Since she is still living with us we would at least like to make sure she is taking her meds as we would find them all over the house wrapped in tissues, under her pillow etc. etc. but wondering if we just somehow put them in the food we give so at least she is getting them since we know she is taking them on her own. This seems to be the easiest thing to do without causing a fight with her. Any thoughts?
A person who is cognitively fine can make that decision rationally. They know the pros and cons (or at least they CAN find out and mull it over.) If you or someone puts your meds into something, you KNOW it's there and immediately have negative thoughts about it.
Those with dementia don't have the capability to make those rational decisions. They DO have the right to say no, even in MC, but we can try to convince/coax them to take it, make it their decision - this is how staff worked with residents at mom's place. If the medications are critical to their well-being, and they can't swallow it, or think they don't need it, then the option is to "sneak" them in other ways. IF a pill can be crushed and added to something sweet and tasty or made in liquid and they'll accept it, what's the harm? No one's saying pin this woman down and force the meds in between her pinched lips and/or clenched teeth.
For the record, I'm NOT a big fan of medications myself. IF there's no alternative, I'll consider it (antibiotics** are one.) Best alternatives are changing eating habits and activity levels. This can sometimes help us get away from high BP, diabetes II and other conditions. Not always, but if there's a non-drug alternative, I'll choose the latter. There are some I can't take (allergic reaction), there are some that just don't do anything for me, and then there are those like Fosamax. I did my research and choose NOT to let this crap cross my lips!
I also would not push various medications at my mother, given her age and dementia. However, she'd been taking BP meds for as long as I can remember. Even on these meds her BP ran on the higher side (140?) One time, after missing 2 days, her BP was over 200! IF she wasn't taking them, she'd have been dead years ago. She continued taking them after moving into MC. The staff would dispense. She might question it, as her reality was drifting backwards, to a time perhaps when she didn't take medications. She wore hearing aids for many years too. During one visit when I asked where it was, she said she didn't wear any! I found it in her room and when I showed it to her, she asked where I found it. So, which is it? She doesn't wear one or just forgot about it? I believe her dementia was brought on by BP, but she made it to about 90 before this happened. Without meds, like noted above, she would NEVER have made it that long! With dementia, she wasn't a drooling lump in a corner, so I wanted her to keep taking this life-saving med, to keep her BP under some control and extend the life she did have left. Sadly a stroke impacted her taking meds, but she was over 97 then.
(** I do have an issue with this:
"...some of those times he would want me to take some antibiotic, which we would get in liquid form, and still I struggled greatly but I gave it my all. At one point I discovered of the dose, I couldn't do it in one swallow, and it was that extra little remaining bit that was so so hard. So I stopped trying. One swallow was it. The way I looked at it, and bless him, he agreed, was that ANY amount of the med going in was better than NOTHING."
My issue is more for your friend/surgeon and his take on it. While the amount you took in may have been enough to knock down whatever it was intended for - perhaps it was only a preventative dose rather than treating a real infection? - the instructions for antibiotics is to always take the full dose AND complete the entire course. The reason for this is the amount you got may have knocked out the worst of an infection, but if any remains, it will be stronger and harder to treat next time! This is one of the reasons we now have antibiotic resistant medications. Those bacteria not killed may have "learned" and be resistant, which gets passed on to the next generations, and it gets worse.)
"All drugs have side effects." - false. They all *can* cause sides effects because everyone is different. But most people experience little or no side effects from taking medications.
"And drugs for dementia make the dementia worse.." - also false
"Google the side effects for yourself." - sure but you'll get a whole bunch opinion and very little clinically proven data, mostly from profiteering peddlers of unproven and ineffective supplements.
"You might look into natural alternatives to the medicines." with the word "natural" in quotes because supplements still interact like chemicals because that's what they are. Just because something is "natural" doesn't mean it's healthy or harmless...like arsenic, hemlock, belladonna, castor beans, oleander and tobacco.
"Natural medicines such as herbal and dietary supplements are made up of chemicals, too, just like everything else."
Source: https://www.nccih.nih.gov/health/know-science/natural-doesnt-mean-better#:~:text=Some%20chemicals%2C%20like%20iron%20and,too%2C%20just%20like%20everything%20else.
