Medication help - Mother forgets she has taken her AM pills and is insistent she needs them (during

bernmorr

Hello! This is my first post here (after joining last year) because I have been able to read all the wonderful advice everyone has given for those who have had questions regarding the care of their loved ones and I have experienced the same things. I now need some advice regarding my mom's medication and how to handle her insistence that she hasn't taken them.

My 85 year old mom was diagnosed with Alzheimer's in October 2021. She is also diabetic, has high blood pressure and high cholesterol. The only medications the neurologist has her on is Memantine and Zoloft. We have tried the others (Aracept and Buproprion) but unfortunately she cannot tolerate them and she had wild hallucinations, nausea, sleeplessness, you name it, etc. She takes 4 other meds (Metformin, Rybelsus, Amlodipine, Atorvastatin) in addition to her Alz meds. The Metformin and Memantine she takes in AM and PM. The other 4 she only takes in the AM.

She has always been independent and she keeps these pill bottles in a basket and she would dispense her own meds. Until last year, that's when I started to notice that the count in some of her pills were going down or the refill time was too short (and Rybelsus was NOT cheap). After that, I started to monitor her dispensing her pills. Family and the doctors were also insisting that she use a pill box, but I knew that wouldn't work because she started to forget her days and times and this would result in her taking the next days pills, etc.  I just kept with watching her dispense her pills.  The monitoring has been working up til the last couple of months. 

I started to notice that the pills were being depleted again and found that she would take her PM meds with her dinner and then within 10 minutes forget that she had taken them and go to her pill basket and pull the PM pills out and take them again! I went and hid the PM meds and left the AM med bottles because the instructions on the AM bottles say 'AM only'. Well, after a few days, I noticed that the AM meds started to go down, too. And we have a camera, so I can see her look at her PM pill box and think that she hasn't take taken them.

I decided to buy a lockbox and now I hide all the meds.  I have a little note in her basket that says something like: "You Already took your AM Meds. No more pills for today." When I come to my mom's in the morning, I pull out the medicine bottles and put them in her basket to dispense herself. I do this when she is still asleep so they are ready to go in the morning with her breakfast. 

I also have other notes around telling her that if her PM pill box is empty, she already took her PM meds. 

This was working til this past week. She has been forgetting more that she has taken her AM meds and is confrontational and adamant that she never took them. She starts screaming that she NEEDS her pills. She realizes that the PM pills are there for dinner, but she thinks she needs to take her pills when it's lunch time. She also thinks that me withholding her pills that I am allowing her to die. She then will refuse to eat her lunch. I just walk away and let her be because I know she is getting tired of me hovering. When I am not here, that is when she feels more independent (not using her walker, starts rearranging things around the house, etc.).

I do know that this is the disease talking and I have learned not to take these hurtful comments personally. Does anyone have advice on how to divert when she acts like a kid and throws a tantrum about her pills? I would love to tell her that I'm trying to protect her from dying (due to overdose), but she won't understand.

Thank you all in advance for the advice.

-Bernadette

terei

My mother could read a note ‘you took your pill’ out loud, but had no idea what that meant.  Your mother is at that point.  She cannot be depended on to take any meds on her own IMO.

I would ‘disappear’ all the pills + tell her the doctor demanded that she be giving all her pills by someone else.  She should not be able to see the bottles, lockbox, etc that remind her of them.  She might do better if someone else dispensed the pills(other that you) if you can have that done.     

When my mother got to this point, initially, a family member actually went to the MC where she was to give her her meds twice a day.  After a progression of 18 months or so, staff gave her her meds til she became extremely agitated about taking them, even with pudding, etc + I finally stops ALL the meds she was on for the last 6-8 months of her life.  It was not worth having her upset twice a day over it.   I actually never saw her health change because she did not take them.    

Also, If she cannot see the pills in her living area, her attitude about this might change.  Cross your fingers

Ed1937

Terei gave you some excellent pointers on the subject. If you think that would be too hard to do, you could try telling her that you both need to take your pills together. If you are not on any meds, you can use M&Ms, mints, or something else so you can take them together. Just another idea that may or may not work. 

You could also ask the doctor if there are any pills she can do without, reminding him that she has dementia, a fatal disease. Do away with any that you can safely get away with. Meds to help with memory seem to be an easy one to get rid of, and there might be others. Only keep the ones she absolutely needs, without question. 

