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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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See that a nurse is present when the meds are given to her and that that nurse watches her swallow the medication(s). Insert - what happens when the nurse leaves without seeing the patient actually ingesting the meds?
We ran into this with my mom, sometimes she would forget yet be sure she took them and other times she would double up. We found an automatic pill dispenser (I found it on eBay after researching them) and it has made life so much easier. It’s round and holds two weeks worth of morning and evening pills, we set the time and the appropriate slot spins to the aces able spot and beeps along with a small flashing red light to let her know it’s time. We also have an alarm set on her phone because she doesn’t hear well but this way we can all see if she has taken her pills or not and if she misses her morning pills for instance when it’s time for her evening pills the morning rotates to a non accessible slot as the evening dose becomes available, no chance of taking the wrong ones or double dosing. She can also see that she hasn’t taken them when we call to say it looks like she hasn’t. We have a camera over the table where all her pills and insulin shots are kept and check it morning and night to make sure. Not sure if this would work with your LO but it’s been a game changer for us.
My mom does same thing but if I am there I will bribe her with a chocolate and she lights up and I just let her know after all her pills are taken. But I am not there all the time (she's in LTC) so some staff know how to do it the way I have suggested but others are not good. Sometimes I have found pills stuffed in night table! Staff is NEVER to leave pills beside her cause she will hide them. The good staff know to give to her a couple at a time and go (with pills) and come back in 15 minutes or so cause she will have forgotten and keep doing it until all pills taken. Does she have anything that she likes so much that you could bribe her?
I would call the nursing director and ask that your mom's medication be taken while a nurse is with her, and not to leave the medicine for her to take on her own. Explain the reason why. There is no reason why the facility can't commit to that. The nurses could always crush the pills and put it in apple sauce or something instead. However, some pills, like the slow release, are not to be crushed.
I understand where you are coming from. I have caught my mother collecting her doses in a jar. She has also hidden them in her cheeks like a little chipmunk only to spit them out later.
What to do? I manage them from start to finish. I take care of refills, sorting, and dispensing.
I remind her daily that her medications help keep her blood pressure under control. In the past, I would give her an honest assessment of her blood pressure readings. I made comments such as “looks great”, or “your blood pressure looks better than mine”, etc. I realized this only gave her a false sense of security.
Now, I tell her “your blood pressure is a little too high (or low) I’ll go get your meds”. She is much more willing to take them if she thinks there is an immediate need.
Also, much like what is done in a hospital setting, I give her a cup of water with her pills. Then, rather than hover over her (because I think it irritates her)—I do “busy work” close by until I see she has swallowed her meds.
Just another example of the little “white lies” we tell our aging parents to keep them around because we love them.
If you have several meds with several times a day to take it, it can get complicated. start with doctor and find out if all of them are necessary (multiple drs can add things that other drs don't know about). Then ask if the necessary meds can be taken 1 time a day at the same time. Some Rx drugs that you take 3 times a day actually come in a single longer acting medicine.
They have companies that will package your doses of medicine. I think Simply or Simple Medicine is one of them. They are sealed in individual package with time and day to take the contents. That might help.
No matter what works "today" may not work tomorrow. Dementia is a inconsistent "constant" What they can do today might not be what they can do tomorrow that includes anything from reading a note reminding them of a medication, an alarm reminding them to take a medication or to get out of the house in case of a fire. If medication is important the only way to be sure it is taken is to observe that it is taken, handing it to the person and trying to get them to take it, or mixing it with food. Given the course of dementia medications might be one of the things that is looked at to determine if some of them are really that important. Dementia medications do not work forever. In later stages is a Statin really important? Is that thyroid medication really important given the broad scope of things? And given the course of dementia sooner than you realize you can not leave this person alone. They can not follow directions or remember the directions given (one of the reasons rehab often fails for people with dementia)
Is your mother bedridden? (you mentioned nightstand). My sister lives with me. She's ambulatory. I have a typed sheet that is laminated that lists in a table the time that she's supposed to take medications each day, the number of pills due at each time, and a box to write what time she took them. (We use a dry-erase marker so it can be wiped clean and reused each day.) I have an old cell phone set up to alarm each time she's supposed to take pills. The list and pills are always in the same place on the kitchen counter.
When the alarm goes off, she (usually) comes to take pills. Each time period is separated in a little Tupperware container (lids are easy to remove as opposed to little daily pill containers that can be tough to open.) Each container is labeled with the time of day scheduled. Sometimes I have to assist with certain portions of this, but she generally is able to manage on her own. But as for your mother, if the pills are still in the container, then obviously she didn't take them because they're still there. Who can argue with that?
If you can get her more involved, rather than just handing her pills, maybe that will help. Have her write at least her first initial indicating that she took that dose so something is in her own handwriting that she will believe.
I had the same problem with showers. She would say she just took one yesterday. So again, I decided to get her involved in keeping track. We agreed on showers every Sunday and Thursday. I got a little monthly calendar book and after her shower, she initials the calendar that she had a shower. It's working perfectly so far.
