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I wondered if this would happen and now it has. My LO has dementia. AD is suspected. She has an appointment with the neurologist tomorrow. I assume he will order a brain scan. She takes meds for diabetes and bone problems.

Until recently, my LO (cousin age 63) was cooperative and took her meds with no problem. Lately she is refusing to get out of bed and to take her medication. The staff calls me and puts her on the phone and I convince her to take it.

She says she wants to quit her job and she doesn't want to do it anymore. (She thinks she works at the ALF and is going to work when she gets up in the morning.) I tell her that it's up to her if she wants to quit her job and that if she will get dressed and take her meds,, she can relax and watch tv all day if she wants. That seems to appease her and she then gets dressed and takes her meds.

She knows she is causing a problem, because she admits to it. Although, she forgets most everything, she remembers enough to tell me she wasn't cooperating and she feels bad about it.

What do the staff normally do with patients who refuse to get out of bed or take their meds? Do they ask them to leave? How do I get her reassessed? Maybe she needs to enter a Dementia only facility? What do they do in Dementia Units to get them to take meds or to get out of bed? I have a business to run and can't be called from my job continually to deal with her refusing to cooperate. I'm about ready to turn over her care to the state. There are no other family members to help with her and she is gradually becoming more uncooperative. Any suggestions would be greatly appreciated.

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Mom gets an anti-anxiety med (Xanax/alprazolam) twice a day and an antidepressant SSRI (Zoloft/ sertraline) at bedtime. The Zoloft was increased from 20 to 25mg They also increased her beta blocker, Metoprolol, from 25 to 37.5 mg twice a day. Stick with the Neurologist's recommendation. Expect some trial and error. Too little and they are angry, too much and they are dopey.
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Pamstegman,
What behavior meds are you describing? That sounds promising. Should I ask the neurologist about it tomorrow or does the GP handle that?
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Thank you for your comments.

I'm going to see what the neurologist says tomorrow and then ask for a reassessment. My LO, who is actually my second cousin, was doing pretty good before she took a fall. She's been in pain since then, and so it could be that is causing the failure to cooperate. I suppose it's worth it to see if she improves, once her spine fracture heals.

Also, the GP put her on a mild anti-anxiety med yesterday, so that will kick in today. Hopefully, it will help too.

I have located an excellent Dementia Only facility that is located in a great location, but they will not accept Medicaid patients for at least a couple of months. My cousin is on Medicaid and if a facility accepts Medicaid residents, they have to take the patient for what their income is minus $66.00 per month. The state pays the rest to the facility. The facility has to accept this a full payment if they accept Medicaid patients.

The ALF where she resides now is full of dementia patients. Many are not communicative, most are in wheelchairs and most do not function nearly as good as my cousin does, so I 'm not sure what their criteria is for being too advanced in dementia. The place also has a Nursing Home next door, but that is for people who cannot get out of bed. She is fully functional or she will be when her back heals in a few weeks.
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Assisted Living has no way to force a resident to eat, bathe take meds or even come out of their room. AND if she goes to the hospital, they are required to re-evaluate her before she comes back. That's state health law.
Mom fell, split her knee, went to the ER and the head nurse said she could not return to the ALF. The ER wanted to discharge her to us. We said NO WAY, and we left the ER. So the hospital was forced to keep her. She was non-compliant and fell again there. then she was transferred to rehab for a week. They had to keep her at the nurses' station the first day because she was yelling and throwing stuff. Her behavior meds had to be slightly increased. Finally she was able to walk enough to get back to assisted living and willing to play nice. One day at a time.
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It is AL, not a NH, Maggie. People in AL aren't hand fed. Meals are provided in a central area. Staff help with some things, e.g. cleaning once or twice a week and giving pills at certain times, but not with more complicated things. The staff at AL (or other places) cannot make a resident do anything. They can just assist them in doing it.

Sunnygirl, it may be that your mother can still be in AL, but in a memory care unit. We have two in within 10 miles of me, so I imagine that they are in most cities. They are not as restrictive as the heightened care of NHs, but have staff who are trained to deal with the trials of dementia. The bad thing about these facilities is they are expensive. If your mother can afford it, it is something you may want to look into. It may be simpler to move her to a memory unit of a NH if there is a nice one around. I don't know how incapacitated your mother is. A reassessment of her skills may point you in the direction to go.
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What? They can't hide her pills in her food? Or in a little serving of apple sauce? If she's taking insulin by injection, can she take it with a patch? (I have no idea.) Can her medication be liquid? I'll tell you what, they can keep their "bone pill."

In my opinion, this is failure of staff. I'd figure, if mom were in a nursing home and I were paying $8,000 a month (what it costs at the facility where she'd be placed), they'd better find a way to get her to take her pills or make suggestions on what I should be doing to solve the problem.

Some suggestions THEY ought to have come up with:

When the nurse first begins dispensing meds, the goes into her room first and tells her, "I'll be back in 15 minutes to give you your pills. How does that sound to you?" (Mom, at least, always says it sounds good. That's her warning bell.)

Keep an individual serving of applesauce with her pills, put them on a spoon, and administer them that way.

Promise her a small treat after she's taken her meds.

Offer to have her escorted to wherever after she's taken them. (The garden...the dining room...the gathering room.

Have a different staff member than is currently doing it administer them. Maybe your mom doesn't mesh with him/her.

This is their problem to solve. If they think some anti-anxiety meds would help? Or a very mild tranq would do the trick? They should discuss that with you. For $8,000 a month? You'd better find a way. I'd discuss this with the Managing Floor Nurse.
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It sounds like she is beginning to need more care than the AL or you can provide. If the AL comes to the conclusion that she needs more care than they can provide they will have a meeting with you to discuss her options. Probably a nursing home.

Is there a social worker at the AL? She would be the one to go to for a reassessment but if you're already thinking that your loved one needs more assistance the reassessment will probably agree with you.

In a nursing home or memory care unit the residents are encouraged and assisted by staff in getting up in the morning.

Staff in a nursing home can be very persuasive in getting the residents to take their medication. Maybe if the responsibility isn't on your loved one anymore to take them she'll be compliant with staff in a nursing home.

It doesn't sound like your loved one is being difficult, it sounds like she's just not able to get up and going by herself. She needs some motivation. You've been giving that to her but you can't continue to do it everyday. She'd get what she needs in a nursing home.
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