Medication issues. Please help!

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Medication issues. Please help!

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My mom (with dementia) lives alone and has started moving her daily meds around in the weekly container. For example, she had already taken last Sunday - Wednesday, but didn't take Thursday, Friday, or Saturdays (not sure which day she didn't take them) but she moved one of those days pills to the Sunday spot. Any suggestions are appreciated.

Alzheimer's & Dementia Living Independently Medication Management

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She obviously can't live alone and needs help, supervision. What do you think?

She'll keep making mistakes with the medicine, and she probably has made mistakes with other important matters that you may not have noticed yet.

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People with dementia shouldn't live alone past the very early stages. Medication non-compliance and errors is one of the reasons for that.

Consider contacting the local Area Agency on Aging and asking for a "needs assessment".

Be there for the assessment, because your mom most likely thinks she is taking her meds correctly and will report that.

It sounds like mom needs, at the very least, someone to hand her her pills each and make sure she takes them.

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Mom should not be living alone. She should not be in charge of her Meds. You either hire an aide to be with her, move her in with u (which I do not recommend) or place her in an Assisted Living if she can afford it. If she can't afford it, then it will need to be Long term care with Medicaid paying.

It's only going to get worse. I would call her PCP and explain what happened. Blood tests can be done to see how much medication is in her system.

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As already said, your mom should no longer be living by herself. She's no longer safe.
Best wishes in figuring out the next steps in her care.

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Your profile says your mother is living in your home. If you plan for her to continue there, you’ll need to lock away all medicines now and give her each medication as she needs it. This isn’t a behavior she can change or do better with, and sadly, it will worsen. Consider strongly that a medication error by her could make her situation so much worse, please don’t chance her having access again. I’m sorry you’re dealing with this change and wish you the best in adjusting

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Mom has reached a point where she needs supervision.
Not a total comparison but you would not let a 4 year old be in charge of their medications would you?
She may have already reached a point where she needs supervision in the bathroom and for most if not all of her ADL's (activities of daily living)
Now I am a bit confused. You say in your profile mom lives with you yet your post indicates she is living alone.
If she is living alone she should not be. If she is living with you but in a little apartment you need to step in and be there more.

You also mention that you feel that your spouse and your mother could do more for themselves.
I can not comment on your husband but wanting your mom to do more...that ship has sailed.
She might try to do more but in some cases her doing more may make more work for you.
Give her tasks that she can do and if she finishes, great if she doesn't no big deal.

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My mom would take two days of meds at a time. I had to pay someone in her apartment building to go in and hand her meds twice a day. They were kept in a lock box. We had two trips to the ER for taking excessive amounts of blood thinner. She now lives in assisted living.

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She can no longer live alone.She needs help.

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Hi ima777,

I am dealing with this at the moment. There is no answer when we can’t remember which day it is or if we have already taken them. Missing pills is one thing. Possible overdosing is now also possible. Your Mom needs someone to administer her meds. Hope you can find someone.

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I agree that it is no a longer safe situation.

Given that you asked for help so a thought. A locked dispenser with a timer which hopefully complicated enough she cannot figure out how to open it. We had a pet feeder with timer and I found something for human pills as an idea https://www.amazon.com/LertTM-Premium-Automatic-Dispenser-Transparent/dp/B087JY8BVB/ref=asc_df_B087JY8BVB/?tag=hyprod-20&linkCode=df0&hvadid=507695844407&hvpos=&hvnetw=g&hvrand=4322485647007397559&hvp

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The same thing happened with my mother. I presort her meds for her (place them in containers) and would call her with reminders. She used to take meds 3x a day, and I would have her write down the time of day she took them. I talked to her pharmacist, and her regimen was changed to 2x a day (am and pm only) because it was easier to manage. Suddenly, literally overnight, she got confused. She could no longer distinguish am from pm, and the days of the week (even though she has a "Dementia" clock on her nightstand). Even with the reminders, she took a few times, double doses, or would forget to take the pm meds, even with the reminder calls, from me or a caregiver.

I've taken the medication management responsibility away from my mother. I have caregivers who go to her home twice a day, in the am and pm. They pass the pre-sorted meds to her and supervise her while she takes them.

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My MIL has been in facilities during her journey with dementia and medication management was the first AL service she needed. Love the dementia clocks but yes, dementia does progress to the point (and rapidly sometimes) that time is basically meaningless. In my MIL's case, it started with her all of a sudden stopping her daily routine of crossing out the day on the calendar and checking what was on the schedule. A few months later, she would look at time and immediately forget but still had a general sense of morning and afternoon. Now, if she asks the time and we point her to the clock, she'll read it, not absorb it and ask two minutes later. She would forget she ate a meal...every meal is breakfast now...and wander back and forth to the dining room. She gets a daily schedule of activities which is meaningless to her but she hoards old ones saying she may need to refer to them. They come get her for exercise class, social events, etc. now.

