Caring for Caregivers Newsletter
Published by Janice Wallace, The Eldercare Coach

Ask Janice!

My mother suffers from vascular dementia and her mental health has recently declined. As a result, she is now refusing to take her medication. What suggestions do you have to handle this problem? - Ellen

"Vascular dementia is a common form of cognitive impairment in older persons that is usually due to a series of small strokes which affect some mental functions. Symptoms include confusion, problems with recent memory, impaired reasoning, wandering or getting lost in familiar places, loss of bladder or bowel control (incontinence), emotional problems such as laughing or crying inappropriately, difficulty following instructions, and problems handling money. The damage is typically so slight that the change is noticeable only as a series of small steps. However, over time, as more small blood vessels in the brain are blocked, there is noticeable gradual mental decline."

Dear Ellen,
Refusing medication may be your mother’s attempt at exercising control over the environment. It may be a reaction to interacting with her caregiver. Is her caregiver experiencing problems with other types of care like toileting or bathing? Your mother may no longer understand that her medication is necessary.

My suggestions are:
1. Check with her doctor to find out about alternative forms for medication. Are any of the meds available in liquid form? Can the meds be crushed? This gives the caregiver different ways of offering the medications and the option to mix the medications in a spoonful of favorite food such as pudding or yogurt. Be sure to ask about possible interactions of medication with food to make sure that the potency of her meds is not being affected by what they are mixed with.
2. Her caregiver should be calm and matter of fact when offering medication. Your mom may be more rebellious if she can sense the tension in her caregiver. If the situation becomes difficult, back off. Try again in a few minutes after distracting your mom from her upset.

Sincerely,
Janice Wallace
The Eldercare Coach

 

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