How do I make sure my father with Alzheimer's remembers to take his medicines?
Are there ways I can ensure that my father takes his medicines for Alzheimer's and his other health issues on schedule? He's 82 and also takes medication for high blood pressure and a prostate problem, plus vitamins and a daily baby aspirin.
Even in cases of mild or early dementia, it's common to have poor prospective memory -- that is, memory for events in the future -- like taking medication or keeping appointments. It's also hard to form new habits, whereas longtime pill-taking routines may be easier to remember and maintain.
A multidimensional approach is often needed. One step may be to set up a pillbox in which you can put a week's worth of pills sorted by day, for example. If you're not available to do it, have a home health care worker who can come into the home regularly take responsibility.
See whether your dad can keep up with his medication regimen by checking the pillbox every day. If that's not enough of a reminder, you might look into some kind of system that uses the phone or computer. For example, caregivertech.com offers software that uses the computer's internal clock to remind the person to take a pill. When the person takes it, he presses a key to confirm that it's been done. There are also Internet video systems available that let you verify whether someone is taking medication.
At the Mayo Clinic, we teach a calendar, or journaling, system over a six-week period to help people keep track of dates and things to do. In between sessions with us, a study partner -- a spouse, an adult child, or someone else -- cues the person at home, reminding him to carry and use the calendar. The person is prompted every day: "Do you have your calendar?" "Do you have your journal?" "That's an appointment. Did you write it in your calendar?"
The idea is to get the patient to overlearn the system so he can do it automatically. At the end of six weeks, 90 percent of people are able to use the system, and it helps carry them further into the illness functioning independently than they might have been able to do on their own. You can ask at an area medical center for aging whether this kind of resource is available near you.
When a parent can no longer take care of himself in this way -- keeping track of medications and appointments -- it may be time for assisted living or a move to a situation in which the environment is structured to help with these things.
My hubby won't even try to use the new telephone we have, with a button to turn it on and one to turn it off.He prefers the old one...also the same sort of buttons,but he is adamant about not using the new one. He has only morning and night pills but I can't trust him to take them if I left them out for him. He has to have me to remind him. Now, he has to take eye drops, one kind is 5 times a day and one is 3. There are 3 times when the two drops are taken at the same time. He is always surprised that it is time for drops, questions why he has to take two, or only has to take one, each time...and at times, says he has had enough, he needs no more. He will not even listen to me when I remind him the eye dr. said don't go into sunlight without sun glasses....he just goes out in the bright sun and reads... Pills and drops can be a pain for caregivers...also following some sort of so called "orders." Charlotte
In addition to the options already outlined, there are some other medication reminders out there for folks who have difficulty remembering. A simple one is an alarm available from epill.com that is easy to set and can ring several times per day. There are also electronic medication reminder systems, ranging from battery operated with an alarm that does not shut off until the pills have been dispensed, to dispensers that are connected to the phone line - if the person does not take the pill, the person will be reminded by a phone call and/or a care provider will be called, texted, or emailed to let them know that the pill has not been taken. There are a variety of different options depending upon the person's deficit, situation, and preferences, this is not a "one size fits all" kind of thing. There are a few of us who specialize in this area and help figure out what system is best based upon the person's specific circumstances utilizing both our knowledge of the technology options and our Care Management skills.
Julie Menack, 21st Century Care Solutions www.21stCenturyCareSolutions.com
My husband could not handle a new phone - "The simplest one available" said the regular companies. We got him a Jitterbug, and he is quite happy with it. The features are large and easy to see, and the staff is very helpful, and located in the US! They have a service where they will call their customer to remind him to take medication, and / or do a daily check. I haven't used it, but I appreciate the service.
When my mom was unable to remember her meds, we subscribed to a service that has an automated pill machine that can be filled and programmed to specific times throughout the day (you can buy the machine without the service of calls or have the service with calls for about $35 a month). When it alarms, the alarm keeps buzzing until the compartment is opened and then closed. If the patient does not open the compartment, it then calls family members in a certain order to alert them. This worked well for my mom for several months until her Alzheimer's became more severe and she would take the pills out and put them somewhere in the house and not take them....it really depends on the level of Alzheimers that your parent has. Many best wishes with your family!
Having the pharmacist 'blister pak' the pills can also help - with a doctor's note, they can 'blister in' the vitamins and the baby aspirin.
