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My mother is in the unit. She will not takes medicines. We have used a compound pharmacy to make a gel to put the medicine on her neck. She is refusing that now. She is agitated, fearful, tries to kick the caregivers and pretends to shoot them with her finger. Can the home request a patient leave? She prided herself on not taking any pills when she didn't have the dementia.

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Not to sound horrible but have you considered moving to more palliative care to keep her comfortable rather than pushing meds that she may need to prolong life but don't help her comfort? I recently had a conversation with my mother's care team to do this, they were all up in arms because she wasn't taking her heart and blood pressure medications for a heart condition she has had for 20 years (Angina). At this point my mother is in a constant state of confusion and fear is in her eyes. She cries all night in her sleep and wakes up saying she CAN'T. Not sure what she can't do but that is her mantra, adding "I don't know anything" every now and then. I ask her to take her medications and she says no, they upset her stomach or she has trouble swallowing them and chokes them down. So I ask, if she takes them fine, if she doesn't we collectively agree that it is no longer necessary to get all uppity about it. The family and her care team agree that prolonging her life is pointless in her current state, bordering on mean. She feared this and now it is her reality. We are letting go, what happens is up to God. She had a great life, filled with love and joy and deserves to have her dignity and exit in God's grace. Our hearts break knowing she is losing her memories, her knowledge of her family members and surroundings. This once independent, strong and vibrant woman is now trembling on the couch and trying to figure out how to open a door or set the time on a microwave. Letting go is in my heart the right thing to do for her, not saying it is the right thing to do for everyone but for us, palliative care to keep her more comfortable and measures to child proof the household to keep her safe sounds more humane.
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Have u had here checked for neuropathy in her ankles. That's why my Mom falls.
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You know, we DID have a doctor and a pharmacist check out all the side effects of the pills. Each one said: no dire side effects indicated! 'So why is mom falling down, I asked?' Oh, she's weak from not moving around enough, we'll send a physical therapist over to show her some exercises! I sweartogod, that's what they did. Like, 84 year old mom who could barely shuffle from the recliner to the toilet was going to develop legs of steel! Yeah, that's the ticket....
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Facilities are not allowed to force residents to take meds. Maybe a med to help calm your Mom. They did this with mine. Just a mild one. Helped a lot.
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Blood pressure pills can cause dizziness and falling; cholesterol drugs can make memory worse and don't help older women. Have a good pharmacist check all the meds...and a doctor that isn't a pill-pusher.
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The nursing home people know how to administer medications, let them do it.,,, As already mentioned, if there are unnecessary pills, they can be eliminated. My mother was taking the usual prescriptions (maybe 3 or 4) , plus vitamins. Vitamin B, Vitamin C, iron, a stool softener to counteract the iron, and then they added an expensive prescription for Vitamin D! Plus Nexium and tylenol daily just in case. I made sure she took her prescriptions for cholesterol, blood pressure, anti-depressant, and dementia. (As time went on, the doctors eliminated some of these, as after a while, they do no more good.) The Nexium and Tylenol were in case she had heartburn or pain and couldn't tell us. The vitamins, I figured they weren't going to make her well, healthy, full of vim and vigor ever again. If she didn't want to take them, no big deal.... Frankly, if I were her age, in her position, I wouldn't want to take all those pills, either! To keep me alive, incontinent, with dementia for how many more years, but great blood pressure and cholesterol numbers? Feh!
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When my friend in memory care began to refuse all help getting cleaned up when she had soiled herself and wouldn't let staff touch her, I was advised to take her to the geri-psych ward at the hospital to find an anti-psychotic drug that would make her mare amenable without doping her up. She was there 3 1/2 weeks and after that was happy and cooperative and still alert until her frontal temporal dementia progressed further. It was a good answer to a problem that really needed dealing with. This stage of resistance with dementia is often encountered but there is a "solution" to help them past it. When blood pressure meds, for example, are part of their daily meds, they really need to be taken, which is why they are prescribed to begin with. They aren't "unnecessary", unless you don't care if they live or not, in answer to those doubting about all the meds people are on.
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In my FIL's last few weeks of life, he'd sit in his recliner and "palm" the pills. then he'd say "Ok, I took them". I believed him, b/c I was too stressed out by the neverending care he required to check.

