SIL argues and resists everything

Gallmeiers

Moved SIL into AL last Wednesday. Saturday she was admitted to hospital for COVID. Discharged today. Took her to AL and gave her her evening meds plus the new antibiotic for bronchitis. She refused to take any pills, saying that she took them already. I am looking at the discharge papers which are clear about what to take when, not to mention the nurse was clear about what she needed to take at home. This discussion lasted for 20 minutes. Didn’t want the antibiotic, didn’t think she had COVID. Doesn’t remember a doctor telling her. Doesn’t remember the two of us spending 7 hours in the ER. Finally she took them but was quite angry. This is an ongoing problem with her. She doesn’t believe doctors, she doesn’t need doctors, she doesn’t need an echocardiogram, she doesn’t need any new meds, etc. We don’t know what to do. We’re exhausted. They checked her for UTI and it was negative.

Quilting brings calm

Does the AL provide medication management?  My parent’s AL provides  it as part of the regular fee.  I know that others provide  it for an additional fee. The nurse at the AL takes care of ordering their medication refills. That is sent to a local pharmacy that packages it in the pill pacs and  delivers it to the AL.  The pill pacs are kept in a locked cabinet in my parents apartment.   The staff unlocks the cabinet, finds the right pill pack and gives them to my parents. For things like antibiotics, you can always pick it up if necessary and deliver it to the nurse… who will take it from there  

sandwichone123

Welcome, Galmeiers! As you've already noticed, explaining doesn't work. The rational part of the brain is not working any more. I don't guarantee you can get your loved one to do what you want, but I do assure you that you can have more pleasant conversations and fewer arguments if you don't explain.

Unfortunately, memory of events is transient, but emotional memory can be durable, so the person with dementia (PWD) may not know why they're mad at you, but they may still have that emotion. Instead of addressing the facts of the situation, it may be helpful to address the emotions she is feeling, so instead of, "you just got these prescriptions, you have to take these meds," you might try, "you are looking pretty upset. What's going on?" Whatever the answer is, don't correct it. The goal is to understand *her* reality, not to try, and fail, to get her understanding yours.

MN Chickadee

Give up the explanations and reasoning, find the right therapeutic fib. Try taking your "pills" together with her and yours is tic-tacs. Be upbeat, she will feed of any of your emotions. Got to take our medicine or vitamins to be healthy. Keep that heart healthy, or bones, or whatever might push the right buttons.  You can also ask the pharmacist about crushing them and putting them in pudding or something she likes. Many meds can be crushed but not all, so do ask the pharmacy. I would think especially the antibiotic could be done that way.  Same for doctor's appointments, find the right fib. Convincing her she has a problem won't work. Don't tell her ahead of time and give her time to fret. Maybe the appointment is for you and she is along for the ride. Maybe it's something Medicare or insurance requires now, a quick check up. I would quit talking about any diagnosis, memory problems, or her need for treatment. It will never make sense to her broken brain. I would also consider more of a palliative approach and decide which appointments are really necessary. Sounds like possibly the ones that would lead to a diagnosis. 

She has had a ton of upset to her routine and familiar surroundings over the last 2 weeks which is extremely hard on a PWD. An adjustment period is to be expected, even without covid and the hospital stay it is unlikely it would be smooth sailing right now. What kind of AL is it? If it is not a memory care specific AL nor high acuity it may not be the right setting for her. Many ALs are not remotely equipped to deal with dementia. They aren't going to have the staff ratio, time or training to get her to take the pills or any other ADLs for that matter, nor any of the supports and services that memory care offers. Being at the wrong level of care can lead to all kinds of anxiety as the person tries to survive the day to day stressors and challenges.  Hopefully it is a place where you can ramp up the structure and oversight. 

Iris L.

Gallmeiers wrote:

. This discussion lasted for 20 minutes. Didn’t want the antibiotic, didn’t think she had COVID. Doesn’t remember a doctor telling her. Doesn’t remember the two of us spending 7 hours in the ER. Finally she took them but was quite angry. This is an ongoing problem with her. She doesn’t believe doctors, she doesn’t need doctors, she doesn’t need an echocardiogram, she doesn’t need any new meds, etc. 

This is anosognosia.  She truly believes she is fine, and if you confront her with reality, she will resist and become upset, as you have noticed.  Read up on anosognosia and learn the work-arounds that the members talk about.

Iris L

Rescue mom

Most ALs will handle the meds (usually for a fee), which sounds like an immediate  need. Talk to managers there about that. 

Meanwhile,/otherwise, I just second what others have said. Not all ALs can or will handle dementia. They do not have enough staff, and/or the staff is not trained for dementia. Other residents who do not have cognitive issues often don’t want to socialize with one who does.

 Arguing, explaining, reminding—those will not work with SIL now. It wastes your time and energy, and upsets her. You may want to start looking for a place that deals with dementia residents, or get her into whatever dementia help (if they do any) the AL provides.