At your wits end trying to convince your dementia loved one to take their medications? You are not alone! This is a problem experienced by caregivers everywhere, not just home caregivers, but also by nurses and employees who work in memory care units. Although our initial instinct is to assume that your loved one is being “difficult”, it is important to explore the possibility that they may have a specific reason they are avoiding their medications.
Any experienced caregiver will tell you that watching the nonverbals of the dementia person can give you a lot of insight as to how they are feeling even if they are not able to express it properly. For example, do they make a sour face when they are taking their medications? Perhaps it is because they don’t like the taste or it makes them nauseous. The solution could be as easy as putting the pill in applesauce, pudding or flavored syrup to disguise the flavor left on the tongue and help to coat the stomach. How big is the pill they are taking? Watch for faces and head movements that indicate they may have difficulty swallowing the pill whole. The easiest fix may be to place the medication in applesauce to help the pill slide down their throat. If that doesn’t work then you should check with the pharmacist to see if the medication administration can be altered by cutting the pill in half or crushing the medication. (Note: Not all types of medications can be broken or crushed as it could change the medications effectiveness or side effects, so it is important to check with your pharmacist.) If the medication is not able to be crushed or cut, then perhaps there is an alternative medication that can be prescribed in place of the one that they dislike.
Another reason that someone with dementia may refuse their medications could be due to lack of understanding or feeling a loss of control. We must remember that the brain of a person with dementia no longer processes information the same way they did before. Being verbose and giving too much information to someone with dementia can leave them feeling even more confused than normal. Attempting to rationalize with the dementia person with a long explanation will often result in them being unable to process what you are saying. It is also improvement to watch our tone and message when we are talking to someone with dementia, as they also use nonverbal to help decipher the messages they are receiving. A negative tone or loud voice may indicate anger or frustration and deter them from wanting to participate in whatever it is you are offering. Try being direct and calm and do not attempt to explain or reason with them. Use assuming non-verbals, such as moving your hand towards them and looking at them expectantly to increase their compliance. For example, say “Here is your diabetes pill” and then hold the pill out in your hand until they take it. This is effective for multiple reasons. One, less words equals a better understanding. Two, silence after the command allows time to process what is being asked. Three, the non-verbal outward gesture of the hand elicits an automatic response to take the pill out of the hand. And four, it gives control back to loved one as they must physically pick up the medication and put it in their mouth. It is essential to have a cup of water already prepared and within reach to facilitate taking the pill as soon as they decide to take the medication. You should follow the completion of the task with positive words of praise and rewarding the behavior with something they enjoy, like maybe ice cream or a cup of coffee. This creates a pleasant feeling around the task of taking the medication and will reinforce the idea that the next time will also be pleasurable. If it doesn’t work initially, then don’t force it. Try again after a 15 min break or a different time of day. It may take a few tries to get it right. Once you find a time and process that works, then stick with it. Routines work!
Lastly, caregivers should be mindful of the atmosphere in which they are asking the person with dementia to take the medications. This includes the environment and the person making the request. You are likely to have greater success in a calmer environment with minimal distractions. Ensure that there is no loud music or blaring television in the background or a large group of people gathered around, as that can increase confusion and may also agitate your loved one. It is also important that you are also calm, using a soft tone and well articulated speech, to ensure that the person with dementia does not feel as though you are angry or rushing them as this can also increase their agitation and make them more likely not to cooperate. Have you noticed that they take their medications better with certain people? Does the nurse have better luck than you do? If they are not able to have their preferred person for each medication administration, try to schedule the most important and the bulk of the medications when that person will be there. Study their approach to see what techniques they us in order to get your loved one to take their meds. Perhaps sitting in their favorite chair with some soothing music playing while their grandson offers the medications could be the answer that you’ve been looking for. You may also want to try using technology to help them feel like they have regained some control. Setting an alarm or even getting a verbal speech reminder from an ‘Amazon Alexa‘ or ‘Google Home’ may allow them to not feel like they are being told what to do. Preparing the medications into a daily or weekly pill box is a great option for people who are still in the early stages and can use the pill box appropriately.
In any case, finding ways to get your dementia loved one to take their medications isn’t always and easy feat, but persistence, trial and error and a bit of love and luck is probably the best place to start. Good luck and down the hatch!
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