Hydration

Some people with Parkinson’s do not hydrate properly because of the loss of a sense of thirst and bladder control issues. This is because of the unusual messaging to the brain. However, if you forget or avoid water intake it will compound continence problems. Instead, see a urologist or continence specialist for some possible solutions and track the amount of water you drink over the day.

1. Drinking a glass of water when you take your levodopa helps “flush” the medicine from your stomach to your small intestine, where it is absorbed. Drinking a glass of water and taking your levodopa on-time and on an otherwise empty stomach will ensure that more of the medication is absorbed, giving you the full benefit of the levodopa.
2. Staying hydrated aids in digestion. Just by drinking more fluids, you can help alleviate one of the most common and bothersome Parkinson’s symptoms – constipation. The bowel needs water to work properly, and dehydration can lead to constipation and other digestive problems including an overly acidic stomach. This also increases the risk of heartburn and stomach ulcers.
3. Drinking water is vital to kidney health and helps to avoid kidney stones and urinary tract infections (UTIs). Infections are the leading cause of admission to hospital for people living with Parkinson’s. These infections also increase the risk of falls, confusion, delirium and hallucinations.
4. Drinking water helps to avoid high blood pressure. When the body’s cells lack water, the brain sends a signal to the pituitary gland to secrete vasopressin, a chemical that causes constriction of the blood vessels. This causes blood pressure to increase which leads to hypertension.
5. Drinking water assists with the delivery of oxygen throughout the body. Blood is more than 90 percent water, and carries oxygen to different parts of the body.
6. Drinking water boosts skin health and beauty. Dehydration causes the skin to become more vulnerable to skin disorders and premature wrinkling.
7. Drinking water cushions the brain, spinal cord, and other sensitive tissues. Prolonged dehydration can lead to problems with thinking and reasoning.
8. Dehydration can affect brain structure and function. It is also involved in the production of hormones and neurotransmitters.
9. Drinking plenty of fluids helps your joints move more smoothly, removes waste products and transports vital nutrients around your body.
10. Fluids also help control body temperature and hypotension (i.e. dizziness often experienced from sitting to standing).

There are a few precautions you can take to avoid dehydration:

• A recommended daily water intake is the well-known 8 glasses (2.1L/day) per day for women and 10 (2.6L/day) for men.
• To make sure you hydrate properly, drink a glass of water with or before each meal or snack throughout the day. This can also help with any swallowing issues when having food.
• It‘s best to take your medications with a large glass of water and on an empty stomach to maximise uptake.
• You can consume foods with high water content, such as watermelon, oranges, rock melon, cucumber, celery, tomatoes, cabbage and spinach.
• Not only is it important to increase fluids such as cold water, it’s also a good idea to limit alcohol, caffeine, high protein drinks, and hot liquids, which have a diuretic effect and exacerbate dehydration.
• If you have trouble swallowing, try using a straw to drink liquids from. You can also thicken liquids.
• If you’re worried about incontinence, drink small amounts of water over the course of the day.
• Set an hourly reminder to drink more.
• Drink water before, during and after exercise.
• Add lemon, lime, orange or cucumber slices, a splash of juice for added flavour and enjoyment.
• Line up cups on the counter to use throughout the day as a reminder, or have a drink bottle tally by its volume.
• Keep a log or checklist of the number of liquids consumed, on paper or in a health app.
• Avoid exposure to dry, hot weather for prolonged periods.
• Avoid medications causing excessive water loss (diuretics).
• Talk with your doctor about issues causing excessive water loss through drooling, urinating & sweating.

IInfosheet kindly reviewed by the Australasian Neuroscience Nurses Association

The Australasian Neuroscience Nurses’ Association (ANNA), is the peak body for neuroscience nurses. Their mission is for the advancement of neuroscience nursing through education, networking and support to enable optimal care. ANNA achieves this through the provision of opportunities to network, access to resources and promotion and support of the neuroscience speciality. More at: www.anna.asn.au