I'd say she gets about 20% of her medications into her body. It will likely lead to her death, but that's OK. As I said, she's on hospice now and this is the one thing she can still control, so I'm fine with it.
If they have dementia they can not make a decision to take a medication or not. Given the same logic if they do not want to be changed, bathed or go to the doctor do you allow someone with dementia to make those decisions? OR do you allow a child to make a decision to take medication or not. What if the "child" is 18 do you allow them to make a decision not to continue with a medication that will keep them healthy, alive?
If a person is cognizant then they can make an informed decision as to take medications or not. If medications are for diabetes, blood pressure, things like that then taking or not taking can be a life or death decision. Medications like fish oil, medication for slowing the progress of dementia, daily vitamin can be stopped without a problem.
If a person has dementia depending on how advanced it is there may not be a benefit of continuing most medications anyway. ( but that is a discussion to have with the doctor. )
Have you tried asking her about it?
By asking, I do mean asking and not telling (let alone nagging, bullying, browbeating, frightening or any of the other tactics which I am sure you would not try however tempting).
When you find the next stash, speak to her about it nicely; e.g. "I couldn't help but notice these when I cleared your plate - did you mean to take them after supper?"
Then, crucially, listen to what she says and don't argue.
You can explain, you can encourage, you can reassure, you can recommend following her doctor's advice. You can support in ways such as prompting, timing, organising. It may even be that she says something that makes it a good idea to go back to the prescribing doctor and support her, e.g. "is there perhaps a formulation that's easier to swallow/doesn't taste like frog poo/won't give her heartburn, please?" But the relationship is between MIL and her doctor: it is the doctor's responsibility to inform his/her patient and to frame treatment in a way that is acceptable to and practical for her, not yours.
In due course, as MIL declines, it may be that she will no longer be able to give or withhold consent and your DH will be acting for her. Even then, it will be better to tell her what is happening, and to leave it to her to take or not take unless there is an overwhelming medical reason that says otherwise (there hardly ever is).
I give her all her meals & meds she is totally dependent on me for everything!
Also, you would have to chk with a Pharmacist, just call Walmart Pharmacist and ask about each medication she is on as some meds can be mixed and some can't. You may also ask if any of the meds she is taking come in liquid form.
Also, go over all the Meds she is taking and see what they are for and then talk to her Dr and try to eliminate some of them. Just have her take the most important ones.
It's a known fact that most Seniors are taking way too much meds than necessary.
2. Ask the doctor or pharmacist what ones come as a liquid or a patch.
3. Ask the doctor or pharmacist what ones can be crushed.
Usually any that are coated or time released or capsules can not be crushed.
near end of life. Skip the rest. He will be able to advise you in a professional
manner.
Definitely YOU should be managing the medications, i.e. they are kept under your control and when given to her, she takes them in your presence. When mom was still at home and able to take the medications (mainly BP), we had to use a locked timed dispenser, but sometimes she would miss doses. At least she couldn't take TOO many. Hired aides for 1 hour/day for a sanity check (mom was early dementia) and med check (they can't dispense the meds, but they can check and direct her to them.)
At MC, they kept the medications under control and would give them out with water, making sure they were taken right then and there. Once mom had a stroke and had trouble swallowing, she would spit them out. I asked the pharmacist if we could open the capsule and put the contents into something like applesauce. She told me we could, but they were "time-released" so if she managed to chew any, they wouldn't be as effective. But, like you said, something is better than nothing!
This may not work for her, but just recently I read a recommendation that said put the pills in the mouth, take a sip of water, tip the head DOWN, and then swallow. The object is to have the pills floating in the water. Seems counter-productive, but it does seem to help.
Do you know why she isn't taking them or eating properly... is it possible that she is having difficulty swallowing and the spaghettios are easy to get down? She may benefit from a modified diet, swallowing problems can be evaluated by a speech and language pathologist.
As for the pills, if she is willing but unable a spoon of applesauce, pudding or jam (especially good because it is sweet and chunky) can help pills go down more easily, if she is just unwilling it may be time to have a conversation with her doctor about cutting the number back to the bare minimum.
When my husband was having trouble swallowing near the end of his life, I would put his medications whole in some applesauce, and he was able to swallow them no problem. Best wishes.