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Good evening. My mom is 67 yrs young. She has horrible short term memory. She has suffered from Epilepsy for 50 yrs. Her memory has been bad for as long as I can remember, but the last few years it has gotten much worse. She does not have dementia, but if you didn't know her you might would suspect she was in the beginning stages.


Here is my problem: she double doses her meds sometimes! I ALWAYS prepare her meds in the plastic minder bins. One box AM M-S, PM M-S. I put the pill bin in a plastic storage box that latches. There is a note taped to the box " Mama LOOK at the DAY on the CLOCK before you TAKE MEDICINE. Do this for me. TOO much med is dangerous!"


I purchased her a clock from Amazon that shows the Day, Time, Morning, Afternoon, Evening. It also has an alarm, which I have set for 8am and 5pm.


Today at 7 pm she had already taken Thursday AM meds.


I am at my wits end. I don't know what else to do. She does not belong in a facility. I can't afford an aide every day. She doesn't meet the ADLs for Medicaid to pay for an aide. I do pay an aide 2hrs 2 days a week. I have to work, I can't go over there twice a day and dispense her meds.


When she double takes meds, it makes her "drunk". She literally falls and I worry that it will eventually kill her.


Please, anyone have suggestions.

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Well if your mom is taking her meds incorrectly it would be difficult to know if she has dementia or is over medicated.
Dementia in the beginning can be very subtle.

Having said that, the important detail is how to get your mom’s meds given correctly.

Obviously your current method does not work.

Have you checked to see if she can take all of her meds at once instead of AM&PM. Extended Release is available for many meds.

Next (or maybe first) I would look into the locked medication boxes that only open at a specific time. I’ve never used those but many on this forum mention them.

I tried calling my aunt each morning to walk her through her meds. She would say. Ok I’m taking it now. She was not. I had installed cameras and I could see her hang up the phone and go right past the meds. In the time we were talking and she hung up the phone she would forget.

She had one very important pill she needed to take on an empty stomach and wait 30 min before eating anything. After two ER visits in one weekend I faced the fact that I had to have an aide come in each morning to give that pill and monitor her food intake.
I know this is hard for you and mom. It may be time to try to get her located closer to where you live to make life easier.
Hopefully someone will have better ideas to help.
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gdaughter Jun 2019
That was something I meant to include with my response...to check with MD's and see about necessity of meds and timing. Sometimes meds they prescribe are not as essential; sometimes when MD's might know the whole situation they may realize the risks outweigh the benefits.
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Hi Ipromised. So stressful I know. Is there a neighbor that you could ask to stop over your Mom’s when you cannot be there to dispense meds? I have to ask, how do you know she does not have early signs of dementia? With memory getting worse and visual cues not working sometimes? Is your Mom struggling with other things? Bill paying? Driving? Keeping up with household chores? Hygiene? It’s all very difficult to face I know. I’m caring for my Mom and struggling badly today myself.
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Ipromised May 2019
The neighbor idea is a good one. I failed to mention, my mom is also very moody; always has been. I did have a neighbor giving her her meds up until about 2 years ago and mama snapped on her, making her cry. She called me later and said she loved mama, but she just couldn't be responsible for mama's meds.
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How about a volunteer through the senior center to assist with meds that might understand moody and forgetfulness? Could you split up the aide help to 1 hr 4 days a week instead possibly to get you more days with eyes on your Mom? What kind of help is the aide providing?
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Ipromised May 2019
I have not considered anyone from the Senior Center. I will make that call. As far as her aide, she doesn't really "do" anything. Mama prides herself on cleaning her house and she loves doing laundry! (CRAZY RIGHT!) I basically expect her aide to get her out of the house and 'hang out' with her for a while...essentially a paid best friend. She doesn't drive. I worry about her being lonely. She has had a tough life. She could very easily fall into a low, low. It's nothing to walk in and she just be crying bc she's sitting there in the quiet thinking about her brother who has passed away or her mother who passed away many many years ago.
Thank you for your time responding to me.
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It is not realistic to request a volunteer from a senior center or a neighbor go into a person’s home and assume medication management from a stranger. What happens if they make a mistake?

