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Mom is very independent and lives alone. Contracted COVID a month ago and was hospitalized for a few days. Over the past few weeks, she has been having difficulty taking her meds. My sisters and I have set up her medications in a pill organizer. She also takes insulin several times a day. The problem is, she cannot remember which little box to take her pills from. She does fine when one of us is there with her (we make her do it)-she reads and follows directions well, but then says she can't do it if one of us isn't there. She knows what day it is, date, cooks, etc. just like normal but, for some reason, cannot figure out the pill thing. Any ideas on what we can do to help her? Some days, she does really well and needs no help or reminding but it's getting worse every.single.day. She will be evaluated by the neurologist in 3 more months as he has a 4 month wait list. Ugh.

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COVID can cause some "mental fog". I did not have the problem but a few on this forum have experienced it. Maybe they will chime in.
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Kellyww921 Apr 2023
Thank you, Jo Ann. We've been wondering if it might be COVID fog. It's just really weird that she has no trouble with anything else. This is the only thing that seems to be confusing her. Can't help but wonder, sometimes, if this is her way to get us over there every day. She has a history of attention-seeking behavior but this is a dangerous way to seek attention.
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According to your profile, mom suffers from dementia/Alzheimer's which is likely why she's having issues taking meds. That was my mother's first red flag for me....finding pills in coffee cups she'd "take later" or under her recliner that'd fallen w/o her knowledge.

You say you know "she's not ready for long term care" yet it's obvious she does need help and guidance daily, at least with medications. Keep an eye out for more issues which can crop up slowly or quickly, sometimes overnight. Mom was fine until one day she emptied her bladder 100% on the elevator up to her AL apartment. One day she's fully continent, next day THAT. From that day forward, she quit arguing that she didn't need Depends and thus began her 6 year struggle with dementia.

Whether your Mom has covid fog, dementia, or both, she's showing you a need for more help. See if you can hire in home help to assist her w whatever crops up next.

Good luck to you
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For good measure, have her checked for a UTI, which can cause such symptoms but can be treated with antibiotics. UTIs are very common in older women. Also, how do you know she's taking her insulin correctly? If you are asking her questions, you need to understand her answers may not be accurate, and she may sincerely believe she's giving you accurate answers. This is what happened with my MIL.

You should also examine her house to see if there are any other subtle signs of cognitive problems: unopened mail, unpaid bills, check register in chaos, etc. My MIL had ordered dozens and dozens of boxes of checks because she kept forgetting she ordered them and where she put them. She also had $930+ in overdraft fees when I checked her unopened monthly bank statement. These are "easy" signs to look for. It will help in getting anwers.

Discount all other possible medical issues that can cause her current symptoms while waiting to see the neurologist. In particular, make sure she is eating and drinking properly. Don't go by what she says... make sure you see it with your own eyes.
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Missymiss Apr 2023
Yes on checking the medications are being taken. Originally my mom was living alone and one state away, but I was taking her to her medical appointments. She swore she was taking her medications. Her blood work showed otherwise. I set up a visiting nurse to help weekly to set up her meds. She complained she didn't need a pill organizer, that she took them directly out of the bottle daily, and after the first time she stopped answering phone calls from the from the nurse to set her next visit. Next appointment at the doctor, bloodshot shower she still wasn't taking her meds.

Other signs were there that something was wrong (don't assume she is cooking for herself)... don't assume all is well. Use your eyes.
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This might be outside of your moms comfort level initially but do you think she & you all could try to use Alexa to get a “medication reminder” system going?

Really truly folks are doing this.

Google “Can Alexa be used for Reminders?” There will be a bunch of options, just sub out for medications then seniors. Folks are doing this.

And you can do the camera on Alexa too if you want to be watching what’s happening although if she starts touching it, that becomes an issue. I would NOT do anything iwatch, it’s way way tooooooo small. It gets touted to be used for health stuff, imho, no way it’s feasible.

fwiw when I started looking at facilities (IL to AL to NH ages ago), I’d see ladies who seemed to me perfectly fine but in the NH…. like appropriately dressed, hair done, wearing jewelry, seemingly social, milling around the nurses station or the activity center…. they didn’t look like they needed to be in a NH. I asked why they were in a NH as I was kinda expecting more elderly “infirm” at the NH. They were there as they needed “medication management” and the RXs they were on were such that they needed oversight. Your mom being on insulin would be this. Medication management is a very real care category and qualifier for a bed in a skilled nursing care facility. Keep that in mind as it may come in handy should you need to place mom into a facility.
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My mother with MCI and recent memory problems, benefited from a printed list of daily activites where she could "check off" the boxes; made one in Word and gave her a fresh list everyday posted near the door of her room. My SIL with diabetes went into an AL after covid and an unattended fall for medication management; perhaps your mother needs this care/oversight too (or may need it soon).
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I have friends who had Covid fog after even a mild case of Covid. In some cases that’s when dementia came in or was worsened. This is what Covid is doing and it’s why we should all take precautions not to get it. We’re still in a pandemic, and even though we might not have to be hospitalized, it can leave us with ongoing brain, heart and lung damage that never goes away. There’s plenty of credible research about this if one cares to look.

