Mom in pain, refuses meds, says everyone is poisoning her, does not eat, will not even take anti-anxiety meds. What now?

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In the nursing home, they cannot force her to take meds. They suggested a psych facility but said then her medical needs won't be met. Hospice cannot pick her up. She was spitting at everyone today. What do I do if this continues? Can they make her leave the nursing home? I am ready to just wash my hands and let her alone to her own choices. One day they tell me she probably make it through the night, the next day they say that is no longer the case. I am so lost. What do I do now?

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Does she have a beloved doctor? My mother has a family doctor for ages, if he told her that the moon was blue cheese she'd believe him, she is of the generation that doctors are Gods and priests can do no wrong, though this one didn't diagnose her dementia. Anyhow, I digress, the point is maybe the doctor can talk to her and encourage her to take meds, they have liquid pain meds here, codeine and paracetamol.
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correction ...

that fit into their story LINE
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SuziQ - have you tried going to the priest in your local parish? Explain your situation, there may be people within your church to help or perhaps he could call the charities for you and get some movement.

If we are taking care of a sick or elderly person who is cranky, paranoid, controlling, mean, or any other negative behavior you can think of, each and everyone of us will learn over time that we will make up stories or hide the truth from the one we are taking care of just to get them to do what is necessary either for their own good or to get them through the day. It is excruciatingly clear that if we try to practice "honesty is the best policy" it will only blow up in our faces.

And the repetitive stories, as well as the confabulation (making things up that fit into their story 9 or memory gaps) are just part of the process. They have no awareness that they're doing this. The sad part is when we realize that's the only memories they have access to. It's a pitiful disease.
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Does she have a UTI (urinary tract infection)? Often in elderly women it causes the kind of behavior you describe.
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I would sure try a liquid or crushed pill in something she likes to eat like pudding or applesauce or ice cream or a drink like a shake. I would ask for it fast before they ask you to move her someplace else.
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My 90 yrs old mother will only take Tylenol which doesn't help. So I asked the doctor to give her something stronger which I add to her seven day pill container. She doesn't know I do or she wouldn't take it. So I don't know if it's working that well, but it makes her sleep a lot. Well, Tylenol also made her sleep too. If I didn't do it this way, she would be in terrible pain from her broken hip from 2 yrs ago. But I can't leave her because she might fall. She also has dementia which is getting harder to listen to the same stories and some made up stories. I'm trying to find someone to come in and sit with her so I can take time for myself. I get depressed sometimes. I've called the Catholic Charities a dozen times, but they won't call me back. They would come in 4 hours a week for free. That would work for me if they would just call. Good luck to all and God Bless.
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When I mentioned Haldol, I neglected to mention that one of the biggest problems with it is that it can become a zombie-fying drug. You know your loved one the best and you must watch for changes that indicate the doctors maybe ordering too much. Your knowledge about the persons usual behavior and calm, logical reporting to the medical staff and the doctors should result in and adjustment to the medication that will benefit the patient.
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Liquid Haldol doesn't seem to have a flavor, and can be added to a small drink. Just be sure it is finished. It helps the paranoid, and out of control behavior.
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corrections ... (once again I have to apologize for the voice recognition on my android...yikes!)

tablets are often better AND CAN BE disguised IN PUDDING or applesauce

I am frankly surprised that they CAN'T handle it

TO help take some of the pressure OFF the nursing home

There's AN uncooperative, almost psychotic phase

Is she in A LOCKED AND licensed memory care facility

a new place that suits HER needs
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Depends on what shes taking.

Capsules are tough because they're not supposed to be broken up. If doctors are made aware of the problem, they can frequently prescribe a crushable tablet as an alternative. Or sometimes a liquid, such as Tylenol or Advil.

Flavored liquid Tylenol or Advil can be put into juice and giving it is imperceptible. Medical tablets are often bitter the candy disguise inputting or applesauce. Your profile says your mom has dementia. Is she at a dementia friendly facility? Nurses and caretakers there typically know the routine. Unfortunately what you describe is not out of the ordinary and I am frankly surprised that they can handle it.

Also, if they are alternating between telling you she's on her last leg and then she's not, a conversation with the doctor is in order as to whether or not she's hospice appropriate, which would involve the doctor certifying that in his opinion she has 6 months or less to live. Then through the hospice program there are other services available the help take some of the pressure of the nursing home.

There's uncooperative, almost psychotic phase that a lot of dementia patients get into at the end and that's why Haldol, which is an anti-psychotic, also comes in a liquid form. How progressed is her dementia? Is she in a lot and licensed memory care facility? If not, they just don't know how to handle her and the inadequacy of that is rubbing off on you. YOU may need to find her a new place that suits your needs and level of care.
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