Trust issues

Lisa21

My mother in law (early into mid stages) is having trouble trusting her husband when it comes to taking medications, wants to argue, can’t remember already taking or then won’t take.  Tried digital timed dispenser but she won’t go by it either. She still knows quite a bit and all of us, but gets agitated more easily and moody/depressed.  I want to gently encourage her to trust her husband is giving her the meds, but don’t want to upset her and cause it to be a source of worry for her. Trying to ease both of their frustration levels but not sure how. Ideas?

M1

Lisa when my partner was stage 3/4, it was quite a battle to give up control of taking her own meds.  Not surprising that it got difficult, because she takes about seven different prescription meds and two or three over the counter daily.  But when it got where she couldn't remember/handle all the different bottles, we tried a weekly dispenser that I set up (morning and night), but then it became clear she couldn't remember the days of the week.  A daily calendar helped for about six months, and then that didn't help either, so I had to physically move the dispenser and all the bottles to my bedroom/bathroom, where I set the dispenser up and physically hand her the pills morning and night (as well as oversee an as needed pain pill four times daily).  

She was hugely resistant to this, but has now acquiesced.  We had to go through the discussion mutliple times that she couldn't remember what she had taken and when--especially the as needed pain pill, she was at risk for overdosing because she'd take it again if it wasn't immediately effective.  I still have to hide the bottles; she recently went through my vanity drawers (where they used to live) and confiscated her pail pill bottle and a full bottle of 180 Celebrex capsules.  Fortunately we found the pain pills (which cannot be refilled/replaced) but still haven't found the Celebrex.

All this to say:  yes, it's an issue, and it took a long time to work it out.  If I were you/your dad, I would:  move all the bottle to a safe location; still set up a dispenser for your/his convenience but hide it too; just physcially give her the pills to take at the appropriate time.

If she still obsesses about this, it may be worth talking to her doc about medication for anxiety.  Hard to control obsessions without it--my partner has others, and medication is NOT one of them.  Good luck.  But the most important thing is her safety, this is an  important issue.

I know other posters make taking medication a "together" activity:  here are yours, I'm taking mine now too.  Maybe that would also help.

M1

Welcome to the forum BTW, I see this is your first post.  You've come to a good place, though we all wish it weren't necessary.

Lor2014

Dementia is a hard road to navigate. This was a difficult one for me, too, when I realized my mother couldn't manage her meds anymore. It helped me to think about how I would feel if my daughter started taking over the parenting of me, as this is what is happening. It would be so hard to lose all of the decision making power, ability to drive, and manage my life. But with dementia, that is what needs to happen to keep the patient safe.

At some point, I stopped trying to reason with my mother, and simply explained to her the new way things were going to be, including the meds. At a certain point, my mother couldn't remember what we talked about within 30 seconds of the discussion. Nothing "sticks" anymore. When she was agitated about certain events, asking over an over, I framed  a sheet of paper with simple statements such as, "XXX visits you every week," "All of your bills are paid," "I love you, signed XXX", etc.

Of course, those framed papers would disappear, and I would simply replace it with statements that would help to answer her obsessive questions so that she might see it when I was not with her.

You could also talk to her physician and have him/her emphasize that the meds are required to be managed by someone else, thereby making the doctor the scapegoat. 

{{{hugs}}} Dementia sucks.

ButterflyWings

Hi Lisa - So sorry you have to be here with us, as this is not a good journey. But the friendship and wisdom in this circle is the best in the world, so you are in the right place. Everyone here has been through, is currently wrestling with, or will likely have to deal with exactly what you are facing. So we help each other.

M1 and Lor gave you some great input. Here are a couple of links I found that may help also. And Teepa Snow videos are very popular for her expertise and validation, calming work-around advice. Is your FIL open to joining this forum? It helped me so much to just read everything.

 https://www.brightfocus.org/alzheimers/article/refusing-take-medications-tips-alzheimers-caregiver

Alzheimer’s Disease and Refusing Care

This resistance to help with meds was a huge sticking point for my DH too starting in Stage 4 soon after diagnosis. This was a dance we did, multiple times daily. It got so I'd have to hide his medication in a blueberry, crush or stir it into applesauce, ice cream or some pills can be crushed and dissolved into juice or a smoothie. There also are liquid forms for some meds, which can be super helpful. Caregivers have to find indirect ways to do what needs to be done.

