find a good vein in an older person (your Mum's not that old though is she?), if it's still slow going to get enough blood it could mean she's not drinking enough.

Take care,
Toni

 

[FifiMo]

It might be easier if you get some small plastic bottles and put them in the fridge. Then maybe get your dad to give her a bottle every hour or whatever. Don't forget that there are other ways of hydrating someone eg does your mum like sweet things? Jelly is more or less all water so maybe that could become her pudding. Custard has lot of fluid in too. Ice cream or yoghurt are good too. Soup again has lots of fluid in too. You can also think back to old fashioned drinks that she might remember, for example, my mother loved her soda water and lime. Well ok, it was now sparkling mineral water and lime. Another one she remembered and liked was ginger beer. Favourite was home made lemonade ... Sliced lemons in a bowl with some sugar and add boiling water. Chill it in the fridge and serve it in a glass with a slice of lemon in.

If the dementia has reached the part of the brain that regulates things like thirst and hunger then putting a drink in front of her would not necessarily get her to voluntarily drink. That is where you can find the little bottles can help. You can try saying things like "By the time I come back from the kitchen this bottle needs to be empty" sort of making a game of it. Least it lets you see how many empty bottles there are at the end of the day, or not, as the case may be.

Fiona

 

[Jessbow]

lift the skin on the back of her hand, if it falls quickly, she's not dehydrated.

Make drinks interesting- vary them- I have about 4 different bottles of squash on the go, fizzy pop and flavoured sparkling water ( 4 for £1.50 from supermarkets Asda, Tesco etc)

 

[Nebiroth]

The skin test is not very reliable in elderly people, because they can have wrinkly and loose skin that does not snap back - as a child I used to dleight in pulling my gran's skin on the back of her hands into peaks where it would stay for ages. Moreover, IIRC, this sign only appears when dehydration has passed into the more severe stages.

A dead giveaway is urine. This should always be a pale straw colour, if it is darker, then it is concentrated, a sign that the body is short of water and attempting to preserve it. However, urine is naturally darker first thing (because the kidneys produce less but more concentrated urine as we sleep, otherwise, we would all be getting up three or four times a night to go to the loo) - also, some medications can change the colour.

As said, a good way to get someone well hydrated is to tempt them with puddings - jellies are almost all water and the body does not care where it gets water from, it will extract it from food just as well. Although it takes longer - if someone is dehydrated the best solution is a drink of water.

Coffee and tea are perfectly acceptable, although caffeine is a mild diuretic, this is more than made up for by the water content of a cup of either beverage. Alcohol should be avoided though.

 

[Witzend]

Has your mum been in the habit of drinking plain water?

According to staff at my mother's CH, most of the residents don't like plain water, nor do they like drinks that are very cold, I.e. just out of the fridge. They give them lots of small glasses of weak squash, at roughly room temperature. There are always lidded jugs of orange and blackcurrant squash in the open plan kitchen/sitting room.

Maybe your mum would like something of the sort,if you left a jug of squash out for her?