Mom plans to smuggle meds into AL

lilacgirl

UGH. I'm so tired of dealing with this immaturity! My mom has been having lots of back pain, but she refuses any sort of medical help for it, aside from Tylenol. As is common with AL, medications, including OTC, are not allowed in her room and must be dispensed by the staff. She knows this, she understands this, and she hates this.

I take her shopping once a week, and she is still pretty good at doing that rather independently, so I don't really have control over what she buys. She's already told me that this week she plans to buy Tylenol and Tylenol PM and hide them in her room.

Aside from the fact that this is not allowed — Tylenol PM would be so dangerous for her. She already takes a pill cocktail of 3 anti-depressants at bedtime. There's no way I can let her do this, but it's going to be a big battle, I can already see that. If you aren't supposed to argue with a PWD — what do I do??

SusanB-dil

Do tell her doc about her ongoing pain. Even if she refuses, maybe tell her the appt is required to continue medicare or something similar. In the meantime, can you get a placebo and switch them in the Tylenol pm bottle? But do tell staff, so they know it isn't contraband.

H1235

I would either not take her to the store or take the Tylenol out of her bags before helping her bring things in to Al. Let her think she forgot it or left it at the store. She may eventually get wise to this. Unfortunately I don’t know what else you could do. Trying to convince her she can’t have the Tylenol is only going to cause you both a bunch of stress. My mom would insist on buying things she didn’t need or shouldn’t have. I eventually stopped taking her to the store. It’s too bad because I know she loves to shop and it would be a nice chance for her to get out, but it’s just not possible. But then again she is angry with me for not bringing her to the store. I can absolutely picture my mom doing this. I feel for you. Sometimes there is just no solution that doesn’t cause anger.

harshedbuzz

@lilacgirl

This is a hill to bleed on. Tylenol is not a benign medication, and the PM version is especially inappropriate for a person with dementia.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/649062

How is she obtaining the medication? Or is this just talk?

This kind of behavior might suggest that AL isn't the right level of care for her.

HB

April23

I agree with H1235, you find a way to get it out of the bag or no more shopping. If she thinks she can buy Tylenol PM and take it, then she’s not capable of independent shopping anymore. Having safety awareness is a skill that disappears due to the disease.

Emily 123

Hi lilacgirl,

It sounds like this is the unmet need driving her behavior:

"My mom has been having lots of back pain, but she refuses any sort of medical help for it, aside from Tylenol.".

She isn't at a point to be able to have the autonomy to reliably manage her back pain, so needs to get management of her back pain written into her care plan.

I'd discuss the situation with the DON and your mom's care provider to get her on something for her back, either as a scheduled med or 'as needed', but with it written into her care plan that the staff assess her level of pain and need for the tylenol at least twice a day if it's not going to be routinely given. I personally would go with the scheduled dose if there are control issues or if she's the type to go "No, I'm fine" if staff were to ask her about her discomfort.

Until she gets relief from her back pain she'll be triggered to look for the tylenol. Buying the tylenol this week resolves the issue for a single shopping trip, but she'll be right back to asking for it when her back hurts because she won't recall buying it and it won't be in her room.

I taped a reminder on my mom's bathroom mirror for her brief changes—you might try one to the effect of: "Sorry Mom, state law makes the facility keep all meds locked up! Please let the aide know if you need a tylenol!"

ARIL

What an awful disease this is! Horrendous.

The goal of keeping a PWD calm is superseded by the safety goal. It’s true of driving. It’s true of money management. It is true of medications.

But if it can be managed quietly, that will be better for everyone. Maybe don’t go to the store, or “lose” the Tylenol along the way? I am afraid that switching out something benign in the bottle will be too hard on the AL staff: is the Tylenol really Tylenol this week? That’s a lot of risk for them to assume. And what if she helpfully offers the “pills” to another resident who’s complaining of pain? Is it live, or is it Memorex? Who’s to say? (Yes, I remember ads for audio cassettes. A weird flash of memory for me...)

If she’s in pain, she needs medical care. Can you get advice from the DON? From her doctor? Can you insist she go to the doc for some fabricated reason? I agree that this whole thing may be a step toward a higher level of care.

I am sorry. It’s just awful.

H1235

I have found that any medication that was prescribed as needed never gets taken. Mom forgets she can ask for it and says nothing to staff about the pain or problems. Mom complained about hip pain so much (to me not staff) that Tylenol was just added daily. Of course she doesn’t like taking it daily and now sometimes complains she doesn’t need it because she is in no pain (because she is taking the Tylenol 🙄).

Quilting brings calm

My mom had horrible back issues. She had Voltaren cream that the AL allowed her to have in her apartment ( my step-dad could put it on for her). However, the prescription oral medications that she had to be taken as needed were kept in a locked cabinet and the staff had to get them for her. The fact that they had to have staff dispense the meds annoyed my parents … but I didn’t trust them to take their meds properly so I had them put on staff medication management when they moved in. There were residents that handled their own medication needs.

FYI- they did the same thing of buying Tylenol etc at the store and then eventually having it confiscated by the AL nurse. Just like children, sometimes you really can’t watch them 24/7.