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Mom was diagnosed with vascular dementia a little over a year ago. She is 77, my Dad is 79. My mom has always been a very strong personality, I mean strong!


Over the last year she is increasingly becoming aggressive and angry. She makes up stories and believes them to be gospel especially about drugs. She curses my Dad out over every little thing until he backs down and leaves her alone.


She barely eats, like say, she eats 2 eggs for breakfast she'll go sometimes til the next evening before she takes a few more bites of food. And she flat out refuses to take her dementia medication, I mean she will get so aggressive and angry we end up backing down for fear she'll stroke out.


She wakes up in the morning in or around the middle of stage 4 and every hour she slides, by dark she is in the middle of stage 5 if not near the end of that stage.


Does anyone in here have a LO that is this hard to deal with?


No matter how we've tried to talk to her about her meds she gets so irate that we fear she will seriously stroke out, we tried calmly talking, being a little assertive, ignoring it for a few days... nothing works. If you ask her if she took her pills she will tell you yes, if you check you quickly see she is lying. Then the next day the pills go missing, takes us days to find them. Dad even tried waking her at 5am (since she is calmer than a cucumber in those hours) and she was taking them with no problem, 4 days later she took them from him and threw them screaming she doesn't want them anymore. That was the last time she took them.


We took her to a neurologist and she walked out and refused to go back in. We are at a loss at this point. She is so hard to deal with or talk to it makes it incredibly difficult to get her to do anything.


Here is an example on what we deal with: she is telling us a made up story that never happened... she will ask us for a name or place, if you say you don't remember she gets angrier than a badger, if you make up whatever it is she asked you she gets incredibly angry and starts to curse you out, if you ignore it like you didn't hear her she starts calling you names and belittles you.


If we do get her to take her medicine for a few days in a row (which hasn't happened in about 6 months, up above) she is good... calm, not mean, she eats, can hold a conversation, more willing to do what she needs to do, and even takes her evening pill on her own!!


We are at an absolute loss on how to get her to take her medicine and eat. Those 11 steps from Alzheimer's to get them to take their meds would never ever fly with Mom, literally, she is meaner than a badger on a good day.


Thought about crushing pill and putting in food, again 2 problems with that, 1) she barely eats and 2) she feed her dogs her food.


The family Doctor, the only one she agrees to see, tells us every 3 months at her check up, that we need to get her to take the medicine... we know this, he knows this, everyone knows this but, HOW do we do it, is the question. Any and all suggestions would be greatly appreciated, especially from those that deal with the same aggressive rattlesnake.

