IV Fluids for Someone With Late-Stage Dementia

IV Hydration in Late-Stage Dementia

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There are multiple decisions about end-of-life care for someone who has dementia. One of those decisions involves the use of intravenous (IV) fluids for hydration.

As Alzheimer’s and other dementias progress into the late stages, the ability to take in adequate hydration decreases. If your family member resides in a facility or is in the hospital, you will likely be asked if you want your loved one to receive hydration via intravenous fluids.

What Is an IV?

An IV is a small tube usually placed in your arm or top of your hand. Fluid is pumped through the tube into your body to prevent dehydration.

Temporary Use of IVs for Hydration in Alzheimer’s

The use of an IV for hydration is fairly common in the early and middle stages of dementia. For example, if someone has the stomach flu and has lost too much fluids, an IV can be started to replace some of the lost fluid. This is a temporary use and in a day or two, the IV is typically discontinued since the person is able to regain the ability to take in nutrients and fluids.

Late-Stage Dementia

When a person with dementia is beginning the dying process, he will often refuse to take in food or nutrition, or he may cough when you try to give him a drink. He may have developed swallowing problems or simply be less responsive.

A common fear of the family in this situation is that their loved one is experiencing thirst or other discomfort from a lack of hydration.

Will IV Hydration Help in Advanced Dementia?

IV hydration may delay death, but it likely won't prevent it. It is felt that the inability to take in fluids orally may be a sign that the end of life is approaching due to the advanced dementia. Thus, providing fluids will usually not remedy the problem if the trigger is the actual dying process.

Some hospice organizations feel that hydration increases discomfort because more fluid builds up in the lungs, making it more difficult to breath or necessary to suction secretions out of the throat and mouth.

Risks

  • Over-Hydration
  • Discomfort or Pain at the IV Site
  • Injury from Attempts to Pull Out the IV
  • Restraints
  • Increased Chance of Catheter Placement
  • Electrolyte Imbalances
  • Infection of the IV Site

Will Your Loved One Be in Pain or Discomfort Without an IV?

According to the Alzheimer's Association, dehydration in the dying process is a normal and expected state. Multiple studies have concluded that dehydration actually decreases discomfort, possibly because there are fewer secretions to cough or choke on, and the process of dehydration may release ketones, which can decrease pain.

Options to Promote Comfort

  • Ice Chips
  • Swab Mouth to Keep It Moist
  • Place Lanolin on Lips
  • Cool, Damp Washcloths on Forehead
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Article Sources

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  • Alzheimer's Association. Late Stage Care.

  • American Hospice Foundation. Artificial Nutrition and Hydration: Beneficial or Harmful?

  • Hospice and Palliative Nurses Association. Artificial Nutrition and Hydration in End-of-Life Care.

  • Northern California Chapter of Gerontological Advanced Practice Nurses Association. Artificial Nutrition and Hydration For the Person with Dementia.