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For the last year, I have been filling a Sunday through Saturday pill box for my mom. She uses one in the morning and one in the evening. She takes them on her own and occasionally needs prompting. Recently though, I’ve been finding pills on the floor in her bedroom. I am concerned that she is missing doses, also that our dog may find them instead of me and ingest her medication. When I suggested that I start handing her the doses to take every day she got very angry with me. She does not want to be dependent on me. The reality is that she is very dependent on me for everything.


Any suggestions on how to navigate this touchy subject?

Mom had a programmable pill despensor that was set up with lifeline and worked through the phone line. I had to refill it and set up a schedule with the lifeline office. It would talk to her when it was time for her meds. She would press a button and the med cup would pop out. This doesn't work well if the patient has hearing deficit and spends time in other rooms of the home, however. A central location is best to avoid that scenario.
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Reply to lynina2
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Imho, check her vision. My late mother was a legally blind woman demanding to live alone (until there was zero choice except for me to move in). She also had the weekly cassette boxes, but was dropping pills on the floor, too.
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Reply to Llamalover47
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I would tell her that you have found pills on the floor and you worry about the dog accidentally eating them. Discuss that maybe "we" should change things a little to prevent _________ (insert name of dog) getting poisoned.
Suggestions changes: Watch as she takes the medication to make sure none falls on the floor (I have no memory problems, but occasionally a pill goes wandering and I have to sweep the floor to find it). Have her open the "door," put a little cup - like a Dixie cup - over the opening and "pour" it into the cup (upending it) so it doesn't end up on the floor. Make sure she takes her medication with a big glass of water. Afterwards, please check to make sure medication doesn't stick in the pill box of the "medicine cup."
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Reply to Taarna
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When I was caregiver for my mother and now my husband, I say nothing, but I hide the weekly pill box. Then in the morning with breakfast I bring a very small white plastic glass with the pills in it and make sure they go from glass into mouth not hand to mouth. If any fuss about it, I say little only “that is what the doctor said has to be done”. Then walk away. Hold firm. Say little to nothing. I do that with my husbands pills and eye drops. “I have your (pills or eye drops)” and administer. It then becomes normal there after. Hide or lock up, all the pills as well as anything else that can be dangerous as you would with a child.
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Reply to Marylepete
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"I do several weeks at a time but only sit one box out each week." This is okay until she forgets what day it is, or that she already took them, etc. Mom was already using those, but still managed to take extra or not enough. Those kind can be opened at any time, and if you aren't living in the same house, how do you know when they were actually taken (or even if they were taken, not dropped or tossed?)

We moved to a timed locked dispenser, with all the alarms, and even then she was missing them (but it was VERY easy to tell.) Next was to hire aides 1hr/day to check on her and see that she took the meds (they can't dispense, but can check and point it out.) Less than 2 months later she refused to let them in. Plan B was MC, where they use those medication cups with a small glass of water, and they wait until the meds are taken before moving on to the next resident. It can take some coaxing there - I'd seen mom question the aide, despite having taken these meds for most of her adult life! Thankfully she wasn't like some, who would adamantly refuse.
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Reply to disgustedtoo
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My mom was forgetting some pills and skipping or taking extras. Her doctor made the decision for me to fill and dispense her pill boxes. I do several weeks at a time but only sit one box out each week. The extras are tied up and placed on top of the fridge against the back wall. Mom cannot even get close. She does not like the situation but she complies.
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Reply to InFamilyService
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Make it all about the health of the dog rather than her dropping pills, etc.

My dad did an ingenious thing for my mom's meds. He got those little pleated paper cups you put ketchup at a fast food place, and put Mom's pills in those. The smallest ones fit perfectly into her pill box, so he just took out the whole cup and handed it to her to pour into her mouth. Half the time she insisted in pouring them into her hand, then putting them in her mouth -- resulting in dropped pills, but the pill dropping decreased a great deal.
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Reply to MJ1929
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NeedHelpWithMom Nov 20, 2020
That’s so smart! Those little cups would be great! That’s what they use in facilities. Why not at home too?
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Mom was like that with me when she lived in our home.

It’s a situation of our parents wanting to be independent and with my mom, a touch stubborn too!

My mom has Parkinson’s disease so she is losing fine motor skills to handle small pills.

I found pills on the floor too. I was concerned about her missing her meds and about my dog.

My mom and my dog were best friends so I told her that I did not want the dog to get sick to encourage her to make sure that she got every pill in her mouth. She loved my dog!

I would stand by her to make sure the pill went into her mouth and not fall on the floor. She felt independent and I knew she took her meds and the dog would not accidentally eat a pill.

Mom is quirky. She didn’t care if I handed her the pill but she liked putting them in order lined up for the day. She couldn’t use a pill box. She didn’t have the fine motor skills to remove from a pill organizer so she would line them up in this large shoebox lid that she kept.

Even though I had instructed mom not to feed my dog, she did it anyway, so naturally the dog loved her! She snuck him treats.

