Approximately one year ago, I wrote about my mom experiencing hallucinations after a severe case of diarrhea.
Here is the past article for your review:
https://www.functionalmedicineuniversity.com/public/1986.cfm
My 91-year-old mom is now living with my wife and me.
She was put on a diuretic, and shortly following the administration of the diuretic, the hallucinations started again.
A urinalysis indicated severe dehydration.
Urine specific gravity (USG) is a non-invasive measure of dehydration that can indicate severe dehydration when it’s greater than 1.035:
Normal: 1.005–1.020
Dehydration: 1.020–1.030
Severe dehydration: 1.035–1.055
The following photo will provide the urine color to evaluate for dehydration.
Urine specific gravity (USG) is a non-invasive measure of dehydration that can indicate severe dehydration when it’s greater than 1.035:
Normal: 1.005–1.020
Dehydration: 1.020–1.030
Severe dehydration: 1.035–1.055
The following photo will provide the urine color to evaluate for dehydration.
Severe dehydration can cause hallucinations, which are false perceptions of sensory experiences. Dehydration can cause hallucinations by leading to delirium, a mental disturbance that can cause hallucinations, confusion, and changes in consciousness.
Dehydration can also cause hallucinations by leading to hyponatremia, a condition that occurs when the body excretes sodium and electrolytes to compensate for lower osmotic pressure. Hyponatremia can cause cerebral tissue swelling, which can lead to hallucinations or coma.
Due to the seriousness of her dehydration, I took her for a saline IV drip therapy with appropriate administration of electrolytes.
Intravenous (IV) therapy with saline and electrolytes can be an effective way to treat severe dehydration.
My mom received the IV drip with electrolytes for three hours.
It was amazing to see a return of my mom’s cognitive functions.
He significantly improved, and the hallucinations stopped.
When dehydration reaches the point of causing hallucinations, emergency medical intervention is required. Failure to restore the osmotic balance in the body can lead to organ failure and permanent brain damage. Moreover, the changes in mental capacity leading up to this point can further exacerbate dehydration.
Facts to Know
Water accounts for 60 to 70 percent of our body weight. But shockingly, up to 75 percent of Americans—especially seniors—are chronically dehydrated.
Thirst isn’t always a reliable indicator that your body is dehydrated.
Signs of dehydration
How can you tell if you’re dehydrated? Start by checking the color of your urine. Clear or pale yellow urine usually means you’re drinking enough water. But if your urine is dark yellow or amber, then it’s time to drink more water.
Other signs of dehydration to watch for include:
Bad breath
Less urine than usual
Dry mouth and swollen tongue
Feeling sluggish or tired
Cravings for sweets
Seek immediate medical attention for symptoms of severe symptom dehydration, which may include:
Confusion
Dizziness
Fainting
Heart palpitations
Hallucinations
5 Ways to Respond to Your Loved One’s Hallucinations
As the son of a mom with early-stage dementia and again having severe dehydration, it is essential to know how to help a scared person having hallucinations.
I felt terrible for my mom and wanted to comfort her when she was not sure why she was seeing things that simply were not there.
The following are appropriate action steps to help a loved one when having hallucinations while the root cause of the hallucinations is being addressed.
#1: Remove Possible Triggers From the Environment
Hallucinations are not always all in the head. Sometimes, there are environmental triggers to consider.
Sounds can be hallucination triggers. Reduce or eliminate easily mistakable sounds, such as the TV or an air conditioner.
Nighttime hallucinations in older adults are common, and this can often be linked to shadows.
Shadows can easily confuse someone prone to hallucinations, so try to reduce them. Look around and see if there are shadows that look like something specific, and do what you can to move objects around to eliminate the shadow.
#2: Stay Calm and Don’t Be Contradictory
Telling a loved one that what they are experiencing isn’t real might seem like the easiest and kindest reaction to a hallucination, but you should not do this.
Especially if the hallucination is linked to dementia, someone experiencing this type of event is not able to rationalize that what they are seeing or experiencing is not accurate.
Remain calm and collected, and do not attempt to use logic or reason to convince them that they are hallucinating.
#3: Provide Reassurance and Validate Their Feelings
While you are staying calm, provide reassurance to the person experiencing the hallucination. Let them know that you are there to support them.
If they are gaining joy from the hallucination, you might say, “I see that you are happy! I am so glad that what you are experiencing is bringing you joy!”
