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he suffers from Parkinson's. Its shattering for my mom to look at her like this. Please HelpMy grandmom is 68. She has trouble to talk and just can't speak.The Parkinson's affects her confidence levels. Its infuriating sometimes cuz other people can't understand her. Sometimes she just wont speak, even with my mom. For a day or so she would go without talking. And when it comes to taking her pills, she would close her mouth tightly and and won't let us feed her. We have tried many a tricks but she won't budge. Her son, my mom's brother, has even tried showing to different doctors, but the results don't change. Sometimes she doesn't even eat. Transfers everything to her husband's plate. It is saddening to see my grandma and my mom in this state. I can't do much help either. Can someone please give my a solution for this? Thank you.

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Another option is to give them rectally either in their current pill form or made into a suppository by a compounding pharmacist. not the post pleasant way to give or take meds and it is usually only something like a long acting pain med that is essential for patients to have. Another pain option is to change over to Fentynal patches but they may not be very effective if the patient is extremely thin. They must be placed either at the back or front of the chest or on the upper arms where there is some fat.
Lots of things that should not be done in long term facilities are often continued for convenience, lack of time or plain inexperience. Save your battles for the most important problems. Getting a reputation as a complainer won't get you anywhere.Just keep your powder dry.
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Llamalover, I was speaking of my experience. They crushed my mom's meds. One of them should not have been crushed. That bothered me, so I spoke to the charge nurse and the NP. They told me it's a common thing NHs do when the only other option is that the pill does not get taken because the patient refuses to swallow. They even do it with extended release pills. Veronica91, I know why ER pills really should not be crushed and I disagree with what they did. That doesn't change the fact that they did it and my mother was not harmed.

Llamalover, just to be clear, I'm not telling the OP to crush meds that shouldn't be crushed. We don't even know if her loved one is *taking any meds that shouldn't be crushed! So all this alarm may be moot, but please don't tell me that my own firsthand experience is inaccurate. I'd appreciate that.

I'm simply saying that crushing meds and putting them in pudding is an option.
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Christine: "They even do it with meds that shouldn't be crushed"-in no way is that statement at all accurate. There is a reason why certain meds shouldn't be crushed. Who is the physician anyway and why is he or she still practicing medicine? Good grief!
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Hold on a second Christine, there are several reasons meds may not be crushed. One such as taste is not important but others like extended relief are dangerous to crush. The reason is that extended relief gives the patient a 24 hour dose all at once if crushed.
Suppose your loved one is getting an extended relief pain med do you want he/she to get that all at once? All kinds of nasty things can happen from coma to death and screaming in agony as soon as it wears off many many hours before the next dose is due.
Be sure to check the reason why something can not be crushed. Ask your pharmacist if it is home care or the NH staff. If they don't know call or visit a neighborhood pharmacy and ASK. Even post a question Can XXX be crushed? Any thing that has ER after the drug name has a reason not to crush it.
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At mom's nh, they crush the pills and put them in yogurt or pudding. They even do it with the meds which shouldn't be crushed. You can try that.
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Definitely speak with her doctor about this issue.
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Is she at least drinking water?
If the behavior of refusing to eat or take meds is new, or newer,
have her tested for a urinary tract infection, (UTI).

A UTI in the elderly is signalled by behaviors, as often they don't present with the usual symptoms-sometimes there is not even a fever.
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Slowly the disease marches on to the point that she will not be able to walk or swallow. However if your grandma can blink her eyes to yes and no questions you can find out what she wants before dementia takes over. It may be time to get hospice involved and ask her what she wants. The hospice assessment does not mean by asking she will get services, she will be assessed to see what she wants, but at least the family will be educated to make choices in her best interest and not someone elses take.
The horrible decisions are made from family members who just do not know what will happen over time. Short of restraints and force feeding which is truely unethical if the person does not want to live this way is just adding quantity of life (including the suffering) vs quality of life.
My aunt who was 97 found out she had heart failure, while in rehab she refused to eat and to take her medications because of the side effects. I asked and she told me she did not want to live this way. Her mind was very intact. I had hospice evaluate her and do a psych exam. She got her wish, came home early and passed within 3 days on her own terms.
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Daddy had Parkinson's, dxed at about age 65--he seemed so old to me at the time, but as I am almost 61 I realize how young he actually was.

He HATED and I mean HATED the meds. All had s/e. Nothing really "helped". He went steadily downhill for almost 10 years. He wanted to die, and finally did just refuse to eat, drink or take his meds. Mom freaked out, but he got his way.

Maybe grandma just has too many people in her face. Daddy HATED the attention, the fuss, etc. He was compliant if there was just one of us and if you gave him options. He felt that he was being babied and he didn't have dementia of any kind until the very last few weeks.

