I have an elderly friend (I’ve known her since I was 12 and she became a family friend) who has always been very self-sufficient and independent but because of age and a stroke early this year, she is experiencing some cognitive problems (she also refuses to get help/diagnosis for this) and has been forgetting to take her meds— sometimes refusing to do so. It caused a lot of distress, and arguments between us—I became her IHSS provider to help her a couple years ago—but now she refuses to let me help with several things, gets irritated and angry when I try to remind her about taking her meds etc. I bought her an automatic pill dispenser that she used for a bit but after coming along so far in her recovery she refuses to use it. She also refused to let me keep using Alexa to remind her to take her meds when I’m not there, as she lives alone— and threatened to cut me out of her life if I tried, and I just. I don’t know what to DO. She doesn’t trust me, doesn’t want my help anymore with the important things, she yells at me and I could feel myself becoming more and more overwhelmed/short with her. I’ve quit being her IHSS provider and encouraged her to find someone else who 1) could be with her more hours than I could (I have a full time job and am going back to school soon) and 2) I think our relationship is making it difficult for her to see me as someone who can help her (in her eyes it’s a little kid trying to tell her what to do—I’m 28). I didn’t want to keep fighting with her I need her to trust me and call me when she needs help, I need her to not shut me out. It became something unsustainable as it was. she doesn’t have kids and her siblings are far away and unavailable, I still see her a couple times a week to check in and help her get food and make appointments and take her to them etc. nothing's changed she doesn’t take her meds—she’s on three blood pressure meds, heart meds and blood thinners. If I do much as bring it up she gets mad and essentially stops talking to me until I leave. She had a stroke, this is important! I don’t know what to DO. Her nurses and social worker know about this too, but because she’s still capable of making her own decisions they say there’s nothing they can do? She’s poor, has no kids no real family and she won’t let me help in the ways I need to? Any advice on this is hugely appreciated, I’m worried and sad and frustrated and every single option feels like a bad one.
She is progressing in her dementia and there is utterly nothing you can do to change that. This is reportable to those managing her care. You are responsible to someone in her care, so whomever that person is needs to understand that her medications are now sometimes not taken. She may require placement. You are doing your best, but currently this just isn't working. I wish you the best. Do know that some medications (my levothyroxine and my atenolol for instance are two) are virtually tasteless and can be crushed and put in food she loves, milkshake or something, but many shouldn't be crushed, or taste awful, so that is just a thought.
sometimes the consequences have to happen and then the help they really need can be put into place.
Let the nurses and social worker take over for a month and see if they realize she needs more care .
If she does trust you with her care, one suggestion that might help is talk to her doctor and see of you can limit the amount of medications she is taking...perhaps one tablet can do the purpose of two ailments...if you explain to the doctor her aversion to taking tablets, they might be able to work with you. They SHOULD be aware of this kind of temperament in old people, and they can find a happy medium to maintain the health of the patient without stressing them too much. If she absolutely will not take medication, maybe the one or two tablets that are absolutely important can be mixed in her food, ground up in pudding or applesauce. These workarounds I have used on my mother who has dementia and I have advised her aides/nurses in the nursing facility to do the same, and it has spared us a lot of grief. I commend you on your dedication and I wish you success in helping your friend.
IF her friend has been diagnosed as not having capacity then medications can be covertly given. If she has not been diagnosed incompetent then her friend is within her rights to refuse medication. And to grind meds up and give them to her is not legal.
If her friend has been diagnosed as being incompetent then she should not be living alone.
You can be a friend.
You can be a "caregiver" of sorts.
You can't be both to this person. She won't accept it or allow it.
You can be there for her as a friend but you need to accept that at some point the choices she is making may shorten or end her life.
If she has family you can relay concerns. If she has a POA you can relay concerns. You can relay concerns to her doctor. But you can not expect family, POA or her doctor to comment about your comments or concerns.
Decide what you want to be, friend or caregiver and make peace with that role.