Quilting brings calm

Have her pills changed to a pharmacy that will put them in blister packs labeled  with date and time of day.      Only give her the blister packs for that day if you are there every day.     My parents are in assisted living and their meds are in  blister packs and kept locked up. Staff distributes their medication at the appropriate time of day.

zauberflote

Hi Bernadette-- I know exactly how your mom feels lol. I take some very critical meds and if I knew I hadn't taken the AM ones, I'd freak out too. I like the blister pack idea, and the others are all excellent too. My mom was taken off her statin when she arrived at MC, because it had been found that they're useless (or some such) after age 75. Mom was 90! She was also taken off whichever memory drug she'd been on. Maybe there are tweaks your mom's doctor can make. 

I thought of something you might try at a lunchtime if it gets difficult-- can you pretend to call the doctor, say that mom didn't take pills this morning and is very concerned, and what does dr recommend? The "doctor" could reply that it's fine to wait until tomorrow. Or, you could try saying something like, you're fine Mom, I saw you take them 5 minutes ago! Sometimes a person will surprise us and fall for that. 

M1

We had the same battle here. There will be nothing short of taking it over and dispensing them to her and watching her swallow them. That's the only safe alternative. And yes, i had to buy a lockbox too and hide the bottles.  Blister packs won't help in the long run, there will be nothing to keep her from taking more than one.

harshedbuzz

Bernadette-

Hi and a belated welcome. I am sorry for your reason to be here but glad you reached out.

Sadly, there is no electronic device, gadget, gizmo or hack you can order from Amazon to substitute for human supervision.

For the time being, if you are in charge of medications, they need to be at your house and you (or another family member or aide) need to dispense and confirm that they've been taken. Removing them physically may be enough to calm this situation as often PWD need a visual trigger to set them off. Out-of-sight is often out-of-mind at a certain point. 

The bigger piece here is needing a Plan B. Dementia is progressive and her days of independent living will be coming to an end soon regardless of how she self-identifies or however much grief she hurls in your direction. Safety is job one here. A camera sometimes gives a false sense of security as it won't prevent her starting a fire in the microwave or drinking brightly colored detergent.

I agree with Terei that it might be time to re-evaluate her medications for risk/benefit in the context of a life limiting diagnosis. We also jettisoned a number of dad's specialists. Dad's PCP felt the GI side effects of Metformin weren't worth it for him (YMMV) given that incontinence was coming. And when we placed him in the MCF, we also ditched the statin and greatly reduced and then stopped his BP meds as his BP dropped with the disease progression. We kept only meds to support his breathing and to treat anxiety and hallucinations at the end.

HB

Beauchene105

Hi, meds are such a common ordeal with dementia. In my mom's situation, she is the very opposite and refuses to take meds.  Before dementia, she independently counted them out and kept them in pill reminders, but "that was then".  So just in case your loved one begins having this problem with meds, I am sharing my experience. My mom will claim to have already taken them and that the nurse at the AL has it wrong! She will hide them under her scrambled eggs, sneak them into her pockets, whatever she can do to avoid them. Her anti-seizure medicine is of great importance and the neurologist wrote a prescription for her to have the liquid form. The nurse has been putting it in her orange juice and this has worked for the most part. We've tried crushing the meds, me taking mine at the same time, rewarding her with pieces of candy for each one taken, you name it. My mom also claims the pills are going to make her nauseated, so we keep Bonine on hand and give her a Bonine with the assurance that she can take her meds with no fear of nausea. Good luck and hope you find a solution that works for you.

mommyandme (m&m)

I haven’t read everyone’s response so forgive me if this is a duplicate.  My mom was on the other end of the spectrum, she demanded that she had taken her pills.  We got a large dry erase calendar and among other things were an “am/pm” note written on each day.  When she took her pills an X would mark the spot.  Her caregivers and I would show her the calendar and that would appease her enough to deal with it…until it couldn’t.  She hated taking them.  One on one supervision becomes necessary for meds often.  I would take pills with her to try to help, many pills started to be removed.  Eventually she only had meds in yogurt but by then she didn’t know she took pills anymore.  If/when crushed pills in food etc…becomes a thing, make sure to check which can be crushed with a pharmacist. 

Welcome to here but sorry too! 

GwendolynD

Bernmorr, Hi.  I don't have a lot of advice.  I just have a similar problem as you .  

My Mom was very good at taking her meds on schedule - until about the last month.  She has become sort of apathetic about taking them, or dismissive when I ask about them.  She tells me she has taken them and when I look - gosh - I realize she must be imagining it because she is skipping days at a time.

I need to take over administering the meds, but I know I am going to hurt her feelings.  I might just take over the most important med - her thyroid medication - and hand that one to her with breakfast every day in a pretty little egg cup.  Her other meds and vitamins I feel more comfortable with her managing for a little while longer.  (I will check with the Dr. to see if she agrees with this....)

