How can I get my patient to take her meds?

A fellow caregiver asked...

I am the DMPOA/Elder Care manager for a lovely woman who, for years has been a pill hider/disposer. Recently, we've been crushing meds and placing them mixed in with apple sauce which, for a time, she accepted since there was NO trace of her taking meds. That has stopped. We switched to crushing meds.and mixing it with chocolate Boost telling her it's chocolate milk and even giving cookies for her to dunk. She also receives Seraquel 50mg at bedtime. As of last night, she is refusing even this method. Can you please offer alternative suggestions? Help is needed and appreciated. She just lost her husband of 57 yrs not even a week ago today. The past 2 days she has not mentioned him or shown any signs of grieving. Keeping her refocused, redirected and entertained.

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.


This is a tough question. First, please make sure that the pills are safe to crush BEFORE you do this. Ask a pharmacist if it's OK –  for each medication. I know many people are resistant to taking medications, so I would try to find out why this is an issue. Is this person on too many pills – experiencing pill overload?  Sometimes asking the health care provider to reduce the number of pills solves this problem altogether, either lowing dosages, using higher dose therefore fewer pills, or eliminating when possible. Does she have trouble swallowing? It's a good idea for her to have a thorough check-up, with attention to swallowing, mouth, and gums.

Before crushing pills, ask a pharmacist if the medication is available in dissolvable tablets or in liquid form -- these make mixing much easier. Crush and mix the pills in a soft food that's easy to swallow such as applesauce, pudding, or ice cream, as you've been doing. It makes a big difference if you pick a food or flavor the person likes. Try new foods; switch it around, perhaps without telling her where the medication is, unless she asks. When you crush pills, make the bits as small as you can, like dust. Or try to dissolve them first in a little warm water, and then add this to food. If she's taking capsules, these can usually be opened and the contents sprinkled on food or in a drink. Crush or mix the medication in the least amount you can while masking the taste, in case she doesn't want to eat much. You want to make sure she gets all the medication.


Finally, is there someone who can have a heart to heart with her about the importance of taking her medications? Maybe a family member or social worker. This may shed light on her resistance.