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We don't give my mom very many meds anymore, she was refusing to take them. Only if she complains or looks like she's in pain or really, really agitated. She told us before the dementia got bad, she didn't want to be like her sister. She had a feeding tube, in diapers,sleeping most of the time..
The doctor asked to speak to her alone, she told her we where forcing her to take pills. She wants to go see my dad, he died 10 years ago. She's 91, going into hospice next week.
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Hope this helps. I get liquid med. and vitamins and put them in a plastic cup with ocean spray drink. I will let him use a straw. He is a little weak so I hold the cup for him. When he doesn't eat well I put something sweet like jelly or cranberry or sweet potato at the front of spoon so he can taste the sweet and he will start eating. This works most times . When He misses a meal I will give him a health drink. His favorite taste is vanilla. So far so good. Hopes this helps you.
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I had some trouble with Luz taking her meds. I finally had to resort to crushing them into a powder and mixing them with ice cream. she would take them without knowing. But the secret was to reduce the meds to a powder form other wise she would find the small pieces of the meds and spit that out.
If she will eat puddings or ice cream try that.
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There are a lot good suggestions here. Another thing you need to consider is the priority of your Mom’s medications. In other words which drugs must she have to help ensure her mortality and healthy well being. Once you determine the priority you can focus on those medications for each day and the other drugs can wait for a better day.
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Jerzee....I'm so sorry your'e having this problem with your Mother and all I know to suggest is smashing up her medicine and putting it into some applesauce,just 1 small bite and giving it to her yourself.Maybe you could tell her it's a new kind and say "Here,taste this" and just put the spoon in her mouth.
I know she needs her medicine and she would feel and do so much better if she had it.You must be very frustrated about this and I really hope you find a way to get it down her and soon.
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I'm struck by a couple of things you said. First once she has a regular level (a few days medicated) of the medication in her she becomes cooperative and even takes her meds on her own. Second it worked for a while when Dad woke her up in the middle of the night to take it. So first things first I would remove her access to her medications, she doesn't want them anyway so just put them somewhere out of sight so she isn't able to hide them or get worked up over the sight of them. Then perhaps dad could wake her up for a few days to get her to take the medication long enough to even her out and then move to a pattern that has someone you, dad whoever she is most apt to be ok with, putting out just the days worth right before she needs to take it. So she has control over taking her medication but not access to all of it to hide should she decide not to take it. This way you can also track (quietly) if she has taken it each day. Then if this works you will need to keep a close eye on any changes beginning to happen in her demeanor, our bodies often build up a resistance of sorts to these medications and the dose needs to be increased to get the same benefit or sometimes a particular med stops being as effective all together and it's time to try another that treats the same thing. You might want to work closely with the doctor prescribing the meds to have a plan in place should there be indications she's back sliding ( you know to give her an extra 1/2 for instance) because the difference between the 2 or more days it takes to notice, call and get her in to see the doctor might be more time than you have to keep her cooperative enough to figure something out. It is of course possible the doctor is going to say she will need to be put in the psyc ward or some equivalent for elders while they figure out the right treatment balance too and it might be that's what you need to do now to get the meds in her system and working so she and everyone else is safe at home again. Sorry I know how awful that sounds and will likely be but I'm not sure it's going to be any worse than what you are doing and heading for right now.

