My dad: Is 83On 12 different medications (takes AM and PM)Is stubborn but mentally competent. Has CHF, Kidney disease, diabetes, High BPSleeps late unless he has to be up for an appointment. Usually until 10:30 or 11:00.Will be living alone shortly, when his friend moves out. (I live 3 miles away)
I manage his medications – he admitted to me recently that he would never be able to keep all them straight. I manage his doctor visits. I do his bills for him and try to keep him on track.
One problem I have (not the only one) is that he doesn’t think it’s important to take his pills on time. Sometimes he takes his AM pills at 1:00!!! I only know this because his friend recently told me this. She told him it’s important to take early and at 12 hr intervals, but he doesn’t think it matters, so he takes him when he wants.
I put the pills in a daily AM/PM pill box for the week and they are sitting right by his chair in the living room. I tried calling him in the past and telling him to take them and he just gets frustrated and says he will take them and hangs up. But does he? I don’t know. I can’t be there. I work a full time job and I cannot quit.
But it’s the fact that he sleeps so late. He just doesn’t care anymore – at least that’s what I think, because he doesn’t express anything to me or really tell me what he wants from the rest of his life. I could ask him why this? or what does he think of that? He would just shrug his shoulders as if to say, “I don’t know or I don’t care.”
Even if I could be there at 9am to wake him, have breakfast, and make sure he takes his pills, he would say I was rushing him. At 83, he moves at his own pace – doesn’t like when people rush him.
It is so frustrating and I know I can’t force him to do anything. And having someone come in a couple hours in the AM would not sit well with him. It’s also an expense neither he can afford or myself.
I have an appt for him next week at a Senior Care Associates division of the hospital in our area, which is a team of geriatricians, nurse practitioners and social workers that provide consultations, comprehensive evaluations and recommendations for senior care. And also to evaluate physical, emotional, social and functional needs to assist planning for future.
Other than all I am doing, I really don’t know what else I can do to help him but keep my sanity – and my health intact.
Any advice - or just some words of encouragement?
Its good to hear that there is an upcoming consultation/visit in a few weeks. That’s a great time to discuss the issues you face. Get dad’s permission to discuss these issues and be sure to include him in the discussion & planning. He still wants to be treated as an adult who has some capability to control his life.
hoping this is helpful.
Probably hard to do since he has so many serious health issues. But unless you or someone else is going to put the pills down his throat, or dissolve them in whatever he drinks every day, there isn't much you can do when he refuses to take them.
My 97 year old mother takes one pill for her thyroid. Every morning I put it into her hand and on the days when she refuses to take it, that's fine with me. I'm not going to die on that hill.
Peace.
His am is different from your am.
My room mate has an am at 10am or 11am and sometimes even 1pm and a bed time about 1 or 2 am and even sometimes 4am. My am is 5am and my bed time is 10pm so we differ a lot.
At 83, he has earned the right to live any way he wants to. And he's not going to be perfect. In fact, it seems he is purposely rebelling. Because nobody likes someone else telling them what to do.
Let him be.
Your sanity and your health do not need to be sacrificed trying to force him to conform.
I'm not saying that you are nagging him - I know you're reminding him - but his reaction to you seems as if that's how he's taking it.
I would talk with him when it's nowhere near the time for taking meds and when he's in a good mood. Ask him what method he'd like as a reminder (think about some of the suggestions in the other comments here) and give him a sense of autonomy.
Try not to get too hung up on there not being 12 hours between the doses. He's taking them, and that's the main thing. If there are 8 hours between meds (lunchtime and nighttime) that's not ideal, but not too bad either.
You can't control everything, I'm afraid. Also, it will help your sanity to accept "better than nothing" rather than busting a gut through striving for perfection.
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At 83, he is somewhat entitled to do as he wants - and you do your best to do what is necessary for his welfare.
* You are stretched (way) to thin now - caring for your dad as you do and (needing/) working full time. It is exhausting. Certainly acknowledge yourself for all you do - do. I send you a huge hug.
"It is so frustrating and I know I can’t force him to do anything."
Yes, that is very frustrating. Unless he is medically diagnosed to not be able to care for himself (dementia), he can do what he wants, legally.
I understand the expense involved which can be prohibitive.
- You mention a person living with him moving out. Is there a possibility of someone else moving in - to help him out. (Not caregiver in exchange for room and board-a live-in is considered an EMPLOYEE. It is very complicated).
- See if you can find a college student studying / getting credentialed / a master degree in Nursing, counseling, geriatric. Hopefully someone can be available for a couple of hours a day - this experience is helpful to them when they seek employment.
- See if he qualifies for Hospice (my friend did-supplemented the nursing home care although Hospice will not do 'anything' to keep him alive, they will provide comfort care only (and a person doesn't have to be terminal to get Hospice care).
"And having someone come in a couple hours in the AM would not sit well with him. It’s also an expense neither he can afford or myself."
- Change won't sit well with him. That is a given. He is likely scared, frustrated, perhaps confused/regardless of the / his needs.
You do what you have to do for his welfare as best you can. And, let your best be enough. It is. You are. ... Many of us do what we can and it often feels like there is so much more to do. There is. We need ACCEPT and be GRATEFUL for what we can do for a loved one. Burning yourself out won't help him.
Re medications. Is he forgetting or not wanting to take?