I would still seek out other options.

Aides cannot dispense medications (legally). The aide can point to the medication mediplanner and ask that the person take the meds at that time. And legally aides should not be filling
mediplanners either.

Would mom be eligible for a 55+ Community that has an attached health center? Or an AL with medication management services provided?

Medication mis-management leads to hospitalization. Can you speak with her providers and get meds that need only one dose per day vs twice a day? This is a hard situation as many other seniors have this as a potential problem as well.

Good luck to you!
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gdaughter Jun 2019
You nailed it!
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When you say your mother does not belong in a facility, doesn't that rather depend on what sort of facility?

Your mother cannot safely manage medications. Take them away from her. Do you or does anyone see her every day? Depending on what the medications are, it may be possible to change the formulations to modified release of some kind so that she doesn't need two visits.

I strongly question the assertion that your mother does not have dementia. Fifty years of epilepsy treatment would make her more, not less, vulnerable. Has this actually been investigated?
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I think when you say she doesn't have dementia you are probably thinking dementia = alzheimer's, she may not have that but is definitely cognitively impaired and I think her neurologist should order a full assessment of her abilities so you know where you stand.

Thinking of work around solutions, there are pill dispensers that won't open until the appropriate time, like this one

https://www.alzstore.com/electronic-pill-dispenser-p/0032.htm

Also, people have also been using personal assistants like Alexa to help monitor their loved ones and to set reminders.
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Anytime someone has a neurological problem, which epilepsy is, they may end up with Dementia. Since your Mom has been dealing with it for 50 years and she is 67 I would say she probably has it. Next time she goes to the neurologist, have him/her test her. The next thing is ask the doctor if meds can be taken all at once. Tell him the problem you are having.

Phillips has a pill despenser that is really neat. Its been awhile since I have seen it demonstrated but I think the cost maybe worth it. It is locked and only u will have the key.

If I remember correctly, it holds 10 days of pills and dispenses when needed thru out the day. Each set of pills is put in a little container. At the time they are to be taken a voice comes on and says "time for your pilks" the person pushes the button and out pops the pills. If they don't push the button after a couple of tries by the voice, u will be notified.


https://www.lifeline.philips.com/pill-dispenser/health-mdp.html
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I understand the problem.  I had it here, too, and she was living with me!  She was an RN, so she insisted she take the pills from their original containers after carefully reading what they were .  I also put each pill she took in a.m. on a photo-copier, and wrote what each one was.  I watched her put each pill on top of its picture, then take them all.  She did well on her own with this for nearly a year.  Suddenly I realized the pill amt. was not right in the bottles.  She'd been double dosing.  She kept the pill pictures, put I took away the containers.  Yes, she was upset, but it was necessary.  Next I got the containers for each day for the week, and let her have in her medicine closet only one day's container.  Later in her dementia she refused to take them unless I stood there.  She'd drop them down the back of the recliner, tried to feed them to the dog (who thank God didn't like them).  I wasn't ready yet for her to have a nurse, so I let go of what I could not control.  Hard to do.

This whole caregiving is a series of finding solutions to the ever-changing problems.  As soon as one was solved, or a routine established I thought I could count on, it all changed again, and again,.......

Good luck with your mom.  AL and later even Nursing Home were less expensive than the home care alternatives after awhile.  Round-the clock care became essential, and my health needed help also.  I'm 72.

