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You cannot and should not try to force medications on your mother. If she refuses, so be it. She’s 90 years old - question your motives and identity your actual goal. There’s no cure for dementia.
If you can't, you can't. Then nature takes its course, as it will anyway with dementia.
My mom seemed to draw comfort from some of her hallucinations. She wasn't violent, though sometimes she was afraid. If your mom's behavior isn't endangering her or anyone else, then you need to decide if it's worth fighting that particular battle.
A 90 year old with dementia is terminally ill. When my mother refused her meds, due TO dementia and losing her ability to use logic, her PCP ordered a couple of them crushed and put into her food. The others were just discontinued bc NOBODY has the power or the "responsibility" to make sure she can take her prescribed medications as directed by her physician. Unless they hold her down, force her mouth open and push the meds down her throat. Which is obviously undoable. Forcing meds on a terminally ill person is just an attempt to prolong a miserable life of suffering anyway, imo. If you are trying to get mom to take meds to control hallucinations for her benefit, ask her doctor or the pharmacist if they can be crushed or come in liquid form.
Other than that, there's not much else you CAN do for a demented elder who's decided they no longer want to take meds. Call hospice in for an evaluation to keep her comfortable, especially if mom has other underlying health conditions. The Medicare reason my hospice company used to get mom approved was "Senile Degeneration of the Brain" which is non Alzheimer's dementia. AD has it's own classification.
There is no simple answer without additional information regarding your mother's situation, and your role in caregiving for your Mom. Are you the POA? If so you are responsible as a family caregiver to make sure she can take her prescribed medications as directed by her physician. The role of a home-care aide is to assist, remind and encourage her to take her medications. If the meds are in a med reminder laid out with the correct dosage by time of day, it should be easy for the aide to remind your mother. If she is uncooperative, there are different approaches to this issue. You can find out why she refuses. Are the pills too hard to swallow? I agree that some medications either in liquid or capsule form can be mixed into soft food if it is easier for her. Palliative care can help, but she may not be as advanced in her disease to require palliative care. Her primary care doctor may also have many suggestions.
Be careful with usurping her wishes. My psychiatrist dad said meds that aren’t tritiated (timed and dosed) properly put patients in a state where they’re neither awake nor asleep and that state creates hallucinations.
My 88 year mom only needs and takes blood pressure meds willingly. everything else was a fight . for a while we tried all kinds of drugs to control her hallucinations which were upsetting to her and me as well (such as the day she thought we were living in North Korea and there were babies crying under the bathroom floor. Though when she thought the people on our tv were actually filming in our house she was very happy) the drugs actually made her more aggressive and with worse hallucinations- plus she said they made her feel sick and very out of it so she refused to take any. Ultimately with her doctor we decided to stop the pills- the hallucinations aren’t life threatening and she feels physically less sick without them i dont know how much real research there is on elderly drug reactions- elderly over 85 not 65, I assume the physical body for those 30 years may change some things so which drug would work best if at all is a question mayo clinic did some research and found placebos worked much of the time so adding drugs that are not for physical ailments seems like my best best my mom doesn’t sleep more than an hour at a time day or night. We tried all kinds of sleep aids and sleeping pills from otc to prescription and same reaction- just made things worse or at best benign and no better At this point the only pills I give are those that control physical health and occasionally pain pills - arguing with her to take pills that make her feel sick at this point does not seem worth the fight she already feels helpless and without any control over her circumstances fishes doesn’t sleep that seems to affect me more than her and thankfully my mother put away some money we use for night help
If you don't think that you would ever seek curative treatment, the best option I've found is to put her in pallative/hospice care. They have the capability to get drugs in different forms.
For instance, my Mom refuses anything in pudding or applesauce. She started refusing to take any pain pills because she said she already took them. As a result, she was in intense pain and ended up with potential UTI. However, she didn't have enough urine to do a sample because she refused water, juice, etc.
Pallative/Hospice came in, gave her tylenol as a suppository, ordered liquid broad spectrum antibiotics since she had all the symptoms of a UTI, even though, we couldn't get a urine sample and getting blood was extremely hard due to her dehydrated state (although she said she drank plenty of liquids)...and 6 hours later, she bounced back and is back to eating food and drinking and taking her pills. And yes, she hallucinates...claims she was getting married a second time (which was not bad, considering that she remembered that she was previously married once).
