Mom argues with me about her medication. She swears she took it, but the pills are still right there in the little dish I set out. Advice?

Difficult.

We paid caregivers have very strict rules when it comes to medications, and it's far more common for people to get stroppy with us because they think we're being obstructive than to worry because we're too cavalier. But anyway.

One rule is that we may not dispense medication for the client to take "later." We dispense, we pass, we observe, we record. If the client changes her mind after we've removed the medication from its container and decides not to take it, for example, it's a major pain in the behind - lots of paperwork!

But there are sound reasons for the protocols, and you've highlighted one. Don't leave medication out for her to take because it leads to confusion, uncertainty, ambiguity - all very bad things in the context. Either wake her up and give it to her with a nice drink, or leave it for the caregiver to handle.

A bit of formality might make your mother more compliant, as well as reducing the chances of getting it wrong. Use a proper chart and record what's given. If you Google "MAR chart templates" you should find plenty to choose from.

Old folks are being forced to take too many pills. I agree with another comment. Perhaps some of these can be eliminated from the regimen. People in their eighties and nineties are not going to have their lives significantly lengthened or improved by most of what doctors want to do to them.

My Alz. mother went through this same issue, refusing meds and hiding them, even pretending to put them in her mouth while palming them. Yep!

I found many little bags of pills in her room hidden at the bottom of stuff, probably weeks and weeks worth of pills. Apparently, she didn't die from not having those pills. So, finally I stopped caring whether she took them or not. I asked her doctor to review her med list and eliminate all except the 'must take' meds. Before she was taking 8 to 10 different meds, not counting vitamins, and eye drops; now, she's down to 2 meds which I crush and put them in her drinks.

No more arguments.

I had the exact opposite problem with Mum. I used to have a weeks worth of tablets sorted into seven daily boxes and further sorted into breakfast, lunch, evening and bed-time boxes. This worked for a long time, but then she would take the pills designated for a particular time, then forget she had taken them and go and take the next lot or tomorrow's as well. This meant sometimes she was overdosing, sometimes she wasn't getting any. And she always blamed me if a box was empty, saying I hadn't sorted them out correctly. She would never accept that she'd taken too many. I was forever ringing the NHS helpline for advice, as she takes morphine, warfarin etc.

In the end I bought a timed dispenser, You can set it to dispense up to 6 times per day and only the the tablets for that time are accessible. Everything else is locked securely away. This way I can tell that she's taken them (there is very occasionally a tablet left, which she has missed), but the important thing for me, is that she can't get to the others.

DH aunt, 95, with dementia, not taking her thyroid tablet was when I knew she was going to have to have extra help.

I used logic to help her understand she wasn’t taking them by comparing the number of pills left over to the calendar days left before a refill was due. Lot more pills left than days until a refill. That was early on. That pill was so important, had to be taken on an empty stomach, no food or sweetened coffee for 30 min etc. She simply couldn’t remember she hadn’t taken it. It’s like you said, she had taken it so often, it seemed she had.
She did understood that she hadn’t (couldn't have) because of the math. We went on for years with the pills being a bit of a struggle with one solution working for awhile and then no longer working as she further declined.

The last thing I tried that still works for me is giving the pills in separated batches. They weren’t as intimidating to her. She would have forgotten she had taken the first batch and so was agreeable to the second one as it was just a couple of pills I would say to minimize the importance.

I have always refused an am/pm dosing as she had no one to give evening pills to her in earlier days. Occasionally she had an antibiotic that required an evening pill. Twice a day might be ideal, once a day may be sufficient. I never had a problem getting the doctors to prescribe this way. But not everyone’s health issues allow.

Tothills suggestions are good. At 98, I would want to know which of the pills were absolutely necessary and why and offer those first. Then I wouldn’t sweat the small stuff. Some can be crushed and added to a favorite food but when she doesn’t eat the food you just have to let it go and try something different. DH aunt needs to take Metamucil powder daily. She would struggle with getting that down. Now we just stir it in her coffee and no more struggle. If she doesn’t drink her coffee that day, it’s ok. She will drink some tomorrow. It’s what she does most of the time that matters.