The blister pak has a sun for morning pills and a mooon for evening pills and can be marked with the date (so family can tell if pills have been taken).
We used this for my mom-in-law, but then one day she took her night pills (with a hypnotic) in the morning... so now we have homecare come in the morning and in the evening. The pills are still blistered, but they are kept in a lock box on top of the fridge, and the homecare worker has the combination.
You do what works, for as long as it works and then you try something new.
My mom is in a nursing home. She has 3rd stage Alzheimers. She uses a wheelchair. She can communicate, at times she knows who i am & others she doesn't.
Personally, I would not recommend trusting a person with Alzheimers to take their own meds. Its up to you but when mom was on another floor in the nursing home, she was on the toilet & a nurse LEFT the cup with her meds...well, i came in & found them. I went up to the nurses station & raised holy hell. You don't leave meds laying around for Alzheimers pts. as another resident could have come in there & taken them. I am also a CNA, i've worked in hospitals, nursing homes & am now a Home Health Aide. I have seen former patients & residents chipmunk the meds in their mouths & later spit them out...its best for someone to give them the meds & WATCH them swallow & then check their mouths... Just my opinion....
In people with Alzheimer's disease, someone must give them their
medications and then see that these are ingested. Even at early
stages the mechanisms described above wouldn't be sufficient and
really are more relevant for older mildly forgetful folks who live
alone but are capable of taking care of themselves. Our family
faced this problem when my mother in law developed Alzheimer's.
It was necessary to move her to our city into an assisted living residence where she could be cared for and we were close enough to visit her often.
When my MIL was first diagnosed we set up a monthly pillbox with the date on each window. Twice a day we phoned her when she was to take her meds (waiting until she said she had taken them). We visited each weekend (we lived out of state). Even so, she failed to take them as she said she had. We then had a home health aide who did a daily visit where she supervised her med taking. After a few months she fired the aide so she came to live with us. Through these four years she has had to be watched like a hawk when it comes to meds. If she is not supervised at the actual taking she would pocket and hide them. She kept asking what was each med was for so made a chart (photocopying and labeling each pill). Little did we know that when possible--she would only take the med for her restless leg (the one med she thought she needed)and her calcium chew that she liked. She would put the other meds in the clear wrappers that her candy came in and hide them. It is amazing the absolute determination that they can do manage when they are determined.
I live in the UK, so systems are different here.The British Red Cross can provide an automated pill box dispenser, which automatically sounds an alaram when the pills are due, and the appropriate section in the dispenser opens up. My wife could then take the pills due. As I am also at homr, we now use a 'blister pack' as described earlier,where each day there are 4 sections of pills, with times to take them. This works well, and we can easily see if one dose has been missed.With Alz, and other conditions my wife takes some 16 pills per day, so important to check they have been taken. It works very well, but possibly reliant on my being here to ensure they are taken -when due. Being in 'late middle stage' my wifre can still think about taking pills - even if not at the right time. Its not easy.
We're having the same problem here -- in duplicate! Both of my folks have different levels of dementia. They are in a retirement community, but still living independently. The daily/weekly pill boxes haven't worked for quite some time -- even when they were better and still living in their home, I would find some pills taken and others not. We've set up a system in which we use individual containers for each person, clearly labeled with name and time for medication -- one container for breakfast, another for dinner, and a third for bedtime. The container for my dad is a different color and shape than the one for my mom. On a daily basis someone (usually me, but sometimes my brother or one of my kids) will go over and refill the containers (the meds are all kept in a lockbox to prevent overdosing). The breakfast containers are kept in the cabinet with the cereal, dinner meds are placed on the dinner table, and the bedtime containers are set aside on a different part of the dinner table. It doesn't guarantee that the meds are taken, but it has seemed to help. Also, because the meds aren't usually all out at the same time, it helps to keep my folks from taking everything all at once (which I've seen happen before). The alarms and cell phone ideas are great, but I know they wouldn't work with my folks, it would just confuse them more. Good luck to all.
My mother has a pill box for the whole week and I also taped the time she should take them (9am) etc in large letters on the tops of the lids. I also posted large notes on her bedroom mirror,by coffee pot and on table she uses beside the couch. I call her regularly to see if she has taken pills. She will tell me yes but then my brother(who lives with her) will find the pills squirreled away in various places. She has also taken down the signs because,as she puts it, she is not a crazy person. So frustrating. My daughter or I stop in to see her several times a week. We check the pill box and watch her take pills. My brother however is still in denial about her having any sort of medical issues. He says that she is just being a drama queen so that we will come and visit her. That is also soo frustrating. Mom is still able to basically take care of herself so we would like to let her stay in her own home as long as possible. But what do I do about my brother? We know she isn't going to get hurt and be left lying on the floor or anything like that but it would help so much if he would make sure that she takes her pills. Any suggestions?