My Mom was having trouble swallowing basically anything prior to Hospice/pallative care coming in and lately, it takes a bit to recognize who I am.
Ask the pharmacist if the meds can be crushed or come in a liquid form or other form (like a patch, suppository, nasal spray). Most of the time the "do not break or crush" instructs are on the Rx label or the paperwork that comes with it. For many meds, even if you can crush them, they are incomprehensibly bitter, even when hidden in food.
The aide, unless certified, should not be distributing meds especially this type of med. CNAs are not medically trained. From some of the posts lately, seems some agencies r pulling people off the street with no training. Definitely these people should not be distributing meds. All an aide can do is remind the client there pill is due to be taken.
I am assuming that you and the aide understand how to hide medications in puddings and etc. and that none of that stuff is working? What does your mother say about WHY she will not take her medications? At some point, dependent on the answer as to WHY she won't take meds you may need to discuss with MD. You may be looking at a wish for Hospice and end of life care?
Wishing you the best. Only so much can be done. We cannot force medications down their throats.
A great deal depends on her medical and legal status as documented in med redcords or other. If she's deemed cognitively impaired there are actions you should commence, if not, she still has the autonomy to make her own decisions; this all depends on how much planning has been done.
As Geaton confirmed, most meds cannot be crushed or disguised. It would be unwise to attempt sneaking in her meds if mom retains her cognitive autonomy as regards her primary MD and the courts.
You don't provide any info as to DPOA or POA involvement but that person needs to get her to the ER for evaluation; not doing this places her life at risk, depending on the meds required purpoeses. Once evaluated. she'd likely be placed on a 72 hour hold or longer to get her back on her meds and then it's very likely that that the hospital will recommend NH placement.
Your mom has the financing for live in care, it's likely she has the assets to pay for in-facility care while the DPOA works to get her qualified for eventual Medicaid LTC.
Ultimately, someone needs to file for an emergency Guardianship & Conservatorship so that all of mom's needs are met.
It's a very hard thing to shake up her living situation but in all reality, how grounded is she in her current surroundings?
This situation is emergent and if no family member can or will take the necessary measures to ensure her wellbeing, then immediately turn it all over to APS with request for a case mgr.
Luta65, if the OP's mother has live-in aides, it's likely that she will not be eligible for Medicaid; in any case, almost certainly not soon, so this is probably not a current concern. I'm also going to disagree with you regarding the condition's being life-threatening. Meds for dementia are aimed at controlling the symptoms, and not taking them should not be life-threatening. If her mother is not taking anti-hallucinogenic drugs, then she may have more hallucinations, but again, that shouldn't be life-threatening, especially with the aide there to be sure she is not injuring herself. And the problem is not taking the meds at home. Hospitalizing her and putting her on meds when she's not going to take meds at home is not productive. It could be that some meds that are not being taken that are more critical for life, such as blood pressure meds; we aren't told.
Mikoukounas, do you think part of the problem is the sheer number of meds your mother is being asked to take? If so, perhaps you could learn from her physician(s) (if you have POA) whether some meds might be discontinued. Otherwise, you might want to consider consulting a behavioral psychologist (one who could come to her home) to see if the psychologist could plan some strategies to get your mother to take her meds. Again, though, assuming different aides are with your mother at different times when she's supposed to be taking her meds unless all the aides are taught to do the same things, there's still going to be a problem.
Does she indicate why she won't take them? Like, does she have problems swallowing or does she chew them (and they are probably extremely bitter)? Can you put them in a vitamin bottle to make her think she's taking something else?
Your profile says she suffers from depression... maybe meds for this is where you start rather than the other symptoms?
People may suggest breaking or crushing the pills to hide in food but many medications are time-released and breaking them destroys this mechanism. Also, crushed meds are incomprehensibly bitter and few, if any, foods can mask that awful taste.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
My mom seemed to draw comfort from some of her hallucinations. She wasn't violent, though sometimes she was afraid. If your mom's behavior isn't endangering her or anyone else, then you need to decide if it's worth fighting that particular battle.
Other than that, there's not much else you CAN do for a demented elder who's decided they no longer want to take meds. Call hospice in for an evaluation to keep her comfortable, especially if mom has other underlying health conditions. The Medicare reason my hospice company used to get mom approved was "Senile Degeneration of the Brain" which is non Alzheimer's dementia. AD has it's own classification.
