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My father is 96 years old, WWII vet, with dementia and PTSD. He is at home and currently under Hospice care. My sisters and I take turns to care for him 24/7. Our problem at this time is his refusal to take any sort of medication, whether it is crushed pills in applesauce or liquid form in juice. He is so resistant of this that at one point he threatens to punch the person trying to give the medication. Hospice is getting frustrated with us because we give up giving him his medication, which is for his anxiety, sleeping aid, thrush, and morphine for pain. We don't know what else to do, we are worn out because of his lack of sleep (yells out for us through the night), we are frustrated by his refusal to drink and eat (tells us he is hungry or thirsty but wont eat or drink) and scared/worried of his aggressiveness. Plus he is going through a sexual stage where we have caught him pulling off his diaper and fondling himself or try to pull our hands to touch him down there. We know this is not our father but the dementia. Any advice or suggestion or anything that will help us!

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My mother had severe Alzheimer’s, fought us, refused medicine, attacked people. After struggling for years, going to care centers, getting no help from doctors, the only thing we could do, was keep her at home, in her own bedroom, while we slept on the sofa. We stopped fighting her, if she didn’t want to eat or drink, we didn’t force her. We watched her 24 hours a day, in relief shifts, and when we finally needed some time, we hired an adult care giver, to babysit. She passed away in her sleep. When people fail to make arrangements in advance,or do not consider their children and family, there is nothing you can do. You’ll just wear yourself out. I ended up in the hospital after she died, just from neglecting my own health. It’s not worth it. Hospice is supposed to come over and help, and they left us stranded. We couldn’t even get a nurse, they would all walk out. So it’s either put them in a hospital or nursing home, but it’s so expensive. Best thing for us was to just leave her in her own home, and we babysat.
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Reply to sherryhodges100
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TinaO03: If he's such a pugnacious and mean-spirited patient, I would think that ANY Hospice Care worker(s) would be afraid of him. He's a danger to himself and others. In some of these cases, APS had to get involved or it could end VERY badly.
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TinaO03 Feb 4, 2019
I don't think you are understanding what my father is going through and I prefer that you no longer address my issue.
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My two cents from similar situation. Make sure the facility and hospice teams are on same page. Talk to every person so They know you are concern are to be gentle. Once that's done...create a restful relaxing atmosphere so he can rest. Agitation means stress and he may be confused about what to do. My dad allowed me to feed him and I discussed it was ok to trust the people ...he gradually trusted them but your dad can see and hear what they say. How do his Chaplin visits go? Staff can administer meds while they are there. Praying angels comfort and heal the patients in his facility and Gods will is done on Earth as in heaven.
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TinaO03 Feb 2, 2019
Thank you for your advice. My father is at home and the hospice team visits him there. He has gotten more aggressive with them though. I had a rough time the past two days with him trying to hit the visiting hospice nurses aide, the hospice RN, and the VA RN. Yesterday I helped the nurse's aide clean my father and meanwhile he was throwing punches and kicking, when I grabbed one of his fist that he was ready to throw, he grabbed my hand and squeezed so tightly and pulled my thumb back with his other hand, I was in pain. I was able to pull away and the aide and I stopped. We were able to slip a clean diaper on him and walk away. Later he kept apologizing to me and I can see he was truly sorry.
I know its the dementia making him behave this way and he probably thinks the visiting hospice people are probably WWII enemies but it is scary and sad. My father is always kind to the visiting hospice Chaplin though. He seems to soothe him.
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can you try and get his medication in a patch or spray or lotion? I just got seroquell in a patch.
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TinaO03 Feb 2, 2019
He has a fentanyl patch for pain but the haloperdal and morphine is liquid and the Ambien is a tablet that we crush. Without these, he is up all through the night calling out
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Please let the Hospice professionals handle this situation. That's what they're trained for.
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TinaO03 Feb 2, 2019
I would love for the Hospice professionals to handle this situation but they are not in his house 24/7. Its in our hands to give him his medications and feeding, drinking, cleaning him, and changing his diaper. The Hospice RN visits once a week and the aide visits 3 times a week. Any suggestions on how we can get Hospice to stay with him 24/7?
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"He does love ice cream but for some reason it gives him diarrhea."

He could be lactose intolerant. There are nice dairy free ice creams. It might be worth trying one of those - rice based, coconut based or soy based, I prefer the coconut ones.

