How to manage medication for an uncooperative patient?

4 answers | Last updated: Sep 12, 2016
Retired mom asked...

My 61 y/o husband is on numerous medications for COPD, heart, chronic back pain, neuropathy, etc. He is also involved in chemotherapy and radiation therapy for non-hodgkins lymphoma. Some are strong narcotics and he has a tendency to take more than prescribed if he is not monitored. We argue about this and I am so fearful that he might overdose. He is also on oxygen therapy at home and doesn't always take this as prescribed. I am starting to feel like we have a parent child relationship now and I am not just a caregiver anymore. How can I get him to understand that I only want to help him?

Expert Answers

Linda Adler is the director of Pathfinders Medical in Palo Alto, California. She has dedicated her professional life to helping patients and their families find optimal ways to deal with medical challenges. She has worked in all facets of the medical establishment, including primary care, research, and policy settings at UCSF, Stanford, and Kaiser Permanente. Her current focus at Pathfinders includes crisis management, mediation, and advocacy.

Hi there,

How about buying a pill box and organizing it weekly? Many of the caregivers I work with find that rather than trying to talk about this issue, just supplying an easy solution gets the job done. And the majority of the time, the patient finds that this makes their lives easier too, and accept it quite readily.

One other thought: have you explored any options for getting some support with this situation? Inevitably, illness yields all sorts of challenges, and talking to a trusted advisor can help. Do you have a good friend, a spiritual advisor, a medical professional or a counselor you can talk to?

Please do write back and let us know how you're doing,


Community Answers

Retired mom answered...

Thank you for your advice.. We have used the pill box for a while now and the problem comes when he feels he needs more pain medication and I am reluctant to give him too much. He has abused it in the past and has been to rehab for this. That attempt was a failure. He becomes insistent to the point that I give in. The narcotic pain meds are the most difficult to manage. Others have offered advice but I guess I feel desperate sometimes and just want someone else to "fix" this problem for me. Then I feel guilty for not helping him as much as I should. I think I have come to the point that I need the counseling. Is this something al-anon could help me address?

Linda adler, mph, ma answered...

Ah, now I understand better, not only your challenge but your desperation to fix it. You could certainly try Al-Anon, but perhaps NA (Narcotics Anonymous) would be more helpful? I'd also suggest discussing this with the prescribing physician and see if he/she could play the "bad cop" role, rather than it falling on you. Do you have other family members or friends who can rotate caregiving duties with you? If so, he might respond differently to them, not challenging their authority in the same way. Another suggestion: attend a support group for caregivers so you can get suggestions from others who have similar issues. These are available at many medical centers, through local support agencies or online.

I hope you're getting out and about and getting some time to reduce your own stress. Are you exercising, meditating, doing something fun with others from time to time?

A fellow caregiver answered...

Have you ever tried a placebo pill that looks just like the prescription ones? .. or ... have you at least discussed that idea with his doctor? In many studies placebos work just as well as the real pill because the patient believes it's the real pill.