Expert: Alanna Shaikh - 12/14/2008

Question
Hi,
My 87 year old grandma has Alzheimer's, I moved in with her to take care of her as she can not take care of herself. I have a couple of questions:
1.I would like to know what stage you would consider her to be in? She does not do anything by herself, I set her up, lay her down, she does walk with me holding her hands and gently pulling her forward(otherwise she would just stand there)I completely bathe her, most of the time she is incontinent of urine when we take her to the bathroom and tell her to go pee she ask whats that but at the same time if she see's my dog she'll say get that dog out of here. She does not recognize us most of the time. She knows her name most of the time but not always. She knows my grandpa's name but does not always recognize him. Sometimes her speech is garbled other times its plain. She has to be fed, she makes no effort to do anything by herself. The stages are confusing so I was just wanting someone else's opinion.
2.How can we get her to drink liquids? She eats good but will not drink and has been in the hospital twice this year with dehydration. We are lucky to get a 6 oz glass in her a day.
Thank you in advance for taking the time to answer questions.

Answer
Dear Michelle,

I don't tend to focus on the stages of Alzheimer's. It's an unpredictable disease, and I think that knowing what stage someone is in is not especially useful information. That means I don't have any particular insight to offer you. I recommend you ask your grandmother's doctor about what stage he/she would estimate; her doctor will give you a better estimate than I can.

The drinking issue is tricky. Does she seem to fear liquids, or just dislike them? Is she having trouble swallowing? If she is having trouble swallowing, then a clinician can offer suggestions about thickening liquids to help them go down. If it's not a swallowing issue, it may just be a dislike on her part.

Have you tried offering many different kinds of liquids? Maybe a particular juice flavor would be popular, or even soda. People with Alzheimer's often grow to like sweet flavors, so Kool-aid or Tang might also be more appealing than plain water.

Also, I am sure you have thought of this, but try to choose foods for her with plenty of water in them. Fresh or canned fruit, for example, jello, and vegetables have liquid in them that can help stave off dehydration. You could also try poaching and braising as cooking techniques to get more liquid into the food she eats.

You are doing a wonderful thing caring for your grandmother, in the face of a terrible disease. She's very lucky to have you; it sounds like you are doing an excellent job of caring for her.

Please feel free to write back if I can answer anything else for you.

Best,
Alanna