What next when they can't swallow pills?

Timmyd

I know from experience that today's occasional problem is tomorrow's permanent limitation. In recent weeks, my DW has struggled with swallowing her pills. What comes after unable to swallow pills and how do I know it when it is time for that?

SPin-need

I used to crumble the pills and put them in applesauce.

sandwichone123

This is really common. If you're touring memory care or nursing home facilities you'll see a device on every nurse's cart that's labeled "Silent Knight." It's a device for crushing pills to put in applesauce or pudding. A pharmacy near you sells various devices for that purpose as well.

Brief historical note: The reason it's called "Silent Knight" is that the device previously used was SO NOISY and disruptive to patients, staff, and visitors alike. This one, while not completely silent, is considerably quieter.

annie51

My DH can still swallow them but sometimes he’ll pick them up and put them on his cereal. Seems to work! And in the evening he would sometimes refuse to take his pill so I now I put it in the food or ice cream. He never notices it’s there. This will work until I have to start crushing them.

SDianeL

talk to the pharmacist about which pills can or cannot be crushed. Extended release pills can not be crushed. The doctor may have to change the prescription to tablets that can be crushed. I would start crushing them now and mix them with applesauce so she can get used to it. They also may be able to change the prescription to liquid for some meds that you could put in drinks. Does she have trouble eating and swallowing food or just pills?

CindiEC

you can get a pill crusher at a pharmacy or Amazon. My husband didn’t like applesauce or pudding so I put the crushed meds between crackers with peanut butter.

Timmyd

https://alzconnected.org/discussion/comment/242426#Comment_242426

Thank you and everyone for the useful advice. Right now she fails about one in five attempts to swallow pills. One of her pills is a capsule. I have not seen any problems yet swallowing food. It sounds like my next discussion needs to be with the pharmacist.

harshedbuzz

@Timmyd

If your concern is that difficulty swallowing pills indicates an issue with swallowing, be aware the swallowing difficulties typically begin with liquids before solids. This can include saliva and reflux and can be very subtle meaning the first clue is aspiration pneumonia.

HB

MN Chickadee

Some folks have to switch to thickened liquids as swallowing problems arise with dementia. You may find a swallow study helpful, usually performed by a speech therapist. Also talk to the pharmacist about which drugs can be crushed and put into pudding or apple sauce. Also talk to the doctor about whether she really needs all her meds now. Once a person is to the later stages where swallowing is a problem some drugs can be eliminated because it becomes about quality of life, not extending it as long as possible. In the later stages the doctor and I eliminated some of mom's meds and gave her only the ones for mood and seizures. When it comes time for hospice they can do liquid forms of their comfort meds.

upstateAnn

pills crumbled in app,Esau en in the am.

Pills crumbled in yogurt in the pm.

elainechem

My hubby began to have difficulties taking his medication in the months before his death. He was still able to swallow, he just forgot that he was supposed to. I would give him a pill and then give him some water. He'd drink the water, but the pill would still be in his mouth. I started crushing what I could. I had to discontinue giving him extended release or gel pills.

In his case, it wasn't an inability to swallow because he had no trouble eating. He just didn't have the ability to understand what was expected.

ImMaggieMae

My DH only takes a few pills, but I crush them in a pill crusher and add them to applesauce or yogurt. Capsules are pulled apart and the contents added. I checked with the pharmacist before combining different pills in the applesauce. This has worked fine for us.

Traveler18

Yes, crush what you can. I had one that I couldn't split and a doctor revised the prescription to get it suspended in a liquid. I had to go to a compounding pharmacy (they crush the pill and put it in a suspension (oil- or water-based). One thing to note on using a compounder is that it may not be covered by insurance so be sure to check that or be prepared to pay out of pocket.