How do you make sure they take their medications without having to stand over them each time?

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My dad has decided he only needs his pain medications and the rest are just placebos. He has been in a depressed mood lately and has told me to cancel his Dr. appointments because he isn't going to get any better. I don't want to treat him like a child but it's a little ridiculous to me that he has decided he doesn't need his high blood pressure med, his depression med, his acid reflux med and so on. He either takes what he thinks is the pain meds and leaves the rest or refuses to take them at all. He feels sorry for himself and I can't blame him with all that he has gone through but I'm having a hard time trying every day to put a smile on his face, get him motivated to move around and especially take his meds. Sorry for the ramble. Thanks

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I'm going to chime in with a different voice.

At some point, a person is not competent to decide whether or not they should take their meds or not. This point in life does not come with an announcement ahead of time. It sneaks up on you, especially if you are with the person all the time.

I assume you have the durable power of attorney, which gives you healthcare attorney rights and you can talk to his psych about this change in behavior. You should. It may be a very simple correction in a dosage or a different med. It may be time for a cognitive assessment to make sure his decision making is sound.

My mother has always taken a lot of meds her whole life. Another long story for a different post. When I had to assume responsibility for her care she was on 19 pills. She was taking them randomly, if at all, and was quite mean about not needing help with it. Very mean - mainly due to not having her anxiety pills in her system. This was a cover up tactic. She knew she couldn't keep up with the instructions anymore. If she was mean to us, we would go away & leave her alone about it and the problem is then solved. This is 3 year old logic. And it is a sign that it's time for help.

We had a med nurse start making up the biggest pill box I ever saw in my life to handle all 19 pills. Something every 4 hours almost. The rest were kept in a lockbox, out of mom's reach. After a couple weeks of that, mom stopped taking her meds again. She got angry and threw the box at the wall and broke it. Pills, I mean $$$$ all over everywhere.

At that point we switched to a nurse who came in and handed her the pills twice a day. Mom had to take the cup and swallow them on her own. She was slick & crafty though, and would do all the typical little kid tricks to avoid it or pretend she had taken them.

This was another sign of cognitive decline. Mom was then in a 24/7 supervised unit and didn't have a choice. The nurses gave them meds. The would reapproach 3-4 times if they got a refusal. Then the supervisor would come out and get those meds taken. She would not be argued with. Sometimes it just comes to that. "Miss Daisy, you are going to take these now. Stop messing around."

I wish they would make more meds in the form of a patch so it's not about patient cooperation anymore.
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Oh, by the way, Dad lives with me, sees a doctor every month for his health, shots and medications. The doctor actually got rid of three of his Rx's. He also sees a psychiatrist for his depression. I have a schedule of appointments for Dad, my husband, my kids, my ex-mother-in-law and myself. I'm the "mother and nanny" for everyone her in my house. Sorry, rambling again. I just wanted to say that he sees all his doctors and dentist as he is supposed to and I take him to and from all.
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Thank you all for answering my question. I understand the independence issue. I do everything for my kids, my husband, my dad, my ex-mother-in-law, the house, the budget, and anything else that needs taken care of. I would be a bit upset if someone told me what to do. I like my independence. Your advice is appreciated.
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Never apologise for 'rambling' (you weren't, anyway!) - we could all write War & Peace, couldn't we, on the subject of the frustrations of recalcitrant parent-patients?

I was going to say "you can't. So stand over him" but that was before I read that your father is actually being a refusenik, rather than just getting in a muddle.

Mmm. The thing is, he does have a case - not that the meds are 'placebos', but in terms of whether or not the cost-benefit analysis really does make sense in his case. The years go by, the px lengthens and diversifies, more and more are added to counteract the negative effects of the previous ones… You can end up with a right can of worms - that he is then expected to swallow meekly and be grateful?

So. I'd ask his GP to do what my mother's GP, bless him and save him, did: address this seriously, sit down with his latest charts and his full prescription, and have a really good look at the whole picture. After a proper review, you should find that either a) a surprising amount of clutter can be removed with no ill effects or b) your father can be persuaded that complying with his prescription is worth his while.

But he's not being childish, is he, to question if there's any point to the ritual. It'll do his doctor no harm at all to be asked to provide a rational basis for everything he prescribes.
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Frequently I see moms medication laying on the table. I have learned not to remind her to take them as she becomes angry and accusing me of treating her like a child. If she takes the medication fine, if not, that's ok too. Her health is poor so why try shoving pills down her to try and extend a quality of life that is miserable and debilitating.
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Eyerishlass is right. We can get caught in this dilemma -- the blood pressure medications help to extend life, but what if the person doesn't want to extend it? People who are depressed usually don't care if they keep living, since life doesn't seem to have any joy in it.

What you can do is tell him that the bp pills help to keep him from having a stroke. Even people who don't care if they live don't want to have a stroke. The rest will have to be up to him if he is competent to make his own choices. I know how exasperating this can be, since we feel we are responsible for what happens. Let others (family, doctor) know that he chooses not to take them, so others will be aware of what is going on.
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Your profile doesn't say that your dad has dementia so I'm assuming he's competent. Since he's competent he can make the decision to not take his meds. I know how frustrating it is but maybe your dad is asserting his independence in the only way he knows how.

Maybe if your dad's Dr. speaks to him it would help. The Dr. can go over what each med is and what it's for and what could happen if your dad stops taking it. But if, after your dad has spoken to his Dr., he still refuses to take his meds let him refuse them. What else can you do? You can't force your dad to take his medications.
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Are you living with him?
If so, each morning stand with him and tell him he HAS to take them. end of story.
Tell him that the pills HELP him.

My MIL (mother-in-law) did the same thing.
But we told her she would become healthier in doing so.
When she had episodes or headaches or whatever, we told her that she needed to take the pills EVERYDAY. NOT just when she felt like it.

Have you taken him to a Doctor lately? I would make an appointment for him and take him to the doctor asap! Perhaps if a professional tells him to take them, if a doctor accesses him; he will listen .

For my MIL, that is what SHE needed. Cause you know. Family or whomever is the caregiver IS the BAD GUY. so getting the Doctor to tell him he HAS to do this may work.
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