Geriatric Psych Ward?

Karsten,

Have a talk with the geriatric psych ward to see what they will try. Maybe they have a “pill” whisperer who can gain mom’s trust? I doubt it.

My experience and fear for you is that it won’t matter if your mom goes to a psych ward as she will still refuse the meds and my experience is she can. I only write this to prepare you not to say she shouldn’t go.

They can’t force her to take them. APS can’t force her to take them. It is not against the law for her to refuse her meds. She has rights. Just remember your taking her home with you is not one of those rights.

It might work if you were trying to find WHICH pill would work for her. She isn’t willing to take ANY pill that she can’t verify is prescribed for her, based on what you have posted.
Make sure that is written very clearly in her record so that when she gets to the P ward they understand right away what the problem is.

I do wonder how the hospital is able to get her to take meds if/when she has been in the hospital? She won’t see a bottle there. That makes me think it’s a trust issue.

She could be tricked or manipulated but a straightforward request is not going to get her to take the meds.

My experience is with a family member.
She has been taken to court in an effort to get her to take meds. She refuses. Judge said basically that it wasn’t against the law to be mental.

You might be better off to put your mom in a small care home where she could be catered to?

My family member goes off the rails and is taken to a clinic where she is given a shot and it really helps bring her out of her psychosis. Why she will take the shot and not the pills … I don’t know. Some shots she won’t take as she had an allergic reaction and it caused an abscess on her arm. She was in a State hospital and her docs were finally able to get her to take meds in a negotiation to get out of the hospital. She knows her meds and her rights.

Since I don’t know your mom, this might not work at all but you could do something like take one of the pills and glue it/tape it to a piece of heavy weight paper with a copy of the pill bottle label glued on as well. Then mom can look at the pill offered and the one she has on a chart and make sure it’s the right pill. (Of course if the manufacturer changes the pill color or shape, or facility gets a new source to provide, the sample will have to be updated. ) Often a drawing of the pill is on the pharmacy info sheet. She might accept that and not have to see the actual pill. Perhaps she could be shown the sheet each time she is offered the med?
Lot of trouble yes but something like this might work. Help her find a way to work around her fear.

Some of her meds might be okayed to discontinue. Some might be able to put in a liquid form and she might be able to see the bottle it comes from. Some might be mixed in a pudding to “help” with the taste of the liquid one. It is a negotiation with moms demons and the med rules and all to be done over and over again when a new med tech comes on board or until the meds help calm her. If you figure out a way that she accepts, ask the doctor to write orders for it so that each shift, or new employee can see it and not pretend they didn’t know.

What strugglinson wrote is pretty accurate in my experience. Try to talk to the psych doctor like he did if that is possible.

I know she’s been in ALF for a short time. How is she currently taking her meds?

The doctor at mom's MC ordered her meds crushed up and put into applesauce and fed to her.

If they can help to arrange that, I would be for it, quite honesty. The best place to try out medications that may work for her, or med cocktails that might, is in a place where they can best be assessed.
At some point it may be worth discussing palliative or hospice, and not worrying about medications; this doesn't sound like any good quality of life at all. Am so sorry. I am sure a huge worry for you.

You can refuse meds in the US. It is legal to have untreated mental illness in the US.

In a short answer, I believe so, yes, they possibly can refuse. This may depend on if they are admitted voluntarily vs put on a hold. If they go in voluntarily on their own doing, they will have more ability to refuse stuff, per my research so far.
There may be some variance depending on the state. And for sure things can be different in other countries.
In my state, if you are admitted involuntarily, on an involuntary hold (which has to be due to being a severe danger to harm self or others), then during that time certain meds can be given if deemed essential. But that's for a short time usually that they are on that hold, it needs re-evaluation, and the patient has some rights to appeal etc. I'm not sure how an appeal can get done for someone with dementia if they themselves want to appeal but the family / POA / guardian want them to take the med. I'm not totally sure.
Once the mandatory hold period is over (no longer an impending danger to self/others), they can technically refuse again. However that would depend on whether the docs determine whether they have actual capacity to make decisions, and that would be part of their evaluation. I'm not totally sure all the details. There may be ways to prolong a forced medication. Its complicated it seems. This is in my state.
Then what happens when they are discharged? It would depend on their level of sharpness. If they recognize a new pill and flat out refuse to take it any more (which seems your Mom is doing), then what? Even if they are "required" to take it, and you were conservator/ guardian, its going to be difficult to literally force against someones will (unless hidden in food etc etc)
I read the other day that with the homeless population, there are some strong shots of pscyh medicines that can last 1-3 months after 1 shot. >I'm not sure if they are using those strong meds in the elderly though.
I think one would hope that the med takes enough effect in the hospital so they feel better, anxiety / OCD improves, so then they are willing to continue when discharged. In your case, it may well be worth looking into trying / considering a hospitalization if you can get your mom to go. If its covered by insurance, could be worth a try. It may be a shakeup going in there, there might be patients making noise etc etc all the time....that could be a downside depending on the place. Kind of like a miserable low end MC unit, which someone today just was posting about.

Its possible it can help. The main question - will she agree to going? Its not easy to force it, and not easy to take someone in kicking and screaming against their will

I have read and there have been other posts that it can help. In my dad's case, the psychiatrist doubted it would help, as often the insurance covers only a very short time, and if the elder is prone to stopping/ not wanting to take meds, they quite often just stop again after being discharged from geri psych hospital , he said. However, in some cases, if they have enough days for medicine to start working and clearly feel better, it might click to them to keep taking the med.....
so if you think you can convince mom to go and she is reasonably willing - worth a try?
see also my post:
https://www.agingcare.com/questions/any-suggestions-or-tips-on-how-to-get-elder-with-dementia-to-take-psychiatric-med-489277.htm?orderby=recent