MIL refuses to take meds as scheduled. Any advice?

If she's mentally capable I don't think there's much you can do ... she'll eventually overdose and pass away. I cared for my mother in her home for four horrendous years before she went into a nursing home. Then I had to clear her house and get it ready for sale.

During those four years I never went through her cupboards or anything ... I was a mere servant who lived in the cold, dark basement, just there to be used and abused. When I cleared the house I found pills stashed everywhere ... gathered them all up and took them to the pharmacy to be disposed of.

You say "Goodbye". That's your choice, but you need to dump MIL and you know it as well as we do.

VIrginiaDIL has apparently decided not to post anymore. But it's a good example of an elder needing to be careful who you have as a caregiver. The adult married son is unemployed and needs housing (so moves his family in with Mom). DIL took over the Mom's narcotics--a major power position. MIL-DIL relationships are difficult enough, never mind with DIL controlling MIL's narcotics. OMG. This family needs professional help as in hospital social worker or nurse case manager. DIL should NOT be putting herself in a position of being suspected of consuming/selling the meds and MIL should not have to tolerate this type of control from the DIL. DIL needs to find other housing, pronto. Highly dysfunctional situation. Sad to see this.

My husband has severe stress-based fibromyalgia. It is extremely difficult for him to deal with her without it causing him to flare such that he can't get out of bed.

MIL has rickets. After many surgeries on her hips, knees and back, she got staff and lost one of her legs. Her pain is due to a phantom leg and a rod in her back. We live with her because she had no other blood relatives to care for her, she cannot manage her money and because my husband hasn't worked in three years we have no where else to go. She did say she was going to stay in a nursing home once, but checked herself out after about 9 months and stayed with her brother for three weeks before we found out. No one called us; we found out because we called to ask a question about some of her insurance paperwork.

She failed her pill count today with the pain doctor because she managed to break into her medicine while I was out of town. If she misses her pill count again, her pain doctor will drop her.

I appreciate those of you who took the time to read my posts or who tried to help me find some solutions. I will not be posting here anymore. Good-bye.

I have to say I really sympathize with you, Virginia. The fact that left to her own devices she will and has overdosed puts a big burden on you. I don't have any magic answers but I do have a few questions for you:

You say that other than her addiction to pain meds, MIL is fairly healthy.

1) What are the pain meds for? What causes the pain?
2) Why is she on a low-protein diet? Often that is for kidney or liver disease. Is that the case for MIL?
3) Why are you in this caregiving role? Could she live on her own? Aside from the pain meds, can she take care of herself?
4) Where is her son (your husband) in all this?

I've seen a little of pain-pill-addiction behavior, and frankly, no matter how much I loved the person I don't think I could handle it. I have a lot of skills and strengths and competencies, but dealing with someone addicted is not among them.

Sometimes it is just best to admit our own limitations and withdraw from situations we can't handle. If MIL went into drug rehab and got her pain manged better, perhaps then you could handle it. Or maybe you can handle it just fine now -- I just know that I couldn't.

(And I certainly don't mean this in a judgmental way. I am NOT saying MIL is a bad person and I wouldn't want her around. I am just admitting my own limitations in not knowing what to do in this kind of situation.)

What is the source of her pain?

Is she being seen by folks who specialize in pain management? Are they concerned about addiction? Has she been evaluated for addiction, for cognitive difficulties?

It sounds as though you and she are in a lose/lose situation. She's still in pain and you are close to burning out, as would anyone in this situation.

I'm also curious where your husband is in all this.

You need to go with her back to the pain docs and ask for better solutions. She may need an antidepressant added. She may need accupuncture. She may need mindfulness training. But this situation can't go on.

Virginia I am very sympathetic to your situation. I stayed with a girlfriend 40 years ago after she had back surgery. They had her pain meds (she was in the hospital) scheduled every four hours. She'd start crying and begging me to go get the nurses after about two hours for more meds. Of course the nurses wouldn't give her any meds until the scheduled time. I would literally hide in the hall, because I couldn't stand listening to (and watching) my friend cry from the pain. It was awful for both of us.

I don't have great answers, other than to get your MIL into a facility so that professionals can deal with her. If you can't do that, then I'm just here to say I sympathize. It's tough! If you're a caring person, it's hard to watch someone else in pain begging for your intervention.

If all you wanted to do was follow orders, why did you ask?

I don't know what else to say except her pain doctor sees her every month and they haven't adjusted her meds. The ER doctor told me to make her eat if she wanted her meds the last time she overdosed, which she absolutely will do if given an opportunity. Her PC told me to get her to eat before she takes her meds, no matter what. I'm not withholding her pain meds any longer than what the label says. If it's every six hours she gets it every six hours but she has to eat first. I'm doing what her doctors told me to do. Trust me, my house would be more peaceful if I just let her have it every hour when she wanted it, but that would be reckless. She goes back to be evaluated tomorrow. I told her to tell them again that her pain is too severe for her dose. If they change it, great, if the don't I have to follow her doctor's orders.

A lot of times, when my parents were prescribed meds, I base it on what I was told by the pharmacist. Because I have no POA, the doctor doesn't discuss anything or the meds with me. Instead, I'm given the RX and told to pick it up at the pharmacy. I go to the pharmacy, and base it on what is given to me on that little sheet of paper. The rest of the time, I have to Google how to use the meds.

I have always taken pain meds with food. If I don't, it causes me stomach pain. I don't know of any other way of taking meds - unless someone tells me otherwise. Motrin - if taken without food - can causes bleeding of the stomach. Yet it doesn't say 'take with food'. It gives you the Option of taking food. When my dad is in pain, I insist he takes some food before taking the Motrin or Tylenol.

Virginia, I've learned now that when I pick up prescriptions for my dad, to ask questions with the pharmacist. I have a list - and ask her. Can he take it with milk? with herbal supplements? with food? without food? etc.... I think you need to contact someone - doctor, nurse, pharmacist for advice.

Dad's appetite has changed. One day he loves this food, the next day, he doesn't. You need to find a variety of food and give tidbits throughout the day. You can do a search on the top right of this page. There have been many questions on how to get a parent to eat when they are not interested in food.

Why are you withholding her pain medication? We simply cannot know how much pain another person is feeling. A nurse or doctor should be the one to decide her dosage. You simply are not qualified.

Making her eat before she gets pain relief sounds like torture. Why are you doing this to her? Please do not tell us that her doctors tell you to withhold her meds until she eats. I will not believe you. Narcotics are powerful appetite surpressants.

If the time between doses allows the pain to break through, in my opinion, she needs to be re-evaluated by a professional.

She's not all that close to death. She refuses food because she says nothing is appetizing. (Then I start offering her foods and she picks one but she almost never eats what we prepare for her the first time within a special low-protein diet that she's supposed to be on. She feeds it to the dog and demands something else.) Other than being addicted to her pain meds, she's in fair health. She's obstinate with her pain nurse as well, when the she requests more meds and the nurse won't let her have them at their visits. She's on a highly controlled substance and is supposed to submit to monthly pill counts and so forth but she breaks into her meds anyway and tells me I'm just being cruel if I won't let her have them when she wants them. But close to death, no...she's not close to death at all.

If she is refusing food and water, she is close to death and probably in a great deal of pain. Have you considered getting Hospice in the picture?