I have an elderly friend (I’ve known her since I was 12 and she became a family friend) who has always been very self-sufficient and independent but because of age and a stroke early this year, she is experiencing some cognitive problems (she also refuses to get help/diagnosis for this) and has been forgetting to take her meds— sometimes refusing to do so. It caused a lot of distress, and arguments between us—I became her IHSS provider to help her a couple years ago—but now she refuses to let me help with several things, gets irritated and angry when I try to remind her about taking her meds etc. I bought her an automatic pill dispenser that she used for a bit but after coming along so far in her recovery she refuses to use it. She also refused to let me keep using Alexa to remind her to take her meds when I’m not there, as she lives alone— and threatened to cut me out of her life if I tried, and I just. I don’t know what to DO. She doesn’t trust me, doesn’t want my help anymore with the important things, she yells at me and I could feel myself becoming more and more overwhelmed/short with her. I’ve quit being her IHSS provider and encouraged her to find someone else who 1) could be with her more hours than I could (I have a full time job and am going back to school soon) and 2) I think our relationship is making it difficult for her to see me as someone who can help her (in her eyes it’s a little kid trying to tell her what to do—I’m 28). I didn’t want to keep fighting with her I need her to trust me and call me when she needs help, I need her to not shut me out. It became something unsustainable as it was. she doesn’t have kids and her siblings are far away and unavailable, I still see her a couple times a week to check in and help her get food and make appointments and take her to them etc. nothing's changed she doesn’t take her meds—she’s on three blood pressure meds, heart meds and blood thinners. If I do much as bring it up she gets mad and essentially stops talking to me until I leave. She had a stroke, this is important! I don’t know what to DO. Her nurses and social worker know about this too, but because she’s still capable of making her own decisions they say there’s nothing they can do? She’s poor, has no kids no real family and she won’t let me help in the ways I need to? Any advice on this is hugely appreciated, I’m worried and sad and frustrated and every single option feels like a bad one.

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GB, like many folks here, you are "awaiting the crisis" that will put her in the hospital. At that point, the hospital with have enough evidence of "self neglect" and "lack of insight" to say that she can't go home. They will find her a facility.

You can't help folks like this.
Helpful Answer (14)
Reply to BarbBrooklyn


The bottom line is, as much as you would like to see your family friend listen to reason, you can’t force her to see things from your perspective.

You have offered your help. She has shown you that she isn’t interested in following your advice. So eliminate the sentence, “I don’t know what to do.”

There isn’t anything left for you to do except to step aside and allow her to take over the reins. Perhaps her care team will be able to persuade her.

It’s disappointing and even unsettling to us when we have someone’s best interests at heart and they refuse our help.

You can remain being her friend if you wish. Leave it at that though because anything more will cause nothing but frustration for each of you.
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Reply to NeedHelpWithMom
TouchMatters Dec 11, 2022
So well said.
Gena / Touch Matters
GB, welcome!

Some folks CAN'T be helped. They have capacity to make decisions for themselves and insist on making BAD decisions. You can't stop that.

Visit as a friend. Don't nag.
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Reply to BarbBrooklyn
Isthisrealyreal Dec 5, 2022
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GB, you are new on the site, and you have given us very little information about yourself and your friend. Your problems in ‘making’ your friend be sensible are shared by many carers (especially daughters!), and so are the increasing problems with ‘irritated, angry, no trust, threats about ‘cut out of life’ etc. Sixty year old ex-nurse daughters with POAs can’t solve this, and you have a lot less chance yourself.

You “don’t know what to DO”. “Every single option feels like a bad one”. In fact you have almost no real options, and the situation is likely to get worse. She will eventually have a crisis, with sudden death or compulsory care (neither or which are necessarily bad). You have no rights to intervene, in fact less than “her nurses and social worker”. Leave it up to them. You have DONE what you can. You can’t always succeed, no matter how crazy it seems, or how bad things are. Accept it, and if you want to stay in touch, make it a friendly social visit.
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Reply to MargaretMcKen

When dementia sets in, due to a stroke or for other reasons, logic flies out the window. That includes the logic required to take pills that are needed to keep the person alive & somewhat healthy. You can't force this woman to take her meds, nor should you try. Arguing with a dementia patient is an exercise in futility, as well, and should not happen. Expecting your friend to call you when she needs you, or to trust you, may not happen anymore either because again, once dementia sets in, so does paranoia and general distrust of everybody including loved ones.

In the long run, extending her life may not be the wise idea you think it is. Living with dementia and all the headaches & heartaches associated with brain dysfunction is not something most people want to do. If she decides to stop taking her meds, so be it. She will let the chips fall where they may and it's up to her siblings to intervene to save her life if they so desire, 'unavailable' though they may be. There is only so much you can do as a family friend. If you feel she's in danger as a vulnerable adult living alone, call APS to do a wellness check on her. If they feel she should not be living alone, THEY will see to it that she's placed in a Skilled Nursing Facility for her own safety.