I also learned the hard way to watch him (surreptitiously) like a hawk after I hand him the meds and juice, to be sure he actually swallows it. Sometimes he did not, and behavior went off the rails unnecessarily - I'd be baffled until the missed med was found, under a pillow, on the floor, wrapped up in a napkin. Now at stage 6d, he still sometimes resists...usually I can wait a few minutes and try again, and he will take it. I may chat him up about something else as a distraction while handing him the meds and juice and then he takes it as if he forgot how hard he just argued against it.  Go figure. 

Sometimes we both get super agitated to be honest, as it can catch me off guard after days of cooperation. And just last week I had to get a small lock box to keep the meds safe from rummaging hands (I used to keep them in my purse but he did like M1's LO with her vanity). 

Best of luck to your family as you navigate these rough waters. You seem like a caring DIL.

Arrowhead

My wife was obsessed with going “home” to the house she grew up in. She would try to leave several times a day. Finally, I began locking the gates to our yard so she cannot leave. It agitated her and she continued trying to leave but eventually she stopped. She no longer tries. Your mother-in-law may fight the idea of her husband controlling her medication at first, but eventually she will probably get used to it and accept it.

Emily 123

Hi Lisa,

She can't remember any of it, and that's why she can't adapt to any of the reminders as well as not believing she's taken her meds already (been there, done that). 

I  bought this type of pillbox and loaded it each month--it helped me order med refills in a timely way too. 

https://www.amazon.com/gp/product/B07WZRVX23/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

Every morning the day's box was put on the kitchen table.  My mom was still ok identifying 'AM/PM', and she would take her meds accordingly.  If she'd later ask if she had taken them, I'd tell her to check the box on the table.  The monthly pill holder was kept up on a high shelf out of sight.   When she would pushback I'd tell her that I was reordering her meds for her online, and it helped me keep organized to do it this way. Any new routine can be hard to initiate, and sometimes a fiblet about why changes are occurring can help smooth out the bumps.

Quilting brings calm

Have your dad ask the pharmacy to put her meds in the blister pack ( or pill pack) packaging. It will have her name, date and time to open and take them. If their current pharmacy won’t do that, switch to one that does.  Local pharmacies usually do it. She might trust the pharmacist. 

When my mom had a UTI, she was paranoid and suspicious of everyone.  It was almost impossible for her to trust us when we gave her the pills. Even when we just out the weekly reminder box in front of her and told her what bin to open.it was 30 minutes of frustration.   

harshedbuzz

Lisa-

Hi and welcome to the best club nobody wants to join.

Your question speaks to so much more than getting more to graciously accept her DH to supervise her medications. 

Dementia is about so much more than just forgetting. Some of the earliest losses are those related to reasoning and executive function. Her brain is damaged and cannot follow a line of reason. The cardinal rule of Dementia Fight Club is that one does not attempt to reason with a person whose "reasoner" is broken. Your explanation "I want to gently encourage her to trust her husband is giving her the meds" suggests that this was what you hoped to do on your FIL's behalf. 

The ability to feel emotion is preserved well into the disease process. It might be achieve your aim, if you were to just focus on comments with MIL about how much FIL loves her and wants to spoil her rather than cast him in the role of her caregiver. 

Sometimes it helps to put oneself in the mindset of a PWD when making caregiving decisions. This piece really helped my mom and I grow as caregivers and devise ways to get care accomplished when dad was fighting us on eating, hygiene, hydration and meds in a bid to maintain what little autonomy he had.

12 pt Understanding the Dementia Experience (dementiacarestrategies.com)

There may also be some anosognosia in play in this situation. This is common with dementia. Often PWD cannot appreciate that they have had a cognitive shift and are no longer capable of doing certain tasks. In their mind, they are the same as always and trying to convince them otherwise will feel like gaslighting and strain interactions going forward. 

That said, there are strategies to make this easier. Pill packets- ideally for MIL and FIL so she doesn't feel singled out- can be effective if he keeps the bulk of them locked up and they do their pills together.

Sometimes, a PWD will get stuck on not taking them. Sometimes they mentally go back in time to a point where they didn't take the med, or they think they've already done so, or they believe they're being poisoned and you need a work around. If the pharmacist OKs it, many meds can be crushed and added to foods.

Good luck. Supporting the caregiver, as you are, is so important.

HB