Big (((HUGS)))
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gdaughter Jun 2019
Oh Grannie...you are creative and masterful! I count my blessings because of living with my folks, I can be the on site dispensary LOL. No batteries needed! I just have to remember (!) to put mom's in a custard cup at night before I go to bed so she can get it in the AM. And all she takes is a half of something for BP. But your story reminds me of the time I knew I had to take over being the controller...because the dementia slipped in we did not yet know what we were up against. And there we were at the airport for their last trip to visit my out of state sibling. Mind you I had already thoroughly, I repeat, throughly gone through the entire house and taken every damn pill bottle there was to be found. ANd there we were at the ticket counter, and prior to going through the TSA checkpoint I did my own search of the carryon bag she had packed for herself. I nearly died: A WHOLE BOTTLE of her BP pills were in there! When I asked where they came I believe her response was "THEY'RE MINE!!!". LOL ANd then she also told the counter agent that I couldn't wait to be rid of them. I still laugh about that one...
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I discovered an alarm controlled daily pill dispenser that has saved my sanity. I bought it off of amazon. I fill the compartments weekly, but it has an alarm and dispenses only the medication for that day and time. I spent about $100 on it and had mom’s doctor write a letter stating that it was a necessity and was able to write its cost off as a medical expense on her taxes. It has been both a lifesaver and a sanity saver.
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Check out https://www.top5reviewed.com/automatic-pill-dispensers/ for a review of 5 automatic pill dispensers. We used 2 round ones (to minimize the number of refill times) for our mother and they were a god-send. Well worth the expense.
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Good morning. I don't know if you've tried this or not, but there is a lock medicine dispenser that she can only get to when it is the right time for her meds. I think they run about $32.00 to $170.00 depending on the need. Try Googling "locked med dispenser". You should be able to get a lot of places to find something like this. It worked for my mom until she had her first big fall. Then she couldn't live by herself anymore. She's 89. A lot older than your mom. Good luck. I hope it helps.
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We purchased a locked medicine dispenser kit for both my mother and father in law. It has a light that flashes along with a beeping noise when the Medicine is being dismissed. It was a huge help! I found it on Amazon. I also purchased extra trays so I could prepare their meds in advance and be able to quickly replace the empty tray with a new one. I highly Recommend! It kept them from double dosing As well as reminded them when to take their meds.
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First, consider the medication devices mentioned above
I would also have her reevaluated. Her needs considering what you have said should be cause for reevaluating.
Also, in dealing with anyone who has dementia or similar, you must use as few words as possible to communicate...you're overloading and confusing otherwise. But even this is no guarantee. For instance my mom, who does have dementia...gave her a beautiful arrangement of silk tulips in a vase that gave the illusion of water being in it. I left a note that said "Do Not Water." For your bedroom or bathroom. Found it in her bedroom. Filled with real water.
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I will chime in my support for the automatic locked pill dispensers. My stepfather was not taking his medications correctly until we got him one of those. You fill the medications in each compartment and can set it up to dispense as many as four times per day, you control the amount. An alarm sounds when it is time to take the medication and they can only access the pills meant for that time. It was a lifesaver!
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We had the same problem. Search in Amazon for:
automatic pill dispenser with alarm and lock
Was the perfect fix for us. Hope this helps!
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Ipromised You are doing a wonderful job Caring for Your Mom as well as working in a full time career. No Daughter could possibly do more and it is unfortunate that You do not have another Sister or Brother living near by Your Mom's Home to share in giving Her the medications at the proper times. We must realise that People Who suffer impaired memory loss can not be relied upon to carry out instruction correctly.
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Where I live you can buy a device that has 30 days of lockable meds that open by a timer. It ensures no overdosing but cost around £80 here
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I put my parents on Pillpack, they divide up the pills in packets with dates and times on them. That way I can check their meds and see if they are doing them right or missing any.