Wishing you the best of luck detaching from this situation with love, realizing there's nothing you can do for a person who does not want your help. As long as she's still considered competent, there's nothing ANYONE can do to save her from herself. It's her right to live as she sees fit, and to die the same way, if it's in the cards for her to.
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Reply to lealonnie1
GB2012 Dec 5, 2022
I think that’s been the hardest thing to come to terms with for me and my family, the fact that we can’t and shouldn’t force her to do these things even though it’s for her own safety and well-being. She’s told me she would rather die than end up in a home practically since I met her. I can empathize with that, but it’s hard to reconcile that with the reality of her as she is right now. As for APS, they’ve been by to see her a few times now. She was a VERY good nurse and conference speaker for hospitals when she was young so she knows what to say to them to keep up appearances when they talk to her I think. I may need to call again. At this point I think what she wants most and maybe needs most is a friend, since nothing else I do or did is actually helping. It’s hard. Everything you’ve said is hard but necessary to understand i think. Thank you.
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There is only so much you can do. My father throws all his medication out every time I fill it. I gave up trying. He should be on blood pressure medication and a few others. Him not taking it could very well lead to some bad health outcomes, but as he has Alzheimer’s (and had a stroke last year) and is also adamant that he never goes into care, what purpose is fighting with him to take medications that only prolonging the inevitable? This sounds harsh I know, but if he wants to stay in his home (he lives alone) and refuses care, then he is going to get his wish and whatever the consequences are of that. At some point there will most likely be an event that triggers placement. Same with your friend. Live your life. You are too young to let this derail you.
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Reply to Caregiverstress

give up the pill fight. GIVE IT UP.

Just be the friend who checks daily to see that she’s still alive. There will likely come a day when she gets p.o’d that “you are all up in her business checking on her every day!”

Do not nag about the meds. Do not even mention it.
Helpful Answer (9)
Reply to XenaJada

You speak so very well and express the situation beautifully.
I understand. There comes a time when we realize we've done all we can - and that we need to let go. You need to let go.

Yes, it is difficult. However, it appears to me that this woman:
1) is depressed and needs MD assessment for medication to deal with depression;
2) is cognitively compromised, perhaps due to stroke, perhaps not. Clearly she is either choosing not to do what she needs or cannot. She needs a MD assessment and it appears only she can arrange for this, which she won't.
3) Her needs / issues / health concerns are a combination of the above and/or more / different.

You are so right. A person will not listen to a friend, relative, neighbor, etc., as they might listen to a professional - be it MD, social worker, etc. Perhaps the only - and perhaps last resort - strategy you can do is report her to county senior services or some outside agency that can knock on her door to see what is going on - and see if she will accept the help she needs. Clearly, she likely would 'slam the door in their face' - and you will know you've done all you can.

Without POA status, many elders or older people health compromised, be it physical, mental, cognitive, psychological will make decisions not in their best interest - and there is little to nothing we can do. It is important to realize when the time comes to know when to stop, step back, and feel both sad and also self-acknowledge all that you have done and tried to do. You must take care of yourself.

KNOW THAT YOU did a huge service to this woman.
It is now up to her.
Letting go is one of the hardest things to do.
It says a lot about YOU coming to us here for support.
You will get it. Take it to heart.

Gena / Touch Matters
Helpful Answer (9)
Reply to TouchMatters
NeedHelpWithMom Dec 12, 2022
I totally agree with you that letting go can be extremely difficult for many people.

People feel that they are strong for ‘holding on’ but sometimes it takes more strength to ‘let go’ and very often ‘letting go’ is what is most needed.

By holding on people are hoping to be able to control the situation. It generally doesn’t work out very well.

I also feel that it is best to allow an objective professional, (MD or social worker) attempt to persuade them to move forward in the proper direction.
Call Adult Protective Service. If she will not take her meds, it’s potentially life threatening.

Sadly, the only thing they can eventually do is have her placed in a facility. And the only thing you can do is visit her. At least she will be getting hers meds and will be looked after.

Please don’t hesitate doing this. Speak with her social worker and her nurses…there’s no way they are letting her not take her meds. Can she grocery shop? Pay her bills? Drive? How are these things getting done? If it’s you, tell the social worker you will stop and to get her placed.
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Reply to Donttestme

Please call Adult Protective Services and request a welfare check so that her home and lifestyle can be evaluated for placement through Medicaid (if she isn't already using that option). Stop trying to be her caretaker so that they can see what will happen to her without constant care and medications. Let go and see if the Adult Protective Services will do what they get paid to do. It sounds like her nurses and social worker have taken a pass and just washed their hands of seeking 24/7 care; while she might be able to vocalize her decisions, are the really healthy decisions?

All you can do is call in the authorities and show them videos of her dealing her medications. Everyone uses their phones to document dangerous situations nowadays.
Helpful Answer (6)
Reply to ConnieCaretaker
Isthisrealyreal Dec 11, 2022
Connie, people of ALL ages and ability make really unhealthy and dangerous choices every day. This isn't reason enough to take someone's autonomy.
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