After he died, my hubby and I went to clean h is condo. We upended his chair and there were about 100 pills, all surreptitiously stuffed down between the recliner side and to the floor. All we could do was laugh, He'd won.
I'd think in a NH they had a million and one ways to get meds in patients. Maybe your mom just doesn't want you there at "pill time". Tell her you are popping out for minute while she takes her meds. And DON'T go back in until she has. She might be exerting what tiny bit of authority that she has left to show you she's still in charge. Just a guess--but you have her in a NH, so she must need the care. Let the nurses do their jobs.
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A PB & J sandwich works wonders. With a dementia patient it is all about taste and texture. Smooth will not always work because the person will reject it (they seem to be able to detect undisolved small chunks of the medication). For example in our day facility we have tried smooth PB and jelly, both are without texture. Try using chunky PB and jam instead of jelly. Jam has a chunky texture that plain jelly does not have which seems to make a difference in how well a person receives it. For whatever reason the chunky texture of the PB and Jam together create a rough enough texture to hide little chunks of the pill that may not totally get dissolved into the mixture. sometimes a person may have a preference for crackers rather than bread with the PB & J mixture.
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You can't really do anything. When a person gets dementia, they don't know what they're doing & often an aggressive side will come out where the person exhibits their "right" to say no.

Check to see what meds she is on, and if they are absolutely necessary. I find that sometime LTC facilities tend to overmedicate people---the piles of pills people take in LTC facilities is mind boggling---and the meds they are trying to give her may not even be necessary. If you have legal control over her medical care, you can tell them to discontinue all medications. I agree with SallyA, but it sounds as if the meds she is on don't do anything to control her behavior. One thing I hated as a young nurse was fighting with elderly people with dementia/Alzheimer's to take their pills----they had no quality of life, didn't know who they were, where they were, what day it was, or who their family members were, wouldn't eat unless they were force fed, became incontinent, fell numerous times trying to get out of bed by themselves, etc. It's like torturing them, and for what? To keep them going with absolutely no quality of life? Usually it was those people that were on a pile of meds & I used to ask myself "WHY?" the doctors would do this to those people. Leave them alone.
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What meds is your mom taking? Consider whether the meds are really essential. Depending upon your mom's condition; she may not need many of the meds that are prescribed. Consider comfort care only. That would include pain meds and possibly behavioral meds. You may be able to stop all other meds.
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NAPLES
I laughed when I read about your mother pointing her finger and mock shooting the nurse! She must have a sense of humor left in her somewhere.
I will tell you about a situation I had with the 82 yrs male friend I take care of. I had been to the drug store to get his meds etc. and saw one of those red rubber noses that walgreens' had - I bought one on impulse. When I got back home I was tired and crabby and had no patience. I was trying to carry all the groceries etc. in the house and put them away. Of course, like a toddler, my friend wanted my attention. I, like an overworked caregiver had no patience and voiced it. I gave him the "red nose thingy" and he left the room. It was very quiet in the house - then he returned to the kitchen WITH THE RED NOSE ON!!! All I could do is laugh and give him a hug. So I think the suggestion that the nurse pretend to be shot might just be an approach that could work. If anything it could break the tension and help you mom and her caretakers to solve a problem with a little humor to get cooperation. Kind of like when you are feeding a toddler that doesn't want to eat and you play airplane that zooms the food into his mouth.
I write this not to make fun of a serious situation but to recognize your moms' feelings and help her feel in charge and co-operate.

rosepetal
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If she's in a memory care facility, then they can make her take her dementia meds one way or another. The first one is called an injection. Another option I know of is slipping it into their food or drink in the form of a liquid and blending it with something soft so they don't know it's in there. They can even give her a liquid tranquilizer in her food or drink to calm her down
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I had the same problem when my mother was in her own home so we hired a family friend (who she didn't know) to come over every day to give her the pills. This worked well as my mother was compliant with a stranger.
When my mother moved to an assisted living facility where she's resided for the past five years she's been taking her meds....mostly. She's bipolar and even though she's taking medication she still has minor manic episodes. On two occasions she refused all meds for several weeks. The facility states that they cannot force a resident to take meds as it's a violation of their rights, but they continued to offer them to her every day. Then suddenly she just started taking them again. I know this isn't a solution to your problem but can a person be forced to take medication? Is it a violation of their rights?
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try rubbing neck and giving a backrub? then from the back another person with meds sneak the meds on? They dont have to be on back only...
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I have to laugh, shooting the caregivers with her finger! They should make believe they are shot and fall over.
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We are using a compound pharmacy, they change the meds to gels that can be rubbed on.
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Usually an Assisted Living or Nursing Home is familiar with patients who refuse to take their medicine and have developed other ways to get this done.

My Mom wouldn't take medicine, so the nurse would put the ground pill into apple sauce... that didn't work because my Mom didn't like apple sauce.   So one nurse tried chocolate ice cream.... WE HAVE A WINNER.

Then at dinner, if Mom got chocolate ice cream to eat [without the ground up pill], she wouldn't eat it because it didn't taste as good as the morning ice cream :)
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