Alzheimer's Dementia Thirst Checklist (Research)

The first thing I do as a hospice volunteer when I visit a resident’s room at a nursing home is look for a filled water glass. This is year-round, regardless of the weather. Because most of my hospice patients share a room with two or three other residents not assigned to me, I usually look for several glasses. Beyond looking for glasses, I also observe patients for clues about their overall condition, including dehydration.

Residents with advanced dementia are at a particular disadvantage when it comes to expressing thirst needs verbally. They often resort to communicating these needs through behaviors and psychological symptoms for caregivers and others to interpret. These expressions for making their critical thirst needs evident require accurate assessments to maintain their well-being. One way of doing this is with a checklist.

A research study on the thirst status of people with advanced dementia was created to develop a checklist. The initial items were developed through interviews with 10 professional nurses who were caring for these patients. Four experts in dementia assessed the content validity of these items. In addition, caregivers from eight facilities were then invited to complete the checklist based on their current advanced dementia patient care experience. Analysis identified these seven checklist items for determining thirst needs:

Checklist to Assess the Thirst Status of People with Advanced Dementia 

1)   Repetitive movements

2)   Squirming

3)   Restlessness or anxiety

4)    Persistent or unreasonable demands

5)    Pacing back and forth

6)    Repeating a sentence or question without purpose

7)    Slow reaction

Although the reassessed internal consistency reliability was .66, caregivers can still use this checklist as an aid to identify the thirst or fluid needs of people with dementia who are unable to communicate their needs effectively.

Drinking enough water daily is something that we all should do. Experts recommend that we drink 8 cups of 8 ounces of water daily. Unfortunately, over 40% of Americans drink fewer than 4 cups, and 7% report drinking none daily. 

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

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