Being thirsty is an unpleasant sensation, and can be even more difficult to bear for a home hospice patient, especially if they are bedridden. Dehydration can also lead to consequences such as causing strain and discomfort for the throat, decreasing the effectiveness of medications, and can even lead to serious health complications. Caregivers must learn to recognize the signs of dehydration early and have strategies and plans in place to ensure that their loved one receives adequate amounts of fluid despite challenges such as difficulty swallowing or mobility limitations.

What is Dehydration?

Dehydration occurs when our bodies lose more fluids than we consume, creating an imbalance of electrolytes and other essential nutrients in the body. Hospice patients can be particularly susceptible to dehydration due to decreased appetite, difficulty swallowing, medication side effects, or even medical conditions that cause dehydration, such as kidney disease or diabetes.

Recognizing Dehydration Symptoms

Early recognition of dehydration is critical to prevent complications. Watch out for symptoms such as:

1. Dry Mouth and Lips: One of the clearest indicators of dehydration is having dry lips with cracked or parched surfaces, along with a dry mouth accompanied by sticky saliva.

2. Decreased Urine Output/Dark-Color Urine: Reduced frequency of urination coupled with dark-colored urine could indicate dehydration.

3. Fatigue and dizziness: Dehydration can leave one feeling lethargic, weak, or dizzy, particularly when standing or changing positions.

4. Headaches and muscle cramps: Electrolyte imbalance caused by dehydration can contribute to headaches and painful muscle cramps.

5. Sunken Eyes and Decreased Skin Elasticity: Dehydration can result in eyes that appear sunken, as well as skin that loses its elasticity, becoming dry and tented.

Techniques to Help Keep a Home Hospice Patient Hydrated

Now that you know the signs of dehydration to watch out for, here are some strategies for ensuring adequate fluid intake:

1. Keep your loved one drinking frequently: Even if a patient doesn't express thirst, it is still important to provide fluids regularly throughout the day, offering small sips at regular intervals in order to maintain adequate hydration levels. Try setting an alarm or basing water drinks around commercial breaks, daily routines, or other activities that happen at regular intervals.

2. Offer Hydrating Foods: Alongside fluid-rich beverages, include other hydrating foods in their diet like soups, smoothies, popsicles, and fruits with high water contents like watermelons and grapes.

3. Keep track of fluid intake: Monitoring fluid consumption will allow you to determine if your patient is getting enough liquids per day for their daily needs, consult with hospice care team about appropriate goals for fluid consumption, etc. Try using a water bottle with ounce markings that can help you track how much water your loved one has consumed.

4. Adjust Fluid Consistency: For patients experiencing difficulty swallowing, thickening their liquids using commercial thickeners or pureed food products can make them easier for them to swallow and decrease the risk of choking or aspiration.

5. Explore Alternative Hydration Methods: If swallowing becomes difficult, alternative hydration methods, such as intravenous fluids may be recommended by hospice care team to ensure adequate hydration.

6. Provide Ice Chips or Popsicles: These tasty treats may offer additional hydration and relief from dry mouth and thirst in patients who struggle to drink enough liquid.

Strategies to Help Hospice Patients with Swallowing Difficulties

Swallowing issues can make it much more difficult for a patient to remain hydrated. Here are some strategies you might try:

1. Proper Positioning: For optimal swallowing ability and reduced risk of aspiration, work with your hospital nurses to figure out which position(s) might work best for your loved one. Consider using pillows or an adjustable bed to help the patient sit up more easily.

2. Adaptive Equipment: Utilizing special cups, straws, or utensils designed specifically to assist individuals who experience difficulty swallowing can make fluid intake easier and safer.

3. Thickened Liquids: As previously discussed, thickening liquids with commercially available thickeners or pureed foods can help manage swallowing difficulties and avoid aspiration.

Need Help? Ask Your Hospice Care Team!

Dehydration in hospice patients can have serious repercussions, so it is vital that hospice care teams - such as nurses, physicians, occupational therapists, and other specialists - be involved in providing solutions and strategies tailored specifically for the patient. They may offer invaluable guidance tailored specifically to the patient's specific needs and condition.

Patients of Coastal Home Health and Hospice can call us at any time with questions about dehydration, helping patients drink, and more.

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