I believe that this mom needs to be in a care facility as some of my friends now are after Covid. Medication management is important, and there’s no point of waiting for brain fog to go away when it may never go away. Plenty of research indicates that Covid accelerates cognitive decline.

Keep that in mind whenever someone tells you the pandemic is over. For the elderly population, it’s creating problems that will affect them and their caregivers for the rest of their lives. And then there’s the CNA in my doctors office. She’s only 30, got Covid that her child brought home from school where precautions are not taken. She was in the hospital for several days and now has a heart irregularity that she may be living with the rest of her life. No one can say if it will get better.
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Your mother should be placed into a facility for RX management. Since she required diabetes medication, if not properly managed or not taken at all may cause serious health complications or death.

Speaking of Covid. I'm sorry, but with my research, it may never go away. Variant and sub-variant virus strains continues to spike, with the latest type in India and Nepal. I've been told to not worry, yet several of my friends and some family got breakthrough infections after getting updated booster shots! We are in a new normal. Once long Covid happens, I doubt that it goes away. It is an ugly life sentence.
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If it was just pills being the issue I would suggest a different pill organizer with the day of the week spelled out. This seemed to help my mom for a short while. We had to hire caregivers and they were present when it was pill time.

Amazon has automatic pill dispensers with alarms you can evaluate for her. My mom refused it because of the alarm.

The insulin is a much more serious issue along with checking her glucose everyday.

Most likely the Covid fogged her brain and who knows if she will recover from that.
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We got one of those round auto pill organizers for our mom, probably the best move we made and kept her more independent for several years. She takes pills morning and night so we can fill two weeks worth at a time. It reveals the pills she needs to take at the time we set (8am and 8pm in our case) and beeps as well as has a little flashing red light when it reveals the new set. If she were to miss taking her pills, we check in with her when it’s time so that doesn’t happen, the last dose so morning in our case if it’s time for evening pills, is covered up so no chance of double dosing. They also make a stand for the machine which we have so all she has to do is pull the blue handle and her dose of pills dump into the silver cup underneath for her to take.
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Google PharmAdva Medacube. I use this to manage my husband's medications. It is expensive, but so worth it if you can afford it. I understand many may not. You load the meds in, set up the doses and schedule and then it all happens automatically. I can record a message for each scheduled time for meds, eg good morning love, time to take your morning meds. You have 6 total to take, 1 large white, 2 medium pink pills, 1 square yellow pill and 2 small white ones. Love you!
If he doesn't take right away he'll get reminders every 5 minutes, a phone call at 15 minutes and I'll get a phone call also. There's robust reporting also. And I get emails daily when a med has less than a 30 day supply. You can set the days for that, eg less than 10 days. I can't speak highly enough about this. It gives him a sense of control and me the comfort of knowing he gets his meds at the same time everyday in the right doses.
I do still need to check that he hadn't unknowingly dropped any one they've been dispensed but that occurrence reduced significantly since I updated the recorded messages to describe to him the pills he's taking at that specific time.
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Here is a great review of medication dispensers

https://www.techenhancedlife.com/citizen-research/best-automatic-pill-dispenser-you
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This sounds so like my mother (gone15 years now) at Assisted Living, who swore that she was taking her Meds 'right' and yes, we had a pill organizer that was easy to see and read. I kept finding 'pills' though, that were not taken, and Mom would be crushed when confronted with this. Your mother's situation is more serious as insulin is involved. She is telling you the truth that she can't do it without help. The COVID episode may have contributed to the mental deficit, but: deficit is not likely to clear up. You state that your mother is "independent and lives alone". Yes, but it is done at great risk to her safety, as she has demonstrated that pill management is beyond her. This is not a manipulation to get you over to her house. Please hire a helper to go to her house daily, unless you family members can rotate being there to watch insulin and pill administration. I think the time to begin to look at Assisted Living with extra money paid to administer daily meds, for your mother. A good idea to begin looking now. I paid extra for my Mom at AL to administer her meds. She was still playing Bridge at this point, and very functional in other ways but taking Meds as prescribed was just beyond her, at a certain point. I hope you can accept that she needs daily help, particularly as Insulin is one of her drugs.
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They make pill dispensers that dispense only one slot at a time. We got one that has 28 slots and a timer. You choose what time your mom will take her pills, an alarm goes off, and she picks up the dispenser and turns it over to release the pills and shut off the timer. My mom got irritated that it tried to tell her when to take her meds, but it worked really well for a bit.
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TouchMatters Apr 2023
Do you have a link to where this timer/med dispenser is?
Does the alarm go off ... after it goes on ... or does it stay on until someone turns it off? I've never heard of this. Thank you for letting us know about it.
Gena
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I wish more people knew about this item. It has been a lifesaver. It comes with a key so it prevents the elderly person from taking pills that they are not supposed to at the time. It is not cheap, but well worth it! You set an alarm on it and only that slot opens with their pills. It also flashes for the hard of hearing. My dad doesn’t hear it, and he has almost no short term memory, so it doesn’t work for him. My sister and I do have to give his to him because he doesn’t realize what is flashing. The alarm only goes off if it’s turned over, such as turning it over to get the pills out to take. Not sure if this explains it cieairy or not. 😂We love it! Med-E-Lert Medication Dispenser with Automatic Lock Box 28 Sealed Pill Compartments (Clear Lid) https://a.co/d/i80lwUI. If the link doesn’t work, it’s on Amazon.
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"My sisters and I have set up her medications in a pill organizer."

