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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?

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My mom's memory care always had luck crushing them into ice cream or even coffee! Makes a big difference sometimes to keep the steady meds instead of missing due to refusal. Best of luck!
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Reply to Carolinechcs
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Imho, you should tell her physician about this issue. As far as the prescribing physician knows, he/she rx'd the medications to her and is assuming that your MIL is taking them as directed. How will he or she know any different if you don't speak up about this issue?
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Reply to Llamalover47
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gdaughter - it is YOUR right, the right of ANYONE to refuse treatment, including medication. Yes, even those with dementia. However, there are differences in this discussion.

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.)
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Reply to disgustedtoo
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maybe the side effects are bothering her. All drugs have side effects. And drugs for dementia make the dementia worse..Google the side effects for yourself. You might look into natural alternatives to the medicines. even old people are intellagent & have feelings..even if they have trouble expressing them. If you secretly adding them to her food you are forcing her to do something she doesn't want to do. And could end up with a legal case on your hands
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Geaton777 Mar 2, 2021
Sunshinelife:
"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.
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My mother is on hospice, but she has dementia and can't decide whether she does or doesn't actually want to take her meds. She's taken to to throwing them on the floor when the nurse gives them to her at her nursing home, so now the nurses try a variety of tricks to get them in her. However, if she refuses them after they've put them in her food/tea/water, then they let it go.

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.
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disgustedtoo Mar 2, 2021
Same with my mother. She'd been taking BP meds for a long long time and continued while in MC. After she had a stroke around Labor Day, she began spitting them out, unable to swallow them. I did check with pharmacist. One of hers was a "time release" capsule. She told me we *could* open the capsule and put the contents into something like applesauce or ice cream, but if she managed to chew any, they would lose effectiveness. My thoughts were some is better than none! I suspect her BP was the reason she developed dementia and so recommended checking her BP as well. If it remained stable with or without the meds, no big deal, but try to get some in. She did have another stroke, as I expected she would, several months later, which did her in.
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There is a jewish/yiddish word called mashuganah(crazy) and imo humble opinion, that's what you will be, however well-intentioned, to try to pull this off. Also this pops into mind...if you have any pets, this is very dangerous her leaving the pills around and in tissues. She has a right to refuse. If the meds are essential, then I would discuss this with her MD, or she should. This is coming to you from a totally non-compliant, unable to swallow pills person, who had a life threatening, usually fatal circumstance 5 months ago. Coming home with a wad of rx for drugs I didn't want to take, that were not even reviewed with me. For too long a story to get into, the whole thing caused me huge stress and impacted my appetite and I made a decision based on the fact that the goal was my staying alive. I said screw it. I put the bottles in a corner and got on with my life focusing on the important factors of eating, sleeping, stress reduction and moderate exercise. I also was totally straight about it all with the surgeon. He wisely did not harass me, only said the best thing I could do to help myself was to keep my blood pressure low. I just celebrated (quietly) my 5th month of survival. You mil needs to talk to someone who can help figure out what her objections are and if there are any alternatives. For instance with me, even though they knew in the hospital my difficulty swallowing pills and would pulverize them and get me some sorbet or something to take it with, in spite of close to normal lab results, they still prescribed supplements for potassium and magnesium...HUGE pills for something that can be had in dietary sources. Would you have to eat 100 bananas to get the same dose? Maybe....but any of the source would be better than none. But hiding it...we're not stupid...we KNOW. You will destroy any trust you have established and cause agitation. IMO, bad idea. not clear on if your mil has dementia or not....which of course would be a factor and complicate things...
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Reply to gdaughter
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sunshinelife Mar 2, 2021
Absorloutly, correct. medications don't restore health...They ease symptoms for a very short time...then cause a rapid decline...and a lot of unnecessary suffering. People have rights in America. And if a person is refusing drugs, it is wise, and only fair, to respect their choice.
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Explaining and asking why they are not taking medications is great IF the person does not have dementia.
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. )
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Reply to Grandma1954
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Putting the pills in her food is a good idea. I live in assisted living and they crush the pills into yogurt.
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gdaughter Mar 2, 2021
Blech. Stay back 6 feet from me with that yogurt crap! But bless you for trying....
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Don't.