Most plans accept Pillpack, you should check into it.
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Those are good, but assume that she can still tell what the date is, and read the clock .
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A number of people have mentioned the locked medical dispenser which I highly recommend. I will add that my father’s is provided through our local elder services. I requested it through his case manager when he started double dosing. His alerts me if he does not take it within 90 minutes of the scheduled time so it is also another safe guard that is in place. It isn’t perfect because I will sometimes go over in the am to find that his night meds are dispensed but still sitting in their containers, not taken. But I figure nothing is perfect and this makes everything measurable. I also added a simple paper that has the days of the week on the left and am and pm divided off at the top. I keep a pen on it so he is to write down the time that he takes it. It’s just another step to help keep him oriented and guide me if there’s a screw up. Good luck on this crazy journey so many of us are navigating. I’ve gotten so much help and ideas from this website 😘
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I also moved my parents to assisted living because I was afraid of falls and worse people taking advantage of them. Solicitors knocking on the door or calling. They bought a lot of stuff they didn't need, refinanced their home, put in new A/C, all kinds of stuff I just couldn't control. When I did the expenses including the loss of money assisted living would be a savings! They are both suffering from dementia so it's one day at a time but for the most part I know they are being well taken care of and not missing any meals nor pills! They can do their own laundry if they want or have it done for them. Best of all they kept their cat and dog so they are happy about that. Worse part is I had to take the care as they keep getting lost and don't know where they are going or where they have been. The Assisted living has a shuttle and keeps everyone entertained with day trips and social hours.

Good luck to you, it's a very challenging roll taking care of our parents....who knew we'd have 80 year old children.
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Hickmalj Jun 2019
Same here joybeth . My mom is at an AL now and I’m so thankful we can afford it for awhile and hope we will able to qualify for Medicaid later . My mom will say she doesn’t have a dr and hasn’t seen one in years snd she never takes medicine —— well no she didn’t because they were lying all over her house where she’d not take them ! She eats so much better , they administer her meds , keep her orientated , activities . Yes , she did get better after she was there because she’s doing what she’s suppose to be doing now . If she had been willing to not be so stubborn at her home we could’ve managed for her to stay a bit longer but the same thing : buying everything Ect . I don’t care a bit about the “ inheritance “ would rather spend it all on her knowing she’s taken care of and I’m not a spring chick . If something happened to me everything is taken care of for awhile . The past two years every month something has come up in which I’ve said that it was the hardest thing I’ve had to do and yet something else happens . Her husband passed after dealing with all his issues and I’ve moved her to the AL snd now getting rid of everything she’d ever worked for . Wow . Really hard .
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Hide and lock them up, and you give them. If any of them are psychotropics or narcotics, she's probably hooked on them and increases risk for falling.
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Pill pack from pharmacy no extra charge seems to be helping. A few drugs are not in it so need to do those weekly.
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As others have said, get a locked timed dispenser. The number of days between fillings depends on how many daytimes need to be scheduled (you mentioned AM/PM, so you would get half as many available days.) The best part of these is that it will ensure no double-dosing. If the day or timed pills are not taken before the next dose, the dispenser moves that slot and the pills cannot be retrieved.

We opted for this initially because we had no way to determine if mom took hers or doubled up (or more) because she forgot she took them. We still had to hire aides to come to ensure they were taken (minimum was 1 hour, so we didn't care what the balance of the hour was - just ensure she takes the meds! They cannot give the pills or fill the dispenser, but they can remind the person to take them.) Unfortunately, after a few months she refused to let them in, so we had to change plans from stay-in-home to MC.

I do like the ones several mentioned that will notify you after X time that the pills have not been taken! Although it is likely much more expensive (and I would guess requires some kind of WiFi), it would cost less than hiring aides! However, intervention will be required if she doesn't take the medication - a phone call might work, otherwise someone will have to stop by and make sure she takes her medication. Installing a camera might help as well, focused on the area where the dispenser is so you can see that she takes the medication (note someone else used this method because the person yupped on the phone, but walked away without taking them! I know mom was like that when I would ask her to write on the calendar appointment that I would take her - she would call me every day or every other for up to 2 weeks before asking me if I could take her. Yup. No mom, take a pen or pencil NOW and write it while we're on the phone!!!)

