Mom is refusing fluids and becoming dehydrated, any advice?

Stop trying to control what your mother eats and drinks. Make healthy meals (a good diet for people with diabetes is a good diet for everyone.) Make sure beverages are available. Include soups often. Serve juicy fruits. But let her decide what she will and won't eat and drink. Don't discuss it.

She is an adult. Presumably she has been told repeatedly the consequences of poor carb management, poor nutrition, and insufficient fluids. She can make up her own mind.

I think you may be on to something suspecting it is about more than food. Just drop the entire subject. Don't let it become a power struggle.

purplesushi, my mother is diabetic, also. She does what some people call "chasing carbs" all day long. She makes her own breakfast and lunch. She has waffles almost every morning and something like a sandwich for lunch. She eats sugar free cookies and crackers quite often. Sometimes at night she has little binges while I sleep. I see the evidence in the morning. I used to say something about it, but now I am much calmer about it.

My mother is 86 years old. When she first learned she was diabetic in her 50s, she was a stickler for her diet. I think she reached a point when she was older that she wanted the comfort of food she liked. She was tired of depriving herself.

What I do is buy only fairly safe foods. I keep sugary things in my room hidden from view. She used to be able to avoid sugar, but she slips if I leave it out. For example, I left a box of pecan rolls out two evenings ago and saw that two were missing from the box. I didn't say anything, but took the remainder and squirreled them away in my room. If I were to say anything, she would say that her sugar was low and she needed to eat them.

I also had to stop putting sugary fruits, e.g. bananas, out. She would eat too much of them. Her control seems to be loosening lately. She is drinking too much orange juice and eating too many crackers and sugar free cookies. So I bought her some peanuts to munch when she wanted something.

The only way I try to control her behavior now is through what I buy at the grocery store and what I put out for her to see. I don't deny her the sugar free things, though they also play havoc with her sugar, since they are carbohydrates. I cook one meal a day and make sure it is vitamin and protein rich with a satisfying portion of carbs, e.g. potatoes or corn.

My mother doesn't like water except the bottled kind, so I buy little bottles of water. She drinks them fairly well. To keep the cost down, I buy the gallon bottles to refill the little bottles. Sometimes we run out, so I fill the little bottles with tap water. She doesn't know the difference. In her mind, they are still bottled water. The small bottles are only 5 oz, I believe, so they are very easy for her to handle. I think she likes the independent feeling of getting her own little bottle of princess water from the refrigerator. :)

I understand why people don't drink enough water. I am very guilty myself of not drinking enough. I'm always glad when I drink it, though. It is the best cure I know for anxiety and brain fog. Water can be like a sedative to me, so I need more of it.

I don't like drinking water either. However, to get myself to drink more, I have the little bottles of water from Walmart or Sam's (16.9 oz.) and I drink those. It sounds dumb but I don't like tap water or water in a cup/glass. But I will drink at least 3 bottles a day. Go figure. Blessings

I understand what you're saying, and I appreciate the response. She does decide what she will and won't eat most of the time & it puts her body into a tailspin by eating all that carb-loaded crap, then we have to call an ambulance & get "those looks" from the doctors because her sugars are so out of whack. I understand that she's an adult, but at what point do I draw the line so I'm not investigated for neglect?? Am I not supposed to be concerned with that?? Now that she is most certainly dehydrated, will that fault land on me if she winds up in the hospital?? It's just so damn frustrating!!! I just don't know how to help someone that doesn't seem to want to get better...but then bitches and moans about how crappy she feels and how much pain she is in, when her poor choices are what got her there - or do I even bother?? All I hear is "something has to be done about this..." Yes - something does - she needs to follow her doctor's advice! She's got a pressure ulcer on her tailbone because she refuses to stand up at least once an hour as instructed to keep the circulation going. There's no reason she CAN'T do it - she just doesn't WANT to. She's had them before for the same reason, yet here we are again. The home nurses ask me "don't you make sure she stands up throughout the day?" ....like it's MY fault she refuses to do it. THIS is what I mean. Even though I tell them I remind her, I can't force her to do something she doesn't want to do, but I have to deal with the result. I don't know...I just don't know what the hell I'm supposed to do when she won't even meet me half way.

Sorry - my above response was for Jeanne. Forgot to mention that. :)

purplesushi, I'm afraid that my answer sounded more critical than I meant it to. I do understand that you are motivated by what is in your mother's best interest. You love her and you want what is best for her. Also you are getting outside pressure to "make" her take care of herself (as if you could!). Damn frustrating is probably an understatement, right?