Do you know if he) Is he clinically depressed? on meds for depressions?
Have you asked him if he 'wants' to take his medication(s)?
- What does he say?
Does he know what might happen if he doesn't take meds as prescribed?
- What does he say?
* The Senior Care Assoc Div of the hospital in your area sounds incredible.
Good for you - finding them and utilizing whatever support they can provide.
I support you to take some time to yourself - between caring for your dad and working full time. Find a 1/2 hour or an hour each day for YOU (or more if you can) --- be it reading, meditating, taking a walk, going yoga. You need to take care of you.
Do you know if he qualifies for any govt' assistance?
See if you can find volunteer(s) in / through Church, networks, local associations relevant to his condition/medical needs, neighbors/networking.
Keep us updated on how you and your dad are doing.
Gena / Touch Matters
Today it's the pills, tomorrow it'll be personal hygiene or some other thing. Since he has dementia, he should stop driving.
I'm sorry, there comes a time when all your best efforts won't work anymore. You're there.
Does your dad have a Long Term Care insurance policy? If so, it sounds like he may qualify for this. My mom has a caregiver who doles out her meds and this has taken a lot of the pressure off of me. Plus he's become a companion for her during the day.
Otherwise, understand that even in nursing home settings residents refuse pills all of the time. It is not uncommon.
Otherwise, hire caregivers that come in 3 hours in the morning(generally the minimum you can get them for). Have them remind him about his pills, get his breakfast and get him dressed.
My dad's dementia progressed to the point that he couldn't deal with a pill box himself at all (mixed up day and night, couldn't remember what day it was, took two days' worth at the same time, etc.). So then he had his pills doled out to him on schedule by my mom, which he resented. He acted like and said that he was taking them, but then we discovered that he was often spitting them out and hiding them. When we asked about this, if he said anything at all, it was he "just forgot" or "it was an accident" or he didn't know how all those pills got in his sock drawer or whatever. That was around the same time he started hiding or throwing food too.
How is your dad's diet? Is he doing his laundry, making meals, washing up in the kitchen, changing his clothes and bathing regularly and brushing his teeth?
Apathy can be a symptom of dementia. Apathy means not caring or bothering. Just mentioning in case this is developing with your dad.
Good luck!
The missing part of the question is: when does he take his pm meds? That information will be needed to get good information.
Good luck with the new clinic.
Should review all his healh concerns. A fresh look at where his health currently is.
From there..
Medication:
Review everything he takes?
Cut some out? Change doses?
Ask which meds are time-sensitive.
Social:
Discuss Dad will be living alone.
Will this be suitable? What services are available to help?
Or if not suitable, what then?
I would like to set up this kind of Geri team for a LO. As many conditions cannot be cured, we move towards aiming for Quality of Life.
In your Dad's case, dementia dx or not, he has many conditions that may be effecting his mental sharpness, kidney function may be a big one.
Your dad obviously shouldn't be living on his own anymore and needs to be in an assisted living facility where they will bring him his medications at the appropriate times.
And if money is an issue he'll have to apply for Medicaid.
But until you get all that figured out, I would talk with his doctors next week at his appointment, to see if he still has to take all of the medications that he's currently on. Perhaps they can cut down on some of them.
And you can ask just how important it is that he takes them at a certain time each day, as I'm guessing there is quite a bit of wiggle room there.
Your dad now needs more help than just with his medications, however if you're not his POA, you may have to wait for an "event" to happen before you can do anything about it.
At the facility depending on the LPN on duty, morning meds could be anywhere from 8:30-10am and nighttime 8, 9 or even 10. One time the meds were dispensed at 11:30PM
We tried putting up signs around his apartment, and even moving the signs to different locations as eventually one's brain will dismiss the signs if left in one place too long.
Since Dad was living in a senior living facility, I signed Dad up for what is called Med Tech which is a Staff member who gives Dad his pills (the pills are kept at the nurses' office), and the Staff member would come in twice a day. She would stand there until Dad took his medicine. It was an expensive option for Dad to pay but worth everyone's sanity.
I would ask his doctor how important is it for him to take his meds on time. From what I understand some meds do better overnight. Some not so much.
He is not going to adapt or get better. You can’t do it all for him. He needs assisted living where his meds can be monitored and he can get on a more suitable schedule.
Do not quit your job. Do not pay for his expenses. Do not move in with him or let him move in with you.
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You also do not quit your job , nor do you move a stubborn man to live in your home .
That leaves , letting him to his own devices at home or assisted living where they will give him his medications . Hopefully he owns his home and it could be sold to pay for his care some day .
If he’s competent , nothing you can do about it . Is he on an antidepressant ? Maybe it would help . They also have pill boxes with a reminder alarm .
Hopefully you will get some answers at his assessment at Senior Care as to whether he should be living alone or not .
make it impossible to get Dad to change his ways . He most likely should not be living alone . Start looking for assisted living facilities . Do you have POA? If so has it been invoked yet ?
If Dad ends up in the hospital , tell them he can no longer live alone and you can’t take care of him 24/7 , you work . You tell the social worker at the hospital he’s an “ unsafe discharge “ and can not go home . Have a few assisted living in mind so he could be transferred to there via ambulette service . It will have to be paid for out of pocket ( use Dad’s money ) but it’s better than taking Dad in the car and him refusing to get out of your car at assisted living .