How can I help my mother-in-law with Alzheimer's to stop refusing to take her medicine?

A fellow caregiver asked...

My mother-in-law has Alzheimer's and frequently refuses to take her medications. We can't tell if it's just her way of trying to gain control of her life, or if she believes she just took them.  It's causing her blood pressure to be out of control. Do you have any tips for getting her to take her medication?

Expert Answer

Beth Spencer is a social worker in Ann Arbor, Michigan, with more than 25 years of experience with families who have a member with dementia. She is coauthor of Understanding Difficult Behaviors and Moving a Relative with Memory Loss: A Family Caregiver's Guide. Previously, she directed Silver Club, early-stage and adult day programs serving individuals with Alzheimer's disease and related illnesses.

Medications can be difficult. As you rightly point out, sometimes saying no is a way of gaining control. Other times the person simply does not understand the need. Also, some people have difficulty swallowing pills and this may increase as the Alzheimer's gets worse. Be aware that some people keep the pill in their cheek and spit it out when no one is looking.

First, I would ask your pharmacist if the medication is available in other forms. Sometimes a liquid is easier than a pill. Ask if it can be crushed and mixed in with something like ice cream or pudding that might be appealing. Also, make sure you have a medication that can be taken as few times per day as possible.

Other suggestions:

  • With some people it is possible to use a behavioral approach, e.g., "When you have swallowed your pill, I have a dish of ice cream for you."
  • When she refuses, back off and try again a little later.
  • Try different approaches. This may have become her place to take a stand; if so, try to make it more casual and less of a power struggle.
  • To the extent you can control it, pick times of the day when she is likely to be most agreeable.

Sometimes there is no good solution to this. As a caregiver, you can only try your best -- you may not be able to get her to take it every time. But if you can find ways to defuse the situation, you have a better chance.