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).
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Reply to Countrymouse
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Does she like chocolate? Slip them into chocolate pudding. If you want to slip in some nutrition too, Ensure chocolate puddings. https://www.carewell.com/ensure-original-pudding/?sku=54846-EA1&g_network=u&g_productchannel=online&g_adid=497512129573&g_keyword=&g_adtype=&g_keywordid=pla-297490955905&g_ifcreative=&g_campaign=Smart+Shopping+%7C+NB+Categories+%7C%7C+Nutrition+VIP&g_adgroupid=117696029196&g_productid=8675&g_merchantid=114738081&g_partition=297490955905&g_campaignid=12303754746&g_acctid=333-280-7133&g_ifproduct=product&gclid=Cj0KCQiA4feBBhC9ARIsABp_nbWnQAYfzeTBzRj54LkQoHpIMytxQvRTAA5oKx_UOq0FY1DNQjw3UU8aAlSREALw_wcB
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Reply to LauraDangel
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gdaughter Mar 2, 2021
From the dark (i.e. non compliant) side...BLECH. BLECH BLECH. WE KNOW YOU STUCK THAT CRAP IN THERE. HOW STUPID DO YOU THINK WE ARE? You gonna be wearing that chocolate pudding! LOL. Truth: Once home I truly tried to be good and follow the plan with meds. I succumbed to using the pudding cups. It left a sweet taste behind and even the couple spoonfuls took away my appetite before a meal or I couldn't tolerate the thought after. Just wasn't working. I was made to feel badly by more than one professional care provider because S%%t at my age I should be able to swallow a pill, right? But like I said, keeping my strength up, eating healthy and getting the nutrients in was more important imo. First things first. And yes I've read all the helpful articles on how to get pills down too. I may be non-compliant, but I'm honest and determined. And in a worst case scenario, some of these darn drugs do come in a patch form.
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My mom willingly took her Alzheimer's meds, but she had trouble swallowing them, so I hid them in mashed potatoes or applesauce, and it made things easier for everybody. I agree with the advice to see which meds can be crushed, and which need to be taken whole.
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Reply to rlynn123
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Be aware that many medications say to not crush or break the pills as this effects the dosing, perhaps any time-release action built into the pills. Also, some pills when crushed are incredibly bitter, to the point where they are not really easy to "disguise". Do look for powders or patches when possible.
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Reply to Geaton777
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The worst thing family members do when they start taking care of someone is to control them. You can't do that. People have a right to refuse medication and not be harassed or made to feel bad about it. All you can do is tell him or her what happens if they don't take it. This information can be provided by the prescribing physician. You should not be hiding medication to force someone to take them. It is actually a crime.
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Reply to SeniorsHelp
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gdaughter Mar 2, 2021
BLESS YOU. One of the absolute worst, most stressful, and heart breaking aspects of my illness was to feel as if I had lost my identity and control over my life while in the hospital and rehab. It was a huge stressor. For example when in the hospital I had thought and turned out to be true that there was some outdoor access. So one day the PT person had heard my request and wheeled me to the floor with outdoor access, and had me walk from the elevator to the door. When in rehab, my requests were ignored. I also knew I could refuse the meds, but there are many so called caregivers who are bullies in the name of doing good, and we are often weak and recuperating and have no energy to fight the powers that be. They can also predict horrible and dire consequences for refusing any sort of treatment, putting fear and additional stress into people. Might be a little different in a home setting with family caregivers, but in my heart and head I still feel it is the patient's decision and dementia or not, they are still conveying their sense of self, autonomy, and conveying a decision they have made on their own. I think as I go forward and get my won POA's in order, I will make it clear how I feel about this so there are no misunderstandings.
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Careful if she is suspicious. If she catches on, you will have a real problem. If not, and then why is she hiding them ?, you should explain it to her.
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Reply to Moxies
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I would speak with her physician! Typically they can eliminate meds that are not "necessary" and for others, there may be an alternate form i.e. liquid you can add to her drinks or powder you can dissolve or disguise in food! Just be sure she doesn't notice or she will accuse you of trying to poison her...
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Reply to Donna518
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I don’t know if this is any help, but my Mother can not swallow any type pills, but I crush them every morning and she gets very special pudding, or yogurt, or fruit(baby fruit) I also give her very special baby cereal. But she lives with me
I give her all her meals & meds she is totally dependent on me for everything!
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Reply to Teeavilnor
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You have to be careful giving her meds secretly because she might be taking some and then she would end up taking a dbl dose.