Best of luck to you.
everything else was a fight .
for a while we tried all kinds of drugs to control her hallucinations which were upsetting to her and me as well (such as the day she thought we were living in North Korea and there were babies crying under the bathroom floor. Though when she thought the people on our tv were actually filming in our house she was very happy)
the drugs actually made her more aggressive and with worse hallucinations- plus she said they made her feel sick and very out of it so she refused to take any.
Ultimately with her doctor we decided to stop the pills- the hallucinations aren’t life threatening and she feels physically less sick without them
i dont know how much real research there is on elderly drug reactions- elderly over 85 not 65, I assume the physical body for those 30 years may change some things so which drug would work best if at all is a question
mayo clinic did some research and found placebos worked much of the time so adding drugs that are not for physical ailments seems like my best best
my mom doesn’t sleep more than an hour at a time day or night. We tried all kinds of sleep aids and sleeping pills from otc to prescription and same reaction- just made things worse or at best benign and no better
At this point the only pills I give are those that control physical health and occasionally pain pills - arguing with her to take pills that make her feel sick at this point does not seem worth the fight
she already feels helpless and without any control over her circumstances
fishes doesn’t sleep that seems to affect me more than her and thankfully my mother put away some money we use for night help
If you don't think that you would ever seek curative treatment, the best option I've found is to put her in pallative/hospice care. They have the capability to get drugs in different forms.
For instance, my Mom refuses anything in pudding or applesauce. She started refusing to take any pain pills because she said she already took them. As a result, she was in intense pain and ended up with potential UTI. However, she didn't have enough urine to do a sample because she refused water, juice, etc.
Pallative/Hospice came in, gave her tylenol as a suppository, ordered liquid broad spectrum antibiotics since she had all the symptoms of a UTI, even though, we couldn't get a urine sample and getting blood was extremely hard due to her dehydrated state (although she said she drank plenty of liquids)...and 6 hours later, she bounced back and is back to eating food and drinking and taking her pills. And yes, she hallucinates...claims she was getting married a second time (which was not bad, considering that she remembered that she was previously married once).
My Mom was having trouble swallowing basically anything prior to Hospice/pallative care coming in and lately, it takes a bit to recognize who I am.
One never knows what to expect with dementia....
What does your mother say about WHY she will not take her medications?
At some point, dependent on the answer as to WHY she won't take meds you may need to discuss with MD. You may be looking at a wish for Hospice and end of life care?
Wishing you the best. Only so much can be done. We cannot force medications down their throats.
As Geaton confirmed, most meds cannot be crushed or disguised. It would be unwise to attempt sneaking in her meds if mom retains her cognitive autonomy as regards her primary MD and the courts.
You don't provide any info as to DPOA or POA involvement but that person needs to get her to the ER for evaluation; not doing this places her life at risk, depending on the meds required purpoeses. Once evaluated. she'd likely be placed on a 72 hour hold or longer to get her back on her meds and then it's very likely that that the hospital will recommend NH placement.
Your mom has the financing for live in care, it's likely she has the assets to pay for in-facility care while the DPOA works to get her qualified for eventual Medicaid LTC.
Ultimately, someone needs to file for an emergency Guardianship & Conservatorship so that all of mom's needs are met.
It's a very hard thing to shake up her living situation but in all reality, how grounded is she in her current surroundings?
This situation is emergent and if no family member can or will take the necessary measures to ensure her wellbeing, then immediately turn it all over to APS with request for a case mgr.
Wishing you the best in all of this.
Mikoukounas, do you think part of the problem is the sheer number of meds your mother is being asked to take? If so, perhaps you could learn from her physician(s) (if you have POA) whether some meds might be discontinued. Otherwise, you might want to consider consulting a behavioral psychologist (one who could come to her home) to see if the psychologist could plan some strategies to get your mother to take her meds. Again, though, assuming different aides are with your mother at different times when she's supposed to be taking her meds unless all the aides are taught to do the same things, there's still going to be a problem.
Your profile says she suffers from depression... maybe meds for this is where you start rather than the other symptoms?
People may suggest breaking or crushing the pills to hide in food but many medications are time-released and breaking them destroys this mechanism. Also, crushed meds are incomprehensibly bitter and few, if any, foods can mask that awful taste.