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hieronymousboss Asked April 2022

So frustrated with elderly parent who keeps dropping pills. Advice?

So, my mother moved in with me a few years ago. Since then, it's been a constant battle to reinforce and reteach good habits- like handwashing, dressing etc. She kept insisting on taking her meds in bed and she has dropped many, many pills. I set a house rule that all medications must be taken at the table safely over a plate, which she agreed to do. Just today, a visiting caregiver found six of one kind of pill under her bed and a whole bunch of another type scattered on her bookshelf. It's not just this. She also keeps eating while on the toilet, using the garbage can in her room as a sink etc. She says she doesn't want to have to get up and do these things elsewhere in the house and she just wants to do everything from bed and not have to get up. She keeps promising to alter these behaviors, and has periodically- but then seems to go back to doing whatever she wants to do and lies to me about it! The pills are a serious danger to my cats whom I love dearly, and any children who come to the house! Plus she's not taking those doses. She regularly sees a memory specialist who says she does NOT have dementia, but just normal age-related cognitive decline and she can be taught information. What bothers me is that she makes such poor choices and then fights me on it, then agrees, but lies and keeps doing what she wants. I don't trust her at all! She keeps bugging me for a space heater in her room and I feel absolutely certain that she would burn the house down. I talk to her doctors about these things, but they have nothing useful to offer except to keep reinforcing the good habits. Ultimately though, it's up to her whether she wants to comply. I'm just so angry about the last bout of pills on the floor. I feel defeated. Does anyone have any practical suggestions that have worked? Would liquid medications work better? Does such a thing exist? I work everyday so I can't be there to stand over her while she takes pills and I need to be able to trust that she's not going to poison any children or animals while I'm not there. ARGH.

Countrymouse Apr 2022
She doesn't have to get up to take her meds. You go in there before you leave for work with her a.m. medications and a glass of water, gently wake her, ask her to sit up, hand her the meds and watch her swallow them. If she were English I'd take her a cup of tea and a biscuit, too, to sugar the pill as it were - I'm sure you have an equivalent treat. Then she can go back to sleep if she likes. Don't argue with her about it, just go in expecting her to take them, and if she doesn't then you chart "declined" - which, as a 'competent' adult, she is within her rights to do - and take them away again.

If she's that unreliable I wouldn't be happy about her taking Tylenol independently anyway because, although as drugs go it's a very safe drug, doses must be spaced at least 4 hours apart, and what are the odds of her getting that right?

If the drugs for midday/afternoon are dispensed into dosette boxes or similar, the aides can prompt her to take them, and they can remove the boxes from her reach to a safe place afterwards.

That leaves you with pm/bed time medication. If your mother is on anything that has to be taken four times a day then ask her prescriber to think of something else. There are various modified/sustained release options which should make it possible to avoid a fourth session.

There is no foolproof method of enabling independent medications administration. I've lost count of how many gadgets there are, but I am compiling a list of the ways in which they spectacularly fail to achieve their object.

The thing is. We're asking rather a lot of people with this. There are the 6 Rights...
- Right Person
- Right Medication
- Right Dose
- Right Time
- Right Route
- Right Documentation (i.e., in a domestic setting, a note of that and when they have been taken)
... and then on top of this you have to multiply all that by the four, six, eight, upwards separate medications they've been prescribed, either in individual packages, each with its own design flaws, or in blister packs which present their own problems for people with impaired vision and arthritic fingers.

Ugh blister packs! - seven tablets, and when inevitably one or two get dropped - which are they?

The cats are not going to take the tablets. I grant you that if there ever were a way to make a cat take a tablet it probably would be to beg it not to, but I don't think even cats are quite so contrary. Also, they didn't - you found the tablets.

One lady I know who has the above mentioned impaired vision and arthritic fingers uses a shallow tray, like a baking sheet, and puts all the boxes on it. She told me herself that she does this so that when they go astray she can find them easily, and if you pick a dark one, the tablets will show up, too. Only I can't see your mother taking to this method, can you?
pamzimmrrt Apr 2022
As to the cats not eating the pills.. I have a story! My mom took eye vitamens that look like a kidney bean.. my puppers loves kidney beans. I once found her messing with a kidney bean one morning,, licking it and rolling it around. then I remember I had NO opened kidney beans around! Grabbed that sucker ( the pill not the pup) and found it was moms eye pill!
Grandma1954 Apr 2022
You have to start monitoring her medications.
She must take them while supervised. Either you or a caregiver. I would portion them, place them in a small cup (shot glass works great) and hand the cup to her to take.
An alternate would be to have the prescriptions portioned in "pill packs" and delivered that way.
Medications can also come as liquids or patches. You could discuss this with the doctor. In either case dispensing liquids would need to be monitored so would patches to make sure a previous one has been removed before another placed otherwise she could be overdosing.
Food now can not leave the kitchen area. Any eating to be done at the table.
You may have to begin monitoring her in the bathroom as well.
And it sounds like no liquids in the bedroom as well.

