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Hi, all,


First, a belated thanks to this board for all the support the past 2 years. Dad is in Assisted Living now (went in last November) and Medicaid was approved two weeks ago. Yay. This board was a huge support to me even if I did not post often. So thank you.


My question now is this: The facility has allowed my father to manage his own medications but recently he is getting more confused and not storing/taking his meds correctly. The nursing director gave me the heads-up that he is going to switch the meds to being administered by the facility. I am fine with this. But dad is going to flip out over it. How do I convince him that it's the right thing to do? The last time the facility was going to do this they gave him one more try. Obviously it didn't work. At that time my father was livid that they were taking away this part of his control and would rant to me all day for a week. Any advice?

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Blame it on his doctor.
When he begins to rant, say "Dad, this isn't in my control or yours. We can talk about something else or I'll have to go".

Don't entertain the ranting.
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SZHNJ1023 Aug 11, 2020
Excellent advice, thank you :)
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Yes, Barbs suggestion is a good
one.

This was one of several tips I learned from the smarty folks here. It came late in my caregivers journey - unfortunately I found this site in year five of six - but nonetheless...

The act of politely saying “... I’m gonna go now. I’ll come back on day when you’re more up to a visit” works wonders iIn a variety of situations when the elderly loved one is attempting to take their anger and frustration out on you.
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I would say let him rant, and that mostly because there is no way to stop it. Tell him "Dad, you are right, it is one more loss, and I am so sorry for it. But the facility cannot let you take your medications when it goes wrong too often, because they are liable if something happens to you. It is the rules. I don't like it and you don't like it and it is one more loss, but from the time we are born we are born into rules, and we die in rules as well. I am sorry. You are angry and I understand this. It isn't your fault. I already have periods when I forget whether I took my pills or not. (lie!) and the time will come when I need help, too." That's it. Then he will rant some more. When my brother went into assisted living he had a diagnosis of probably early Lewy's. He ASKED me to take on his finances, to do POA, to be Trustee of his Trust. BUT he also admitted how hard it was to have all his controls removed one at a time, with nothing to look forward to but more loss. Your Dad has had another loss. It is worth raging over. Then it is just one more thing to "live with". Isn't it so hard to see? For me at 78 it is even harder to know I am "going there". Remind Dad he once had to listen to you when you didn't listen to rules, and you will listen to HIM, but that you will only listen so long, because you can't "fix everything", and then take Barb and RainMom's advice, and take your leave.
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SZHNJ1023 Aug 11, 2020
Thank you, well put.
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My Moms AL never allowed medication in residents room not even OTC drugs. The Nurse handled everything with a doctors order. Tylenol was administered "when needed". To me this made sense, the AL was protecting themselves and the residents.

Tell Dad that the ALs policy has changed by State law. Residents are no longer able to have medications in their rooms. Violation of this policy could mean penalties for the AL and his rent going up. 😊

Then if he rants let him. Nothing u or he can do. You can always walk away.
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Barb said what I was thinking, don’t take the blame or listen to the anger. “It wasn’t decided by me, I’m sure it will be fine, how was your night’s sleep?” Or whatever other topic. No need to take on what you can’t change or fix
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I would just point the conversation in another direction...."Dad, this is what we pay them to do, let them do their job.  That way we don't have to worry about such things and can spend our time doing other stuff."  Or as someone posted previously, blame it on the lawyers and tell him that everyone in the facility has to have their meds given by a nurse...it's the law.

When I noticed mom wasn't bathing herself regularly, I asked the facility to come in and help her in the mornings and mom resisted in the beginning.  I finally told her that the hand held shower sprayer was really difficult to use and everyone was complaining so they have to have someone come in and help everybody in the morning to make sure they can manage the sprayer and not slip and fall while doing it.  She seemed to go along with that...

It's hard to get into the mode of "fabricating" stories to our parents, but if it's in their best interest...I feel justified.

Good Luck
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Well hold your horses a second - who is consenting to this, you? Because somebody has to.

Whoever does, though, there are - as you have already identified - several steps to Medicines Administration. What the ALF ought to be doing is involving your father in as many of them as is practicable, in line with the end result that: the Right Person gets the Right Medication in the Right Dose in the Right Manner at the Right Time.

So, counting them off...
Ordering repeat px's.
Collecting same.
Storing.
Dispensing.
Following directions.
Taking.
Recording.

What cannot be done BY your father must be done in front of him, and explained to him as it is done, each and every time. Your father's right to refuse a particular medication, and his right to know what he is being offered and what it's for, must be respected.

The explanation must be comprehensible to the person expected to understand it. So for example: with some clients, you'll say "this is the Apixaban" and they know much better than you do what it is and what it's for; with others, you might tell them "this is the medicine to stop dangerous blood clots in your circulation."

The facility ought to have some sort of Consent to Medications Administration form which explains how the process works, and which somebody ought to be asked to sign. This would also be an opportunity to reassure your father that his material rights - to be treated only with his informed consent - will remain intact.

There are two extremely sound reasons for people to be uneasy/resentful/livid about their medications being taken away and then handed to them by staff. One, they may not have that much confidence in the staff. You say your father's not storing/taking his meds correctly? I'll bet he'll come right back at you with "what makes you think THEY will?" Two, they may not be happy that they know what they're being offered.

They are *right* to have these concerns, and the facility must reassure them by explaining their safe handling and administration protocols.
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SZHNJ1023 Aug 14, 2020
I'm all for them taking control. He has either overdosed himself to the point of running out of heart medication and not telling anyone to misplacing prescriptions to just not taking them at all. It was all okay for some time, but lately he's getting foggier so I see why the facility wants to step in on this. For him the issue is control, not confidence in staff or not trusting what they are giving him. Thanks for the reply!
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I'm surprised the AL have allowed you Dad to manage his own meds. My Mom hasn't been in AL long, but it's policy to have their nurse dispense meds. Any way you can tell him it's a new policy because they had an incident with another resident?
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Imho, the medications may have to be managed by the staff. Case in point - my late mother had terrible medication management by herself. The pills were lost to the cause and on her floors. I took over the management with the direction by medical professionals to get cassettes - one color for day and one for night. This is a little off topic from your post, but this did not even work because my mother insisted on removing the pills and placing them on a teaciup saucer. Ugh. Good luck.
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Let him rant and rave if he gets confused. Don't give in. In the worst case, get some simple NON-medical pills and pretend he is in charge. It can be done. Otherwise, just ignore him. He will never give in and understand. Don't even try to talk to him.
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