Since it sounds like you have tried everything you can think of, I'm just wondering what would happen if you tried nothing? Could it be any worse than it is now?

And just because she wants high-carb meals all the time, that doesn't mean you have to serve them, does it? If you serve broiled salmon and green beans and a whole-wheat dinner roll and a tossed salad then she can eat it or not. It doesn't satisfy her? "Gee, I'm sorry Mom. This is what we are having for dinner tonight." Don't talk about what is good for her or not. You are the cook and this is what you made.

But I'm not listening to her whining, and you are. :-)

Now that you've had her living with you a while, how do you think it is working out? Could you have a better emotional relationship with her if she lived elsewhere and you came to visit her? If you weren't in charge of making food for her? If someone else tried to keep her hydrated? And to keep her butt sore-free? What would really be best for you? For her?

I hear you frustrated and miserable. And I don't blame you. The status quo doesn't seem to be working so good. I just hope you can make some drastic changes in what is happening at home so it will work at least a little better, or that you can change the situation altogether so that she isn't your full-time responsibility.

That your mother will not comply with medical advice is Not Your Fault.

I can relate Purplesushi! The minute I try to tell my mother to do anything or even just encourage her, she instantly sets up resistance. Been this way all her life really. I'm pretty much repeating what others said, but I'd say just only have foods available that have a high amount of fluid in them so she has no choice - then she's stuck with it. Soups, veggies, fruits, casseroles, no dry foods. I guess she'll give you hell over it though.

Another option which I have no idea will work but I just thought I'd throw out there because it makes ME drink more.....is make it special. Get a Brita pitcher so the water is filtered and has a good taste, put it in a special beautiful crystal glass. You could even get her bottled water from exotic locations like Glaciers and Fiji! Do you think any of that would appeal to her?

Jeanne - I know you didn't mean it that way - I was just pissy when I read it..sorry! My husband and I were talking about the situation today - he knew I was upset that she yelled at me, and he was upset that she did also, and it really "shouldn't" be such an issue but it just wears you down day after day after day. I get that she doesn't feel good, and I get that she's in pain - I just find it hard to have sympathy for her, ya know?

Jessie, you hit the nail on the head with "carb chasing" - that is her to a tee. She doesn't eat sweets, but she does love her Ritz crackers and toast. She doesn't get anywhere near enough protein in her diet - to the point that she has swelling in her abdomen, legs, etc. from the fluid leaking out of the cells from lack of protein. I give her protein drinks, etc. - as soon as the condition goes away, she doesn't want anymore...it's like it's been "fixed". Ugh. There were a few meals I made where I didn't ask her what she wanted - I just made dinner. We had a grilled chicken breast, a salad, and some grilled asparagus - she enjoyed the meal and told me it was good. I told her "see - low carb isn't so bad..." - why did I feel the need to say that? I should've just smiled to myself & let it go, but I had to say something... there's that power struggle thing. There are too many nights where I don't know what to make, so for some dumb reason I ask her for suggestions - again - I should know better because I know her suggestions are always going to be spaghetti/macaroni & cheese/etc. etc. No more. You are all right - I need to treat her like I did my kids - this is what we're having for dinner, too bad - but without treating her LIKE a kid...which is really tough these days, I have to admit.

It's hard for me not to resent the fact that I don't get respect or appreciation for what I do for her, for what we have put on hold in our life-plan to have her live here - it seems she has no clue the strain she is placing on us, but she's my mom and she's so frail that I feel I need to suck it up for now. Is that wrong? Probably. Once IHSS comes through (((knock on wood))) my husband told me I need to get a job outside of the home & hire someone to come in a few hours a day so I don't go nuts. He doesn't want me staying home with her all day long, whether I get paid to do it or not - I think he's right (smart man I married!). Being here with her 24/7 is just too much for me (and probably her too). Fairydust - it doesn't matter what kind of water it is - she doesn't "like" water - period...flavored, carbonated, etc. etc., but thanks for the suggestion. I wish it would work! haha!

A good healthy diet for you and your husband would be healthy for a diabetic, too. As you probably know, absolutely no foods are totally off limits -- it is a matter of portion control and a balance between carbs and protein and fat.

Please, don't ask her what she wants for dinner! :-} But you know that now! And for heavens sake, don't discuss what is "good" for her. This is what you made because you are the cook and it is what you wanted to make. You hope she likes it. If not, there is some cottage cheese in the fridge.

