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She'd been doing so until a year ago when she fell; family decided to have the AL home give her the meds. She's been very unhappy about this. Recently she's been taken off a few things she was on (a sleep aid, another vitamin, a gastro med) and her long-time GP thinks she is well able to handle the two AM and one PM meds (two for anxiety, one a vitamin). The home is now insisting that they have to give her a 'test' to see if she knows what the meds are for, when to take them, etc. We think she is well aware of these but think they may be demanding more info from her than is needed, as a ploy to keep charging her nearly $40/day for meds administration. She can be confused at times but her dr. and we (family) feel confident enough to want to try this. (We will count pills regularly to see whether she is taking the right dose.) She gets very unhappy and depressed to be told she can't take her of these meds and is especially unhappy about what it's costing to have others do this.


Question: what degree of testing is relevant or needed? Does anyone else have experience with an AL home resisting self-administering? FM has no diagnosis of dementia but we realize she is sometimes forgetful these days.

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I don't think it's unreasonable for the ALF to want to check. If they didn't insist on this, they'd be in all kinds of trouble for not complying with safe handling of medicines regulation; not to mention that it has been known for families to change their minds about their relatives' capabilities and start dispersing blame...

What sort of test is the ALF proposing? If they're waiting for you to come up with it, I should pop your relative's meds in a pill minder, show her how to use it, then come back with it the next day and allow her to operate the pill minder in front of the facility's designated witnesses.

It is important that she can do this genuinely unaided, by the way. If she can't, you really don't want her handling her own anti-anxiety medication. If the idea offends her, compromise by leaving her in charge of the vitamins and "explain" that anti-anxiety medication is "controlled" and has to be kept in the nurses' station. Hem-hem.
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Reply to Countrymouse
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The homes that we have toured required in AL that the patients meds be given by their staff. Makes sense to me, my step mother has dementia and is very, very confused.
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Reply to DollyMe
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I'd be concerned about her possible confusion. My mother still seems quite clear and competent but on close examination, could not maintain the consistency needed to manage her medications on her own. Our solution was to get an automatic locking pill dispenser that would prevent under/over-medication, with a timer that notifies her at the appropriate time. This is a difficult issue, I understand wanting to support her autonomy while trying to provide her with the best care possible. Good luck!
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Reply to oyadancing
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An AL does have the right to 'test' to see if they feel a resident is capable of administering her own medications. I'd feel a bit leery myself of my mother taking her own anti-anxiety meds, personally. Mom was in AL for about 2 years when I realized she was NOT taking her meds properly; I'd find some pills on the floor, and mixed up in the day-by-day pill box I'd sort out for her on a weekly basis. So that's when I put her on the AL med plan and she wasn't happy either. But it's not about THEM being 'happy', it's about them being safe & properly cared for. After about 5 or 6 months, mom decided she was happy to be on the med program because it relieved her of the worry of doing it herself. And here is another bonus: when the doctor prescribes new meds or changes existing prescriptions, the AL orders the meds and has them sent over and administered without you lifting a finger. Believe me when I tell you that the cost is well worth it.........a lot of your time will be freed up not having to deal with the entire medication fiasco. And even if it is not a fiasco now, it tends to become a fiasco eventually.
Best of luck!
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Reply to lealonnie1
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Her MD has to agree that she is able to give her own meds and must sign that he believes this to be so. Assisted livings in California can charge 500.00 more a month for giving pills, even if only one or two. Most pills must be under lock and key. If she is forgetful then her doctor may not be willing to sign this affidavit, but you can ask.
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Reply to AlvaDeer
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Perhaps it would ease things if her medications were done up in blister packs?

You said in the past you would count her pills, but that does not let you know if she took them on schedule. My late FIL would put a days worth of pills in the chest pocket of his shirt. By the end of the day if his pocket was empty, he figured he had taken his pills. Problem was if he bent down to put on shoes, pick up the paper etc, one or more would fall out. Once we had his pills blister packed it was much safer, no pills missed or on the floor.
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Reply to Tothill
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I am surprised the AL ever allowed her to take her own meds. My Moms AL would not allow it. We had to use their pharmacy. Mom was allowed to use her insurances. The OTC was a little higher, I always found dsales, but I loved not having to deal with her meds anymore.

I would use a pill planner. They have AM and PM slots for each day. See how that works. I would not leave full bottles where she could get to them. Mom had a drawer in her kitchenette area that locked.
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Reply to JoAnn29
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I don't think that I would feel comfortable with my LO who "sometimes" gets confused with taking anti-anxiety meds, being in charge of her own medication administration, since, if she takes too much or too close together, it could make her dizzy, lose balance, cause fall, etc. I'm not sure about the vitamins and what would happen if she mistook those. But, I would definitely look into testing her to see if she is capable. I can understand the facility wanting to ensure her safety on this though. I'd view it more of a safety issue than money.

Where would she keep the medication if she is in charge of it herself? Is it stored in a cabinet in her bathroom? Locked in a drawer? What security measures do they have if left in her possession?
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Reply to Sunnygirl1
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A good test is to have the patient ring for their meds at the proper time every day for a week. If they are able to remember to ring for the meds at the proper time and tell the nurse which meds they need when they ring, that should be proof that the patient is able to handle this themselves. It's too bad she's being made to feel unhappy for what it is costing others, too bad she had to know about that. She doesn't have a lot of time left and it's sad to think she's spending any of that time worrying about what people are spending on her.
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Reply to faeriefiles
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