She would lie to me and tell me that she hadn’t given him anything but he would throw up some of the food. She still denied it. LOL
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Reply to NeedHelpWithMom
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I've been through this exact thing and have some things to say regarding well-meant answers I've read here. My mom is insistent she do everything herself. Like your mother, she does not want to be dependent on having someone else give her the meds she needs each day. She began to double dose herself because she couldn't recall whether she had taken her pills or not. The next day, she wouldn't take any pills because we told her she'd double dosed and that was dangerous, and we (my siblings and I) offered once again to help with her meds. She balked, as usual, and refused our help. How many times she said, "I can do it myself," I can't count. After much discussion, reading, and speaking with her caregiver (who also tried to help with her meds) and a doctor, we purchased a $375 pill dispenser. It did everything ... told her when to take her next dose by beeping until she took them ... when her next dose was due, etc. We explained the whole thing and she appeared to be fine with the idea. Fast forward to the next day - she took a hammer, screwdriver and kitchen knife and broke the dispenser apart, took out all the pills (a month's worth), and attempted to write down when to take each pill (in spite of a giant Alzheimer's clock on the wall that tells the date and time that she refuses to use). The pills were all over the kitchen table, and her "method" of when to take each pill was so confusing she couldn't tell the when, what, or why of what she had done.
We finally stepped up, took away all of her pills, and as calmly as possible explained why we were taking them. She was so embarrassed and confused by what she had done that she finally agreed. Her caregiver is responsible for most of the pills now. On weekends we give them to her ourselves. Ours was an expensive mistake, minus the $375 pill dispenser. If your mom isn't as stubborn as mine and her dementia isn't as advanced as my mom's is, a pill dispenser may work for you. But if you are there to give her meds to her each day you may not need a dispenser. Just do what one commenter did - take them away from her ASAP, and do not take no for an answer. She may be upset, and/or mad, but too bad. After a while, she'll likely forget the whole thing. If she doesn't, just keep giving her her pills. You don't need to explain why every time. Think of it this way: You are now the parent and she is now the child, the End. Good luck!
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Reply to DJTrotter
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NeedHelpWithMom Nov 20, 2020
Great solution!
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A friend of mine had a box that would dispense her mom’s medication at certain times. Ask pharmacy or doctor about this.
My friend would load it up and it was good for a while.
All her mom had to do is take her meds when it came out.
All on a timer.
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Reply to THretired
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Do it anyway. Mom did not have dementia but days all seem the same and would get them confused. It will take a few weeks of complaining, but better than missed or worse yet mixed up doses.
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Reply to desert192
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Found it! It's called a pill-tipper, and it's an accessory stand for Pivotell medication dispensers.

The dispenser sits firmly on the stand, the compartment pops open with an alarm at whatever time, and the person then simply pivots the dispenser so that the tablets drop into the cup beneath.

It honestly does look foolproof (and shaky-fingersproof too).🤔

It is by no means cheap!!! 😠
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Reply to Countrymouse
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disgustedtoo Nov 20, 2020
We had one that depending on how many times/day meds were needed, could be set up from 1-4 weeks (mom's were daily, same time, so I could get her set for a month.)

As noted to another's comment, this isn't the issue. Mom is "taking" the meds, but not ingesting them or dropping them. OP needs to do what they do with my mother in MC - hand them to her in a little cup with a cup of water and WAIT/WATCH her actually take them. This may be a battle, but it is one OP will have to wage to ensure mom gets her meds, not the dog or the vacuum.
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Do it anyway. My mother gave me a hard time too. She insisted she’s been doing it herself for years and didn’t need my help but there were days she forgot and another day she tried to take them twice. When I found 3 different pills mixed up in the same bottle, that was it. I took them and hid them. I put out a little ceramic dish on the table and every morning before she gets up I put her pills in it. She fought me for about 3 weeks insisting she didn’t need me to do it. I just ignored abs kept doing it. The arguments have stopped when she realized she wasn’t getting anywhere with it. Do what you have to do.
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Reply to dgcctoth
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What helped my mom was a pillbox set that had a box for each day of the week with a compartment for dose times. She could then open the morning section and pour the pills directly into her mouth. This did decrease the dropped pills. I hope my description makes sense.
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Reply to MaryNTN
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disgustedtoo Nov 20, 2020
The problem isn't taking them from a bottle, it's taking them from the pill boxes OP has set up and then not always taking them or dropping them. IF OP could get her to pour them into her mouth, as your mother did, problem solved!

"...filling a Sunday through Saturday pill box for my mom. She uses one in the morning and one in the evening."
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Tell her that you're afraid the dog will get a fallen pill and if it happens again, you'll be handing her the pill.

As far as skipping a pill once in a while, well that's not going to kill her as most all Seniors are taking too many med's in the first place.
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Reply to bevthegreat
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You need to do what needs to be done regardless of her reaction. When my MIL, who was living with us at the time, started having similar med issues, this was one (of several) concerns that surfaced about the same time that convinced us it was time for her to move to AL.
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Reply to annandpaul1629
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I wouldn't worry too much about the dog. Remember how immensely superior dogs' sense of smell is to our own - his nose should tell him This Is Not Food.