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.
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Reply to bevthegreat
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1. Eliminate any that are not 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.
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Reply to Grandma1954
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gdaughter Mar 2, 2021
I have a dear friend who became more like a big bro to me who is an oral surgeon and he has had to take care of me multiple times...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. ANd something was....I never had a problem, but I still hate the stuff.
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It is good to mix it with ice cream or pudding. Crush the tablets and if taking capsules just open them up and add to it. Mix it well. When you start to give it to them you need to have a cup of ice cream or pudding as well. They will have no suspicions as to what is going on!
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Reply to Allyson1
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Grandma1954 Mar 2, 2021
many medications that are in capsules should not be opened as they are designed to dissolve at a particular point in the digestive system in order to work properly. Or they can be time released.
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First, ask your Doctor what meds are absolutely necessary especially
near end of life. Skip the rest. He will be able to advise you in a professional
manner.
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Reply to louism
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Here's what worked for my mom: She would drink some water BEFORE attempting to take her pills, which helped a great deal. When she started having more difficulty swallowing, I would coat the pills with soft butter, and they'd slide right down. (Be sure none of your mom's meds have dairy contraindications, if you try this.)
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Reply to PeeWee57
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Check with pharmacist about which medications may be crushed. I have used applesauce and pudding to put medications into, but usually the meds make the food taste different or have different texture. Please keep her medications in a safe place. Watch her take her medications and give her large amount of juice of water to ease swallowing. Check under her tongue and cheek to make sure she does swallow them, If you still have problems with solid medications, talk to her doctor about switching to liquid forms.
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Reply to Taarna
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As others noted, many cannot be crushed and even if they can be, they can taste dreadful. Depending on what she is taking and her age, perhaps some can be discontinued? If swallowing is an issue, ask the pharmacist if there are other options, such as a compounded liquid - usually they can add some flavoring to help with the taste, if there is any.

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.
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Reply to disgustedtoo
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I agree with Cwillie that there is more involved here. Is she having difficulty swallowing pills? Once in the mouth any time at all they taste dreadful and are bound to be spit out. They cannot readily be crushed without the bitter taste, and some meds should not be crushed at all. I would discuss with doctor.
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gdaughter Mar 2, 2021
YOu speak the truth! SPIT!
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A lot of meds are incredibly bitter or otherwise awful tasting when crushed so it may not be that easy to disguise them in food, and she is likely to notice and spit out any lumps if you leave them whole.
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.
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Reply to cwillie
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Some medications cannot be crushed (read the label), but those that can, and even the ones that can't, can be put in some applesauce, ice cream, pudding, yogurt or anything soft like that. I would just make sure though if you're going to go that route, that you have full control of her medications, so she doesn't accidentally take more, thinking she hasn't taken them yet.

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.
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Becca1 Feb 27, 2021
Thanks I was thinking the same because about the only thing we can get her to eat these days is Spaghetti O's.......How sad is that but I guess it is better than nothing.....
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