I also question whether your mom has some additional cognitive decline. We all can be forgetful of something, but when it becomes habitual, it is likely the very early sign of dementia. She should have a thorough checkup - not just a simple checkup. Our mom was getting forgetful, but blamed it on being old and said she's entitled to forget some things. Problem was how MUCH she was forgetting, including repeating statements and questions minutes after making them! Mistakes on bill payments/over-payments, etc were another sign. Damage to the car which she denied doing. The early signs are very subtle and the person can "mask" some of them. If possible, spend a week or two living with her (use some excuse like having your house painted, bug treatment, etc) and what you observe could be enlightening. It is inconvenient, but could be crucial in determining mom's real status (doctors only see us for a few minutes - not long enough to detect REAL issues!!)
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Is there any way your aid could go in twice a day for 5 days just to give her medicine? You are in a difficult position because your mom really cannot process the concept of twice a day medication. Anyone with this disability needs a person to give them their medications. Is there any neighbor
that could help with this or any other family members. Sometimes, your council on aging may have volunteers in the community, or your area aging agency may have resources.
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Shane1124 Jun 2019
Unless you unlimited resources to pay and even Aides can’t legally dispense medications - they can provide reminders.
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I haven't read the responses so maybe someone has already suggested this. We had the exact same problem with out mom. she is diabetic (medication and 1 injection a day), a-fib which requires 2 meds (one being a blood thinner) be taken 12 hrs apart along with several other meds and it was becoming a big problem. She would get confused about what day or what time of day it was and take night pills in the morning or double dose and other times not take anything because she insisted she already had. I found one of those Med-e-lert Automatic pill dispensers on E-Bay very reasonably and it has worked so well! We fill 2 weeks worth of morning and evening pills at a time and each morning or evening at 7:50 her pills are exposed and an alarm goes off and a small red light blinks. The way to turn off the alarm and blinking light is to dump the pills out which we have her do into a glass and then she swallows them out of the glass. The idea being she never puts them in her hand, though that doesn't always work but that's a different issue. It's really worth giving one of these a try.
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What about a locked carousel? It pops open the correct med drawer with pre-recorded sounds or messages at the correct time to take them. These can be provided and monitored by different agencies or businesses such as the Good Rx Drug Store. Much cheaper than Home Care and trips to ER. Best wishes.
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The best device we ever bought for our dad is called MedReady. You load it up and can set it to go off how ever she takes her meds. Whether one, two, three etc. times day. It rotates and an alarm sounds at the correct time. A little door opens to reveal her pills. We got the one that we could even control via online and monitor him taking them or even set a different time. Of course you will have to load and set the alarm times for her. You can lock it so she can’t mess with it. It’s not inexpensive however. Dad no longer needs his so I’d love to get rid of his. I’ve also seen them on eBay for sale. Their customer service is great. www.medreadyinc.net
Another cheaper alternative would be to buy a clock that has a verbal voice command that tells her to take her meds.
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Ipromised Jun 2019
Which one do you have? I looked it up. There are multiple versions.
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Toss the old school medication cassettes. Look at Amazon as there are many new dispensers to choose from.
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Unfortunately sometimes no matter what the gadget it depends on the receiver & whether they can & will consistently access the medications. 

I am a working RN. Episodes of elderly folks mismanaging their Medications at home are way up there for ER & hospitalizations that can lead to fatal or non fatal long term complications from falls, dehydration, etc.

No agency will commit to provide medication management once or twice a day. Aides can’t dispense - they can provide a reminder only (legally). Only licensed staff can dispense meds. Aides are certified; not licensed. 

Unless you unlimited resources to pay and even then, having a licensed person commit to going to the home twice a day at a less than 4 hr increment of time will be difficult for an agency to provide as they prefer blocks of time.

It may be time for LTC or AL with med mgmt services as situations like these are nightmares waiting to happen. 

Safety first.
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First of all, no matter what you do, all the clocks and pillboxes in the world will make her take her meds the way they should be taken - nothing will work! If you are working and you can't get the caretakers, then you must place her for her own safety. Medicaid and an eldercare attorney can advise you about finances. I assure you there are ways to handle this. I know it is hard to do this but you really do not have a choice. Please seek out help at once before something happens. Soon her problems will not only be medicine, it could be turning on the stove, and doing similar things - all danger on the horizon.
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