My mother's in a nursing home and refuses to take her meds.

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She has dementia and has horrible behavior. She hits and punches the aids and throws water on them. The director of nurses explained they will have to admit her to a hospital and give her meds to her through an IV. I am in tears about this whole situation. I hate to put my mother through this, but what other options do I have?


Are you the Health Care Proxy? Do you know what she would have wanted when she was in her right mind? They could start by giving her meds rectally. I am sure she will fight but it can be done. What will happen if she does not take her meds? does it really matter? giving the meds IV won't work either as she will resist the IV and probably just pull it out even if they stitch it in. She will also pull out a naso gastric tube and it would be very distressing to have to restrain her and pass a tube every time the meds are due. If there was something absolutely essential it could be given by injection. Can you tell us which medication she is taking and what conditions she has. This is not an unusual situation to encounter in a geriatric facility so it is probably possible to give her some medication that will modify her behavior so she is easier to handle. This is a no win situation all around. No one likes to sedate an elderly patient but your mother is suffering in her current situation
I don't think I'm a Health Care Proxy. The only thing I have is her Power of Attorney, but I don't have a Medical Power of Attorney. I wonder if they can legally force her to take her medication. They want her to take Adivan and they want to put a patch on her for her dementia--not sure what the patch contains. When she was in her right mind she was opposed to any medications. I would go so far to say that she would rather die than take medications. Without the medication, she will probably continue to be agitated and abusive to the aids. I realize this is unacceptable as the aids have to take a chance of bodily harm everytime they have to deal with her. Yes, this is a no win situation. It helps to talk about it...thank you for your response.
I feel very sorry for all of you! Knowing that your mother would rather die than take medications, I would be opposed to forcing them on her. BUT ... and there is always a but, nothing is ever so helpfully clear-cut ... the choice isn't to take meds or to die, it is (or may be) to take meds or be miserable and make everyone else miserable, too. People can live many years with dementia.

I think would I would want to have happen if I were her daughter, is to somehow get the drugs administered that could reduce her anxiety and combativeness. If she returns to a calmer state, more able to communicate clearly, then perhaps talking to her about her options would be more productive.

My heart goes out to you all.
I have a similar situation though not as serious. My mother has been prescribed an anti psychotic drug for paranoia. She is in an ALF as she is pretty well physically. but has Borderline Personality Disorder and has had it all her life, so is difficult to deal with and is acting out more as she ages. She has never agreed to taking meds for her "mood" and has never been "in her right mind". My understanding is that meds cannot be forced on someone unless they are a danger to themselves or someone else, and then, for example, a sedative can be injected or an IV used. I am in Canada - it may be different in the US. I do know of some cases where a person in a nursing home who refuses meds and is combative, has been given meds, unawares, crushed up in their food. There may be ethical questions about that, but, practically, it seems sensible, This is not to overly sedate a person, but to help their behaviour become more manageable, The antipsychotic drug did not sedate mother, but did calm her fears for the short period of time that she took it. Her life was much more manageable on the drug - easier for her and easier for those of us dealing with her, though it was no panacea. Still, it is her choice not to take it. I think if she were in a nursing home, and in a situation where the drug could be administered without her knowledge, I would think seriously about it if her behaviour became unmanageable for the staff. It is a difficult issue, as when you are acting as their agent, you are to do what they would do for themselves "in their right minds", yet mother has never been in her right mind. I know our family would support her being given the meds any way possible. Good luck
Mthr is very much the same way, very opposed to drugs. However, she escaped from her Memory Care Unit today and was in the parking lot! While she was on the phone with me, after she had been rounded back up and corralled, I told her my husband just sent her pills over to where she is now- the melatonin she has read about and the probiotic to help her absorb food. Actually, it is melatonin, plus Ambien, and we hope to have her in bed by 7! We are trying this for 2 weeks, then on to stronger drugs if it does not work.

Lying to her to get her to take pills just has to be done. She is dangerous to herself and others if she gets away. Think of the damage she could do if she ran out into the road in front of a new driver - the teen would think she would have sense enough to stop, but would be scarred for life by hitting, or worse killing her - and that is if the teen lives.

We have mthr a subscription to a "natural living" magazine full of vitamin ads, and she marks what she wants to try. She is on a good multi vitamin from her favorite company, and we tell her the other pills she is on are the other supplements. She takes them OK unless she is highly agitated.
@ surprise - Mother. at 101 yrs old tried to fly across the country alone. She didn't really have a plan, but said a niece and/or nephew would care for her. This nephew refused to take POA for which I do not fault him. She says she will still go if she gets a chance. I have POA and personal directive. Fortunately the airlines wouldn't sell her a ticket as she doesn't have a driver's license or an up to date passport. We all feel this was not rational and not safe for her, but the docs claim she is competent (barely!). I agree that your mother is at risk. Hopefully the staff will keep a better eye on her now.
@sanantonian - could your mother be fed the meds in her food?
Emjo, good to see you again! You were so helpful last summer when we first rescued mthr!

We have learned that "competent" is a legal term, not medical, and no doc wants to touch that with a ten foot pole! I wonder if this is an edict for their malpractice insurance? Our GP told us that the only doc he thought would determine competence was a psych. We had a court ordered psych evaluation, and since the results were never introduced into evidence, they probably were destroyed. Any way, no one except APS has access to the original.

As long as someone has not been ruled incompetent, they can change their will, revoke a POA, or change their directive. Of course, if they don't remember those documents, they won't!

Wow, an unaccompanied cross country flight. I let my two teenagers do that together once, but Granny would scare me even if she were living by herself and fully competent! :)

First of all, I want to thank all of you who replied to my post. You have helped me so much in dealing with this situation. Here's an update to my dilema....I went to visit my mother today, but decided against going into her room. Before I got there she told the nurse she was going home today and was waiting for her ride. If I went in, she would think I was there to take her home. She still refuses to take her meds and a psychiatrist already has signed off on taking her to the hospital to have them administered to her. They are just waiting for a bed to open. I feel horrible. I can only hope and try to convince my self this is the best thing for her.
My Aunt is in a care home in Alberta, Canada. She has been diagnosed with Alzheimers and is in the state where she currently has periodic bouts of violence. She has been aggressive enough to choke another patient (because they were making too much noise) and it took three staff members to pull her off. Because of low staff to patient ratios they lose track of her quite frequently and it is at these times when she gets into trouble. Does anyone know of any patient tracking gadget for use in Canada so that we could alert staff as to her whereabouts on the ward and perhaps has sensors outside rooms that are not her own if she attempts to enter another persons room. I have to do something and fast or they will move her temporarily to acute treatment and once they discharge her I will have to start all over again with her in the community. Likely this would mean starting in a non-private room which is even worse than her current situation. Repetitive noise of any type sets her off and a room-mate would be dynamite as we have learned in the past.
sanantonian - ((((((((hugs)))))) sometimes there are no great options, but ones that are better or worse. I think this is for the better. It is not what anyone would want for their parent, or for anyone, but we have no control over the progress of the disease, which is causing behaviour that is unmanageable, - obviously the case for your mother. "Desperate times call for desperate measures." and I think that is what you are facing. I am sorry, and know you are grieving the changes in your mum that make this necessary. If I were in your shoes, I would do the same thing. It is a hard call. More ((((((((hugs)))))) Do let us know how it works out.

@lherzog - I am in Alberta and have not heard of anything like that but will ask around. I have a friend in Edmonton who has a lot of knowledge of/experience with seniors issues.

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