Best way to handle prescription medications

LaurieRZ

My mother is at the stage where she's independent enough to live on her own, but she's not able to handle her medications. When the pharmacy calls to tell her she has a prescription ready, she picks it up and sets it on her kitchen countertop. I come over on the weekend and fill her locked, medication dispenser and she has always known that's the medication she takes. When I went over last weekend, I saw she had picked up a prescription, opened it and two sleeping pills were missing. I now know I can no longer let her pick up her own meds or even have them mailed to her. Is there a way I can sign her her for mail order prescriptions, but have them mailed to me? There are so many scammer online that I'm afraid the mail order company will think I'm just trying to get someone else's meds. I just recently got her medical and legal POA, but I don't know if that would allow me to have them mailed to me, especially since there isn't a local office for me to show them the document in person.

M1

Hi Laurie.  We went through this, and it was a big fight:  for background, my partner is on a lot of medications for a lot of different conditions, and I am a physician.  It was a huge, huge deal for me to gradually take over her medications, she hated it and continued to, right up until memory care placement about six weeks ago.  It progressed over years from my having to start setting up a medication box for her, then having to give her a calendar to she'd remember what day of the week it was, to having to take over all the prescription ordering, having to remove the pill bottles from her bathroom, to having to lock them up because she'd come get them out of my bathroom, to my having to keep the weekly medication box in my room (locked) and physically giving her her pills four times a day.    

I would suggest going to talk to the pharmacist --maybe the doctor's offices too--where she fills prescriptions now, taking the POA with you and giving them a copy.  They may have suggestions for you, as they likely have dealt with this situation with other clients.  They may have a mail order program or can refer you to one.  For your mother, you may have to make up some fib about the switch--your pharmacy no longer takes your insurance, etc.  But be prepared for a fight, it likely will not go down easily.

This is probably a red flag that she may need more help in other areas, too, unfortunately.  And while the locked medication dispenser make work for a while, be aware there will be a point where that doesn't work, either, and you won't be sure she's taken her meds unless you see her swallow them.  Those days of living independently may be numbered; I only say that to help you think ahead.  It's a common thing for all of us to underestimate the amount of help our LO's really need, because the changes we see are so gradual.

I have scanned copies of my POA's into my computer and send them electronically when requested, as they are by multiple entities.  

I don't know if any of this helps, but I would start with an in-person conference with her pharmacist.  The nurses at the doctor's offices may be of more help than the docs, frankly, since the nurses are many times the ones handling refills.

ButterflyWings

Hi Laurie and welcome. Not a great reason to need this group, but a great team of fellow travelers. 

I agree with M1 that if your mom is having trouble with her meds, she is likely not safe living independently any more for many reasons that come with dementia. Have you/can you visit her for 4-5 days around the clock and observe how she really is? 

We had (expensive) water overflows/ flooding, a microwave near fire, risky driving, and depleted assets among other things. before I noticed any significant med confusion and resistance. For now, meds even OTC meds (and cleaning products, chemicals, etc.) are locked up. I dispense and watch him swallow them. Learned that the hard way! 

It is not what we want to hear, but by the time we notice some deficits it usually is just the tip of the iceberg and our PWD LOs are likely overcompensating in many ways. Not knowing any better, we can accept many (reasonable seeming) explanations other than brain failure due to dementia. 

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May flowers

We just filled out a change of address form with the mail order pharmacy (maybe online or paper, I can’t remember) , but kept it in my FIL’s name. That may have been the wrong way to go about it, but it worked!

I will say that even though we were filling up his pill box, he was still confused. Once he spilled the whole box, tried to refill it and had 2-3 doses of one med in one slot. Fortunately we caught it in time, or he would have overdosed.

​fesk

I agree with the other posters that it's a good idea to more closely observe your mother as it does sound as if she may not be able to manage more things than you are aware of. I did find early on with my mother that she appeared to handle things better in her own environment and it wasn't as noticeable there but, if you spent more time and did other things together, you could see the issues more clearly.