If she is aware of what she is doing and refuses to follow house rules you could suggest moving to Assisted Living

**I saw your reply to JoAnn29 and it is great that the doctor wants her to have independence but when it becomes a matter of safety and the doctor is not living with you to count pills, pick up dropped one that changes things in my opinion.
She can be independent in other ways. And isn't part of being independent following simple requests from you that will keep others safe

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AlvaDeer Apr 2022
It is no longer safe for your Mom to take her medications without your assistence.
With your assistance she can take them at the correct times and in the correct amounts. You can safely put them in a small plastic mug with a handle. I agree with you; this is a danger to children and pets.
There comes a time when whether in ALF or at a home, medications cannot be safely taken by an elder. Sorry, just the facts, which I know you already see coming. Hygiene will also become more challenging. Time to consider how long you can go on with in home care.
I sure wish you the best and hope others have better solutions for you than my own. You know your Mom a good deal better than we do.

JoAnn29 Apr 2022
"Just today, a visiting caregiver found six of one kind of pill under her bed and a whole bunch of another type scattered on her bookshelf." So she has a Caregiver coming in but if only a CNA the aide cannot dispense meds. She can remind Mom but can't hand them to her.

What meds does Mom take that you can't give her before you leave for work and give her when she comes home. I also would wonder if she needs all the meds. I found with my Mom some meds were given her in the Hospital which she no longer needed once she was stable.

Your Mom should not be able to get to her meds. We put Moms in a kitchen cabinet too high for her to see and reach. I put pills in a weekly planner again putting too high for Mom to get to. My nephew would take the planner and put Moms pills in a shot glass on the kitchen table when he left for work. She took nothing in the afternoon.

My suggestion would be in to find little plastic cups like they have in nursing homes. They come with lids. You put her pills in them and the CNA maybe able to hand the container to her. Your other option, as suggested, is to place Mom. Seems she should not be alone.
XenaJada Apr 2022
Seems so simple right? I’ve been through this w an elderly aunt. For some reason it is extremely difficult for some people to remember to take their meds!

We found >100 pills down inside her recliner and on the floor underneath.
I separated her pills into the day of week container. Had an orange one for daytime meds and dark purple for night. Had a big sign oncher refrigerator to remind her of the color coding. I even had stickers on the dispenser. She’d take Sunday’s day pills on Monday night, skip a day, tke Saturday pills on Tuesday, etc. told me she couldn’t remember what day it was. I got her a pretty calendar. She lost it in the hoard. Someone got her a senior clock. It disappeared. It is maddening!
lealonnie1 Apr 2022
Your mother's memory issues, whether 'dementia' diagnosed or not, are such that she needs help during the day which she's not getting b/c you are working. Has she been FORMALLY tested with a MoCA or SLUMS test, or is her doctor saying her memory problems are 'just' age related, off the top of his head, w/o knowing for certain what's going on? Many doctors make off-the-cuff statements like that and leave children in a position to feel certain mom can be 'taught' or 'trained' to learn better habits when, in reality, they cannot. Even before my mother was formally dx'ed with dementia, her stubborn know-it-all attitude prevented her from learning ONE new thing, ever. She used to go walking the neighborhood w/o a phone or an alert button, all the time, and dad would beg her not to. She'd laugh in his face and do it anyway, regardless that she could fall and not be found, etc. She could not see past the tip of her own nose, in reality; that was her personality; unteachable PERIOD

At the very least, you should consider bringing in a caregiver for 4 hours a day to help your mom out with meals, pill taking and watching her actually swallow them with water while in her presence. When my mother was starting out on her dementia journey & lived in Assisted Living, I'd fill her pill box up for her weekly. When I'd go visit, I'd find her pills under her recliner, or in a coffee cup in the kitchen cabinet! She'd be 'saving them' to take later, then forget. Or she'd drop them on the floor by mistake, and they'd go under the recliner. It wasn't that she was trying to be spiteful or practice bad habits; it was that she was on the dementia highway and had a poor memory along with poor motor skills combined.