Your mother got annoyed because (as she sees it, remember) she is taking her medication perfectly competently and already doing as you advised. She's not a child! She's not an idiot! Why are you treating her like one! (this is all mother's possible view of the matter, I stress).

It seems that the problem is arising between her opening her pillbox and transferring the pills to her mouth. Little/deep compartments, elderly (arthritic, numb) fingers, and teeny-tiny tablets/slippery capsules can all conspire to make accidents happen.

What I would *like* to do when supporting people with their medication is place the tablets one type at a time on a plain, dark-coloured coaster or saucer so that the person can see it, and can easily get hold of it. That gives them at least a chance to start with. I'm not allowed to do that. I have to open their blister pack and decant the whole px into an eggcup or similar, then allow the client (if the client chooses) to attempt to down them in one and chuck half of them down his shirt front. Or drop a couple in his tea. Or swat them up his nostril. Whatever. Oh the fun we have figuring out which has gone where...

I hate blister packs with a vengeance, I have to say. They are the devil to open for people with arthritic fingers, selecting the right compartment from the grid is not nearly as simple as you'd think once you turn the tray over, and the compartments are often quite deep, the plastic creases, and then that Apixaban is going to stay wedged at the bottom forever. They may save fiddling about with half a dozen assorted boxes and remembering which is for what time of day, but those are the ONLY problems they solve.

There is quite a range of pill minders and electronic dosette boxes out there, though, including some which automatically decant the tablets into an appropriately sized plastic cup (like the ones they hand out in hospitals). Might that help?
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Reply to Countrymouse
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jacobsonbob Nov 20, 2020
True regarding the dog, but the OP's mother doesn't need to know that! As long as the mother believes this, the more likely she will be willing to cooperate.
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Talk to mom and let her understand the importance of her medicines. Be patient with mom and keep helping her to understand she needs your help.
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Reply to haileybug
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You can get her pills packed in blister packs that you aren’t counting out for her each week. Find a pharmacy that does this, it is at no additional cost. My mother’s pharmacy even delivers to her assisted living facility once a month. Begin a new habit of her sitting at the kitchen or dining room table to take them. Have a placemat on the table to help catch any she may drop.
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disgustedtoo Nov 20, 2020
Depends on how her current medications are provided. Mom's plan uses CareMark, and she gets a 3 month supply of pills in a bottle for $3. When we moved her in, she had some for the initial move and a full 3 month supply, yet they ordered those blister packs anyway. I asked about managing her medications myself, before the move happened and they were okay with it. Somewhere along the way, that wasn't communicated. I wasn't aware of the order until they handed me her mail on a visit. They told me they had given her the mail and she went ballistic! Her medical plan is AWESOME and she rarely pays for anything other than the minimal co-pay on the meds.

I told them to send the medication back. It was a running battle for some time, as new people weren't getting the info. I saw the bill. It was several hundred dollars, most likely for a one month supply! I also had to pay them a "restocking" fee, which I objected to - WE didn't ask for the meds! When I paid that fee, I wrote them a letter, as mom's DPOA and said DO NOT fill any RX without my okay. Even that wasn't enough. It still took many calls to finally get this sorted out!

But, the point is these may not be cheaper, and I don't see how this solves the problem OP is having. Sorting the pills into any type of dispenser isn't that big of a deal. It's getting mom to actually take the meds, once removed from the dispenser or blister pack. When mom still lived in her own place, recommendation was a timed locked dispenser, but sometimes she didn't see it or hear it (it had alarms and flashing light.) I hired 1hr/day aide to check on her and check her meds - they can't dispense, but they can point it out if she missed it. Sadly less than 2 months later she refused to let them in. So, plan B - MC. There they bring the meds in the little cups with water and wait for it to be taken (some coaxing may be required!)
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I think just a gentle appoach again. "Mom, I love you very much. I want to be here for you, and I know that losing control of things is a fear; you like to take care of stuff on your own. But I have found (say here what you have found) and this is a danger for you, even for our pup if he were to get your medications. I know you don't believe me, but I want to tell you I would not lie to you, and I do not want to hurt you. It is time now that I manage with you your medications. If we can't work together through this then I can't continue to be a support to you, as it would endanger you and I can't allow that. It is awful, but it is now me, or the med nurse at a live-in long term care facility. I understand how hard this is for you; it would be for me, as well. And no one wishes more than I do that we didn't have to have this conversation. But we do".
You are looking now at dementia coming, and the fight against losing control will be dramatic indeed if there is denial. This is the beginning of loss upon loss of all control and dignity and our elders KNOW this. Nevertheless, some things cannot be changed, cannot be made happy, cannot be fixed; they have to be lived with. Hard times. I am so sorry.
I am not saying the above will work. With a mind that is slipping often NOTHING but the medication nurse DOES work. My bro fought like anything to stay in control; it was the worst of it all for him.
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