Dementia and dehydration: hydration guidance
Understand why someone with dementia may struggle with dehydration, ways to help someone with dementia stay hydrated and more.
Hot weather can present additional health risks for people with dementia. Our dementia specialist Admiral Nurses share some useful tips for keeping safe and hydrated during heatwaves.
Keeping hydrated with dementia
Some people with dementia have difficulty communicating, especially in the later stages. This can make it harder for them to express whether they are thirsty or hot, and for carers to know how much they have been drinking or whether they have heatstroke. The person may not recognise that they are thirsty and so not feel the need to drink; or forget to drink regularly.
By the time a person feels thirsty, they are already dehydrated to some degree, which can increase the risk of delirium. They may become more confused than usual.
To help keep a person with dementia hydrated, you could try:
- Setting reminders using a smart speaker; such as Alexa, with voice prompts saying, “Time for a drink”
- Finding out how much liquid their usual cup holds and making sure they drink enough cups each day
- Always keeping a drink within their reach
- Bringing them their drink in their favourite mug or cup
- Keeping watery foods easily accessible, such as melon, jelly, yoghurt or chopped cucumber
Keeping the home cool
To keep the home cool, focus on blocking out the sun and heat. It may be helpful to buy a room thermometer for the room that the person with dementia uses most so you can monitor the temperature and make adjustments if possible.
You can block out the sun and heat by:
- keeping blinds and curtains shut in the daytime during hot weather
- keeping the windows closed when it is hot outside
- switching off electrical devices when they are not in use, like computers, TVs and bright lights
- avoiding using the oven, where possible, and instead using the microwave or serving cold meals
Let in cool air by:
- opening windows in the evening when the temperature falls
- creating a through-breeze by opening doors and windows at opposite sides of the house
- placing a bowl of ice in front of fans to cool the air down
To help the person with dementia cool down, you could:
- place a damp cloth on their neck, if they are comfortable with this
- put a cooling mat in their pillowcase
- provide them with a small, shallow paddling pool or foot bath that they can put their feet in while seated – but be aware of the risk of falls if the person has wet feet, and supervise them if necessary
- give them a handheld or wearable fan
Staying cool with appropriate clothing
Sometimes finding and choosing weather-appropriate clothing can be overwhelming or confusing for people with dementia, especially if they do not recognise that they are too hot.
If you have dementia and live alone, you could:
- pack up winter clothes and store them out of sight, with the help of a friend or relative if needed
- go shopping for comfortable, breathable clothes – you could ask a family member or friend to help
If you care for someone with dementia you could:
- put their winter clothes in storage
- buy them comfortable, breathable clothes
- lay out their outfit for the day on their bed in the morning
- help them choose what to wear by offering them a couple of suitable options
When shopping for summer clothing, it is best to look for:
- clothing made from natural fibres like cotton or linen
- light coloured clothing to reflect the heat instead of absorbing it
Going outside in the heat
Taking some extra precautions can help you or the person you care for stay safe when leaving the house during the hot weather.
It is best to avoid being outside during the hottest time of day. This is usually between 11am and 3pm. However, during heatwaves, it is advisable to avoid leaving the house altogether where possible.
Outside the house, it’s important for the person with dementia to:
- wear a wide-brimmed or peaked sunhat or cap to protect their head
- wear appropriate footwear that supports their feet to prevent trips and falls whilst keeping them cool – avoid going barefoot outside
- use high factor suncream
- avoid any strenuous activities such as gardening
- try to stay in shaded areas
Cooling accessories such as a handheld fan, cooling towel or a water misting bottle can also be helpful.
A person with dementia may be unaware of the dangers of hot weather and go out in temperatures that might put them at risk. Giving them some form of GPS tracking, such as a smart watch, tag or phone app, will enable you to see where they are and how long they have been out, and provide assistance if they need it. It is also important to be aware of the signs of heat exhaustion and heat stroke and seek immediate medical attention if you notice them.
Signs of heat exhaustion and heat stroke
Symptoms of heat exhaustion:
- tiredness
- dizziness
- headache
- feeling sick (nausea) or being sick (vomiting)
- excessive sweating and skin becoming pale and clammy (a change in skin colour can be harder to see on brown or black skin)
- cramps in the arms, legs and stomach
- a high temperature
- being very thirsty
- feeling irritable
Symptoms of heatstroke:
- a very high temperature
- hot skin without sweating
- fast breathing and a fast heartbeat
- confusion and restlessness
- seizure (fit)
- loss of consciousness
Helping your community during hot weather
If you know of anyone living with dementia in your area, especially if they live alone, you could contact them and ask if there is anything they need to manage the heat. They may be unable to visit supermarkets or shop online for appropriate clothes, other cooling solutions or food that is suitable for hot weather.
You could take it in turns with their family, friends and neighbours to shop for anything they might need to stay cool, like fans, cold drinks or hydrating foods, and to check on them during periods of hot weather.
Frequently asked questions
High temperatures can make the symptoms of dementia appear worse by causing confusion, agitation, dizziness and dehydration.
Yes, hot weather can cause delirium – a state of intense confusion that comes on suddenly, over the course of hours or days. It is more likely if the person develops heatstroke or heat exhaustion or becomes dehydrated.
The person may be extremely sleepy, agitated or upset – or sometimes experience a combination of these symptoms. They may feel weak or lethargic and be more prone to falls.
- Offer food and drink that looks tempting, such as flavoured drinks like diluted juice or squash and foods that contain a lot of fluids, like jelly and ice cream
- Sit down with the person with dementia to have a drink or a meal – this might encourage them to eat and drink, as well as giving you an opportunity to spend time together
- Saying “Cheers!” and bumping glasses gently can often make drinking more sociable and fun
- Don’t offer too many choices of drink – sometimes just placing the drink in the person’s hands can reduce confusion about what they should do
- Reduce or avoid caffeinated drinks, as they can act as a stimulant on the bladder, meaning the person needs to go to the toilet more often, and may cause agitation in some people
- If the person likes drinking tea or coffee, consider changing to decaffeinated options
- Offer them fruit that is high in water content like watermelon
Yes, older people are at greater risk of being affected by the heat. This can be caused by:
- their body producing less sweat
- pre-existing medical issues
- reactions between heat and medications
- reduced blood flow
- having a reduced sense of thirst
A person may be more vulnerable to the effects of hot weather if:
- they are frail
- they are in the late stages of dementia, especially if they depend on family or carers to make sure they are drinking well
- they have swallowing difficulties that make it hard to drink or eat hydrating foods – if you are concerned, you can ask the GP to refer the person to the Speech and Language Team for assessment
- they live alone, particularly if they have mobility issues which may affect how easily they can access drinks
- they have urinary incontinence issues and may try to restrict drinks to prevent accidents
Some other medical conditions may make the person more at risk during hot weather, such as diabetes, heart failure, angina, previous heart attack, breathing difficulties such as chronic pulmonary obstructive disease (COPD) and kidney problems. If you have any concerns, speak to a GP or pharmacist for advice.
It’s important to be aware that some medications can make people more vulnerable to the effects of heat, sunlight and dehydration. Caffeinated drinks like tea, coffee and cola can also make people pass more urine and cause dehydration. Always take advice from a professional if you have concerns about medications that might put the person at greater risk in hot weather.
The effectiveness of some medications may be affected if a person becomes dehydrated. This may lead to a drop in blood pressure, falls or fainting. You can avoid this by keeping track of when medication is taken, sticking to the same schedule every day, and ensuring the medication is taken with water.