I think looking for other ways to deliver the meds would help. I know there are morphine patches and a long lasting injectable form of haloperdal. It might be worth checking into those My mother would not take her anti psychotic by mouth but eventually took the injectable form.
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TinaO03 Feb 2, 2019
I am going to ask if they can give my father a Haloperdal injection, that might be an answer to his aggressive and agitated behavior.
Plus a dairy free ice cream might help with the medications as well.
Thanks!
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Does he like sweet's? If you mixed his meds in a Tbs of raw local honey it might hide the taste and the raw honey has anti-bacterial and anti-fungal properties so could even help on it's own but could also be sold to dad as a natural non-prescription remedy. Might he be more receptive to trying something like that or an old remedy from before they had prescriptions, for the thrush I mean (the other meds hidden in the honey). The other plus about honey is it can help sooth a sore throat so maybe it will help sooth his mouth? On the topic of the thrush there are some natural remedies for it that might help if he is more apt to accept trying them and able. I think salt and or apple cider vinegar (raw) are one but he would have to be able to either swish it around or gargle without swallowing I think. A tea can also be made with apple cider vinegar with honey and cinnamon that helps a sore throat as well and would get those things in his system if he would drink that. But the other thing that I have seen people suggest for thrush and candida in general is yogurt. It should be a plain good quality yogurt with as high a number of live cultures as possible, it's the live cultures that help fight off and kill the thrush and I'm not sure how much one needs to eat but it might be easier to eat and therefore get some nourishment in him as well (I would use Greek yogurt myself), I don't know if you would be able to hide the medication in it or not. Depending on the size of a pill trying to hide it whole in a spoonful of something would be better than crushed up where it affects the taste more, if his taste buds are that good. Partly I am focusing on the thrush in case that has more to do with his reluctance to eat than his over all health, if that isn't the case sorry about that.

If any of this does sound like it's worth trying I would suggest collecting yourself, taking some big deep breaths and presenting it to him in a way that allows him, to make the decision it's worth trying. So something like "Dad I was just reading about how they treated thrush before all these medications"..."people are getting back to what worked 50 years ago, what do you think about trying...to see if it might help your mouth?...you know your right it does seem silly that they so easily jump to prescription medications now when we already have most of the things that they used to use 50 years ago, before these meds, in the house. What do you think about giving something like that a try?..." You get the picture, I'm just suggesting finding a way to get him onboard on his own before arguing it out at all. Good Luck!
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TinaO03 Feb 2, 2019
Thank you for your advice. I am going to try an added sweetener to his spoonful of medicine, hopefully it helps him accept it and not fight it.
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MY LO is also on Hospice. They provided me with a little booklet called Gone From My Sight. It describes the transition from life to death. It seems that eventually, the patient stops eating and drinking, so relying on that to administer meds, might be futile. They may also develop agitation. Have you discussed these phases with the Hospice workers? It seems to me that they would have encountered this kind of thing a lot and could offer some guidance.
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Judysai422 Jan 30, 2019
And if not, find a different hospice service. They are not all created equally.
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Most Hospice have "In Patient Units" where they will take a patient for pain management.
Ask your Hospice if they would admit him for pain management and symptom relief.
Once the symptoms and pain are under control he can be transported back home.
This is one of the primary goals of Hospice is to manage things like this so the patient and the family are not stressed.
One of the other advantages of Hospice is they will provide respite care...so if they will not admit him for pain and symptom management tell them you need Respite care for him. You get a week of respite.
One other call you can make is to the VA they can also help. The VA also has Hospice although they do work with other Hospice groups. And the VA has the facilities to admit him if the Hospice does not.

Oh there are other methods to administer medications. There are patches, there are also suppositories although in your case that might be a wee bit of a challenge :) (that might be an understatement)
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Reply to Grandma1954
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Thank you for your advice.
Hospice have shown us multiple ways to give him his medication but even they struggle with him. Once he even swung a punch at the RN and she had my sister hold him down. Sneaking the medication into his food is our only option right now but since his appetite is so irregular, so is his medication.
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JoAnn29 Jan 30, 2019
I understand why he needs the medication, to keep him calm. But, these nurses are not suppose to force medication. This would be a no no if they were working in a facility.
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Does he see you mixing the meds into the food?

I think it is hard to swallow with thrush, making it a challenge because he doesn't understand and probably feels thirsty and hungry but can't swallow, I would do some research and try to find something to help him swallow. Being on hospice they won't treat this but you might find something that helps.

I would taste whatever you are trying to give him with the meds, some stuff is soooooo bitter you can't hide it easily. Maybe add some more honey and cinnamon to the apple sauce. If they have given you pills, request liquids and I would check out if the pharmacy can make flavors.

Just some ideas.

If he isn't eating or drinking he is actively dying, that may be what is happening, things are shutting down. Prepare yourself for the end.

May God grant him a peaceful passing and grant you and your family the strength to get through this journey. I am sorry for your loss.
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Reply to Isthisrealyreal
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TinaO03 Jan 29, 2019
Thank you for your advice and prayer. We are trying to prepare ourselves for his passing but it's hard to even think about it.

We found that he enjoys strawberry flavored applesauce but after a bite or two, he stops. So we now put his medication in the first spoonful and hope is takes it. Since the medication is liquid morphine for pain and Haloperin(sp) for anxiety, we would be hesitant to taste it, but I like the idea of adding extra sweetener to make it easier for him. He use to have a real good sweet tooth.

Thanks again and may God bless
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The aides at Moms NH used pudding. Icecream?
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TinaO03 Jan 29, 2019
Thank you for your advice.
We have tried all flavors of pudding but he didn't care for it. He does love ice cream but for some reason it gives him diarrhea.
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Hospice should be able to tell you how to get these Meds into him. They are the Pros you are lay people. You cannot force, even a Dementia patient, people to do what they won't do.
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