I feel for you and your dad, hang in there!
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Has your doctor found a medication to treat dementia that is PROVEN to work? Because that I know of, none are as yet "proven" and the cost is often horrific. It is not uncommon for doctors in this day and age to get 6% of prescription costs from the drug companies. Moreover, the fact is that often the drugs have side effects quite similar to what they are to CURE. Hallucinations and so on. That's my read on medications these days from an OLD RN basis.
As to eating, it is very common for the elderly to lose their appetites. Not certain how far you are willing to go in this battle for more life, nourishment and food in a person who is making their own choices by what their body is asking of them. These are all decisions we have to make on our own with our doctors. For myself I would not force an elder to take medications at some point, nor to eat, and would consider instead a consult with palliative care physician.
Do know that when it becomes a real struggle, the person suffering from dementia will see it as a power struggle, and since they have power over so little, they can fight very hard for what little power they have.
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You are going to have to face some hard facts. Your mother's behavior will only get more stubborn, more willful and go down, down, down. You cannot force her to eat or take the medication. The only way would be to physically restrain her and force her and I am not sure that is appropriate. Face the fact - there is nothing you can do. Perhaps you may have to consider resorting to a feeding tube. Tell her about it and what it would mean if she refuses to cooperate. It may also be her way of telling her body to shut down so she can say good bye. I am sorry you are going through this. And do NOT under any circumstances allow her to be so aggressive and angry and abusive. Tell her to stop at once in a very firm way. If she doesn't, walk out and do not go back for a long time. I can assure you this often helps with this behavior.
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I want to recommend a book for you-it is short, but it helped us a lot. https://www.google.com/search?q=when+reasoning+no+longer+works&ie=UTF-8&oe=UTF-8&hl=en-us&client=safari#imgrc=2OFEHDDTo3YOWM:
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If you can wake her at 5am to take meds and she is calm, do so. Try to get that on schedule. I’ve found my mom is better when I can keep her level and have her eat protein regularly. Cottage cheese & yogurt do the trick. Keeps sugar stable and she’s much nicer too. So if you could give her a protein treat then too it might help. We try anything and yes, keep dog out of room at meal time. I always say ‘that will give the dog diarrhea’ which no one wants, usually works. All that said, it may be time for NH. Good luck and just do your best; it’s all you can do.
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A person with dementia cannot be reasoned with. Her "lies" should not be addressed or questioned. Just agree and remain out of arguments with her. Perhaps a specialist can address her aggressive behaviors. If she is in the late stage, consider Hospice. It's a marvelous resource and let them give her her medications. Often Hospice care is sought too late.
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You should speak with her doctor.
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I believe that this may be her last bit of control. She has the right to refuse any and all meds. We found that Hospice will provide palliative care also. They are a great source of comfort for the patient and family. The patient does not have to be at deaths door either. Just check. The high pressure of some docs give quantity of days but not quality. Since we have enlisted hospice for both of my parents, they have a nurse check weekly and aide twice a week. The AL and MC provide all other needs. Good luck and prayers are with you.
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Some of the medications for dementia depress a person's appetite. This could be happening to your mom. Perhaps a discussion with her doctor is in order. I have an aunt with dementia that is responding very well to a low dose of CBD oil. It has worked wonders. In the meantime, I would try to provide small, enticing snacks and drinks that have some nutritional value. I used to buy mom ensure clear which tastes like ordinary juice. Instead of a whole meal, just a couple shrimp with cocktail sauce. Little delectable bites and sips. Nothing overwhelming. Is she losing weight?
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Zdarov Apr 2019
Good to bring this up, I’m certain one of my mom’s meds is suppressing her appetite, it could be either metformin or januvia for her blood sugar.
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My mom has very severe end-stage Alzheimer's but I manage by crushing her pills and dissolve them in honey. it may take forever but she eventually will take them. Make certain the pills are NOT time released. If so, have the doctor change the prescription so they can be crushed.
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We went thru something similar with MIL a couple of months ago. We found out that part of her not eating was straight out a control issue. She was tired on FIL telling her she needed to eat. Things got pretty bad between them. We ended up moving her from AL with him Into MC. It was hard on HIM about she was relieved. She was threatening violence against him. In her defense, he was micromanaging everything she did. Once he was not there to do that, she became more willing to eat and take her meds because he was not the one telling her to do so. They are BOTH a much happier and much more relaxed. He doesn’t feel he has to “take care of her” and she doesn’t feel like he’s forcing her to do things.
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My husband had vascular dementia, and one time accused the guy painting our house of stealing his meds, another time the pharmacist short-changed him. Kept insisting he could drive, but had visual problems that caused him to be unable to judge distances. I left taking his meds and eating up to him. Eventually he had a major stroke and died in hospice within 3 weeks as he could not swallow. We both had agreed to no gastric feeding tube. I really do not believe you should make people eat if they don't want to. Sometimes that is the only way they have of getting out of a miserable situation--their lives.
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I agree. You cannot, nor should you try to make someone with dementia eat or take their meds because in the end you cannot make them. Take off the stress. Provide a variety of food and let her choose what or if she will eat. Be generous with treat foods. Saying to someone with dementia that eating this or taking that medicine will keep you alive means nothing and if there is any amount of reasoning left in their brain may make them decline medications. Think about it, would you want to take anything that would prolong dementia, the living hell ?
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If possible, crush pills or twist liquid out(may have to talk to dr to have them changed to pill form, not all pills can be crushed). Add(2 or 3 tablespoons) of applesauce, yogurt or ice cream in a SMALL bowl. Make this an evening/morning ritual.
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What medication is it, exactly? It doesn't seem like the daily fight and stress is worth it.
You can't MAKE her eat if she doesn't want to eat. Also don't worry about what she is eating, just make it appealing. If she likes milkshakes and french fries, provide them! Calories are what she needs at this point, the nutrition part is really after the fact.

