Help! What to do when they refuse to take their medication??
Hello Everyone, my stepdad recently passed away unexpectedly and as a result, I now take care of my 83 year old mom who has vascular dementia. We've only had her living here with us for one week (different state than she was living in previously). We are scrambling to accommodate her as we are not set up for this kind of 24/7 care.
Yesterday she was being defiant in both changing her Depends and allowing us to clean her up after she had massive diarrhea all over her bed, herself, the floor, the bathroom, her wheelchair, etc. This morning she was refusing to have her Depends changed (we did finally get her to allow us to do it), and is refusing to take her medications. Yesterday evening after the diarrhea episodes (three episodes to be exact), she threw her pills on the floor and just flat out said "NO!" at our request to take them. She finally did, but it took hours. Now, same thing this morning. We are taken aback by how bad she's gotten and the level of 24/7 care she needs.
She takes a multitude of pills including blood pressure meds, low thyroid medication, a statin, two meds for the dementia, and several vitamin supplements.
Can anyone here kindly share your experiences with this? I'm sure my mom isn't the only PWD to have these defiant behaviors.
We do have a call into our local hospice to hopefully have someone come out and do an evaluation, but until that time, we are at a loss how to overcome the child-like defiance over the pill taking and Depends changes. Thank you.
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If this behavior is out of character for her, immediately take her to be tested for a UTI. My mom acted exactly like this because of a undiagnosed UTI.
in addition- she is not being defiant on purpose. Her brain doesn’t work, she’s been moved out of her comfort area, and her ‘person’ is no longer there. She’s scared.
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The hospice evaluation sounds like a good idea, as does a rethinking of everything she's taking: probably time to leave off a lot of things, like the statin and maybe even the dementia meds. Going a few days without her blood pressure meds or her thyroid is unlikely to do her any great damage. A lot of the dementia meds can cause GI side effects (as can some blood pressure meds), so leaving those off may also help get her bowels straightened out. Once the meds have been reassessed, you can look at which can be crushed or put in applesauce, ice cream, or pudding; and many come in liquid formulations. But I would just not worry about any of it until you can get some professional help.
Sorry you are facing this but glad you found this forum, it can be a real help.
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Thank you for the helpful information. I was panicking a bit... this is uncharted territory for us.
We just got back from the ER at our local hospital. They did hours of testing since we have very little of her past medical history. She does not have a UTI, nor anything else wrong, except for the dementia.
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I tell my mom the pills are vitamins or pain pills for her arthritis (some are), and she's amenable to taking those. If I told her what they really are (anti-psychotics) she would not swallow them.
At her memory care aids have tried crushing the pills and putting them in pudding or applesauce. She spits that out. Can't possibly taste good.
I've put the crushed pills in a spoonful of jelly and she'll swallow that.
It is often a struggle and several techniques are necessary depending upon her mood. Sometimes I physically pop the pills into her mouth, one at a time, and tip the water cup after that before she can protest too much.
I've asked the MC pharmacy to give her the smallest pills possible, rather than some honking big pill, because those are easiest to pop into her mouth.
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Hopefully the ER gave you some names of doctors and resources to contact, along with those test results. I’ve been to the ER with my parents. It’s very difficult for a dementia patient and their caregivers to be in the ER. You must be exhausted
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I am going through the same thing I had just went to my primary dr whom is moms primary dr as well I went to him for my checkup, and I asked for guidance for help for mom she hasn't been to the dr in 7 months now and won't take her meds the dr has now put her on hospice. This very hard I know. Thinking of you and your mom God Bless!
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If she's accepted to hospice, then I would talk to their NP or physician about which meds are appropriate to jettison at this time. If she's not, I would talk to her PCP about this.
Often, as a PWD progresses to later stages, doctors move to a more palliative approach which included culling the medication list. Dad's gerontologist prioritized his breathing (COPD) and behavioral health and took him off his BP meds, his statin and his metformin. He'd lost considerable weight and his BP was low on meds and his A1C was much improved.
Of them meds you do want to continue, ask the pharmacist if they can be crushed and hidden in a treat like pudding or ice cream. Synthroid, or its generic, can be crushed but be careful as the doses are really tiny so you don't want to lose any. This is one medication I would give until the end as low thyroid can impact mood, cognition, worsen skin condition and cause painful constipation.
