Helping Home Hospice Patients Stay Hydrated
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 staying hydrated much more difficult for hospice patients. Several practical strategies can help manage these challenges and make drinking safer and easier.
Proper positioning makes a significant difference in your loved one's ability to swallow safely and reduces the risk of aspiration. Work closely with your hospice nurses to identify which positions work best for your specific loved one. Many patients swallow more safely when sitting upright or with their head and upper body elevated. Use pillows to support proper positioning, or adjust a hospital bed to raise the head and torso to angles that make swallowing easier and more comfortable.
Adaptive equipment designed specifically for people with swallowing difficulties can make fluid intake safer and more manageable. Special cups with lids and spouts control how much liquid flows with each sip, preventing the overwhelming mouthfuls that trigger choking. Certain types of straws allow better control over liquid flow. Modified utensils and cups with angled designs help position liquid in the mouth for safer swallowing. Ask your hospice team about adaptive equipment options that might help your loved one.
Thickening liquids to a consistency your loved one can swallow more safely often proves essential for managing swallowing difficulties. Commercially available thickening powders can be added to water, juice, coffee, or other beverages to create textures ranging from nectar-thick to pudding-thick depending on what your loved one handles best. Naturally thick liquids like smoothies or pureed soups also provide hydration in forms that are easier and safer to swallow than thin liquids. Your hospice speech therapist can recommend the appropriate thickness level for your loved one's specific swallowing abilities and demonstrate proper thickening techniques to ensure consistency and safety.
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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