My mom also gives me the "I already took my pills" line when I bring her the meds. Here are some of the things that work for me.
I know my mother's memory is shot, so when she says: "I already took my pills," I don't argue, I just say OK, then I leave the pills on the dresser with a glass of water. A few minutes later, on her own, she sees the pills there and just takes them. Of course, this approach doesn't work all the time.
So, other times, I tell her: "Yeah, I know you took your pills, but those were the pills for morning, these are for noon."
Other times, I tell her: "Those pills you took earlier were for xyz, these are for abc."
Sometimes, I just come back 15 -30 minutes later and try again when she's in better mood and more cooperative.
Sometimes, she will just skips her meds because none of the above works.
Here is how it happened with my aunt. In the very beginning it was the thyroid tablet which had to be taken on an empty stomach and a requirement to wait 30 min before eating. Aunt insisted she was taking it. Had been for many years etc. When we counted the pills and compared it to the days left for the prescription to be refilled, she had to admit the math didn’t support her absolute conviction that she had been taking it correctly. After our discussion, she understood the math. She understood she evidently wasn’t taking it.
However she wasn’t able to hold that understanding she had the one day over to the next morning when it was time to take the next pill.
I tried phone calls, notes, placing the med box in different places, finally I got it.
It wasn’t HER that had to do something different, it was ME. I had to accept that she wasn’t being difficult or stubborn. She simply couldn’t remember and I was being obtuse.
So if I wanted her to continue to take the thyroid tablet, I had to find someone to offer it to her every morning.
As her disease progresses so do her needs. We as caretakers have to increase the level of care as the needs increase.
Sometimes the current stage has been slow to advance and lulls us into denial for awhile. Then we come to realize that a new care plan is necessary.
Someone (you, caregiver, workers designated at facility she's at who dispense meds) has to give her medication to her every time. Plus, she has to take the meds while you or they wait. Most can't remember even with pill boxes, pill packets, alarms, reminders. If she fusses that she already took it, try saying 'the dr said for you to take this now.'
I want to say I have a fabulous answer. Alas I do not. My Mama would argue with me all the time saying she took her pills already. Same with her shower. Of course I had already fixed her up with a pill box some time before this even became a problem. The trouble was she took the wrong days pills or none at all. No matter what I said I could not convince her. Had to let those days go. It still amazes me that she is now in Memory Care and somebody comes by and says" Here's your pill Miss" and she swallows that sucker without batting an eye! Tried the pill dispenser too that dings and the pills come out. Didn't do any good as she swore she already had taken them. Plus like others say, there are always a few to be found on the floor. You are not alone with this problem. Good luck!
Quite honestly you cannot. When dementia comes it is almost impossible to handle this medication thing which can be difficult even for people without mental deficits.
With difficulty. I set up my parent’s medicine in a one week box with days and times. I also purchased a special clock that has date, day of week, time of day, and an alarm to remind her to take her pills and she still forgets. I Had to learn not to panic if she missed a dose and not to show irritation or anxiety to my parent. Because of the helpers I have in place I am able to show her what medicine or time she missed. Also at 68 I forget sometimes if I took my medicine and even have had to count my pills so that helps me calm my anxiety. There are Several products on the market that can help an older person or a person with dementia with the medications take them in a timely manner and the right meds. Consult with your Parent’s physician or RN as to what aides are best for your parent’s individual situation. Good luck .
First I have to ask how well she is doing in Independent Living. It sounds like Memory Care might be better for her. If she can not manage her medications someone has to be there to give them to her. Staff in Independent can not, Assisted Living may be able to instruct her but they might not be able to give the medication. There are pill boxes that are time locked but that is no guarantee that the medication will be taken it just guarantees that a double dose will not be taken. There is one that will also alert you on your phone if a dose is missed. But with any of them the person taking the medication must remember what the alarm is for when it goes off and they must remember how to get the medication that has been dispensed. It might be the time to begin the transition to Memory Care
You might need to have someone else give her the medications. My mom got to the point where she could not even use the pre-filled pill box herself - she would skip some of the pills and leave them in the box, or drop them on the floor and not be able to find them, or take some ahead of time and then run out. If a nurse has filled the pill box - for a week or two at a time - a home health aide can help her take them. The home health aide can't fill the box though, as that involves dosing medication.
How about use a pillbox? That way it's either there or not there. Then you can just show it to them to prove they haven't taken it yet. You can also use Amazon to fulfill the prescriptions. They put each bunch of pills into a sealed pack. Then you can show them the pack to let them know that they haven't taken it yet.
Are you present at the facility when she takes it? If so, can you make a little party out of it? Play her favorite music, perhaps bring her a flower (artificial or real), something that appeals more to basic memory than the memory of someone with dementia, i.e., something comforting...sort of a medicine ritual.
And keep a lovely calendar for her so that it can be marked off; she may not remember it, but if one of the aides or someone helps her look at the calendar and see it's marked off, she may accept that.
Is she taking her meds alone though? Isn't there someone to administer them and note the time?
