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He is required to drink 4 16 oz. bottles of water a day because of an indwelling catheter. He has been advised by doctors, nurses, etc. that the water consumption is mandatory. Nothing is working. He drinks flavored bottled water but not near what is required to keep him hydrated and free from infection (UTI). Breakfast goes down pretty well but lunch and dinner, for the most part, ends up uneaten and is tossed. I am at a loss. The doctor is not concerned about the lack of food, but is concered about the water consumption. I can usually get him to drink one bottle of Ensure each day but even that is becoming a problem. Any insistance on my part for him to eat, gets very confrontational. Any suggestions.

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Back way off on your insistence as it is very hard on both of you. Switch to magic tricks. If he can drink a cup each hour starting at 8, he will be finished at 3 and can have a water free evening.
Try offering him the small bottles of water. They aren’t so intimidating or heavy to hold. If he takes pills, it’s a good way to get more water down.
I see he has dementia and might go along with this as he might forget he has already taken some pills. so try taking the pills a few at a time with a bottle of water and then come back in a little later with a few more and another bottle of water.
Also try using a straw as that might make the water go down easier.
If I use an open glass when I drink water I am more prone to sip. If I drink from the bottle it goes right down.

Don’t put the big bottles out where he sees them. That can be depressing. Just refill the small ones for the next round. notice if he drinks more when the water is cold or room temp. I can’t drink it fast if it’s cold. Also hopefully he has had a speech test to make sure he can swallow without a problem.
Ask his doctor to order home health and pt. The therapy will help take his mind off of the water, help him exercise more and take care of him a bit for you on the days they come. The nurse coming every week to visit with him can give support to both of you.
also ask the doctor about something for depression. This is a lot for him to adjust to and most elders have low serotonin and something to lift it can help. Stress makes it worse.

Keep a chart so you know how much he drank that day.
The old fashion instant breakfast (carnation I think) is something we gave my DH aunt for a snack. We would mix it with milk and chocolate ice cream, put a spray of real whipped cream and a cherry and she loved it. Serve it with a straw. Just give him half of one and then later offer the other half with half a sandwich cut in small pieces or some other small plate of food. A few French fries with catsup might make it interesting or a small burger or hotdog or cheese or peanut butter on a cracker. He probably is full from all the water. And if he is eating at least an egg for breakfast I would be happy.

My moms heart clinic had her restrict anything that was MADE with water, so if jello took two cups of water and she ate it all, I would have to count that as two cups. So just something to think about.

If he were in the hospital, ALF or N.H., they would offer the water, maybe nag a bit but ultimately it is up to him to drink it.
Im wondering how much water he drank each day in the past and if his doctor told him in advance he would have to drink this much water after his procedure. It just may be more than your DH can manage in his present mood.

This is a lot of pressure on you. I’m sorry. Give it a good go for a couple of weeks and see if you can tell what makes it easier for him and see how you are feeling at the end of the day. On your log give yourself a 🙂or 🙁. You count too!

Let us know if any of our tips work. We often have posters tells us after posting that things improved. I think posting here helps release some of the burden this home nursing can be.
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I'd have him checked for a swallowing problem (dysphagia) that makes drinking thin liquids difficult, if that is ruled out then offer any beverage he likes in small amounts throughout the day. Keep a cup of water always by his elbow, then and add in coffee, tea, soda, beer, juice or whatever else he likes; I wouldn't eliminate anything unless he has a concrete medical reason to avoid it. Having small snacks to go with whatever he's drinking will help the beverage go down easier and increase his calories at the same time, don't be afraid to offer cookies or salty snacks like chips and nuts along with the usual crackers and cheese, fruits etc
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I agree to try to get him to eat more water-rich foods such as watermelon, grapes, citrus, cukes, cauliflower (steamed), celery. Broth-based soups, diluted fruit juices, ice pops, tea (hot or cold) instead of coffee...etc.

Would he notice if you "thinned" his Ensure with skim milk or water?
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I don't mean to question your doctors, but I can tell you that at 81 I am NOT going to be drinking that much water. I simply cannot conceive of it. I understand they want that catheter not clogging with crystals and dehydration effects; I am a retired RN. But I simply could not do this.

Moreover, there are often reasons NOT to attempt to take this sort of hydration on at a certain age. Our heart becomes a less efficient pump. We are less able to eliminate our fluids and they can more easily accumulate in our peripheral areas and abdomen with right heart failure, and disasterously in our lungs with left heart failure. To withstand this sort of fluid intake your hubby must have a strong heart indeed. Many of our elders are actually on fluid LIMITS.l

I think this needs to be discussed with the MD. Taking in this sort of fluid intake is going to cut down on nutrition. One of the BEST WAYS to diet is to drink a full glass of water before each meal. You are not going to want to eat much.

Speak with a GOOD general practices doctor, a gerontologist about this.
I don't have answers to have an indwelling catheter that supposedly requires this, while the rest of the body fails behind this requirement.

Something has to give here. I can't go against what doctors are recommending to you, but there are limits to what can be endured safely.

I surely do wish you good luck. And welcome to the Forum.
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newbiewife Jan 24, 2024
I wholeheartedly agree, Alva. This "one size fits" all recommendation about water intake bugs me! Some purist recommendations even say that coffee and tea "don't count" because caffeine has a mild diuretic effect. Getting liquids from foods kills 2 birds with one stone by getting calories and nutrition in if the person isn't eating well.
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You state in your profile that you want to keep your husband home and that you don’t feel it is time for a full time caregiver yet.

You say that you would like to have a sitter for him occasionally so that you can leave the house without worrying about him.

I would say that you are either unaware of how much care that your husband actually needs, or possibly you are having trouble letting go of the responsibility of caring for him.

You also state that you are in good health. You must be exhausted and emotionally drained to live in these conditions.

Continuing with this ongoing care will eventually take a toll on your wellbeing. Everyone has a limit to the care that they can provide.

Please know that you will not be failing your husband in any way by acquiring help to care for him. Please look into a help for your husband with help from caregivers in your home or placement in a facility.

Have you ever contacted Council on Aging in your area to get an assessment of his needs? They can help you move forward with a care plan.

Wishing you all the best as you continue your caregiving journey.
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The best you can hope to do is give him foods rich in water, for example, fruits such as apricots, blueberries, oranges, peaches, pineapples, plums and raspberries contain over eighty percent water. Melons such as cantaloupe and watermelon have some of the highest water content, at more than 90 percent.

Try sugar free flavor infusers for water bottles. Crush makes a variety pack available at Wal Mart.

With dementia at play, they develop a strong taste for sweet foods. Try giving your husband small meals throughout the day like yogurt, muffins, parfaits, peanut butter and jelly sanwiches, etc. Smoothies made with protein powder, milk, berries and bananas are good too.

I suggest you buy a copy of the book Understanding the Dementia Experience by Jennifer Ghent-Fuller on Amazon so you can learn about dementia and how to deal with DH a bit better. You can't force him to drink water so offer him water rich foods and that's that.

Best of luck to you.
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Milk, hot chocolate? Broth-based soups? Smoothies? Jello? High water content fruits such as melon and watermelon, pineapple, strawberries, blueberries, etc.? Not all water consumption has to literally be water. Try small amounts of food more frequently rather then 3 meals/day. If breakfast goes down best, offer high water content fruits then. If he'll eat hot cereal, make it slightly thinner than usual or add milk and fruit. I have trouble myself getting in the supposed required amounts of water and don't understand the current habit of walking around all the time with a container of water--ugh!
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