Is there an aid with your mom all morning and afternoon? If not, it may be time to think about additional care. Along with having no concept of time, my MIL gets very confused and can no longer do a couple of her ADL's. She can't remember how to use the t.v. , how to work the shower handle, that she has worn the same clothes for days. She has incontinence which she is confused how to handle. She was properly putting the pads in the lined waste basket but then she put them in the basket of her rollator (yuck). Then she put them in the toilet and clogged up the toilet so water went all over. She was wearing the same clothes for days. So her level of care has gone from the first level to the highest level now that she has these additional needs.

Most of the time she is aware of space and gets around the building fine as well as finding her room. But one Sunday when we checked her back in after a regular Sunday visit to our house, she sat down in the lobby and looked confused rather than going up to her room or to the living room to find people to talk to on her own. She told my husband she was confused. It was a bizarre conversation and got really concerning when she said "I think I've been at this place before". We asked her if she needed help finding her room...and she really did. Although the next day, she was not a as disoriented, we were glad that she is on the waiting list for the memory care unit in the same building. They do well in the AL unit caring for her but there is the possibility that her confusion could lead her to wandering off when the receptionist is away from the desk. They have a more structured schedule in MC than AL which should help her. The staff to resident ratio is higher.

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The Alzheimer's Store, online, has a variety of pill dispensers to address this very issue. Good luck.

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A year ago ima wrote that her mother lived alone, 3 hours away. In this post, she also says her mother lives alone, yet in her profile she says she lives in ima's home. ? ima, can you clarify for us?

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My mom started having a similar problem. I found a medication dispenser that is round and can be filled for two weeks of morning and nighttime pills in our case. It has a timer you set and only reveals the current dose of meds at the appropriate time, if she were to forget to take her evening pills for instance they rotate back to unavailable when the next mornings dose becomes available. It can beep when it’s time to take the pills as well as having a blinking red light and a lock that makes it almost impossible to get to the covered pills. We fill it every two weeks and have a camera over her “medicine table” so we can see if and when they were taken. I purchased it on EBay and saved a lot of money, they are expensive and we later bought a stand for it that is secured to the table and she just pulls the handle which dumps the exposed pills into a metal cup underneath which works really well for us.

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Your mother is no longer safe living alone. Either hire help in the home or place her in a memory care facility.

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There is no other answer.

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My mother had problems keeping track of which pills she had taken and when. I got her some of the pill vials that have a timer on the cap. That worked for a short while but then I started noticing that she was missing doses and the timer said the vial hadn’t been opened for two days. I started asking her if she had taken her pills every day when we talked. I made her get up and tell me what the timer said and often she would find that she hadn’t taken them. I had someone staying with her for a few days a week but since she was a friend and lives near me, two hours from my mother, my mother was on her own the rest of the week other than when I came up for the day. (One of my dogs has a bark that she can’t tolerate so I can’t stay there overnight). I finally had to hire someone to come in for a few hours on those days to check on her meds and help with other things like cleaning. Before we hired the second woman my mother tripped over her walker and fell, cutting her leg. She didn’t tell me until late that day and she said the cuts weren’t bad. The next night she said one was deeper than the others but still not bad. Finally my friend and I went up on the third day to see what the truth was and we took her to urgent care. She should have had stitches but it was too late for that so the cuts will have to heal in on their own. That week was when we hired the second person so now I don’t have to take her word for things concerning her health. She objected but I think she is now enjoying having people around, especially since the new woman also takes her to the movies and other things she enjoys doing. of course she still complains that she doesn’t need someone to remind her to take her pills!

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If possible, don't use a multi-day pill organizer; if possible, have one container for each single day and only let her have access to that container on that particular day (assuming someone is with her every day.)

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This is what we did with my BIL we put cameras in his apartment so that we could watch what he did. Also we put his meds in single containers and we put mornings on the kitchen table in a basket and nights on the counter top in a basket. This helped alot because he was taking 2 days sometimes or not taking them at all. We would call him and watch him take his meds while on the phone with him. He had dementia so this was our way to keep him in his apartment until the day he fell outside laid on the ground for 30 minutes then he went into a nursing home with memory care.

They also have automatic dispensers for medications that will dispense that day only and it will have an alarm on it to make sure they take it.

Prayers

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There are containers which lock and have set alarms and only that times meds will be available . She wouldn't be able to see the others.