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
What to do? I manage them from start to finish. I take care of refills, sorting, and dispensing.
I remind her daily that her medications help keep her blood pressure under control. In the past, I would give her an honest assessment of her blood pressure readings. I made comments such as “looks great”, or “your blood pressure looks better than mine”, etc. I realized this only gave her a false sense of security.
Now, I tell her “your blood pressure is a little too high (or low) I’ll go get your meds”. She is much more willing to take them if she thinks there is an immediate need.
Also, much like what is done in a hospital setting, I give her a cup of water with her pills. Then, rather than hover over her (because I think it irritates her)—I do “busy work” close by until I see she has swallowed her meds.
Just another example of the little “white lies” we tell our aging parents to keep them around because we love them.
They have companies that will package your doses of medicine. I think Simply or Simple Medicine is one of them. They are sealed in individual package with time and day to take the contents. That might help.
Dementia is a inconsistent "constant" What they can do today might not be what they can do tomorrow that includes anything from reading a note reminding them of a medication, an alarm reminding them to take a medication or to get out of the house in case of a fire. If medication is important the only way to be sure it is taken is to observe that it is taken, handing it to the person and trying to get them to take it, or mixing it with food.
Given the course of dementia medications might be one of the things that is looked at to determine if some of them are really that important. Dementia medications do not work forever. In later stages is a Statin really important? Is that thyroid medication really important given the broad scope of things?
And given the course of dementia sooner than you realize you can not leave this person alone. They can not follow directions or remember the directions given (one of the reasons rehab often fails for people with dementia)
When the alarm goes off, she (usually) comes to take pills. Each time period is separated in a little Tupperware container (lids are easy to remove as opposed to little daily pill containers that can be tough to open.) Each container is labeled with the time of day scheduled. Sometimes I have to assist with certain portions of this, but she generally is able to manage on her own. But as for your mother, if the pills are still in the container, then obviously she didn't take them because they're still there. Who can argue with that?
If you can get her more involved, rather than just handing her pills, maybe that will help. Have her write at least her first initial indicating that she took that dose so something is in her own handwriting that she will believe.
I had the same problem with showers. She would say she just took one yesterday. So again, I decided to get her involved in keeping track. We agreed on showers every Sunday and Thursday. I got a little monthly calendar book and after her shower, she initials the calendar that she had a shower. It's working perfectly so far.
Good luck! Everything is a challenge.
I know my mother's memory is shot, so when she says: "I already took my pills," I don't argue, I just say OK, then I leave the pills on the dresser with a glass of water. A few minutes later, on her own, she sees the pills there and just takes them. Of course, this approach doesn't work all the time.
So, other times, I tell her: "Yeah, I know you took your pills, but those were the pills for morning, these are for noon."
Other times, I tell her: "Those pills you took earlier were for xyz, these are for abc."
Sometimes, I just come back 15 -30 minutes later and try again when she's in better mood and more cooperative.
Sometimes, she will just skips her meds because none of the above works.
In the very beginning it was the thyroid tablet which had to be taken on an empty stomach and a requirement to wait 30 min before eating. Aunt insisted she was taking it. Had been for many years etc. When we counted the pills and compared it to the days left for the prescription to be refilled, she had to admit the math didn’t support her absolute conviction that she had been taking it correctly.
After our discussion, she understood the math. She understood she evidently wasn’t taking it.
However she wasn’t able to hold that understanding she had the one day over to the next morning when it was time to take the next pill.
I tried phone calls, notes, placing the med box in different places, finally I got it.
It wasn’t HER that had to do something different, it was ME. I had to accept that she wasn’t being difficult or stubborn. She simply couldn’t remember and I was being obtuse.
So if I wanted her to continue to take the thyroid tablet, I had to find someone to offer it to her every morning.
As her disease progresses so do her needs. We as caretakers have to increase the level of care as the needs increase.
Sometimes the current stage has been slow to advance and lulls us into denial for awhile.
Then we come to realize that a new care plan is necessary.
If she can not manage her medications someone has to be there to give them to her. Staff in Independent can not, Assisted Living may be able to instruct her but they might not be able to give the medication.
There are pill boxes that are time locked but that is no guarantee that the medication will be taken it just guarantees that a double dose will not be taken.
There is one that will also alert you on your phone if a dose is missed. But with any of them the person taking the medication must remember what the alarm is for when it goes off and they must remember how to get the medication that has been dispensed.
It might be the time to begin the transition to Memory Care
My mom got to the point where she could not even use the pre-filled pill box herself - she would skip some of the pills and leave them in the box, or drop them on the floor and not be able to find them, or take some ahead of time and then run out.
If a nurse has filled the pill box - for a week or two at a time - a home health aide can help her take them. The home health aide can't fill the box though, as that involves dosing medication.
And keep a lovely calendar for her so that it can be marked off; she may not remember it, but if one of the aides or someone helps her look at the calendar and see it's marked off, she may accept that.
Is she taking her meds alone though? Isn't there someone to administer them and note the time?