Do you and your husband like pasta? How about one pasta night a week? Use DreamFields pasta to minimize the carb impact. Have macaroni-tuna salad with diced apples and celery and hard cooked eggs one week, and spaghetti with marinara sauce another week, and angel hair pasta with grilled shrimp and garlic olive oil another time. Serve plenty of low-carb veggies on the side. Yumm.

When you serve potatoes, cook only enough for reasonable sized portions. If there are only three small baked potatoes, she can only have one, right?

By the way, your grilled chicken dinner sounds delicious, but it could have had a carb serving, like a dinner roll OR a small potato, OR corn, OR stove-top-stuffing mix,etc. (Just not all of them at the same meal!) Diabetics really need some carbs with every meal and snack.

Several Ritz crackers and some apple wedges with peanut butter might be a good afternoon snack. Half a box of Ritz crackers by themselves is not such a good idea. :(

I guess I'm saying don't eliminate her favorite foods. Just monitor (without commenting on) the portion sizes you make available and serve the carbs with good protein sources and healthy vegetables and some fruits. But I'll bet you know all this. The problem is taking suggestions for meal planning from mother. Maybe you let your kids pick out their favorite foods for their birthdays, but I'll bet you didn't ask them every night what you should cook! And you making the meal decisions is not treating her like a child. You are just doing your job. Do you consult your husband what to make for every meal?

Personally, I think I'd give up on the water. My mother (92) is drinking more water now than she ever has in her life, because now she takes pills and she needs two swallows a day to get them down. Before that she simply drank NO water. Our bodies are expert at extracting all the moisture from marinara sauce and pasta and watermelon and celery and lettuce and ... all kinds of food. Keep serving soup. Make Jell-O once in a while. Offer iced tea and hot tea and coffee and cranberry juice and pomegranate juice mixed with soda water and any beverage you might be enjoying.

Do you wait on Mom all day? If you said, "Your afternoon snack is ready on the kitchen island. Help yourself," would she get up and get it? If you said "You magazine came in the mail today. It is on the hall table," would she get up and get it? I don't suppose you could come up with this kind of thing every hour of every day, but would waiting on her less get her out of her seat more? (I was told several times by professionals that waiting on my husband all the time was not good for him, and I tried very hard to let him do the things he could do for himself.)

I surely to hope that going to work improves things for you. I think it very likely will!

Great ideas from Jeanne! I was all ready to turn out the light and go to sleep, and now I'm hungry as heck and craving some Ritz w/ peanut butter, or some macaroni tuna salad w/ diced apples and celery! YUM! :) Thanks, Jeanne, and good luck Purple. I can really relate to the frustration you're going through, as I'm sure we all can!! Ok, gotta go get those Ritz crackers w/ peanut butter now. G'nite, and God bless!

" it doesn't matter what kind of water it is - she doesn't "like" water - period...flavored, carbonated, etc. etc., "

Just amazing to me! I wonder what about it exactly she doesn't like? Does she have difficulty managing swallowing precisely? Sensitive teeth that the temp of the water makes hurt? Just seems so weird. Wishing you luck and great perseverance.

Yeah - it is weird - I don't know. I suspect it has more to do with people telling her she needs to drink it & her being "in control" by refusing it - the "no one is going to tell ME what to do!" thing. That scenario didn't really click until I had gone back & re-read a lot of things I have posted about her & realized almost every issue I have with her relates to her losing control over a lot of things she used to keep tight reins on (even though they weren't always in her best interest). Unfortunately I have inherited her stubbornness (though not to the extent that she has....i hope! haha!) so between the two of us we are always butting heads. I waffle between watching everything she does to protect her from herself to saying "screw it - let HER handle everything again & deal with the consequences", but when someone continually makes decisions that causes harm to themselves, that doesn't seem to be a valid option either. The only other option is meeting her in the middle, but that's a hard line to draw too as the consequences of her choices are mine to deal with also. Yeah...no easy answers for sure. Sigh.

P.S. - looks like someone didn't like the title of my question & reworded it... rude. lol!

I noticed the title change ... I guess theirs gives a better idea of the problem, but I liked yours better! :-)

I imagine being a moderator on a forum like this can be a challenge. I would do some things differently, but I'm not volunteering!

I've noticed the mods don't like creative titles, but we do.