If their hallucination is frightening, you might respond with something like, “I can see that you are scared. I am sorry that you are experiencing something so scary. I am here for you. How can I help you feel safe?”
If they seem confused or disoriented, you might respond, “I can tell that you feel confused. How can I best help you?”
Simply being present with your loved one through the hallucination can go a long way in helping them cope.
#4: Distract and Redirect
Distraction and redirection are potent tools that you can use to help someone experiencing hallucinations. Please do your best to take their attention off of the hallucination by directing them to something they enjoy.
For instance, you could suggest:
Going for a walk
Doing a puzzle
Having a snack
Doing a chore or other task that makes them feel successful
Looking through old family albums
Singing their favorite song (if they are religious, a song they know from church might be especially helpful)
You can also try taking their attention off of the hallucination and placing it on you. For instance:
If they are hearing voices — talk to them. It will be harder to make out those voices if they are listening to yours.
If they see something — make eye contact. Help them to look you in the eyes and gently hold their attention. This might help the hallucination to fade or even disappear.
If they feel something — try holding their hand or offering a hug. Diverting their attention to you might help.
How to Prevent Dehydration and How Much Is Enough?
To prevent dehydration, always ensure that you drink plenty of fluids and eat foods high in water such as fruits and vegetables, especially if you live in a hot climate. As a general rule of thumb, you should aim to consume at least 6 to 8 cups of water each day, and more if you are participating in vigorous exercise.
No doubt you’ve heard that the typical recommendation for daily water and fluid needs is 64 ounces—or eight glasses—daily. But, there’s more to the story…
The Importance of Water and Electrolytes
Of course, our bodies also need electrolytes. These are key minerals—like sodium, potassium, and magnesium—that regulate multiple functions, including our heartbeat, blood pressure, fluid balance, and muscle contractions.
And yes, dehydration can lead to an electrolyte imbalance.
So, in addition to staying properly hydrated through plain water, be sure to focus on those key minerals as well. The good news is, eating fruits and veggies can help you avoid an electrolyte imbalance, while also keeping you hydrated.
After all, for most folks, around 20 percent of their daily water intake comes from foods. So, here are ten options with the highest water content:
- Cucumbers: 96 percent water
- Tomatoes: 95 percent water
- Spinach: 93 percent water
- Watermelon: 92 percent water
- Mushrooms: 92 percent water
- Cantaloupe and honeydew melon: 91 percent water
- Broccoli: 90 percent water
- Peaches: 88 percent water
- Brussels Sprouts: 86 percent water
- Coconut water
The Bottom Line
We all lose water daily through sweat, bathroom breaks, and more. And it can be easy to let your fluid intake fall by the wayside, especially if you keep busy.
Three Good Tips to Increase Hydration
Tip #1: Simply do it and Increase your water intake.
Tip #2: Add some flavor.
If you’re looking for some flavor, go ahead and enjoy some herbal tea and flavored seltzers.
Tip #3: Keep track.
Keeping a daily log on paper or a wearable device, such as a Fitbit, can help make proper hydration a habit.
Dr. Grisanti’s Comments:
My mom is doing significantly better since we are staying on her to be certain she is getting the optimal amount of water and other hydration measures.
Her primary physician has also reduced her diuretics by 50%.
As of today she is doing better.
My wife and I will be checking her urine for color and specific gravity and of course monitor any time sensitive symptoms indicating a return of the dehydration.
My reason for sharing this article is to be certain that any one caring for an elderly loved one does not miss the symptoms of dehydration which can life-shattering and life threatening.
I would suggest purchasing a Urinalysis Strips Test Kit and measure the specific gravity. The higher the specific gravity the higher likelihood of dehydration.
References:
https://www.sciencedaily.com/releases/2007/12/071217192400.htm
https://www.relias.com/blog/is-dehydration-affecting-your-clients-minds
https://healthy.kaiserpermanente.org/health-wellness/healtharticle.10-warning-signs-of-dehydration
https://www.alzdiscovery.org/cognitive-vitality/blog/can-dehydration-impair-cognitive-function
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986442/
https://caregiver.com/articles/hydration-and-delirium/
https://www.alzheimers.org.uk/get-support/daily-living/drinking-hydration
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603652/
https://www.amenclinics.com/blog/mild-dehydration-is-it-causing-memory-loss-depression-anxiousness-or-focus-problems/
https://www.sciencedaily.com/releases/2007/12/071217192400.htm