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I am working with the husband whose wife has had Alzheimer’s for at least 3 years. She absolutely refuses to allow anyone, including her husband, to handle her medication management. She is not correctly taking her medications and says “I have done it this way all my life, I don’t need any help”.


She digs her heals in in every way, and medication management she needs to let go. She has the cognitive ability to talk to strangers and carry on a conversation but this family needs to show “tough love”.
I suggested working with a social worker. If anyone has any suggestions I would love to be able to pass them to the husband.


Thanks.

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I would have the doctor review ALL the medications she is on.
Discontinue any that are not VITAL for her health and wellbeing.
Then find out what medications can be given as a liquids that can be stirred into food or drink. And what medications can be applied as a patch.
I would replace medications with things like "Tick Tac's" "Altoid" "M&M's Skittles and other items that are not going to cause harm if they are over or under dosed.
This woman should not be in charge of her own medications. Let her have the candy like items that I mentioned, if she questions it tell her that they changed to way the pills looked.
(when the meds are picked up at the pharmacy replace the pills with the candy items so that the candy is in the prescription bottle when it comes into the house, this way she can see that that is what comes out of the bottle. )
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I would first want to do a med review. Taking too much of a med could be a problem. With my Mom she was given meds in the hospital for symptoms of thyroid disease, she did not need once her numbers were under control. BP med was upped, had to be lowered. Once you have this done, maybe the doctor can tell your client you will be doing him a favor to monitor her meds for just a little while. Labs should be done to see if she has too much of a med in her system.
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Why isn't she in a facility? They could handle it.
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Makeadifference Sep 10, 2023
She is too active and would be a flight risk, and is not ready for a facility yet.

she rides her bike for miles on end, she walks over 30 miles per week.

when the husband went in for a tour to 3 places, they all reported that with her physical activity, they would not be able to take her.

my thought is that the husband has to show some tough love as he did when he took her driving privileges away.

other than that a pharmacist could put her pills in packets like they do for assisted living facilities.

she is definitely a tough one to handle and I work with her 20 hours a week.

all she wants to do is walk. We walk all over the place. She is in denial that she has a disease, and I believe the family is doing a disservice to her by not talking about Alzheimer’s Disease.

I understand how horribly hard it is as my mother had it for 15 years before she passed, but she was older and as a family we would talk about it and let her know how proud we were of her.

thank you for answering, and I am so sorry it took so long to respond.

sincerely,

Debbie
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Pharmacies offer compliance packaging, that can be a good way to monitor whether or not meds are being misused. Realistically as an outsider there is very little you can do other than to point out any medication errors and offer solutions, the husband has to be willing to rock the boat (and it sounds like he isn't).
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Her access to the medications needs to be altered. As in, while she is asleep, they are taken from where she has access and placed in a lock box.
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Who hired you? Is it the husband? Or is it another family member who is the medical PoA for this woman? I would bring your concerns to the MPoA and explain how she can now easily under- or over-medicate herself -- and depending on what medications she's on, it could be life threatening.

If there is no PoA then you may have to call social services for their county and ask for guidance.

Also, Teepa Snow videos on YouTube are very helpful because she's an expert on dementia and caregiving and offers very good stategies on how to work with "stubborn" dementia patients so that daily interactions are more peaceful and productive.
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Makeadifference Sep 11, 2023
Thank you for the helpful advice on Teepa Snow.

the husband hired me. Everyone is correct that there is not much that I can do, but my hope was to come into agingcare and get some suggestions as to how to manage medication management with such a fiercely independent woman that believes or is believing that she has no disease?

she is extremely active. I was hired to walk with her as a so called chaperone to see to it that she is safe and does not make unwise decisions. I have been with this family for over 2.5 years and am looking forward to helping not only her, but the family in anyway that I possibly can.
medication management came to me through one of their closest friends who is a retired ARNP and she has asked me if I had any other ideas for medication management.
I reached out to agingcare as everyone on hear has been helpful at previous times in my care providing journey.

thank you for your input.
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