Getting them to drink more water/Zoloft

LaurieRZ

My mother has been more confused the last week, so I took her to the doctor to see if she has a UTI. No UTI, but they said her urine was concentrated which means she isn't drinking enough water. My mother has always been a big water drinker, so she assured the doctor she drinks water all the time. Has anyone found a way to remind your LO to drink more water without being the one to tell them it's time to drink a glass of water? 

I noticed in another post, many LO's have been prescribed Seroquel for agitation. I took my mother's car away in July and she has experienced a lot of agitation and anger towards me since then. I finally asked the doctor if medication would help the situation and he put her on Zoloft. It's been a couple of weeks and no improvement yet. Has anyone had success with Zoloft?

jfkoc

I find that I drink more water if it is in a big tumbler (my Tervis w/lid) with ice and a straw. The straw really works!

M1

Laurie, my partner takes both Zoloft and Seroquel.  If there's been no change at this dose in two weeks, i would call.  May make sense to increase the Zoloft dose first (for another couple of weeks), but then if no response I would ask again.  If this provider isn't comfortable dosing these meds, ask for referral to someone who is (probably a geriatric psychiatrist is your best bet, but there may be a wait to get seen).  

harshedbuzz

LaurieRZ wrote:

My mother has always been a big water drinker, so she assured the doctor she drinks water all the time. Has anyone found a way to remind your LO to drink more water without being the one to tell them it's time to drink a glass of water? 

This is a common way of thinking in dementia. A PWD will insist that they are doing whatever was their custom-- bathing, changing, paying bills, preparing healthy meals, etc-- because anosognosia prevents them from being aware of changes in their ability to function and behavior.

You don't mention stage. Does mom live alone, with you, in a MCF? Are you finding verbal prompts to drink agitating her? If you live with her, might offer to join her in a fancier version of water as a treat-- let's have a sparkling water with lemons in it, or a cup of this nice raspberry decaf tea. You can also up hydration with fruits and vegetables.

Depending on the stage of dementia, a straw cup could be useful for keep water available. But if she's stage 6, I would make sure she isn't developing swallowing issues. Some PWD pocket food or don't always swallow fully, if they drink from a straw or sports cup it could move the food hanging out in their mouth into their lungs before their epiglottis has a chance to close off. This is a common cause of death in Alzheimer's.  

I noticed in another post, many LO's have been prescribed Seroquel for agitation. I took my mother's car away in July and she has experienced a lot of agitation and anger towards me since then. I finally asked the doctor if medication would help the situation and he put her on Zoloft. It's been a couple of weeks and no improvement yet. Has anyone had success with Zoloft?

This is hard to answer. Who prescribed the medication? IME, the best clinician for psychoactive meds will be a geriatric psychiatrist as they are the specialists most familiar with interactions and side effects. A neurologist can also be an option. A PCP might not be the best person for this especially if you aren't coming away knowing what to expect or when. 

It's hard to say whether Zoloft is the right medication for your LO. Zoloft is one of the options for people who get stuck as a result of anxiety. One feature of the SSRIs like Zoloft is that they need to be started "low and slow" with the expectation that you might not see an improvement for 2-4 weeks at which time they may increase the amount taken with the expectation that you'd see the full effect of the med at about 6 weeks on the right dose which can be an eternity if your LO is suffering. 

Another piece to whether this is the right medication is related to the behavior you are seeing. Frequency, duration and intensity of a behavior can factor into which medication is appropriate. If your mom is angry every evening over the car but can be redirected with a fiblet about it being in the shop for a recall and still eat dinner and sleep, Zoloft could be just the thing. If on the other hand, your mom is on this non-stop, refusing care from you and physically aggressive then prescribing Zoloft is like taking a knife to a gun fight. 

When my dad's neurologist refused to increase his Seroquel (he was already on 60mg Prozac daily), we took dad to a geripsych who wanted another visit before changing medications. Dad could showtime like there was a paycheck in it-- he'd trade jokes in Yiddish (FTR, dad was a Roman Catholic with a mostly English background) with the doctor and was generally delightful. I had to send the doctor a video clip of dad at home threatening me via the patient portal to get the second dose of Seroquel he needed. Another option would be to have mom transported to an ER for admission to a geripsych unit during an episode of aggression. 

My dad really struggled with the car situation and it was at the root of a lot of his aggression, too. One thing that was useful was getting the car out of his sightline and validating his feelings about the unfairness of it. This extinguished his ruminations faster than trying to reason with him. 

Good luck. This is difficult stuff.

HB

Iris L.

All older adults gradually lower their sense of thirst.  Dementia makes this worse.  You cannot rely on thirst.  You or someone else must be present to monitor fluid intake and output.  How many times does she go to the toilet?  How many glasses or cups is she drinking?  Perhaps you mom should not be living alone now.

Iris L.

Jgirl57

Yes, my HWD takes Zoloft with success.

I cut up watermelon often to help with hydration as well as 

hello.

Jgirl57

Jello

LaurieRZ

My mother's neurologist never talks about stages, but I would guess she's 4 or 5. She still lives alone. I feel like she's in this inbetween stage, where it would be better if she moved to AL, but I think it would be tough to make her. She is fiercely independent and I think she would try to leave. I've toured several facilities and they all told me if she shows exiting seeking behavior, they won't be able to keep her. I toured a MC facility and she's not near as severe as the residents there, so there's no way I could put her there. She's physicially healthy, her house is clean, she hasn't been cooking and she even still mows her backyard. 

