Problems with caring for a dementia patient. Any suggestions?

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I take the 14 hour day shifts for my wife's parents, and the wife's sister takes the night shift when they are sleeping. The other 7 kid's don't want nothing to do with taking care of them. So the mother in law constantly brags on her daughter to everyone, but my problem is the daughter is not very knowledgeable about medication and she fills the mother in laws medication daily pill container. I fill the father in laws. The problem is she won't give the mother in law all her meds she pulls the meds on her own without talking to the doctor, sometimes she gives the mother in law some of her dad's medication that's not prescribed for her. The mother in law insists on taking it or not taking because her daughter said to. Hey I understand wanting to be proud of at least one of her kids, but I can't see how I can continue to take care of her during my shift if she won't take the proper medication when needed, or take pills not prescribed for her. I can't keep calling the doctor or hospice nurse every time there is a problem. Sometimes the mother in law won't even listen to them. The mother in law keeps the pills with her and takes them on her own. It's starting to cause some health problems, not sure what to do, anything that would happen would most likely be on my shift. And now her daughter is trying to talk the mother in law out of having her pacemaker battery replaced, the mother in law desperately wanted the replacement but she now says it might be easier on her daughter if she doesn't. This is just making me sick.

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You mention the hospice nurse. Which of the couple is on hospice care?
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GT, are your in laws on Medicaid? Can you get them qualified to get them some in home care and respite for You?

Who will SIL listen to about meds? She needs to hear from someone she trusts that the meds prescribed are for her mom's health and needn't be held or changed.
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The meds - most pharmacies will do a weekly blister pack for customers. I think there is a small fee. Got this set up for my mom now. There is no mistaking what to take when, it's all laid out:  morning, afternoon, evening, bedtime. Might be a good idea to do this if SIL can't be trusted to do the meds properly.
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Thanks some good advice, they mil is pacemaker dependent. My MIL kept her own med box filled and it took two weeks of talking by the family before she would let anyone else fill her daily med box. None of the others 7 kid's want anything to do with them. My wife can't do the required lifting so I would have to take on 24/7 for two, really need two or three but no money. The effects of the not giveing one med keeps her agitated and makes for a long day.tottley wore out.
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Yikes. Time to make a doc appointment for MIL, you and wife's sister for a "med check." Explain to the doc that "we" (the family) aren't sure that some of these meds are needed every day, and maybe others are needed. Perhaps the wife's sister is right? Have the doc explain why or why not to everyone's satisfaction.

Also, find out from the cardiologist what % your MIL is using the pacemaker. For example, my Father's pacemaker is used 97% of the time to make his heart beat according to his tests. If we didn't change his battery, it would be an instant death sentence. If that doesn't convince wife's sister, then another 3-way appointment with the Cardiologist is in order to discuss this issue.
Blessings for all that you do.
Jamie
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Offhand I don't have any good suggestions for the medication issue other than documenting as eventually there could be some negative ramifications, and you want to make sure you're covered if there's an investigation.

I will say that I don't think the sister should be involved at all in medication management. Is this something you or your wife could take over, to "relieve" the sister of that obligation? Any way you can think of to get her out of the medication mismanagement aspect?

As to the pacer battery, they obviously have limited life, which a cardiologist can check. If the battery needs replacement and is not, well, it's going to reach the point that it's not effective. And that defeats the purpose of having a pacer if the battery isn't operating it.

Depending on her % reliance on the pacer, she could suffer a fatal cardiac event. The daughter who's meddling in this issue could conceivably be blamed. I don't know enough about your MIL's other needs, cardiac dysfunction, and % reliance on the pacemaker to predict this (that's a cardiologist's province) but I think there might be some consideration of elder abuse or criminal negligence.

Do you think a very frank talk by the cardiologist with your MIL and the mismanaging daughter would bring some medical and common sense to the issue?

I would think a cardiologist should know about the pacer battery issue, and one of your MIL's doctors should be informed about the medication mismanagement issue. They would probably document their files, as I assume they don't want to be accused of malpractice in the event of a negative reaction or inaction.
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