Your mom has lived to 98 and has obviously done a lot of things right to have done so. Try to let the worry of it go. I know it’s hard to do but sometimes we forget that they are in decline and things will change regardless of what we do.

I recently listened to a podcast where I learned that aricept slowed the pulse! I was so upset about that because for years we had to adjust her BP tablets daily to keep her pulse at an acceptable level. When she came off of the aricept the pulse went up to a level high enough we could give the same BP meds routinely. She is on hospice for dementia. We know Aricept won’t cure it. We had considered that it slowed it and perhaps helped keep her moods stable so her geriatrician continued to prescribe. When I found that what it truly slowed was her pulse I felt so foolish. Here I was worried about a possible pacemaker when all I needed to do was stop giving a pill that didn’t work anyway.

Each persons situation/health concerns are different but when you start noticing you are having to argue or persuade, it’s time to change things up. Its a fine line. We work to keep them well taken care of but when they push back it’s time to regroup. I hope you get some suggestions that help.

I am going through the exact situation w my 91 yo father. Says he takes them and too many doses are gone or no dose is gone...
Really though think about this:
They have a fatal brain disease. So if he gets too many of one or none of one, they still have a fatal disease..that will end sometime soon. We took my dad off cholesterol meds as he was extremely lethargic and unstable in that one. Lipitor made him even worse with his dementia.
Ask the doctor which ones can be taken away and look into palliative care.. just keep him safe from injury and let his body continue the fatal process... Many times we think we are doing them a favor by prolonging the inevitable. We all are going to die.. why prolong it with heart diagnostics, Expensive scans, and non life saving procedures when dementia is going to eventually take them...
Spend each day enjoying the time left, stop arguing and just do puzzles. Listen to music or chat. No more struggles , just peace and loving times. Who really cares if they took their cholesterol or blood pressure pill.
Signed, a nurse who wants to make the best of the final days and months. Praying you find wisdom and peace.

I always stay and watch my dad take his pills. I say, let me watch you take them so we can both remember that you took them. Then I have a little chart on a dry erase board and I put a check mark while he watches and we check off each time he takes them. Then if he ever forgets he can look at the chart and see if he took them or not.

Started with the 7 day pill holders. She would argue that Friday was Tuesday, etc, so I switched to giving one day at a time. Then she’d argue the time of day. As I could only be there 2 of 3 pill times, I tried hiring a PSW, to witness the morning pills. She furiously fought having a PSW, although the woman was wonderful. Pills had to be witnessed because, while cleaning, I had found pills tucked in odd places. Behind a photo frame, in a cupboard, in a stack of papers, in a tea cup, in an envelope... I asked her why she hadn’t been taking her pills and she informed me very matter-of-factly that, had the Dr. wanted her to take them, he’d have explained that to her himself, in person. Fortunately only the levothyroxine is life critical.

After telling me for years that she is fine and I am the one with cognitive issues, a medical crisis landed her in the hospital where she was assessed as having advanced dementia. She is in respite care, waiting on a NH room.

I know exactly where you're coming from. I argued and fought a battle that I could never win. It was also a case of taking too many tabs or not taking any at all.

My mom has been on high blood pressure tablets for years. She will still tell a doctor that she takes her tab everyday but this has not been the case for almost 3 years now. I will tell the doctor on the side that this is not the case.

I was given the advise and decided to buy a BP monitor and if she is displaying any dizziness or light headed symptoms, I take her BP just to check if there is any potential risk. So far these have all been false alarms.

Mom basically weened herself off these tablets years ago and arguing with her will only cause anguish for both of us. Usually more for me than for her.

Dementia sufferers can be very cold emotionally. The loving parent we once knew is no longer there. We need to understand that the only emotions displayed are for there own purposes. Sadness, scared, and anger. So in essence what I'm trying to say is let your mom do what she wants. It's not worth the upset unless the medication is 100% necessary. These old people are physically way stronger than we think.

All the best with your mom.

With my Mom if she was responding that way, I could say, "Yes, you are right and yes I believe you took those. Now it is time to take these pills. Could you please do that?"