Good luck>
HB
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My mother became more + more resistant to taking her meds. We tried giving them in pudding, etc. I finally made the decision that having her agitated twice a day (along with the wasted time trying to cajole her into taking them) was just not worth it. About 6 months before she died, I ordered ALL her meds stopped. As far as I could tell, it never made a difference to her overall health. She was far more calm without the daily agitation + resistant behavior, to be honest.
There may be some meds that absolutely ‘need’ to taken..epilepsy meds maybe, but I cannot think of one right now.
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Thank you. I will try the jelly trick!
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Yes, it was a VERY long day. My poor mom was frightened being there. We did get the contact of the social worker at the hospital who deals with these sorts of situations. We will call her first thing on Monday.
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Yes, I am sure at some point there is just no more a caretaker can do. We are scrambling to try and take care of my mom. It was very unexpected--
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Okay, thank you for the information... we are still working on getting her a doctor here. We live in a small rural area so options are a bit limited. I'm going to prioritize eliminating some of her medications as soon as I can talk to a doctor. She's on a lot of supplements/vitamins too-- I'm sure some of these can go, but I will get an official "ok" first.
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Can you talk to her previous PCP and/or neurologist? S/he might have some ideas about what can be jettisoned. Some of the oral medications for Alzheimer's are most effective earlier in the disease and they may feel it's not worth the battle to force it. Around supplements, if the doctor who diagnosed her saw something like low Thiamine or B12, they may want her to continue that as they can impact cognition. Vitamin D and Calcium are 2 others they may want her on if her levels were low. She more likely to be Vitamin D deficient if she has hypothyroidism.
One concern is that Synthroid/levothyroxine needs to be taken in the am at least 30-60 minutes before she eats/drinks anything but water, so you want to get that in ahead of her supplements. You need to avoid iron and calcium (and multivitamins that contain these) for a full 4 hours.
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Thank you for the medication/supplement information.
We are in the process of taking care of all the legal, financial, and medical issues-- plus deal with my stepdad's funeral. It's a lot to deal with-- we are doing our best to get these things done ASAP. It has only been a little over one week since he passed away. We are going to call mom's previous doctor today or tomorrow. I do have some medical records for my mom that are dated from just a couple of months ago-- interestingly, the doctor has listed her as having vascular dementia "unspecified stage"... and that's about all she wrote. Clearly, my mom is in late middle stage or early late stage. We are working on finding her a new doctor here in our area. One of the issues we have is that my stepdad was the one to take my mom to her doctor appointments, and because she is almost deaf and very intimidated by medical professionals, she would clam up and not talk; consequently, my stepdad did all the talking and painted a narrative that she wasn't that bad-- her only issues being that she "didn't drink enough water and didn't like to exercise". He was in a lot of denial over the years, this is plain to see and unfortunately I think the doctor just went with what my stepdad was telling her.
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Yes, my stepdad did hide her disease. He was in a lot of denial about it and basically had the opinion that all my mom needed to do was "drink more water and exercise". Very sad. There wasn't much I could do about it at the time because he was her husband and made the decisions, plus they lived in a different state than we did so we were only able to make visits once or twice per year.
We have been in contact with the local hospital's social worker and she's helping us with all of the issues we are facing. We have been overwhelmed just with the basics of taking care of my mom.
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Yep at a point I guess the all the cajoling just isn't worth the stress. The only med I see that she absolutely needs to take are the blood pressure pills, but we will of course talk to a doctor before we start eliminating anything.
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What thyroid medication is she taking and what's the dosage? Missing thyroid medication if she's on a high enough dose could impact her quality of life and that of everyone around her. Low thyroid levels can impact her mood and her cognition. Later as the disease progresses, it can impact the health of her skin when there is a risk of bedsores. It could cause elevated blood cholesterol which could impact her vascular health. Low thyroid can also cause constipation which can already be an issue in the later stages.
When folks see their PCP for memory loss initially, one of the very first things they do is check for thyroid function has low thyroid can mimic dementia.
HB
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No meds will be altered until we can get her a doctor here and he/she can determine what is best to do.
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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