June 22, 2012 — Taking medication can be a problem with even the most cooperative patient, but can be near

Taking medicine

Getting a person with advanced Alzheimer’s to take their medicine doesn’t have to be a daunting task.

impossible with Alzheimer’s victims.  My mom, at times, could be a prime example of stubborn.  Under normal conditions she was wonderful and I always considered her a people pleaser, especially if they were medical people.  However, there are circumstances when even the most pleasant of patients can become snarling strangers in our midst.


My parents lived together a short distance from me and Ken, but when Mom, who was in the beginning stages of cognitive loss, broke her hip and was ready to return home, the hospital authorities refused to release her to my father even though we were just minutes away.  Until we could find a caregiver who would be a full-time live-in, Mom stayed temporarily at a small private care facility.  I do believe my mother and “Maria” had an immediate personality conflict.  Maria’s specialty was older people with physical problems, but had little experience, if any, with dementia.  She was certain, though, she could handle Irene, and actually all was going fairly well until one particular evening when it was time for medication.


“This is Maria and we have a problem,” said the voice on the phone. Her words tinged with irritation she continued, “Your mother won’t take her medicine.”  I could hear my mom in the background stubbornly repeating, “I will not take those pills.”  “I’ll be right over,” I said.

When I saw Mom sitting at the table I wanted to laugh, but recognizing the problem I didn’t.  Her arms were folded defiantly across her chest, her back so straight I thought she had a ramrod bracing her spine and her lips were drawn in a thin, tight line.  That was Mama’s stubborn-unyielding look, with which I was familiar, having grown up knowing that during important moments she could be stern (the arms folded with the lips tight) but she was also fair.  With Irene’s AD, however, my mother had no reference point other than stubborn. She pounded the table a few more times repeating that she would not take the pills, but after several minutes of relaxed conversation with me and Maria, Mama calmed and I convinced her to take her meds.  I suppose that was the secret: calm and relaxed, a few pills on the end of a spoon and a glass of water nearby. For the remainder of Mom’s stay Maria was able to handle the pill situation.


Before Alzheimer’s Ken was a vitamin person, and because of his  Crohn’s disease he chose to take supplements in an effort to compensate for nourishment possibly lost during digestion.  Whether or not taking supplements for years did him any good, even his doctors couldn’t tell – only agreeing that other than having Alzheimer’s and Crohn’s he was remarkably healthy.  In any event he was used to taking pills.  For years into his Alzheimer’s he happily tossed any medication and the vitamins into his mouth and washed them down with either water or juice.  After a short, but confusing, stay in the hospital following an automobile accident, and to help him readjust to being back at home, we found it easier to just concentrate on his one high blood pressure pill, adding it to whatever he eats at breakfast, his once-a-month vitamin B shot and hope his diet supplies him with the other vitamins and minerals he needs.

Occasionally, though, there is a need for him to take liquid medication.  Pouring the liquid into a large spoon I approach him as in days of old with the familiar word vitamin and as if he were a young boy.  “Vitamin time,” I coo.  “Open wide for your vitamins.”  The right sound at the right moment seems to do the trick as he opens his mouth automatically and swallows the thick fluid from a spoon filled with what he needs.


As Mary Poppins, nanny extraordinaire, Julie Andrews sang a sweet little ditty about a spoonful of sugar making the medicine go down, but the thought makes my teeth hurt to say nothing of a likely dentist bill. Of course the resourceful nanny was dealing with children.  Coaxing adults to take their medication, although different from the younger generation is still similar, especially those who are deeply forgetful.  While plain sugar does well in the song, it is somewhat gritty and a bit over the top with sweetness, but who among us can resist the pleasant taste and comfort of a yummy, smooth dessert such as pudding or apple sauce to conceal needed medication.  The pills can also be hidden in ice cream – delicious, comforting and soft allowing everything to slip easily down the throat.  Even capsules are hardly noticed when buried in something the patient likes, but keep it smooth and make sure it has substance.

I have had great success with both my mother long ago, and Ken in the present, but I do believe that success goes beyond the pill vehicle.  The surroundings must be peaceful, and the caregiver cool, calm and collected.  Be soft, kind and gentle, but upbeat in the approach, and never force any issue. If Ken balks at my tablespoon of liquid or clamps his mouth closed I stop and try again later.  At times I’ve been tempted to drop his age down to toddler feeding when the spoon became a choo choo train finding its way into the waiting, giggling tunnel.  So far, though, “Vitamin time” works, but first and foremost I remember always that the key to cooperation with AD patients, and most others, taking medicine is all of the above – plus a heaping bucket filled with patience, care and love.


Originally posted 2012-06-23 04:06:09.


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