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The sister comes by about once weekly (usually on the weekends when I’m not working) and visits with her (dementia) sister and the husband. The first day I worked at the home of my dementia patient, I went thru the medications and made a record of all the meds that have been prescribed, dosage, etc. when I opened up the pill organizer I found that it was completely disorganized (by the sister). It took me over an hour to get it set up correctly and I politely asked pt.’s husband to see to it that the sister not get involved anymore and I would be responsible for distributing the meds each week so that there are no more errors in proper dosing etc. he agreed. Today I come to work and once again the pills are messed up and this time she (sister) had one medication dosed at FIVE TIMES the prescribed dosage! (1/2 pill once daily... there were 3 whole pills laid out each day for morning, afternoon and night!! If that’s not bad enough, 2 of her other pills were omitted: blood pressure and thyroid. I’m absolutely furious but I don’t want to cause a problem or piss off the sister by telling her to mind her own business but this has got to stop and the husband isn’t helping matters. I think he is intimidated by the sister and is afraid to tell her to stop interfering but whatever the reason it’s not acceptable. This is a touchy situation and I’m not sure how to handle it. Any advice? Note: when I’m not there the husband gives my patient her meds as I have them properly sorted in the weekly pill organizer. Overdosing my patient is a serious concern since the husband doesn’t pay attention to the meds, he just gives her whatever is sorted in the pill organizer. You can see how the sister’s interference makes me very nervous.

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If there is a pharmacy nearby that packages meds in the "blister pack", I would get the Doctor to shift her prescriptions there. My mother-in-law's meds were done that way, and it was a HUGE help. I had to label the days with a sharpie because the lettering on the pack was too light and small, but overall, we were very happy with this arrangement. One month at a time, delivered. We had to hide her blood thinner, as that dosage varied and the pharmacy could not include it. I slipped it in myself as per instructions. Good luck, God Bless
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Takincare Oct 25, 2019
Much easier for all concerned and no reason for the sister to open packages unless to give a dose of meds. I like the idea of marking packs with larger writing too, making it easier for all to read. Some companies and pharmacies will do this free of charge or for a small fee. I would still only leave the weekend meds out and lock up the rest. At least if sister gets it in her head to open packs up and put in pill box she can only screw up the 2 days, not a months worth. What a can of worms you have going on. Hopefully this will straighten out as you work with the family and the wrinkles get ironed out. The medicine dispensary log is also a good idea. Let's everyone see at a glance who gave them and at what time.
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By the way - please log everything like that- date, time, event so it is clear that you were doing what you could. That includes chats with husband to confirm he just hands out, requests he inform the sister, noticed medication mixed up after sister visited,.... etc .
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Reply to DareDiffer
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Jendi58 Oct 23, 2019
Thank you so much ... good advice from you and all the responders. Thank you
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It sounds as though the sister may also be having problems mentally. That’s difficult for you to deal with. One suggestion to cope with this could be to have two pill dispensers, both sorted by you. One is for the days when you are there. The other only covers the weekends when you are not there, and you fill it just for each weekend. The bulk supply of pill bottles and the week dispenser get put away somewhere that sister can’t access. Husband has the weekend dispenser. If sister gets her mits on the weekend dispenser, there is a limit to how much she can mess it up.

You probably need to have a talk to husband to explain that perhaps sister doesn’t understand the pills, and that there are real risks to taking too many or not enough. That’s why you’ve put away the bulk supply and the full week dispenser. Husband may be intimidated, as you say, but he may not realise that sister has lost her marbles – or he may not be brave enough to have that difficult conversation with her. You say that this is how the doctor wants things to be organised, and that the doctor has given you responsibility so you have to follow doctor’s instructions. Give it a go!
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Jendi58 Oct 23, 2019
Thank you... very good advice and I thank you for taking the time to help me out.
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Are u from an agency. Maybe ur supervisor can call the sister and ask that she not "play" with the pills. That your aide is responsible for this and the agency answers to thestate. Can u get the pharmacy to give blister packets.

I like the locked cabinet idea. Also, the locked dispenser.
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Reply to JoAnn29
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Start taking pictures. You need one of all pills in their bottles as a “list”. Then one of each pill next to its bottle to identify it. Then take a weekly picture of the pill container as you left it and a pic as you find it when you come back. This way you have proof of what’s occurring. If the husband won’t stand up to sister he likely won’t stand up for you should the sister place blame on you. Sister could have dementia starting and/or could be taking some of the pills herself. Pill bottles should be in a locked cabinet or drawer and husband keeps the key when you are not there. Blister pacs would be ideal. And if you have a supervisor or agency they need to be made aware immediately. You need to best protect yourself here as well as your patient. This is not a nuisance issue, this could be life threatening to the patient. It could cause injury to organs leading to organ failure or worse. You should make the doctor aware as her bloodwork may shown changes as a result of missed or over dosages. Not sure how doctor could step in, but maybe that would bring in senior social services. Keep asking husband for help. He’s likely overwhelmed but his help could likely control/ stop the sisters interference. Good luck.
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Caregiving2 Oct 25, 2019
And to clarify- a picture on a cell phone which would have a date and time stamp.
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I love the locking dispensers with the timers. I also agree with the respondent who said to photograph everything. Document, document, document!!!
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Reply to MaryMagen
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Document and call your agency to report this at once. I would lock up the meds and only you and husband have access, if things do not improve tell husband to get someone else. Sister sounds like she has major problems mentally. Your agency should support you and help with the situation, if not I would find another agency. This is not safe and could come back on you. Hope things improve.
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Reply to earlybird
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Preferably need a locked cabinet that only you and the husband have keys for!

Get them an automatic pill dispenser – this beeps when it's time to take the medicine and a small opening allows access to the correct pills at the right time

Rather than a “confrontational” situation - design a leaflet on PowerPoint and a poster

A reminder that only the husband and (your medical title) should be dealing with her medication as agreed.

Mention re medication in incorrect dosages can have fatal consequences

State that it has been noticed the medication had been interfered with and if not observed WOULD have caused death of the patient.

State that the medication has been preprepared with the correct medication per day for morning, afternoon and night. These should NOT be altered under any circumstance.

Put a tabled sheet per week re Monday, Tues.... morn, afternoon, night and space for initials of person who hands out each dosage.

You are doing your job correctly - therefore the husband (and sister) need to know it’s being monitored and concerns raised.

Best of luck - let us know how it goes
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Google "Locking pill dispensers".
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Reply to katydid1
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Explain to “medicating sister” that administering meds is one of your duties and it needs to be done accurately. Let her know she has made errors in preparing the meds for your patient that could lead to overdosing. Remain calm as she goes off. Talk to husband about purchasing a lock box for the medications and place in a location with limited access
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