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Get her to her PCP ( Physician) ASAP, for a new " level of care needs assessment". Go with her and tell the physician what you are observing with her medications.
It sounds like there are safety and care issues with her " living alone".
It may be time for other care needs to be considered and, this is best addressed starting with her Physician; also have the PCP refer you to a case manager usually a licensed social worker who can assist you both to navigate the ever increasing complicated world of caring for the aging. You may also want to her assessed by a geriatric specialist and, you may want to confer with an " elder law attorney" to best understand her and your rights, needs, options etc etc.

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I found one source, but your pharmacist or doctor may direct you to others:

https://accupacrx.com/pillpack-solution/?src=gads&keyword=packaged%20medications&gad=1&gclid=CjwKCAjwjYKjBhB5EiwAiFdSfrK0dNOWhvXM5TKcWoT2vY3oc-oKAez3OUhfgR0jYEYdf9O-Zi4zcRoC88AQAvD_BwE

If this process doesn't work for her, perhaps it's time for assisted living or memory care.

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How does the link you provided help irma?? It doesn't give much info.

Home delivery isn't the problem here. the problem is her mom is switching the pills that are already right in front of her.

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Just for clarification, my mom does live alone. I have cousins near by (walking distance) that are my hands, feet and brain when I'm not there. I found a solution... for now anyway. I bought 3 more of the same containers and my cousin take her a new (filled) container every Saturday (to start Sunday). She no longer has access to the pills in the bottle AND the daily container. She can only take them from 1 place now. That seems to be working for now. We haven't noticed any other issues that make us think she's ready for assisted living. Thanks to all of you for your comments and suggestions.

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ima7777: I also used the cassette medication holders for my mother (one color for daytime meds and another color for nighttime meds) based on her physician's suggestion. However, that plan did not work out as my mother would take some of the pills out and place them on a saucer.
Perhaps you will have to obtain lock down containers.
I did see your post of two hours ago wherein you stated your solution.

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Even if you find a solution to the medication administration now, the solution will be temporary. Your mom will get to the point where she will have to have her meds administered to her by someone else. An overdose is as life threatening as missing doses. My suggestion to you is to begin seriously looking for continuing care communities as soon as possible. AL and MC facilities employ medication coordinator's whose only job is to administer medication. Many people need meds in the morning, afternoon, and night on a daily basis. Remembering to take pills is complicated for people whose minds are intact let alone for people with dementia. Placement in a facility because of an emergency is not ideal. Begin your facility search as soon as possible. A facility near you would be preferable to one near her. Best wishes

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You're right. Placement in AL or IL is inevitable. today her mom is messing up the meds, tomorrow she might mess up the knobs on the stove.... or worse.

I hope irma is mentally preparing for the inevitable.

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It's time to stop letting her dispense meds. This won't get better, just more confusing for her and days without appropriate meds. It may also be time for someone to be at home with her or at least a few hours each day to evaluate what else she doesn't quite understand anymore.

I would suggest contacting one of the companies that packages daily pills by AM-Noon-PM. She opens the pack and takes them all. However that's not much different than putting them in the sorter which she's already having trouble doing.

Another option might be to find out from pharmacy if she can take all her pills at one time each day. You or someone could make a daily call, tell her it's time to get the package of pills----allow her time to do it, and confirm it - and then hang up. This would also be helpful to know she got out of bed or that nothing has happened to her if she fails to answer the phone.

My aunt got to where she would just pick a pill or two from random days. Or it appeared she dumped them out and just stuck them back into any slot she could. Pills were then handed to her to avoid problems

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My mom was doing exactly the same. She lived alone but my brother lived only about a mile from her. He would fill the 7-day container on Sunday but when he went over during the week the meds were all incorrectly moved around.

He finally just took all the pills home and only left her the days worth when he went to fix her breakfast in the morning.

You may not live close enough to do this.

There are pill containers that are on timers and disperse only what is prescribed for that time but I think they are expensive.

Even if you take the approach of leaving only the days worth be advised your mom still might not take them correctly. I was cleaning out some junk drawers in my mom’s kitchen I found hundreds of her prescribed med. Hundreds! So I know it was not an occasional spill of her pill box so I’m pretty sure she was not taking her meds as she should. This was really strange because she was obsessed with the meds. If we were at her house she would ask every 5 minutes for her meds and become very mean when we explained she already took them. Her meds were a nightmare.

I read once that prescription med issues are a number one cause of placement in long term care.

Good luck.

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I didn't know that med issues were the number one cause of placement. I do know that misuse of pills was the reason my husband placed his father. FIL was taking high blood pressure pills instead of aspirin.

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When my mom started doing this, I installed a camera to help her to take her medications.

However, shortly after that, she came to live with me.

When your loved-one can no longer manage their ADLs, they CANNOT live alone.

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Medication issues. Please help!

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