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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.
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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.
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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.

Wishing you the best in all of this.
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Igloocar Dec 2023
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.
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I'm going down this road also.

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....
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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.
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Can you get meds in a form to crush up and mix with food?
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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.

Best of luck to you.
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Ask her doctor if the meds can be crushed up or come in liquid form. Then put them in her food and drink and don't tell her. She will not even know.
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Geaton777 Dec 2023
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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.
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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.
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