Purple, I know what you mean about going back and forth. My mother and I are such opposite people. She's Oscar and I'm Felix -- an odd couple indeed. I once tried to control what she was eating by nagging at her. Didn't work and I ended up feeling like the food police. I stopped doing that, opting for the softer grocery-store choice control.

Since your mother is diabetic, water (without salt) is pretty important. Diabetics are more prone to UTIs and peripheral circulatory problems. Getting enough water helps keep these problems down. It helps to keep the urinary tract flushed and helps to keep the blood fluid and flowing to the piggies.

Getting her to drink more is not only for her, it is for you. If she gets sick, who is going to be the one taking to doctor or hospital and caring for her until she gets better? There are some ways to sneak some water into her -- caffeine-free diet cokes, diet Lipton green tea, diet Sprite -- these are just some ideas. They taste good and don't have caffeine. The carbonation and artificial sweeteners make some people frown, but it is better than no water at all. If you go this route, be sure not to tell her it is like drinking water. She'll probably think you're trying to manipulate, so she would just reject.

I think I'll take my mother a bottle of princess water right now. Her intake has been low lately, and I still remember the horror of her UTI last summer. I want to keep her system running as smoothly as possible, both for her and me.

Wow good responses but i never tried to control my mom but i did tell her if she likes being in the hospital instead of her own home..its fine with me, she nevered like the hospital she despises it and thats all i would say i wouldn't comment, nag or anything all i had to do was mentioned the hospital, and i got her to eat and drinka and follow her diet..and it wasnt a threat either ..she would refuse at time with my sisters about her medicine her meals her liquids and one thing she couldn't have was alot of sweets and she was known to eat butterfingers, mints drank coke well she was a diabetic and you know that was a no no to have..but we manage it took some doing she would get mad at them but not me cause i wouldnt fuss with her i would just tell her.."Well mom imma go and pack my over night bag tell he kids i will be staying at the hospital with grma cause she refuses to eat right or drank" and at the time my little one was smart he would call grma and ask her why she is going to the hospital, it was cute tho but it also made my mom think and then i wouldnt have any trouble..if you cant beat them join them in a sort of way.i know this techique wooudn't work with everyone but it work for me...so good luck my friend

Purple, has your mom been checked for a UTI lately? Could be causing her to be more argumentative. Is she incontinent, or does she have accidents? Most elderly do not drink enough due to the constant fear of wetting themselves. Does she like salty snacks? Maybe that would make her more thirsty.
Also, the last sense of taste we lose as we age is the one for sweets. That is why most elderly love their sweets, because they can taste them. Your mom's lack of fluids can certainly contribute to a UTI which will cause all hell to break loose if it gets really bad. I think the suggestions to stop bringing up the subject are the smartest for now. Don't rock the boat and don't give her reasons to argue. Buy her some watermelon and other juicy fruits. And yes, soups area great source of fluids. But definitely keep an eye on her because dehydration is a major cause of death in elderly people. I think she has some other reason for not drinking besides "I don't like water"
Instead of complaining to her doctor, voice your concerns for her health and see if they can check her for a UTI to at least eliminate that possibility. As frustrating as it all sounds, backing away and letting her make her drink and food choices without criticism may be the way to go for now. Good luck!

The doctor asked her if she had any of the signs/symptoms of a UTI on Thursday, but she said no & he didn't pursue it. She wasn't running a fever either - she was complaining of a sore ear and throat & her blood sugars have been sky high - over 3 and 400 (which is why I brought her to the dr. & why I've been freaking out about her food choices) We left with him saying she "probably has a virus" and that's what's causing her sugars to go out of whack. If she doesn't improve by tomorrow, I'm calling him again & demanding a urine test to rule out a UTI just in case it's one of those sneaky ones.

She is incontinent, but her lack of control is more for bowels than urination. She has a tendency to "dribble" if she doesn't get to the bathroom in time, but not full-on incontinence in that she loses control completely. Today she did ask me for some ginger ale - she said that sounded good, so I got her some & didn't say anything more about it. I've been hoping her body would take over at some point & demand that she get something to drink - maybe that's what's happening now?? Time will tell, I guess!

elderly people can be challeniging at times..good luck purple, im sure ur mom will be fine

Yup, a virus or any illness can sure play havoc with blood sugar levels! Did the doctor make any adjustments to her diabetes meds in the interim?

And by the way, good for you for giving her ginger ale without comment!