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Take care, Emily | Community Manager
My dementia Alzheimer's Mother lives with us, which makes it somewhat easier to deal with some things. We have 2 seperate medications containers for morning and evening medications for the entire week that are clearly labeled.I leave the morning pill box by her newspaper on the kitchen table before I go to work. I still call her at 9am to make sure she took them. I hold on the phone until she physically goes in the kitchen and checks because she will say she took them, and she beleives she did but she didn't. Then I am home in the evening to make sure after supper she takes them. Thanks goodness she has no bedtime medication to take. She is still in charge of herself and does well most days. My sister comes by several days a week and takes her out to lunch and checks on her so that is very helpful because I have to keep working as long as I can. It can be very frustrating, but thankfully she is not ugly or argumenative with me at least at this stage. She has never been that way her whole life. I just pray that doesn't change because I know lots of things are going to change. I just hope with the Aricept 25 mg every day she doesn't progress very quickly. This support system on line is so great. Gives me lots of great ideas. I hope this is helpful to someone.
To the person who said father cannot remember or he does not follow schedule when to take his pills it is totally wrong., It is also irresponsible to assume that an alzheimer patient is cognizant of his acts. How can a person delegate responsibility to a memory-faulty behavior patient? From my experience such a patient with such illness has a 5-10 seconds memory and you expect him to program his time to take his pill. My experience with a dear person she does not know what kind of pill she needs, and when to take it and purpose of the pill(s). To allow such a patient to take this responsiblity is very dangerous and potential for overdoses or taking the wrong pill at the wrong time. THIS ONLY THE RESPONSIBILITY OF THE CAREGIVER OR HEALTHY RELATIVE. PERIOD. I WOULD NEVER DO IT OTHERWISE
The best thing ever is a MEDQ Pillbx. I set it for two weeks. When it's my Dad's time to take my pills. It flashes in the individual box he needs to take. If he doesn't see it an alarm beeps as well. He haven't missed a pill in months. It has made life easier for the both of us
MEDQPILLBOX.com and its only 40 bucks. It's Amazing
there will come a time when no reminder is effective...keep this tip in mind wen that time comes...I have worked as a nurse in an Alz facility for many years, it is ok to crush meds and mix them with a spoonful of pudding when your loved one refuses to take meds...check with your doc to make sure it is ok for the med to be crushed, then crush them up and put them in a "treat cup" a small amount of pudding or ice cream, make sure they eat it or tell them to try a bite and put the spoon in their mouth quickly before they have a chance to refuse. this is a technique that works well for late stage Alz folks who refuse meds or cheeck them...you can buy a pill crusher ..pour all of the crushed medicine into a small cup and mix it well with a spoon full of treat..late stage Alz folks love their sweets so pour on the chocolate syrup and you will always get a smile. it is so very very important to keep the meds on schedule and how ever you can achieve this is what matters..good luck and God Bless. I know it is a hard journey...my mother had it too...now i continue by taking care of 40 folks that are unrelated to me yet loved and cared for as well as i cared for my own mom.
Multi-alarm medication reminders/watches – These are programmed to remind the resident to take medicines at a predetermined time schedule. Multi-alarm pill boxes – These store medication correctly and provide reminder alerts to take medicines at the right time. Signup for medicine reminder service, some of them are codmedialert.com, scriptyourfuture.com and many more.
I was in a similar situation a year ago when my mother in law was diagnosed with Alzheimer. She is on a rather complicated medication schedule and she started to forget what and when to take. I have looked online for some simple solutions. Especially I did not want her to handle any new kind of (electronic) device because at this stage it is impossible for her to start using anything new. I found a really cool service called memo24 (I think it is developed by a European company) where basically the service will call you on your regular phone and play a message that you have previously set up. It has also a cool alert feature where it will alert me by email/sms if my mother in law does not pick up or confirm the reception of the call. I have been using it for the past 5 months now, and I can tell it is working :-). you can check it out on www.memo24.net Hope this will help.
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