The Role of Hydration when Dealing with Dementia
Understanding Dementia and the Risk of Dehydration
Dehydration is extremely serious for anyone, but for people living with dementia, it can be even more crucial. “People with dementia may not always recognise when they are thirsty or be able to express their thirst. This may mean that they do not drink enough and become dehydrated,” say Dementia UK.
Because Helping Hands have been supporting people living with dementia for so many years, it’s no surprise we’re the UK’s most trusted home care provider. We have branches across England and Wales, with local care teams working tirelessly to provide you or your loved ones with the highest quality care.
Why Hydration is Essential for People with Dementia
There are many reasons why drinking enough fluids is important, but for people living with dementia, dehydration may:
- Affect cognitive function which can make them more confused
- Irritate the bladder due to concentrated urine, worsening incontinence
- Make the risk of falls more likely, affecting mobility
- Cause medication to work less effectively
Identifying and Preventing Dehydration in Dementia Patients
Being aware of the signs of dehydration is essential to helping someone who’s living with dementia to avoid them as well.
Dehydration can be mild, moderate or severe, and recognising when someone is dehydrated can ensure they get the fastest help. An added factor is that someone living with dementia may not be able to communicate that they are thirsty or feeling unwell, so increased vigilance on the part of the caregiver or family member really does make all the difference. Offering regular drinks and making sure that liquids are always on hand can help, as otherwise the person may forget that they need to drink. Sitting in the person’s eyeline and drinking may also encourage them to ‘mirror’ the caregiver’s behaviour and help them to ‘remember’ the need to drink. If the person resists fluid intake, then liquid should be offered in other ways, such as through soups or fruit, but it’s important to report it to their GP or community nurse as the risk of dehydration could be high.
Common Signs of Dehydration in Seniors with Dementia
Mild to moderate symptoms can include increased confusion, agitation, mood changes, dizziness, headaches and appearing vacant, but as some or all of these can also be exhibited with dementia, it can be a challenge for the caregiver to recognise. Other symptoms include:
Infrequent urination/dark urine
When you’re not drinking enough your body conserves water and the kidneys reabsorb water from the urine.
Constipation
Reduced water in the digestive tract make stools harder and more difficult to pass due to the colon conserving water.
Dry or shrivelled skin
Skin needs water to function properly, just like the rest of the body, but a lack of water disrupts its natural barrier.
Sunken eyes
The skin loses its plumpness when dehydrated, causing the already thin skin around the eyes to show loss of volume.
Muscle cramps
The body loses electrolytes when dehydrated and reduced blood flow can limit the delivery of oxygen and nutrients to muscles.
Bad breath
A decrease in saliva production means that bacteria and food debris won’t be flushed from the mouth as effectively.
Practical Ways to Promote Hydration
Promoting hydration isn’t always easy when someone is living with dementia. However, there are ways to make the person more inclined to drink. Some of these include:
Being patient
Allowing the person time to drink without pressure
Taking time
Sitting and having a drink with them – they may ‘mirror’ your actions
Good posture
Ensuring the person is sitting comfortably and upright enough
Being sociable
Offering a drink to visitors – drinking is a sociable activity
Being vigilant
Contact their GP if you suspect pain, discomfort, or depression
Seeking help
If the person has difficulty swallowing, ask for a referral to a speech and language therapy team (SALT)
Let them choose
Offering what the person prefers – hot, cold, water, milk, or squash
Supporting dexterity
Ensure glass or cup is not too heavy or awkward to handle
Tempting tastebuds
Fluids from food – jellies, soups, custard, yoghurts, fruit and vegetables
The Role of Home Care in Supporting Hydration
By receiving care at home, people living with dementia can have a more personalised experience of support. It’s important to remember that dementia doesn’t define someone; the person is still there, even though their behaviour and attitudes may change. You may have to work a bit harder to communicate effectively with them, but it can be done, just make sure you leave yourself with plenty of time and you’re not in a hurry or under stress. Talking to them, holding their hand, and letting them hear your voice can all work wonders, as they’ll feel comforted that you’re nearby. Also, having a carer they’re comfortable with who is there regularly on a visiting or live-in care basis will encourage drinking and lead to less chance of them becoming dehydrated.
Page reviewed by Rebecca Bennett, Regional Clinical Lead, on May 6, 2025.
How we wrote this page
This page has been produced referencing key insights and data from external experts, trusted medical sources and our team of in-house specialists. We have worked hard to ensure that all information is as accurate as possible and reflects current consensus at the time of writing and reviewing.