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He just out right refuses or insists he took them even though you show him the pills.

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I was solely responsible for my FIL the last 6 months of his life. I would hand him his pills and a drink and walk away. (Assuming, of course, he was taking them).

He went to the hospital for what turned out to be the last time--after he passed I was cleaning and pulled out his recliner. Underneath were hundreds of pills. He hadn't taken anything for well over a month. I just chuckled under my breath and said "You won, dad".

Now, I will state that nothing he was taking was "life altering"..and the side effects...mostly gastro problems--just not worth it.

I agree with Black hole. This could well be your dad's way of saying "I'm DONE!"

I plan to quit all meds when I am 70. I have no desire to live forever, and I see my mother shoveling down 20+ pills a day and I wonder, "why????"
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Does Dad have the capacity to have an honest, cogent heart-to-heart with you? (That you would have to initiate.) Perhaps the pill refusal is Dad's way of saying "enough's enough" ???
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If your dad refuses, maybe it's time to reevaluate what drugs are important for him. What's his diagnosis? If he has dementia, statins are not helping him. They might keep him around longer to suffer the effects of dementia longer (I'd prefer to be taken out by a massive heart attack than by the slow decline of dementia). If the drugs are for anxiety because of dementia, that's different. Docs are required to prescribe for health of the patient, not for the pts' best interest. You can talk to doc and change goals if care to palliative, where you are not trying to cure anything, but relieve suffering.

Once pills are minimized, then it's time to make boundaries. If Dad is unmanageable at home when he won't take his pills, you can make a rule that he has to go to memory care or asst living after x number of days straight, or x times. This is a sign of mental decline and it won't get better. Instead of driving yourself crazy trying to manage, set this number so you have a line in the sand as to when it is time for placement.
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Karen, do you prepare his meals? If so, find out from his pharmacist if the pills can be crushed. If so, crush them and hide them in food. Unless they're particularly foul tasting, he won't know the difference.

Or perhaps you can offer something pleasurable after he takes him, such as a little bit of ice cream, his favorite music (just put it on and play it, but only after taking meds)....little things that he associates with taking meds on a subconscious level.
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Karen, my Dad was always forgetting to take his pills, he would say "I will take them later". We would leave notes around his senior apartment reminding him, and I would rotate the notes so they wouldn't get too common place. That didn't help.

Since Dad was in a senior facility, I was able to use a paid option of having a "med-tech" who worked at the facility come in twice a day to give Dad his meds. His meds were kept under lock in the nurses office, and they would re-order the pills when needed. That worked !! I think it was more the nursing uniform that made him think he better take his meds :)

Now, I don't know if you could hire someone to come to Dad's home to do that as a part-time caregiver who is licensed to dispense medicines.
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I can never figure out what to do, either, when they get stubborn. We really can't make them do anything they choose not to. We can only decide if we are still able to care for them. There comes a stage that even when you have proof in hand that they still don't believe you. Sometimes when my mother is refusing to do things, I just leave her to her own devices and she will end up doing it after I leave the room. It may work to say, "Here's your pills and some water when you're ready to take your pills," then leave your dad alone for a while. It might work.
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