Dehydration and Huntington’s Disease

Contributed by Teresa Tempkin, RNC, MSN, ANP

When Spring arrives in the Central Valley, we know that Summer is not far behind. This is a good time to remind ourselves that our HD friends and family members need to be aware of the dangers of becoming dehydrated in the upcoming summer months.

People with HD are at risk for dehydration. Especially in warmer climates (the Central Valley), and in the summer months. During these times, we throw off excess body heat by sweating. Some people with HD sweat prodigiously already. As body temperature rises, blood vessels dilate and fluid is lost through the skin as sweat. Ambient air and breezes evaporate this moisture, cooling our core body temperature to keep it in an acceptable range. The hotter it is, the more we sweat, and the more fluid is lost. Failure to replace these fluids can result in dehydration.

Why people with HD are more prone to dehydration:

  • Cognitive impairment can alter the perception of thirst. People with HD who have difficulty with thinking and organizing their thoughts and actions may be unaware they are thirsty, or not know to drink extra fluids on hot days.
  • Motor abnormalities and chorea may prevent some people from getting access to sources of fluids. They cannot drink it if they are unable to get to it! Chorea can interfere with a person’s ability to get a drinking vessel to their mouth. This can lead to frustration, and create an additional disincentive to a drinking routine and extra fluids.
  • Dysphagia (difficulty swallowing), can be a risk factor for dehydration. Dysphagia is common in mid and late stage HD. Thin liquids, such as water, are the most difficult fluid to manage orally. Many people with dysphagia need to have all their liquids thickened. Complex fluid preparation and oral fatigue can make it difficult to maintain an adequate fluid intake - especially if additional fluids are required.

How can you tell if someone is dehydrated?

  • Increased heart rate
  • Dry mouth
  • Concentrated urine, and voiding fewer times during the day
  • Poor tear production

Remember that a person with HD may not ask for fluids, or tell you they are thirsty. This means that caregivers, family and friends need to anticipate this need and plan accordingly.

  • Always have fluids available when out and about
  • Drinking water is best. Eight ounces every few hours during the waking hours should be adequate.
  • If you are unsure if the person with HD is getting enough fluid, keep track. Actually create a fluid log and write down every time they drink how much they consume.

When to seek medical attention for dehydration:

  • A change in mental status - they become delirious or confused.
  • Unable to drink or take things by mouth
  • Change in vital signs - increased heart rate, decreased blood pressure, increased temperature.

This article was reprinted by permission by Teresa Tempkin, Nurse Practitioner, Department of Neurology, UCD Medical Center.