As for the rest of it, I know it is extremely frustrating. From her point of view, she is also very frustrated and confused, with having a brain that no longer serves her well.
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Jerzeevibes94 Apr 2019
Aricept, blood pressure meds, diabetes meds
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I found that there comes a point in the stages of dementia that unfortunately this not taking meds and not eating is just a part of the dementia. My mother was in the hospital 2x October 2018, she went down hill rapidly after the second stay. I share this not to upset anyone but she never recovered. She either refused to eat or barely ate a couple of bites, this did instigate her hospital stays. In the end I worked with the memory care facility and put her on hospice care. By December 19th she was gone. Encourage them to eat/ drink and take meds but my experience was this was the latter stages of dementia. I pray this is not your case. Dementia is ugly, wishing you peace in this journey.
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Zdarov Apr 2019
Bless your mom and you, wjared, that had to be very hard. I’ve thought about this too, their lack of desire is natural as well.
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Have the meds made in to a liquid form like they do for children. Your physician and/or pharmacist should help with that. Then maybe make a smoothie with the meds in it or in the scrambled eggs. A medication patch might also be available. Your mother's physician MUST help you! The Alzheimer's Association has a 24/7 help line and they offer wonderful support. They help families deal with ALL kinds of dementia - not just Alzheimer's. Try not to engage in a battle. Good luck to you and your family.
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It is a difficult situation. Have you tried crushing the medicine and burying it in her food. For example if she likes fig or fruit bars put the medicine in the cookie, or if the medicine will dissolve mix it in a sweet drink. I have also chopped pills and hid them in a prune. Be creative! Sometimes the patient will not even know the difference.
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I understand where you are coming from. At one point with Pop he was so bad that he either had to start taking his medications or we were going to have to put him in a care home. Like you, we tried everything, that everyone suggested and all the stuff suggested online. Someone suggested we get tough and be truthful with him. Some would call it cruel, but removing him from his family and all he knows would have been harder on him. Truth is truth and he at least deserved a chance to stay at home. After consulting all our adult kids and making sure we were all on the same page we took the tough-love approach. Basically we said "here are your medications, you must take them or we are going to put you in a care home. We all love you and want to help but you need this medication and you must take it or we can't help." Everyone told him the same thing. It worked. If it had not worked we would have put him in care a home, we would have had no choice. At first, we had to do this each time we gave him his meds. He was still belligerent and he would forget what we had said the last time. Then the meds kicked in and he became more reasonable. Now the meds are a habit, part of his daily routine, and he no longer fights us on it. We handled the food situation the same way by telling him he had to eat, he could have whatever he wanted but he must eat or he would be hospitalized. That worked too. If he only wanted chocolate cake three times a day I used the juicer to puree veggies, added that juice and the peth from the veggies along with protein powder and whipped it up into the cake. LOL whatever works? I think, allowing her access to her own meds is a really bad idea. They need to be given to her, probably, one pill at a time. Hopefully by someone other than her husband. I hope you find a plan that works.
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anonymous903302 Apr 2019
So true. Must hide the medications. Even before the NH, when my mother had 24/7 caregivers, we ended up putting the meds, and even the vitamins, in those huge day and time boxes, on top of the fridge, way back, where she could not reach. But, I did give her a copy of the med schedule that I prepared for the caregivers, so that my mother could read what she was taking and at what times and why she was taking it. Not that she always understood it.....but she felt more in control and kept that list right on her bed.

Also, so true, about food. At this point in life, let him eat whatever he wants, and whenever he wants. As long as he eats! My mother refused to eat a whole, nutritious meal, but would snack on oatmeal raisin cookies, and cheese-itz (way too salty I know), all the way up to midnight. For some reason, though, if me or my sister brought her a meal or sandwich or salad from someplace she liked, she ate all of it. She just would not eat normal meals if she was at home alone with the 24/7 caregivers. Now, at the nursing home, she eats. Mostly. And, on the day she says she has no appetite and did not eat, I know that she goes into her stash of cookies and crackers, because I am the one brings that stuff there to keep her stocked up!

