Hygiene, Meds, Diet

howhale

DW diagnosed with MCI 7 years ago. Initial vehement denial, everyone out to get her into a home. Neurologist prescribed Donepezil to start. Very shortly she refused to take any med. As condition worsened, tried to add memantine with no luck. After first 2 1/2 years of her believing everyone "knew" about her diagnosis (not the case at all) and that they were talking about her and resultant horrible outbursts and arguments, her condition worsened but also relieved that feeling of being judged. Throughout has refused to take any meds regardless of every effort, including blunt conversation with all docs. Then she began to stop bathing or washing her hair, wearing the same clothes for days, no brushing of teeth. When I attempted to get her to bath or wash her hair, her response has been "I have already done it" with bitterness in her voice leading to an outburst. As her taste began to be affected, her diet deteriorated to sweet items, limited quantity of nutritional food, diet soda as only liquid tolerated at all and drinking constantly. Care giver has tried to improve with no success. I have tried but finally given up as a trade-off to the horrible bitter confrontations. So, have others experienced these behaviors and found any solutions? She is at home and I am committed to keeping her here as long as I can. The doctors have been unable to offer any new ideas. It is a horrible way to watch your wife of 56 years fade away. It is truly like living with two distinctly different people. When she finally is exhausted in the evening and cuddles beside me and says how much she loves me and how much I do for her, it is almost too much to bear. Appreciate any suggestions.

M1

Welcome to the forum. It sounds like she would benefit from antianxiety and antipsychotic medications to tamp down some of the uncooperative behavior. There are liquid formulations you could add to drinks or food without her knowledge. I would discuss this with her docs.

howhale

Thanks for your suggestion.

I have discussed it with her docs and will look at anything they can offer. Because she is so watchful of my every move, if I ever slip and she sees me adding anything to her drink (food is not likely since she barely eats anymore or certainly nothing into which I could add anything), it will be all over so it will be tricky. She does have one med available but it is a tablet form which I tried crushing and adding to something sweet. She caught me and it was all over. I have an appt with her doc upcoming.

ImMaggieMae

Welcome to the forum, howhale. It sounds like your DW is far enough along that she doesn’t remember things very long. How about crushing and mixing a pill with food or juice and if she notices, tell her it’s for you and that you are going to have it later. Set it aside, out of sight. Wait 5 to 10 minutes, bring it to her and feed it to her with a spoon if she’ll let you. Or let her eat it herself. Chances are she will have forgotten seeing you mix it a few minutes earlier.

Chammer

Ice cream was the go-to treat for MILwAD. Meds were crushed, mixed into a single serving container, transferred to a "crystal" bowl and topped w whipped cream. I always told her how jealous I was that she got to have ice cream for breakfast and before bed when I served it to her ... "what? Are you the most special queen of the house? I guess so!"

Dio

So sorry for you. I went through this with my DH at various phases. I understand how this makes you feel. I think we all know how hard this is. One minute they're scowling at you, then the next, as sweet as can be. I called it the yo-yo. And I was getting vertigo from it. I think the right medications can help. Maybe crush meds or mix them when she's in the bathroom or during her sleep? When my DH refused to take meds, calling them placebos, I got so exasperated that I just left them on the table and declared, "I've done my job as your nurse dispensing your meds. Take it or leave it is entirely up to you. They're yours." And he'd almost always take them. But my tough love method may not work for you. It did, however, gave me a sense of power back in a twisted way.

Hygiene, on the other hand, was WWIII whenever it was shower time. He'd scream at me and sometimes grabbing my shoulders and shaking me like a leaf, yelling "I've done this already! How many more times do I have to do this?" Not only was I getting scared of being hurt, I truly feared for my life. When incontinence started, it was time for placement, especially when he wouldn't let me change his depends.

SDianeL

read the book “The 36 Hour Day” explains the disease and gives tips for caregivers. I got my husband to take new meds prescribed by telling him the doctor prescribed it for his brain. I never mentioned dementia. I got him to shower 2x a week by getting his shower all ready and telling him it was our shower day and his shower was ready. It worked! The book explains the reasons they don’t shower. They think they just showered, showering involves too many steps they can’t remember and they may be afraid they will fall. Definitely ask for medication to calm her. Risperidone helped my husband.

howhale

Thanks for all the suggestions and even moreso for the words of support. Wish I had found this forum years ago. Only those of us in the depths of this experience really know the truth.

H1235

Adding medicine to ice cream seems like a good idea. Could you mix it all up before she gets up in the morning or after she goes to bed at night. I’m not sure if it would alter the medication leaving it mixed and in the freezer overnight. Or maybe crush several pills and put each in a pill dispenser, while she sleeps. Then when you want to add it to food you can just dump it in quickly. You might be less likely to get caught. Hope you can find something that works.

harshedbuzz

I would attempt to have her seen by a geriatric psychiatrist. IME, their chairside manner at appointments is more engaging and more likely to gain compliance if that’s possible. Either way, they’re the experts on psychoactive medications in dementia and will know which meds can be hidden in food or available in liquid form.

Most folks with dementia develop a sweet tooth making it fairly easy to hide medication in ice cream, pudding, milk shakes, etc. One member here used raspberries as “pill pockets” on mom’s oatmeal.

Because it’s not always possible for a host of reasons for a spouse to provide care at home until death, a Plan B (and her sibling, C, D, and so on) should be in place. Once concern where you are is that should home become untenable for some reasons, her current behaviors will likely restrict your choice of facilities to those willing to take on an individual “with behaviors” or if placed, could lead to being sent to an ER for a psych admission the first time she acts out.

That said, dad was a dirt ball. Formerly fastidiously groomed, he looked like a Yeti. He fought mom on all hygiene, medication and even hydration efforts. This really pained my mom. More than once she spilled something on him in an attempt to force a shower and change of clothes. When his behaviors required placement (and yes, he was rejected by mom’s favorite MCF), he actually was more cooperative with the aides seeing them as professionals. He was better cared for there than we’d been able to manage at home.

HB