Mom's recent behavior has been angry and aggressive and she often refuses to take her medicine. She demands that my brother or I come to her home when she has to take her medicine (5 X a day) or she says she is scared she will choke on the medicine. (which is her anxiety)- recent behaviors involve her saying the aides "are out to get her" and "people live in the walls". She often asks when she will die and what will happen when she dies. We get constant calls from the aides to help calm mom down.

All advice is welcomed and appreciated. I am drained, exhausted and worn out from it.

Seems your mother has severe anxiety and some delusional thought processes.

Please get her evaluated by her primary care doctor. Her doctor may make referrals to a neurologist (to evaluate and treat dementia) and/or a geriatric psychiatrist (to evaluate and treat mental health issues).

Medications can be given as pills, patches, liquids, and injectables. I don't recommend the last form. Pills and liquids may be put into other foods and drinks. As an RN, I have used pudding and applesauce with most medications for folks with swallowing issues. Her doctor can prescribe medications that are chewable or that may be crushed. Either you or your brother must give her the medications since aides are not allowed to give medications in most states.

A doctor can prescribe an anti-anxiety medication to calm her anxiety, anger and agitation. If this doesn't work, she may need a short stay in a geriatric inpatient psychiatric unit for evaluations and treatment. She should then be less anxious and "act out" less.
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Reply to Taarna

I’d first talk to the pharmacist about the medication. Pharmacists are an under-rated source of professional information, and it’s free – just walk in and ask to talk to the pharmacist.

You need to know if some of the drugs are slow release. Crush them up, and you give a very large immediate dose – not good! On the other hand, if she is taking the same drug 5 times a day, there may be a slow release option with fewer pills.

Crushing appropriate pills may stop her ‘choking’ worries. I crunch mine down in my mouth in the night, as a whole swallowed pill gives me oesophagal spasm (heartburn?). Sip of water to follow.

Demanding a visit 5x a day means that the aides aren’t providing what you are paying them for. Are you sure that this isn’t just a new habit that gets you and your brother paying much more attention? The crazy statements might just be deliberate parts of the same thing. Game playing can sometimes be part of unreasonable demands.

A UTI check and a base line assessment are a very good idea. If mother is degenerating quickly, so is planning for the short term future. This clearly can’t go on even at this level, and accepting a new plan may help the way you feel. Best wishes, Margaret
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Reply to MargaretMcKen

She needs to be seen by her doctor, pronto. She likely needs a med to help calm this behavior
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Reply to Daughterof1930

A 100 year old woman i use to care for use to take her med and hide it. SHe would break just one in half. She lived another 2 years till 102. She could walk, played bridge on the newspaper, was insistent on meeting her needs as she saw fit. She did not do with the doctors told her. She knew which meds made her feet swell. She was not having it. Sometimes in retrospect, i think the elders understand how the body truly works and the academic learning of how the body gets into sickness and comes out if it is a lost knowledge. Most elders dont wear masks and never did in my town. They said this co co 19 is coo coo and not how disease works. Especially the retired nurses i run into at the senior centers. Many of the elders i have cared for are suspicious of medical direction if they are from other countries that do not use medicine and they are familiar with the living with elders because they know most of the causes of a health set back and have their remedies to restore health which we don't use here. We don't search and go into the cause. We blame every health set back on a germ caught from the outside rather than what our ancestors knew as cause to be lack of hydration and eating poorly and not being outdoors getting sun and lack of movement.
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Reply to truthbetold

My Mother couldn't swallow pills,so I smashed them up in a grinder and put them in a bite of applesauce and gave it to her.
Maybe that would be easier for your Mother too.
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Reply to luckylu

Does your mother have 24 hour round-the-clock care in her home?
If she believes her aides are out to get her and that there's people living in the walls, she is not in her right mind. I hope she is not ever left alone.
It's not realistic for you or your brother to go to her house five times a day to give her all the medications. You can ask her doctors if her meds come in liquid form or if they can be crushed up and put into food. I don't think this will solve your bigger problem which is your mother is not in her right mind. She is also aggressive and violent with her aides.
It's time for you and your brother to put her into a care facility for her safety.
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Reply to BurntCaregiver

I agree, take her to her Doc -

-Are all the meds taken necessary
-Have him/her check her for dementia and if necessary referred
-Find out which meds can be crushed
-Have her checked for UTI
-Let her Doc know of her anxiety of swallowing and chocking - maybe a mild antianxiety prescription can administered to take the edge off.

It may be time for mom to be moved to an appropriate facility. They are used to dealing with all manner of behavior. You and your brother should be planning for mom's future and not be forced to make a quick decision. If the behavior is new and not due to an UTI, mom may be devolving further into dementia.

Do your best too reassure her that she is fine. As far as death - is she afraid to die - or ready to die? If she is afraid, use her belief system to reassure her. Dad had been ready to die for a couple of years before he did - He was always asking when he would die - He'd ask his doc, he'd ask me - and who knows who else he asked. The doc told him that was up to God - My answer was pretty much the same - but another time I added maybe he hadn't completed his work here on work. He was truly afraid his heart would not stop - or that God had forgotten him and left him behind.

As far as what happens at death - I have no answers - knowing my "smart mouth" and if it were my father asking me - I'd tell him it was a mystery of life and if he got there before me, to come back and tell me all about it.

Good luck to your entire family.
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Reply to cweissp

Take the meds to pharmacist and ask him what can be taken at the same time. Five times a day is probably more often than necessary. Also pills that need to be taken 3 times a day (per 24 hr period) mean you would probably be waking someone up to take one of the pills (every 8 hrs). Ask pharm about taking it closer together in waking hours or skipping a dose that would come in night. If you have several doctors, you may even find more than one of the drs has ordered similar meds.

Find out which meds you can mix into applesauce, yogurt or something mom likes. Then she doesn't get slammed several times a day trying to swallow pills.

As for when she dies - try any kind of comforting words. You'll get to see so-and-so again. Or, don't you feel good when you take a nap - it's like a nap.
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Reply to my2cents

Actually Aides are not suppose to distribute meds unless trained as Medtechs. They can remind a person to take them but they cannot fill med planners or hand the medication to the person. Even in a NH, this is done by LPNs mostly then RNs.

I agree, does Mom really need all her meds. Or, do they need to be taken 5x a day.
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Reply to JoAnn29

Sounds like your mother is suffering from dementia judging by the behavior she is exhibiting. Has she been evaluated by her PCP? Paranoia, fear and agitation are classic symptoms of dementia, so a call to her doctor is in order. S/he may be able to prescribe calming meds so she can function a bit better with her caregivers. You also need to know where she's at, stage wise, with the dementia, so you can know how to get in the appropriate help for her, know how to manage what's coming next, or whether to place her in Memory Care and if so, when? Dementia can take a sharp downturn at a moment's notice, too, so you need to be prepared for what's coming by first getting her evaluated. She should also be checked for a urinary tract infection (UTI) if this is brand new, out of the blue behavior. UTIs can cause erratic behavior in an elder quite often.

Best of luck!
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Reply to lealonnie1

What are the medicines she is refusing to take? Are they all essential or can they be paired down by her doctor to the absolute minimum? Can the meds be crushed and put into applesauce or pudding?

You don't mention her age and so it's hard to give you advice without knowing her age and health conditions.
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Reply to NYDaughterInLaw

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