If she is incontinent bowel wise, just the bacteria from that can cause an infection. If any gets into her urinary tract, she could have a form of strep and would definitely need an antibiotic for that. They may have to do a "swab" for that. She would not have a fever or show any major signs other than a bit of discomfort when urinating and that doesn't always get noticed.
It's always good to have these things ruled out so that you know what you are working with. Mom have a vasovagal response at daycare on Monday and they called the ambulance for her. When I got to the ER she was a bit shaky from being late with her sinamet, but otherwise pretty much the usual. They had already cathed her for urine just in case. I grabbed her meds on the way out the door as I knew she would not get them on time in the hospital. Luckily the nurse let me give them to her, otherwise she would have been a mess! The PA who examined her asked if I wanted them to keep her overnight or sent to rehab. I said no to both, even though respite would be very welcome. What I didn't need was for her to catch something at the hospital and there really is no point to rehab at this stage of dementia. But at least I know she does not have a UTI! Oh and it was full moon last Monday! That always gets Mom going!

Yeah - he had her increase her Lantus (evening) insulin, and adjusted her sliding scale. It makes me nervous because if the Lantus is increased too much she goes hypoglycemic when whatever is causing the rise in levels is resolved. Will be watching that one closely. She did say her throat wasn't as sore today as it has been, so here's hoping she's on the mend.

purple, I know that Lantus is a 24-hour release thing, but I wonder if the release is slightly higher in the hours after the injection. When my mother has hypoglycemia, it usually occurs at night. Because of this, I had her start taking her insulin at lunchtime. We haven't had trouble with nighttime hypoglycemia since the change. Of course, it may be that she is snacking... never can tell with my secretive mother.

@Jessie - Years ago, her endocrinologist had her take Lantus 1/2 dose in the evening & 1/2 in the morning because her readings were so low in the early morning it was scary. Since being removed from her heart pills (after getting a pacemaker) that made a HUGE difference in her sugar readings (who'dathunk?) so she resumed nightly Lantus injections & it's been fine for the most part, but every once in awhile (usually when she's fighting off a virus or some sort of infection) she is insulin resistant & the sugars will be super high for a few days, followed by super lows once her system gets back into the swing of things. This morning was the lowest it's been in a week - it was 69 upon waking (it's been running over 300+) I "suggested" she resume the 10 unit dose, instead of the 12 that her doctor suggested on Friday, since she said she is feeling a little better. To top it all off, we got a letter in the mail today saying that her new insurance company no longer covers Lantus in their formulary, so she may be getting switched to Levemir if the insurance company doesn't accept our request to cover Lantus. I swear, if it's not one thing...ugh.

My mom isn't fond of drinking either. To help keep her hydrated I make sure that she gets foods that have lots of fluids in them. For breakfast she gets a big bowl of mellon or oranges. For desert everyone has icecream, pudding, or jello. We have soup for dinner once a week. We have soup for lunch whenever it seems that she needs more help with fluids than usual. For a snack she has grapes. Since everyone in the family is able to enjoy these foods she doesn't feel singled out.

Purple, I've been thinking about you and this problem. Does Mom have a before bed snack? Some diabetics swear by a scoop of ice cream every night.

Has Mom had a few sessions with a certified diabetes educator lately? Doctors tend to address issues with drugs, with adjusting insulin, adding or adjusting doses, etc. That is suitable. But CEDs also come up with eating suggestions, like be sure to have about 15 grams of carbs with protein mid-afternoon, etc. They aren't all about restrictions. If Mom hasn't seen one in the last couple of years I think it would be worthwhile for both of you to go.

Her health and "scares" ARE affecting you and your family so now that does cross the line and you need to have the frank conversation with her and tell her that you are just trying to help and want some cooperation so she doesn't end up in the hospital or worse.

Ask her "since you don't want water, what do you want to drink?" "Mom, how can we keep you healthy and hydrated?". Maybe a diabetic shake or celery sticks, etc. that are high in water would be more to her liking. Maybe smaller snacks more frequently thru the day; beverage sips thru the day might be helpful.
Agree with maybe having a nutritiionist consultation through her doctor or the hospital is warrented. You may have to change how you and hubby eat as well if you are sharing meals. You prepare and serve and she eats or doesn't; but thats all that is available other than healthy snacks.
Maybe dr willing to have frank discussion and tell her if she doensn't take care of herself and ends up in hospital again, that she might end up in rehab or having to go to a facility where she will be forced to be taken care of -- since she herself isn't managing and she isn't listening to her current caregiver (you!).