A little negotiating (bribery) can work, too. Such as, I know you are having pain, but the doctor said that you have to drink this whole glass of water and take this pill before I can give you the cookie(s).
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My dad has vascular dementia. When you say her "dementia meds" several of us have asked you what medications that is. There is no medication specific for vascular dementia. Perhaps you are talking about an anti anxiety agent or a antidepressant?? Sadly you truly cannot reason with someone with dementia. We keep hitting brick walls when we think we can. It sounds like you have a damned if you do and damned if you don’t kind of situation.
They often think they are right and we are wrong or just trying to be argumentative.
Her behavior is pretty upsetting for you I know. I do wonder if you’ve had her checked for a UTI because it can make the dementia much worse.
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anonymous903302 Apr 2019
Such a good response.

I have learned that we have to live in their reality, not try to impose our reality on theirs. Not that I have the patience to do that all the time.

Yes, undiagnosed UTIs can result in frightening and verbally abusive behavior and things you never, ever saw your loved one do or say. And, undiagnosed serious UTI can also kill. Unfortunately, most people do not understand that it can take 48 hours at least for the urine test to go through all the lab protocols to find out if there is a UTI. So, you go to the doctor, or the ER, and they take urine, and you go home.....with no meds.....not even a light, preventative anti-biotic.....please realize this....then you have to chase them down to find out if there is, actually, a UTI. Yup....you have to do it. And, with the elderly, they will rarely give antibiotics "just in case" because tolerance levels can escalate easily making them almost immune to the generally prescribed antibiotics. Then, let's say there is UTI, and the meds are for 7-10 days....and you want to know if it has resolved itself. Guess what? Nobody will re-test the urine until 5-10 days after the last day of taking the antibiotics. Sorry......just reporting my experience. Several experiences.

Also, if your LO has dementia, or is stubborn, then it can be impossible to get him/her to pee in the cup. You're going to have to insist on a straight catheter, and do not be shy about demanding that. Please.

Generally, maybe this can help.

I don't want to do or say anything that may not be within the rules of this forum,

But there is a book, "The 36-Hour Day" that was recommended to me by several health care providers about 3 years' ago. The authors are Nancy L. Mace and Peter V. Rabins. It's in paperback. You don't have to read front to back. Use the index. There is a reason that it is viewed as almost the bible for families caring for dementia, Alzheimer's and memory loss...and I don't mean "bible" religiously. It is not a religious book. It is not meant to replace personal interactions with others having the same issues. It's just a great resource. Please read it at your local library or buy it.
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jerzee, I have one of these but she lives alone. I just want to pitch in that your father deserves to live better than this! which I know you know. I spent my life stepping on eggshells with my mother, but I challenge her more now. A couple weeks ago while she was resisting meds or food or something once again, I said very loud and clear – Let me ask you a question, how do you think you’re doing? Because you’re not doing well you’re not managing this at all and it would pay you to get a little more humble and pay attention to what others who care for you think. I know you don’t welcome a confrontation but she’s combative anyway. So it’s just a thought: practice your tactic and your words on your own, and be ready for a time (and there further times) that you escalate the conversation and keep your backbone. She gets with it or she will be hospitalized for dehydration and malnutrition. Because she will. So ask her which she prefers, compliance at home or being given these things by nurses while she lies in a bed. I say to mom, I wouldn’t have it this way and I’m not the one that made it this way, I’m just telling you how it is. I honestly do think it’s okay to be clear about her choices, and let her choose. Maybe you being the ‘bad guy’ more often will help your dad.
It only occurred to me recently to let mom know that a nursing home is one of her choices, she could be very comfortable living like that, and ought to consider it. But I call it the hospital because I think that goes down easier.
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Jerzeevibes94 Apr 2019
Thank you!
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Time To Talk Turkey with a Facility, A Social Worker, To Get mom in Somewhere...Contact Adult protective Services for More INFo, You have a Problem for yourself and Sad Dad as well.:((
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I forgot that some pills can't be crushed but you said you thought of putting in her food but she feeds it to the dogs. If they can be crushed still think coffee, with cream and sugar would work.
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P.S. what medication are you giving her that works do well? Would really like to know for my mom. Thanks.
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Does she still drink coffee or yes? Maybe you could mix her medication in that? It's hot and will mix better. Hopefully she doesn't give coffee to her dogs.
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