Am I wrong to insist that Mom handle her own medications?

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My 77-yo mother has NOT been diagnosed with dementia/alzheimer's, although she is in a lot of pain all the time for various reasons and it seems to be affecting her thinking over the past year. Her sense of humor is lost most of the time; she can't understand sarcasm or "puns," and her ability to follow simple directions is failing (cut the fabric 33" by 27" was impossible until I drew the box on the fabric for her; and she still argued with me about why would they want her to cut it to 27" when they had just said to cut it to 33"?!). I handle her bills for her (at her request) as she started sending payments to the wrong accounts and was afraid that she would ruin her credit. She was chagrined to have to ask for help with her bills, it really underpinned her autonomy.

She had surgery last year, and I was handling all her meds for her immediately afterward. As she improved, I started having her help me set them up for the week and eventually made a list she could use to put the meds in their proper boxes herself. Now I make her do it herself every week, and she tracks when she takes her pain meds on paper so that she doesn't double up. She didn't want to do it herself at first, but she has managed pretty well for the last 5 months or so. I felt it was a good way for her to maintain some autonomy and control, as long as it was safe for her to do it.

Lately however, she's made some mistakes that have me worried; she skips her pain meds for hours sometimes and then she can't get the pain under control when we do get them in her. When her pain is that severe, she loses her balance, her logic is completely off, she can't remember what she is saying or doing... and that puts her medication management at risk. Not to mention she still tries to cook when she feels that bad. I have offered to take over the meds again, but it *is* difficult to manage them when I'm working full-time, and she doesn't even want to let me do it now.

How will I know when it's time to just take over? Should I just leave it alone and let her have her way? How can I take over all these small tasks without 1) robbing her of her autonomy and dignity, and 2) work full-time and not make myself crazy/exhausted? Is it even possible?

I read the stories on this website and count my lucky stars that I am not in the same position as some of you are. I think of you as heroes and I feel so bad for the battles you all have to fight -- and I feel a little guilty for being so frustrated and impatient and bitter about my own situation when it could be so much worse. When it might get so much worse in the future. I really admire all of you and the things you do and are going through. Makes me feel like my complaints are so minor!

However, I do know where to turn with my questions, because no one knows more about how to handle our elders with love and respect than all of you do. Hugs to everyone. :-)

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You could write a letter to her doctor outlining her behaviors and ask him to discreetly bring it up to mom. I've done that with my mom. That way, the doctor is the one to bring it up...and if you're there (try to be there for that visit) you can make sure mom tells the doctor the truth of what is going on. My mom always puts on a show for the doctor, so I had to be sure to give the real picture of what was happening.
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OK, I'm planning to take over the meds tonight, guys. Thanks for the advice!

Babalou, how do you bring that kind of testing up with your parent? Mom has mentioned to me that she is "worried" about her mind, but when I say maybe she should mention it to her doctor, she says she'll wait and do it next time she's there. Which, of course, she won't. I think she knows something's awry, but she doesn't want to "know" it officially. I usually go to her appointments with her, unless she can get her boyfriend to take her (yes, at 77 she has a boyfriend, good for her!), so if I'm there I can force the topic. **sigh** It would be so much easier if she would bring it up herself.

Sympathetic, thanks for the ideas. Mom does forget to take her pills, in addition to not wanting to be "an addict" which means she puts it off longer than she should. She is in chronic pain and should be taking maintenance pain meds, but she doesn't want to admit that she "needs" the drugs. We're already using a one-week box that has morning, noon, evening and bedtime, but she futzes around with which pills she wants to or is willing to take and when. At the moment she's convinced that the Nortriptyline (sic?) she's on is giving her heartburn, so she's been negotiating about when to take it. Doc wants her to take it at bedtime, she's been taking it at lunch and dinner, or not at all.

Yes, the more I hear myself talk, the more I know I need to take over this responsibility for her. BLEH! Oh well.
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My mother uses the plastic pill boxes with the seven days a week, divided into morning and evening meds. She leaves the top open once she has taken the meds. Is your mother forgetting or does she have fear of taking the meds? My mother was reading all the technical information about potential side effects of the meds and was intentionally leaving them off. I learned that discussing the dosage amount, cost of the drug and side effects was a never ending process. I have learned to side step these discussions and advise that she talk to her doctor. My role is to reassure her than she can afford the best of medical care and any prescription prescribed by her doctor.
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When we moved my mom into independent living, I got her three pill boxes, yellow for morning, clear for noon and blue for evening.

It's time for you to take mom to a neuropsychologist for cognitive testing. If you have a large rehab hospital near you, call and ask about getting a thorough work up for cognitive decline. This sort of eval was suggested to us by the geriatric psychiatrist who was treating my mom's depression and anxiety. Once I saw how poorly she scored in tests of reasoning and abstract thinking, I understood so much better why we needed to take over her finances, talking to doctor's and setting up her meds.
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I think you should absolutely take over the preparation of the meds. Whether you get more involved in when she takes her pain meds is less clear to me, but based on what you're saying, she needs reminders to take her meds as well.

Taking the correct medications correctly is important to keep parents on an even medical keel. My mom insisted she was fine in taking her meds (I prepared them for her). She missed three days of her blood thinners and after a trip to the ER (problem in one foot/leg), a visit to the vascular surgeon, and a year of an unhealed scab on one toe, we're still living with her foolish stubbornness that she could handle it. I now have girls coming in 2X a day to give her her meds. She can't even remember they're coming in.

So the minute a parent starts to fail in terms of memory/cognitive ability, I say (from experience) the meds become the responsibility of the adult caregiver child - whether the parent agrees or not. Let your mom have autonomy in other areas of her life.
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Take over the meds. Once we took over, mom improved for a bit. Two years later now, several falls and a few strokes, she is in Assisted Living. There is no way she could do meds now.
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The bonus of filling a couple boxes ahead of time is that you can see what pills need to be reordered in plenty of time. You could explain to her that you're doing it for your benefit - that it'll give you peace of mind knowing she has her meds so she's not in pain.
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txcamper, that's a great idea... to have more than one box at a time. Sheesh, don't know why I didn't think of that before! Thanks!
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Thank you Ismiami; I did look at that advertisement, but when I clicked through for more details, the link was broken. I will wait a couple days and try again. That was what actually prompted me to post. :-)
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There is an advertiser/ sponsor of this site that has a product that looks like it may help. Seems to be a "smart" pill box....pill box with a cell phone collection, it has alerts, reports. I did not look into it in full detail, but it may allow her to maintain independence over her meds, provide her reminders, and provide you alerts and reminders. I would check it out. I believe it was medminder.com, I saw it on this site.
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