Even from early on, either I or someone else watched my mother and assisted her with her medication. Thankfully, she was cooperative. As far as managing the prescriptions, I set that up easily with an online app for the store. Stores like CVS and Walgreens have apps where you can manage another family member's prescriptions. I had my mother's permission to do so at the time.

LaurieRZ

 This is just a temporary solution, but I took the POA to the pharmacy and they will now text me when her prescriptions are ready instead of calling her. Her pharmacy isn’t convenient for me, so I still want to get her signed up for mail order. Once I do that, I may try changing the address like mentioned and see if that works.

I have all of the concerns several of you mentioned about her living along. Her house is clean, her fridge is stocked (I will check the dates since I didn’t think about that), but she seems so confused about so many things when I talk to her. I’ve talked to other people that know her and they say they may notice a few things, but she doesn’t seem that bad to them. It’s just hard knowing when she should no longer live alone.

I met with an attorney this week and now have a medical POA and the other one says it is a statutory durable POA. We also set up a trust. I’m already overwhelmed with all the trust information, so I need to start writing down my questions and call the attorney back.

Thank you for all of your helpful suggestions and comments.

jfkoc

You do not know that your mother is taking her meds correctly unless someone watches her taking them.

LaurieRZ

I know she's not able to overdose, but I can't confirm that she's actually taking them, although I haven't seen any signs that she isn't. Luckily, the only thing she takes is something for her cholesterol and she recently started on a mild sleeping pill. Luckily she doesn't have DM or hypertension, so I don't have to worry about any serious consequences of her not taking her medications.

M1

Laurie, just a caution about sleeping pills in people with dementia.  Sleep fragmentation can be part of the disease--it certainly was for my partner--and we started her on Seroquel, which has worked quite well.  but sedatives (Ambien, benzodiazepines like Ativan, Halcion) and antihistamines (Benadryl, hydroxyzine) commonly used for sleep in others can be very dangerous for dementia patients.  You may just want to double-check on what it is.  And I would definitely worry about her taking that unsupervised, no matter what it is.

LaurieRZ

Thank you for the warning. Her Neurologist put her on Doxepin to help her sleep. He started her on 10 mg, but it made her too sleepy during the day, so she's on 6 mg now.

mommyandme (m&m)

Since the POA is in effect, I’d go ahead and get the prescriptions transferred to a pharmacy more convenient for you, at least in the short term.. That shouldn’t be too difficult.  

I’m sorry for these troubles. Even though all of our LOs are different, along with their living situations and caregivers, there are so many parallels in their dementia.   It’s such a bummer yet this forum is priceless for support in each stage of this disgusting disease and I’m so thankful to all of you, sincerely. 

Quilting brings calm

Since the sleeping pills are ‘as needed’,  you can’t do the following suggestion with them. However for the rest, ask for the pill or blister pack.  Labeled with date and time to open and take

NuttyProfessor

Medications - another epic battleground with my mom.  One pleasant thing about her decline in the past few months:  she has stopped trying to check all her meds and demand explanations for each when it comes time to take them.  I started telling her they're "vitamins".  I also talk to the doctors before appointments, to warn them not to talk about medications & behavior issues directly in her presence.

It was easy enough for me to shift to getting her prescriptions myself from my local pharmacy.  It's not a chain, so they didn't blink an eye at a family member coming to pick up prescriptions for an elderly mom.  No DPOA required.  But if you're going to a big chain like CVS, you should have a DPOA and health care proxy document on hand just in case. 

You'll definitely want to have it when you go to your mom's bank, which is something else you should be doing right about now.   I got joint ownership of my mom's checking and savings accounts and my own online access, which is perfect...my mom went through a phase where she'd randomly change passwords and forget them.  I shudder to think how much time I spent on the phone during COVID lockdowns when wait times were hours long, to get my mom's account passwords reset.