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karyll Asked March 2018

My mom has advanced dementia and just yesterday and today we have been having problems with her taking her meds. Any suggestions?

The one so important is for the blood thinner as she has had many small TIAs and think she had a worse stroke about 3 months ago. She doesn't have much of an appetite. We are only getting 6 hrs. care for help with her (not with hospice) but with hospice I think they want you to be very close to death, not taking meds, not eating, etc. to receive any help. I just called her primary care dr. who we are not crazy about but only one we have at the moment and don't know if this is the time to change drs. but thinking of it. My mom has trouble walking and she can't get up without assistance and requires 24/7 assisted care. This is and has been so draining, especially yesterday and today trying to give her her meds and she seems confused about how to swallow them. Doesn't have much of an appetite either. Gave her soup and she ate mostly only the broth. I feel very afraid as I don't know really what to do or what to expect. I thought perhaps she has a UTI as I know this can cause confusion so we are having her urine tested for this. If she doesn't have a UTI don't know what to do. My brother thinks she will have a stroke without her meds and he doesn't want to see her go through another one. I am so sick over everything and haven't had a day and night to myself for close to 5 years now. Anyone know what will happen if she doesn't seem to understand how to take her meds and really, she has been giving us problems about her meds for so long now as she hates to take them anyway; a draining experience giving to her, but this time seems different as she can put the pill on her tongue but doesn't know what to do after. Even after she takes a drink to swallow, she at times will not try to swallow and just lets the drink go down while the pill gets soggy and she refuses to take it then as it is bitter. So at times, we get another pill and today went through 3 of one pill just to have success for it to go down. I love her dearly but this is no way for her to live her life. Thank you.

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K
karyll Mar 2018
My Mom seems to have good days and bad ones. After that incident she has been able to take most of her meds but at times she doesn't want to take them. Her doctor has said that if she doesn't want to take her meds then don't let her take them. We have had the vna here more than once to see if she qualifies for hospice and with them she has to be close to dying in order to get any help. She ate pretty good today and took most of her meds. This is a most difficult situation for me as it is so hard to see this once beautiful woman who was always there for me turn into someone who can't do hardly anything for herself without any assistance. She is able to eat and drink alone. Vna said she would have to be not taking her meds and not walking and not eating to qualify for hospice. This whole thing is so depressing! A nursing home was mentioned again today and as usual my mother said no, she doesn't want that. She has always been a wonderful mother and always been there for all of her children and at least 2 of her children want to be there for her. But it is very exhausting, both mentally and physically. We do get 6 hours of care/week but that really isn't enough. Have been told she could still live for years and even her dr. said she could go another 5-10 years, which we are in doubt about that. Thanks for all of the replies. I will relate some of the information to my brother.
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karyll Mar 2018
My Mom seems to have good days and bad ones. After that incident she has been able to take most of her meds but at times she doesn't want to take them. Her doctor has said that if she doesn't want to take her meds then don't let her take them. We have had the vna here more than once to see if she qualifies for hospice and with them she has to be close to dying in order to get any help. She ate pretty good today and took most of her meds. This is a most difficult situation for me as it is so hard to see this once beautiful woman who was always there for me turn into someone who can't do hardly anything for herself without any assistance. She is able to eat and drink alone. Vna said she would have to be not taking her meds and not walking and not eating to qualify for hospice. This whole thing is so depressing! A nursing home was mentioned again today and as usual my mother said no, she doesn't want that. She has always been a wonderful mother and always been there for all of her children and at least 2 of her children want to be there for her. But it is very exhausting, both mentally and physically. We do get 6 hours of care/week but that really isn't enough. Have been told she could still live for years and even her dr. said she could go another 5-10 years, which we are in doubt about that. Thanks for all of the replies. I will relate some of the information to my brother.
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suzeeQ Mar 2018
This is a tough one, and the consequences so dire. Things are just so much more awful without their meds. We used to crush my mom's pills up and put them in applesauce. It worked pretty well. Good luck, hang in there.
Helpful Answer (1)
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blannie Mar 2018
You could also see if any of her meds could be dispensed by liquid that you squirt under her tongue or even put on in a patch. When my mom was on hospice (and I would think your mom is more than ready), the Ativan and morphine I gave her were both liquids. Very easy to administer to mom, even though she wasn't eating much at that point. Your mom sounds like she's coming to the final chapter in her life and in my humble opinion, pain management takes center stage. She needs to be on some kind of pain med that she will actually take. I'm not criticizing you or your brother - you in particular sound like a wonderful caregiver. Please let us know how you're doing.
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cwillie Mar 2018
Teepa Snow suggested using jam instead of applesauce with pills, it is very sweet and the pills are less noticeable because jam isn't smooth like applesauce.
And you shouldn't crush pills unless your doctor/pharmacist gives the OK.
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worried13 Mar 2018
I agree, pill crusher + apple sauce are your best friends. My MIL also will do the spit out on occasion, but for the most part applesauce or pudding helps it all go down better.
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BarbBrooklyn Mar 2018
Karyll; Do come back and let us know what the doctor says.
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Countrymouse Mar 2018
Karyll, did your doctor come back to you about what to do? If not and you can't call again until Monday, what about asking your local pharmacist's advice?

Your brother needs to understand that if your mother's chewing and swallowing reflexes are going haywire and she accidentally inhales some of her medication she could choke, or develop aspiration pneumonia. Firstly do no harm: if you're not confident that your mother is having a good day and will be able to swallow, then delay giving her her meds until you've had professional advice on what to do.

At some point, he and you will also both need to come to terms with the fact that even powerful medications can't prevent every stroke. It may happen again. The conversation to have with your mother's doctor is about whether the medications are really helping her, and what difference it will make if he decides to scale back her px.

I'm sorry for all the worry and tiredness you must be going through. Hugs of sympathy to you.
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karyll Mar 2018
I purchased a pill crusher and crushed a pill and put it into applesauce. When I gave it to my Mom and put it into her mouth with a spoon, she immediately spit out the whole mouthful, which was not large at all! Seems like sometimes she doesn't understand what I'm telling her and then other times she seems to follow along quite well. Today, she had many aches in the morning and would not take the pain meds so let her rest a little with her pains. Normally would give her the pain meds and let her rest until her pains were much less. When she got up for breakfast she still had the pains but she came to table to eat. Today she did take her meds, including pain meds after eating, but had to tell her how to take them, step by step. Some days she will cooperate, other times she will not. Lately, 2 days she gave much trouble, even after getting out of bed and eating to take her meds.
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BarbBrooklyn Mar 2018
Two thoughts, Karyll.

Find out if the blood thinner meds can be crushed and mixed into applesauce, ice cream, pudding or yogurt.

Regarding Hospice, at least where I am, it's not strictly for folks who are ready to go off meds and bedbound; it's for comfort care when all agree that acute intervention is no longer useful. Blood thinners would be allowed, I believe. Please call a hospice organization in your area ( a non profit one if possible) and see what they need from you in order to send a team to evaluate your mom for their program.

In our case, the doctor at the NH had to say that mom was hospice eligible; we had to request the evaluation and agree to accept the service.
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