Don't assume that grandma is not totally aware of what she is doing. Give her some space, maybe. All the advice here is good. I wish you luck. Parkinson's is one horrible disease.
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The short answer here is "different strokes for different folks"
How far along is grandma in her Parkinson's journey?
She is only 68 she may have quite a few years left still.
Now it all depends on what she wants for herself. Does she simply want to turn her face to the wall and die or is she still capable of enjoying some activities and refuses pills and food because she simply can't swallow.
All of these disabilities are very frustrating and depressing and as I said before she is still young and obviously has a loving family around her.
Many people with this kind of disabling condition agree to have a feeding tube placed. It is possible to have a temporary tube placed which goes down the nose into the stomach. A nurse can easily do this with minimal discomfort. i would not recommend this long term as it is very irritating and she probably would be sensitive having people see her like this. The alternative is to have one placed directly into the small intestine which can't be seen under clothes. This does involve having a very small incision made in the belly which can be done with sedation or anesthetic. Once this is place feedings are given at times of one's choice usually overnight for convenience and the formula used supplies most of the needed nutrition. Medicines can also be crushed and given this way. The caregiver requires a little training to learn to use the equipment but it is quite simple and many patients manage the whole thing them selves. Grandma probably can't because her hands will be too shaky.
Important to start by talking to the Dr and discussing the options including stopping some medications.
With a tube in place as long as Grandma can still safely swallow she can eat some of her favorite foods but it will no longer be a daily battle.
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My hubby refused his 13 pills a day. After much arguing and grouching, one day I put them all in a bowl and set it on the side table by his chair in the livingroom. He took them all, with his orange juice in the morning!!!!! That's what I've done every day since that time.
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Adjust your perspective a little bit, and see if your grandmother's situation looks different.

At the moment, your family is equating the medications with your grandmother feeling better and with her disease being kept under control. That's why it's so important she takes them. No brainer, right?

Only it's not that simple. The medications don't work that brilliantly. Plus they bring their own problems. Obviously, in the round they are *likely* to benefit your grandmother or her doctors wouldn't be prescribing them - I don't subscribe to the "doctors are evil they give you poisonous drugs and take all your money" conspiracy theory - but from your grandmother's point of view they're nasty and they don't help enough to be worth it. She does have a point, you know.

You might find it reassuring, and clarifying, to talk to her doctors, explain this difficulty the family's having, and ask the basic question: "what happens if she doesn't take these?" We all have to pick our battles, and you want the best information you can get about which are the genuinely vital ones.
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Many neurological diseases are helped by a ketogenic diet. The "keto" diet is low-carb and high-fat, with moderate (rather modest) amounts of protein. If your grandma refuses her meds, you might try telling her that she then needs an alternate form of treatment, which is through diet. Carbohydrates (carbs) are sugars and starches. So she'd have to give up her breads, pasta, cereals, desserts, even sweet fruits. And go heavy on healthy (meaning natural) fats, to include butter, coconut oil, olive oil, avocado, and yes, even meat fats. Research the keto diet first, especially how it relates to brain health. If she is willing to make this kind of change, she deserves a lot of credit.
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This is indeed saddening for the entire family. And Grandma is so young!

Is she being seen by a Parkinson specialist? Are the doctors you've consulted specialists? That can be very important.

Has she given any indication why she refuses her medicines? For example, is it a swallowing problem? Is she worried she will choke? Is she very depressed and thinks it is just useless to try anything to help? Is she paranoid and fears she is being poisoned? Since her speech is impaired it may be very hard to get at the reasons -- and she may not understand them herself. But if you can get some clues that may help you and your mom deal with it.

Parkinson's often -- but not always -- includes dementia. Does Grandma have dementia?
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Talk with her dr. And see if some of her meds can be given via another route. For example some medications can be given by a patch applied to her skin rather than taking a pill. You can also try and find a compounding pharmacy. They can make most medications into another form like suckers or creams instead of pills. Since she has Parkinsons it is probably getting more difficult for her to swallow .
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These suggestions are just in case it may be a type of mental state brought on by dehydration or not enough nutrition. See if she will take some flavored water. (I like to use an electrolyte hydration powder which my Shaklee friend gives me. Health food stores have similar. Also you can put a little jello powder in the water, so it's a little sweet, pretty green, flavorful plus has some protein!) Tell her in a playful way, that if she finishes the bottle, you'll bring her her favorite (whatever/ice cream etc.). / See if she'll drink some protein powder. Don't make it too sweet or thick. / Have a little tea party with her, and have tiny finger sandwiches. Find something she might like or that has memories for her - cucumber and cream cheese / pate / cheese spreads , etc.) / Is the environment too noisy or chaotic? That can take away their focus on food, or their desire to eat. She may need some calm, some beauty -- like a little toy, photo, or origami next to her place setting. / Some help in taking down her stress or tension. / These are NOT things you have to do ALL the time, just when there's trouble, irrationality or depression, to rehydrate her and boost her nutrition. / If she can talk about feeling sad about losing her capacities, maybe emotional regrets or grief -- just validate that it is a hard time for her, and it's a grievous loss to lose confidence in moving around and in one's body. / A note about Parkinson's meds: side effects are - increased parkinsons symptoms! I'm not against all meds, it's just that they don't know who will be helped and who will be made worse by the meds. Liver cleanses and Qigong exercises can help a lot to alleviate PD symptoms. Even reverse the disease, as documented by the university of Florida see the website for fightingparkinsonsdrugfree from Howard Shifke, whom I met at the national parkinsons summit. Best wishes for you! I hope some of this helps you!
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