For me, it feels like a minefield sometimes.  Not that my mom is mean about anything, she just is devastated and feels like she is losing her independence.  I'm trying everything I can to avoid that (but its true..sadly).

serenac

Hi bernmorr! I've recently tried an automated pill dispenser and that's helped some. Suggestions here: https://www.grayingwithgrace.com/pill-dispensers-for-dementia/ 

This was also a nice resource for me and I think it could be useful for you too! https://remo.health/learn/articles/7/managing-medications-day-to-day

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RobinNicole

Hello,

I agree with the others that pill boxes are a temporary fix.  But I can recommend medminder.com  We successfully used the box until we placed my mom.  There is room for am and pm doses and the boxes are locked and you control online the times they are open.  The designated box will flash at the time and then it will sound a beep and at intervals get louder and then it will contact you if she does not take the meds.  You can also see online the timings etc.  you can use their pharmacy to send the prefilled box to you but I filled her prescriptions and filled the boxes as I was visiting all the time anyways.  There is tech support so that should there be an issue they can help resolve.   It might be worth your while to check it out    I hope things settle 

CanyonGal

This was a major battle for me. My mother insisted on having CONTROL over the pills. I could visually show her she wasn’t talking her medication because the amount in the bottles were different or even medication was even in the pill box (bottles were stuffed around the room in odd places). It wasn’t until she had a surgery that I removed all medication from her room and I placed her on medication management at the facility. It was no surprise that the medication actually worked as intended when it was taken correctly.

Now, a year later, I am dealing with her spitting out medication. The pills are crushed so I think it is a taste thing, but maybe a control thing too? The last stage of this disease is so disheartening to deal with because it just seems to be harder to make medical choices, know which pills are beneficial and which ones are not really preventing anything when one’s life is already cut short. I read an article that called removing some medication as a pill vacation, see how she does after a few days or weeks being off a medication.

The stress really wears me down. It’s hard to turn the brain off at night.

luv2bcntry

If your parent has Medicare check out the hero med dispenser. It has been a life safer for me. And Medicare pays 100%.

OliviaDep

Thanks for sharing. I am having the same issue. my LO lives independently and was always very diligent about taking medication. When taking pills from the bottles started to fail, I introduced pillboxes. when the multicolor pill boxes seem to cause confusion, I changed to black and white with very clear labeling. Now, the issue is day and night are blurred and she is forgetting when she took pills and going into other days and possibly double dosing. Yesterday, I tried giving her a piece of paper to check off when she takes her meds but the concept seemed foreign to her. what is infuriating is that she doesn't seem to care and quickly blows me off when I try to help. I've been thinking about trying a locked pillbox next, however, it will not work if she is ignoring the alarms and flashing lights. I'm hoping someone can suggest an alternative.

Marta

Olivia - the alternative is to provide personal supervision.

By the time PWD get to this point, it is dubious that she is safe living alone. Would she know what to do in an emergency? Is she eating ? Showering? Paying bills?

OliviaDep

https://alzconnected.org/discussion/comment/186408#Comment_186408

Yes, so far so good on eating, showering, paying bills, housekeeping, etc. and I closely monitor in person and remotely via Camera. however, I know one day probably soon more assistance will be needed. I'm just trying to get over this medication hurdle in the meantime.

mommyandme (m&m)

The cameras are great, aren’t they? My brother and I did long distance caregiving when this journey began, for about 1.5 years. We started with caregivers coming over twice a day, 3 hour shifts (the minimum for the service) in the am and afternoon/evening to monitor meds and meals. They also provided companionship, errand running, assistance with dressing and bathing, as needed. We also used a large white board calendar with boxes to check am and pm pills which the caregivers marked after they were taken. It helped her with a visual when she didn’t know she had already taken them and which reduced frustration for all. Those check marks helped for a couple years. There will come a time that your mom must be supervised during med time and, well, with everything. Sounds like you’re getting close to at least meds supervision.

I hope you’re watching her finances closely because there may be mistakes being made already. Does she do her banking online? Scammers are very good at getting to the elderly online. Unfortunately, I know this first hand. And then there’s the many $5-$20 checks written each month to the incorrigible junk mail scammers. I think she got caught up in those because it was something she felt she could do successfully and of course it feels good to help people and abused animals. What a mess that was to deal with and I’m still getting some of the junk mail addressed to her. She threw hundreds of dollars away each month on those til my brother figured it out.

im so sorry for all of these struggles for you and your ma.

Cdoyle0913

Get a HERO machine or something similar! It was a HUGE help. I can not recommend it enough! We had tried everything from pill packets to a locked pill box and everything, nothing worked. This was a lifesaver!!