For the last year, I have been filling a Sunday through Saturday pill box for my mom. She uses one in the morning and one in the evening. She takes them on her own and occasionally needs prompting. Recently though, I’ve been finding pills on the floor in her bedroom. I am concerned that she is missing doses, also that our dog may find them instead of me and ingest her medication. When I suggested that I start handing her the doses to take every day she got very angry with me. She does not want to be dependent on me. The reality is that she is very dependent on me for everything.
Any suggestions on how to navigate this touchy subject?
You are looking now at dementia coming, and the fight against losing control will be dramatic indeed if there is denial. This is the beginning of loss upon loss of all control and dignity and our elders KNOW this. Nevertheless, some things cannot be changed, cannot be made happy, cannot be fixed; they have to be lived with. Hard times. I am so sorry.
I am not saying the above will work. With a mind that is slipping often NOTHING but the medication nurse DOES work. My bro fought like anything to stay in control; it was the worst of it all for him.
I told them to send the medication back. It was a running battle for some time, as new people weren't getting the info. I saw the bill. It was several hundred dollars, most likely for a one month supply! I also had to pay them a "restocking" fee, which I objected to - WE didn't ask for the meds! When I paid that fee, I wrote them a letter, as mom's DPOA and said DO NOT fill any RX without my okay. Even that wasn't enough. It still took many calls to finally get this sorted out!
But, the point is these may not be cheaper, and I don't see how this solves the problem OP is having. Sorting the pills into any type of dispenser isn't that big of a deal. It's getting mom to actually take the meds, once removed from the dispenser or blister pack. When mom still lived in her own place, recommendation was a timed locked dispenser, but sometimes she didn't see it or hear it (it had alarms and flashing light.) I hired 1hr/day aide to check on her and check her meds - they can't dispense, but they can point it out if she missed it. Sadly less than 2 months later she refused to let them in. So, plan B - MC. There they bring the meds in the little cups with water and wait for it to be taken (some coaxing may be required!)
Your mother got annoyed because (as she sees it, remember) she is taking her medication perfectly competently and already doing as you advised. She's not a child! She's not an idiot! Why are you treating her like one! (this is all mother's possible view of the matter, I stress).
It seems that the problem is arising between her opening her pillbox and transferring the pills to her mouth. Little/deep compartments, elderly (arthritic, numb) fingers, and teeny-tiny tablets/slippery capsules can all conspire to make accidents happen.
What I would *like* to do when supporting people with their medication is place the tablets one type at a time on a plain, dark-coloured coaster or saucer so that the person can see it, and can easily get hold of it. That gives them at least a chance to start with. I'm not allowed to do that. I have to open their blister pack and decant the whole px into an eggcup or similar, then allow the client (if the client chooses) to attempt to down them in one and chuck half of them down his shirt front. Or drop a couple in his tea. Or swat them up his nostril. Whatever. Oh the fun we have figuring out which has gone where...
I hate blister packs with a vengeance, I have to say. They are the devil to open for people with arthritic fingers, selecting the right compartment from the grid is not nearly as simple as you'd think once you turn the tray over, and the compartments are often quite deep, the plastic creases, and then that Apixaban is going to stay wedged at the bottom forever. They may save fiddling about with half a dozen assorted boxes and remembering which is for what time of day, but those are the ONLY problems they solve.
There is quite a range of pill minders and electronic dosette boxes out there, though, including some which automatically decant the tablets into an appropriately sized plastic cup (like the ones they hand out in hospitals). Might that help?
As far as skipping a pill once in a while, well that's not going to kill her as most all Seniors are taking too many med's in the first place.
"...filling a Sunday through Saturday pill box for my mom. She uses one in the morning and one in the evening."
The dispenser sits firmly on the stand, the compartment pops open with an alarm at whatever time, and the person then simply pivots the dispenser so that the tablets drop into the cup beneath.
It honestly does look foolproof (and shaky-fingersproof too).🤔
It is by no means cheap!!! 😠
As noted to another's comment, this isn't the issue. Mom is "taking" the meds, but not ingesting them or dropping them. OP needs to do what they do with my mother in MC - hand them to her in a little cup with a cup of water and WAIT/WATCH her actually take them. This may be a battle, but it is one OP will have to wage to ensure mom gets her meds, not the dog or the vacuum.
My friend would load it up and it was good for a while.
All her mom had to do is take her meds when it came out.
All on a timer.
We finally stepped up, took away all of her pills, and as calmly as possible explained why we were taking them. She was so embarrassed and confused by what she had done that she finally agreed. Her caregiver is responsible for most of the pills now. On weekends we give them to her ourselves. Ours was an expensive mistake, minus the $375 pill dispenser. If your mom isn't as stubborn as mine and her dementia isn't as advanced as my mom's is, a pill dispenser may work for you. But if you are there to give her meds to her each day you may not need a dispenser. Just do what one commenter did - take them away from her ASAP, and do not take no for an answer. She may be upset, and/or mad, but too bad. After a while, she'll likely forget the whole thing. If she doesn't, just keep giving her her pills. You don't need to explain why every time. Think of it this way: You are now the parent and she is now the child, the End. Good luck!
It’s a situation of our parents wanting to be independent and with my mom, a touch stubborn too!
My mom has Parkinson’s disease so she is losing fine motor skills to handle small pills.
I found pills on the floor too. I was concerned about her missing her meds and about my dog.
My mom and my dog were best friends so I told her that I did not want the dog to get sick to encourage her to make sure that she got every pill in her mouth. She loved my dog!
I would stand by her to make sure the pill went into her mouth and not fall on the floor. She felt independent and I knew she took her meds and the dog would not accidentally eat a pill.
Mom is quirky. She didn’t care if I handed her the pill but she liked putting them in order lined up for the day. She couldn’t use a pill box. She didn’t have the fine motor skills to remove from a pill organizer so she would line them up in this large shoebox lid that she kept.
Even though I had instructed mom not to feed my dog, she did it anyway, so naturally the dog loved her! She snuck him treats.
She would lie to me and tell me that she hadn’t given him anything but he would throw up some of the food. She still denied it. LOL
My dad did an ingenious thing for my mom's meds. He got those little pleated paper cups you put ketchup at a fast food place, and put Mom's pills in those. The smallest ones fit perfectly into her pill box, so he just took out the whole cup and handed it to her to pour into her mouth. Half the time she insisted in pouring them into her hand, then putting them in her mouth -- resulting in dropped pills, but the pill dropping decreased a great deal.
We moved to a timed locked dispenser, with all the alarms, and even then she was missing them (but it was VERY easy to tell.) Next was to hire aides 1hr/day to check on her and see that she took the meds (they can't dispense, but can check and point it out.) Less than 2 months later she refused to let them in. Plan B was MC, where they use those medication cups with a small glass of water, and they wait until the meds are taken before moving on to the next resident. It can take some coaxing there - I'd seen mom question the aide, despite having taken these meds for most of her adult life! Thankfully she wasn't like some, who would adamantly refuse.
Suggestions changes: Watch as she takes the medication to make sure none falls on the floor (I have no memory problems, but occasionally a pill goes wandering and I have to sweep the floor to find it). Have her open the "door," put a little cup - like a Dixie cup - over the opening and "pour" it into the cup (upending it) so it doesn't end up on the floor. Make sure she takes her medication with a big glass of water. Afterwards, please check to make sure medication doesn't stick in the pill box of the "medicine cup."