Getting your mother on liquid meds probably wouldn't be a much better solution. She needs someone there to help her with things. Lying is another sign of dementia and/or a poor memory at work & her trying to hide it from you. Again, even if she's not diagnosed with 'dementia' per se, memory problems act just like dementia ANYWAY, so there you have it.

If you don't want her to live in AL, you may as well just hire someone to come in to help her with meals, dressing, showers, and medication management every day (on her dime, of course) and that will lessen your burden a bit. Nobody should be 100% responsible for an elder living in their home anyway; it's too much! Especially when memory issues exist; it makes one feel like they've jumped down the rabbit hole! For real!

Wishing you the best of luck coming up with a new plan to manage mother and her issues.
hieronymousboss Apr 2022
She is tested regularly by a psychiatrist who specializes in geriatric mood and memory at a hospital about an hour away. That's all they do is geriatric mood and memory. She also had a scan to check for vascularization. She's in good health other than having high blood pressure, arthritis pain, and chronic depression/anxiety. She IS heavily medicated in my opinion, with four bp meds, two antidepressants, and then regular Tylenol. She takes that every four hours, so it's just not possible for me to be there to police the Tylenol all day long, and unfortunately that stuff is also toxic to any little ones who might find it. She has dropped many of those. Additionally, she refuses to get up or take her AM meds before 9 or 10 am -or stick to any routine really. That's actually something her regular psychiatric nurse is trying to get her to do. Of course I can't force my mother to get up, and I have to be at work. I can't just wait about and straggle in late everyday, and sometimes I have to travel for work. I do have caregivers who come in every day for two hours- I can't afford to pay for more at this time. I'm so confused because they say her brain is fine and to keep encouraging independence, but surely these behaviors are not normal? She also has a tendency to hoard. I just don't know what to think anymore. She was always very strong willed and made some bad choices in life. I find myself wondering if age just exacerbates what's already there. I'm a nervous wreck over the whole situation.
ConnieCaretaker Apr 2022
When my mother's behaviors became dangerous to her and my family, I had no choice but to get her placed. None of us were happy, but we were all safe.

Maggie61r Apr 2022
My mom needs meds twice a day, so I have one of those AM/PM pill sorter/containers. When it's time for her meds, I transfer the appropriate meds into a small, lidded container like they use for crafts or paints. and give them to her like they would in the hospital. Of course, it may not be that easy if your mom needs her meds at odd intervals. I wish you the best - it's difficult to try & keep everybody safe.
Type in "Small Paint Cup with Lids" or something similar and they should come up. I purchased mine from Amazon if that helps any.
hieronymousboss Apr 2022
My mother has about twelve of those daily containers. I've tried the weekly boxes, the twice daily boxes and nothing seems to work. Oddly, she seems to just make the boxes, and many other items, disappear into her many bags and boxes and hoarded drawers. Today as I was checking to make sure no more pills got missed, I found multiple pill boxes in her drawers, ones she couldn't find for months. She is a hoarder so she grabs everything I give her and tucks it away. I tried giving her cute cups, pink containers with little lids, a pill calendar, a clock, and she just makes them disappear. At the bottom of one of her bags, I find more loose pills, some rotten cheese, and pulverized crackers along with a huge number of used baby wipes. I'll try anything, but I'm losing hope. Meanwhile, her practitioners say there's nothing wrong beyond 'normal cognitive decline'
AnnReid Apr 2022
I can hear the exhaustion you’re feeling as I read your post.

Is there a particular reason why you wouldn’t consider a good Assisted Living setting?

What profession does the “memory specialist” come from? Has the specialist formally tested your mother? Have you seen the results if testing has been done?

Her circumstances sound VERY similar to those of my LO. During a stay at my home, she was spending 7 hours a day in the bathroom, and eating meals there also.

I don’t think there’s any way you can “trust that she’s not going to poison any children or animals” if she’s left unsupervised. Sometimes the aging process produces quirks in behavior that might have gone unnoticed in younger people. I’m not so sure she’s just “unwilling” to comply with you requests.

For your sake, would it be possible to get more “companionship” in for times when you’re away?

Take good care of yourself.
hieronymousboss Apr 2022
I have people who come in for a couple hours a day and I can't afford more, I'm afraid. I'm relieved to hear that I'm not the only one on the planet dealing with the bathroom thing! She has a psychiatric nurse/therapist who does home health visits each week and the message is always "just keep reteaching good habits" Trying, but she's never listened to me. Ever. Why would she start now? *Sigh*

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