Husband (85) who has dementia takes a large spoonful of pills and capsules. Does chewing meds hurt their effectiveness?

Capsules and coated tablets should not be crushed. They may be either time released or designed to dissolve at a particular point in the digestive system or they may be a bit harsh for the system.
Let his doctor know and discuss with the doctor or your pharmacist the fact that he is chewing the medications and find out if there are alternatives. Liquids, patches or crushable/dissolvable medications.

Yes, chewing some meds can effect how they work and how they interact and work with other ones. If he's chewing his pills and holding them in his mouth, then it's time to ask his doctor's if his meds come in a liquid form that you can put into a drink. Most of the time if pills have a line in them it means they can be split or even crushed up and put in food. This usually cannot be done with medications that are in capsule form. Talk to his doctors about liquid meds.

Every medication comes with its own Patient Information Leaflet. This leaflet will tell you whether chewing, splitting or crushing the medication is okay or not.

[It isn't only capsules which shouldn't be broken or opened - for example, some tablets are designed not to break down until they have got past the stomach, and these need to be swallowed whole too]

There are various ways to support someone who has difficulty taking medications independently. Is your husband happy for you to help him?

Your BEST source of information about this would be a pharmacist. Be sure to have the exact information about each medication that he takes. If possible, have the Rx bottle with you.

When mom was having difficulty swallowing, esp post stroke, I called the pharmacy these were ordered from. I knew some medications should not be crushed or chewed (hyperthyroid meds for kitties, was a big no-no), so I asked for the pharmacist there (CareMark.) It took a few transfers and a little waiting after asking, but the answer I got for one BP med was similar to one from againx100 (Some pills are extended release) Since her med was a capsule, I had asked if it could be opened, putting the contents into something like ice cream or applesauce. She indicated this was okay, BUT warned not to chew as this would negate the extended release.

I figured even if mom managed to crush a few of the contents (much less likely with ice cream, pudding, applesauce), at least she would get SOME benefit vs refusing to take them at all. Given dementia (likely vascular) and a stroke, keeping her BP under control was important!

I would definitely be concerned about him taking his medications this way. Not only concerns about chewing or crushing, but whether they are being taken correctly (i.e. right time of day, together, etc - some meds shouldn't be taken with others.)

If calling the pharmacy doesn't work, ANY pharmacist should be able to answer all these questions. Having the medication container is most helpful. as it would contain all the information they would need to provide the best answers.

(IF he needs to take these at different times and/or not together, get a timed/locked dispenser. Depending on how many different times during the day the medications should be taken, these can generally be set up for 1-4 weeks. Audible and visual alarms generally alert the user to take the medication. Only those needed at that time would be accessible. If any are the aforementioned time release capsules, you may have to intervene so that he stops chewing them.)

Pills that are not capsules can be crushed and added to a spoonful of applesauce, pudding, yogurt or whatever he likes.

The capsules are usually time released and may have to be prescribed in pill or liquid form.

Use a syringe to place liquids inside cheek and hopefully he will swallow.

I've never heard of someone taking their pills by the spoonful. Are you giving them to him that way? If so, maybe you have to dole them out 1 or 2 at a time with water so he can maybe be better able to just swallow them down.

Many pills should not be chewed. I think (not sure) that it can mess up your stomach. Some pills are extended release and the capsule or coating on a pill lets it slowly get into their system and have longer lasting effects.

Maybe ask the doctor if any of these pills come in chewable or liquid form. That could be a long shot, but I would at least try to look into it.

Some medications say right on the bottle not to chew. You can verify with his pharmacist which are ok to chew and which are not. Have you tried putting his pills in some applesauce, and feeding them to him? You can probably better control how many he gets in his mouth at a time, and hopefully he would just swallow the applesauce and pills without chewing them. Towards the end of my husbands life, I had to give him his medications in applesauce, and for the most part they just went right down no problem. You can use ice cream, yogurt or pudding too. Good luck.

This is a good question to ask your pharmacist.

Some pills can be crushed, while others need to remain whole.

Would your husband understand this concept?