Since her doctor appointment, I've been calling her to remind her to drink water and she has started writing down the times that she does. I just don't now how reliable this system is for the long term.

 I took my mom's car away in July and it has been an issue since then. It's the one thing she will not forget and has caused a great deal of stress between us. I broke down crying in front of her about a month ago and told her the stress I was under because of the horrible things she was saying to me when she called (I know...probably not the right thing to do). She said she she didn't remember any of it and apoligized. It was actually very pleaseant for the next couple of weeks. About 1 1/2 weeks ago she started calling 10+ times a day. Sometimes she would demand her car back and later in the day she would not know where her car was at all and be in a panick. Since she's increased her water, the calls have slowed way down. The doctor called this morning to say she has a UTI on top of the dehydration. My mom already told me once this morning she needs to get her car back, so we will see how things go once she starts her antibiotics. "Out of sight, out of mind" is definitely not working for her. Sometimes if feels more like Groundhogs day. I think in her mind, she just had the car taken away last week. So far, the car has "been in the shop" twice and now my son is borrowing it with her original approval, because "his care was stolen and he has no other means of transportation". I thought about "putting it in the shop again" and saying it was unfixable. The main reason the "shop" excuse got to a point where it didn't work is she started wanting their number so she could call them. I actually mentioned selling it the other day, which was definitely the wrong thing to do, because she told me she could never trust me again after that and I was going to be sorry. Lucky, she didn't remember the conversation the next day.

Jgirl57

I agree the “in between” stage is very difficult

and emotionally draining. Once my husband got up

to 50mg Zoloft I saw improvement. So sorry you are here

with the rest of us .

mrl

My DH had a couple of watermelon triangles every day and seroquel worked very good.. Michele

Laura4yoga

You and others may be interested in researching this item called Jelly drops. These chewables give hydration in an easy to chew/swallow candy looking item! Many dementia patients love their sweets! The creator started this for his grandma! 

There are also a product (Walmart/Costco) called Liquid IV. It’s an electrolyte powder you mix with water and it multiplies hydration!

Click links for more info:

https://www.jellydrops.us/

 https://www.costco.com/liquid-i.v.-hydration-multiplier%2C-30-individual-serving-stick-packs-in-resealable-pouch.product.100301223.html

Iris L.

LaurieRZ wrote:

 . Sometimes if feels more like Groundhogs day. 

Groundhog's Day sounds unpleasant to you, but this is what you can aim for to be comfortable and more functional for your mom with dementia.  Basically, keep everything the same as much as possible. 

Iris

LaurieRZ

Thank you for the link. A friend of mine was describing these to me, but she couldn't remember what they were called.

Laura4yoga wrote:

You and others may be interested in researching this item called Jelly drops. These chewables give hydration in an easy to chew/swallow candy looking item! Many dementia patients love their sweets! The creator started this for his grandma! 

There are also a product (Walmart/Costco) called Liquid IV. It’s an electrolyte powder you mix with water and it multiplies hydration!

Click links for more info:

https://www.jellydrops.us/

 https://www.costco.com/liquid-i.v.-hydration-multiplier%2C-30-individual-serving-stick-packs-in-resealable-pouch.product.100301223.html

jfkoc

 No UTI Thursday but Saturday your mother has one?????

The info re this would be helpful.

LaurieRZ

Sorry about the confusion. My mother provided a urine sample when I took her to the doctor and they said they didn't think she had an infection based on the sample, but they would send it off to be cultured just in case. The culture showed bacteria, so they called me Saturday to let me know they were prescribing an antibiotic.

jfkoc wrote:

 No UTI Thursday but Saturday your mother has one?????

The info re this would be helpful.

BLapp

Sister (62Yo) with advance dementia AND downs syndrome; Her dr suggested Seroquel as well, but with the adverse reactions/side effects he listed, it wasn't an option for us.  (Downs ppl have heart issues to start) I'd be interested in knowing if you tried and how it is working.

LaurieRZ

My mother has had such tunnel vision regarding her car and that's why I originally asked the doctor if medication would help. So far the Zoloft hasn't helped with that. She even told me one day her car is her best friend. 

BLapp wrote:

Sister (62Yo) with advance dementia AND downs syndrome; Her dr suggested Seroquel as well, but with the adverse reactions/side effects he listed, it wasn't an option for us.  (Downs ppl have heart issues to start) I'd be interested in knowing if you tried and how it is working.

*Ollie*

My mom was not drinking water despite reminders,   She wound up getting a kidney infection and bad UTI because of this.   We put electrolytes in her water now and we are having success with that.  We use a brand called Ultima.

CatsWithHandsAreTrouble

Ollie, that's a good idea. 

We have ice pops with electrolytes in them for mom for when she wouldn't drink enough during the summer. I didn't purchase them so I can't say if the price was reasonable for it

May flowers

My FIL would not drink much water until we started adding Mio juice to flavor it. We bought the tea flavored and it tastes surprisingly like tea. He went from 1-2 glasses a day to 5-6