One thing we’re very keen on optimising through the Butterfly Scheme is hydration – and that means not just making sure water is provided, but actively working with the patient to ensure there’s a steady intake of fluids; there’s a huge difference between making drinks available and actually ensuring people drink! As you’ll know, people living with dementia may well hydrate adequately at home, but once they’re not in their own environment or routine, drinking no longer fits into its usual place in their lives.
I think it’s often not realised that there’s also a generational difference between today’s way of people asking for what they want, as opposed to the old way of trying to be as little trouble as possible. This was illustrated recently by an elderly friend without dementia, who had fallen and needed hospital care. Before being examined in A and E, she was told not to eat or drink anything; she then underwent a series of imaging and other tests and had fifteen stitches to her face. By the time it was all done, it was well over twelve hours since the accident and a full sixteen hours since she’d had even a drink – but because nobody had told her differently or offered her any drinks or food during that time, she’d presumed she still wasn’t allowed to eat or drink! She ended up fainting and the staff then realised she was dehydrated, but it was only when they said she needed a drip that she asked whether she couldn’t perhaps just have a drink. Why hadn’t she asked before that? Well – because they were all so busy and she didn’t want to be a bother!
Imagine, then, a person with dementia, who might not even think about eating or drinking unless someone brings it to their attention and encourages them. Without adequate hydration, people are more likely to fall or develop urinary tract infections – and the consequence can be a longer hospital stay and potentially a much longer recuperation time.
It’s simply not good enough to think that placing a glass of water near a patient with dementia is a job done; properly supporting hydration requires insight, skill and a structured system of care. This is what people with dementia deserve and it’s up to the rest of us to support that expectation.
As always, I thank all healthcare teams who pride themselves on dementia-friendly hydration support.