Did you do this before or after she started having trouble?
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If you did not indicate mom has dementia in your profile I would suggest the possibility of an insulin pump if she is having a problem with the insulin. The concern is..is she properly delivering the correct dose of insulin . That with one of the automatic pill dispensers would be able to manage the meds and insulin.
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As you get older your brain takes care of your, moods, thoughts, and really everything you do! Take a piece of that away(as little as a knat or as big as a pea) and what happens is really up to her way of doing things. She likes that she has her freedom, but in reality she really doesn't because she wants you to be there when she take her pills! At one time maybe she couldn't get the pills down and she might of Chocked and Spit them Out and she got Scared. I have done that before, myself.
If she has capsules you may want to Open them and put the meds in her food or drink(stir it well) for the solid pills you can get a pill crusher at any drug store and for any liquid mix it in some fruit juice!! Now it's easy for you to this for your Mom because she wants to have you around when she take her Meds and these are things to make it easier for her and you! Remember, she thinks she can make it on her own but eventually you need to start thinking about her living with you, or having a Caregiver Fulltime or even 24 hours each day and it's not fun because I'm alone, been alone for over 20 years, I wanted to harm myself, but didn't because getting one is a process, I have had my Caregiver for 3.5 years, I love her like a Daughter but when she isn't with me, I'm really lonely for (2 days) over the weekend, but I like my 6 hours per day that I do have with her. But those 2 days are lonely, so I am now looking for a Assisted Living, to meet new Friends my age and hopefully will find one soon!
Good Luck to You and Your Mom! Just pay more attention, she took care of you, so it's your time to Listen to Yours!!
L.
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Way2tired Apr 2023
Welcome Chatty. I hope you find a living arrangement where you feel safe . Keep coming back , we will listen .
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It's possible she's a little confused because you changed her routine when you put them into daily sorter. Those daily sorters are good, but might have thrown her off.

I created a document on excel and listed all the AM meds first, then lunch, then PM. It had Rx name and mg of pill and how many pills to take. The chart was done for a 7 day week. If a dr took one off, I put that one at bottom of list with date stopped. If he added one, I had the date with Rx name of when added.

There was also daily entry under the med list to enter blood pressure and sugar levels.

Mom took pills out of the bottle, put them in a cup, and took them when she had put each Rx into the cup. She knew each pill she was supposed to take, but the check list helped to make sure she got the correct pills together before swallowing them.

This list was used to check the box as pills were taken out of the bottles. When we had dr visits, I took the chart so dr had list of all meds and her daily vitals.
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If she cannot remember (or focus w/o support there guiding her), she needs (a) help(er).

Hire someone to come in for 1-2 hours/a day (if possible).

While you do not mention her age or disabilities, it is better to start introducing her to support - as she will be resistant now - and moving forward, when she needs more support.

* Hire someone who can do activities / outings that your mom enjoys.
* Tell her (that the caregiver) is a friend of yours - or something if needed.
* Or if she is cognizant and can handle it, have a heart-to-heart talk.

* Her disorientation could be from Covid - could be ongoing from Covid - could be aging/brain changes. You do not know. While an evaluation will / may help, it won't really deal with the issue needed now: taking the correct medication.

You want her to get the meds she needs each day.
It sounds like she needs someone to come in to ensure this happens.
You could tell her the 'helper' is temporary ... and s/he might be.

Gena / Touch Matters
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LiveFine 28-Day Automatic Pill Dispenser with Upgraded LCD Display, Key Lock, Sound & Light for Prescriptions, Medication, Vitamins, Supplements & More https://a.co/d/2dwA5P0
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SueZ1250 Apr 2023
It’s on Amazon! It’s amazing!!
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The Alexa app can be setup to announce from a “Show Me” device which pills to take at the designated time(s). “Alexa, remind me to take levothyroxin from the PINK pill case at 8:00am, 12:00pm and 4:00pm everyday.”
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Kellyww921: Since my mother was having similar troubles taking her medication, I contacted the elder case worker at her town's Council on Aging or COA. That person suggested cassette pill keepers, one color for day time meds and one color for night time meds. This worked well GENERALLY, except there were a few times when my mother threw a wrench in the works by taking a pill out, placing it on a saucer with a facial tissue covering it.
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Hopefully it will clear up. My mother has dementia, and she was starting to take pills from the wrong little. I had to get her a locking medication dispenser. You can set alarms to notify her when it’s time to take the medication. It will only allow her access to the next set of pills she supposed to take. It comes with 28 slots and will last my mother two weeks because she takes pills in the morning and then in the evening. You can set the alarm for each time. I also got an additional tray so that I can have it pre-loaded which makes it easier when it’s time to switch out the trays. They sell them on Amazon.
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