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Questions & Answers - August 2003

Mary C. Fridley, RN,C is a registered nurse certified in gerontology with more than twenty years in the geriatric health field. She is the owner of Gero-Resources specializing in caregiver, eldercare, and successful aging education and advocacy. Mary is also an author of two caregiver advice columns and contributes articles to various websites. She is available for speaking engagements and would be happy to answer your questions or concerns while maintaining your anonymity.

About Mary
Mary's Column Archives: Caregivers'
Questions & Answers

Dear Mary,

I am having a devil of a time getting my mother to drink water. She has been hospitalized with dehydration before and I’m trying to prevent it from happening again. Her weight of 86 pounds equals her age, and she’s as feisty as they come. She has some memory problems but is still pretty with it. Whenever I offer her a drink she says she’s not thirsty and if I leave it for her it’s still there an hour later. What can I do?

Dehydration is a serious problem for older adults. It can appear quickly and is life threatening. Older adults are at risk for dehydration for several reasons, some of which are due to normal aging processes. As we age we dry-up and dry-out! We no longer have fluid reserves to pull from and a decreased thirst response makes us less aware that our bodies need fluid. Our bladder capacity is also diminished so we have to urinate more frequently. Add memory impairment and mobility problems to the mix and the risk is even greater.

Plain water is good but as you have found out, not always the easiest to get down. If she has no dietary restrictions try mixing half water and half lemonade, cranberry juice, or any other clear liquid. Put it in a sport bottle she can carry with her and remind her to sip on it frequently throughout the day. Frozen juice pops, watermelon, orange slices, and other juicy fruits, as well as, any food that melts at room temperature like Jell-O or sherbet are also good choices.

With summer upon us preventing dehydration in our older loved ones is a priority. Keep them in on hot days and be sure they are in an air-conditioned environment.

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Dear Mary,

My 78 year old aunt is living alone and until recently was doing quite well. I visit her at least once a week and talk to her on the phone frequently. She has always been an active person and enjoyed shopping, visiting family and friends, and helping at her church. She drove a car so was very independent. She fell last month and broke a rib, now suddenly she doesn’t want to go out anymore. She has all sorts of excuses and stays home unless someone insists and comes to get her. She doesn’t seem depressed but I’m worried about her. Any suggestions for getting her motivated again?

Talk to your aunt and ask her if she’s fearful of falling again. Falling is the number one fear of older adults. A fall can be devastating resulting in fractured bones, head injury, and even death. But the biggest fear may be disability and the loss of independence. What was the reason for her fall? Did she trip or lose her balance? Did she just suddenly find herself on the floor? Suddenly falling with no recollection of why could be due to loss of consciousness and needs to be evaluated. Also, how are her vision and hearing? Sensory impairments can be very isolating. It’s important that the cause be identified in order to prevent another fall and alleviate her fears.

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Dear Mary,

I hope you can help with this problem. My father has dementia but can still do many things independently. Lately I’ve noticed that when he urinates he wets himself shortly after leaving the bathroom. Then a battle begins trying to get him to change his clothes. I know he uses the toilet because I’ve checked, so I’m at a loss as to why this is happening. Is it a behavior I should have expected with dementia?

Eventually, urinary incontinence is seen in progressive dementias, but I don’t think that’s the problem here. From your description it sounds like there is a physical reason for your father’s problem. An enlarged prostate can cause overflow and dibbling incontinence in men. The prostate partially obstructs the flow of urine so the bladder can’t empty completely, resulting in leakage of urine. Take your father to his primary care physician for a thorough evaluation.

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