You may want to consider following;
If there are any biological relatives for her, notify them re her needs and, that you are no longer available.
If there are none, or if they refuse to step in, call APS, Adult Protective Services and notify them re the patient status. This can be done anonymously if you prefer.
If she is cognitively able to understand you, tell her that her safety is compromised and you must for her best interests step away and, contact the above.
You had no idea what you were getting yourself into. There might a reason unknown to you why no family is around.
Sadly, the only thing they can eventually do is have her placed in a facility. And the only thing you can do is visit her. At least she will be getting hers meds and will be looked after.
Please don’t hesitate doing this. Speak with her social worker and her nurses…there’s no way they are letting her not take her meds. Can she grocery shop? Pay her bills? Drive? How are these things getting done? If it’s you, tell the social worker you will stop and to get her placed.
All you can do is call in the authorities and show them videos of her dealing her medications. Everyone uses their phones to document dangerous situations nowadays.
I understand. There comes a time when we realize we've done all we can - and that we need to let go. You need to let go.
Yes, it is difficult. However, it appears to me that this woman:
1) is depressed and needs MD assessment for medication to deal with depression;
2) is cognitively compromised, perhaps due to stroke, perhaps not. Clearly she is either choosing not to do what she needs or cannot. She needs a MD assessment and it appears only she can arrange for this, which she won't.
3) Her needs / issues / health concerns are a combination of the above and/or more / different.
You are so right. A person will not listen to a friend, relative, neighbor, etc., as they might listen to a professional - be it MD, social worker, etc. Perhaps the only - and perhaps last resort - strategy you can do is report her to county senior services or some outside agency that can knock on her door to see what is going on - and see if she will accept the help she needs. Clearly, she likely would 'slam the door in their face' - and you will know you've done all you can.
Without POA status, many elders or older people health compromised, be it physical, mental, cognitive, psychological will make decisions not in their best interest - and there is little to nothing we can do. It is important to realize when the time comes to know when to stop, step back, and feel both sad and also self-acknowledge all that you have done and tried to do. You must take care of yourself.
KNOW THAT YOU did a huge service to this woman.
It is now up to her.
Letting go is one of the hardest things to do.
It says a lot about YOU coming to us here for support.
You will get it. Take it to heart.
Gena / Touch Matters
People feel that they are strong for ‘holding on’ but sometimes it takes more strength to ‘let go’ and very often ‘letting go’ is what is most needed.
By holding on people are hoping to be able to control the situation. It generally doesn’t work out very well.
I also feel that it is best to allow an objective professional, (MD or social worker) attempt to persuade them to move forward in the proper direction.
Just be the friend who checks daily to see that she’s still alive. There will likely come a day when she gets p.o’d that “you are all up in her business checking on her every day!”
Do not nag about the meds. Do not even mention it.
She was once independent and now isn’t. That is tough for her. I also read in a response that she would rather die than go into a home. I doubt if you can change her mind.
Some people truly would rather die than enter a home. They have specific reasons as to why they feel this way.
I have a friend whose mother consistently tells her she doesn’t want to go into a home. Her reason behind it is fear.
Fear of the unknown is natural, but my friend’s mom’s anxiety is through the roof. She refuses meds.
No matter how much my friend would like to help her mom, she realizes that it’s beyond her control.
Sometimes there is nothing else that you can do.
If there are deep seated emotional issues, along with decline, it is going to be an uphill battle that may never be overcome.
You can't help folks like this.
You “don’t know what to DO”. “Every single option feels like a bad one”. In fact you have almost no real options, and the situation is likely to get worse. She will eventually have a crisis, with sudden death or compulsory care (neither or which are necessarily bad). You have no rights to intervene, in fact less than “her nurses and social worker”. Leave it up to them. You have DONE what you can. You can’t always succeed, no matter how crazy it seems, or how bad things are. Accept it, and if you want to stay in touch, make it a friendly social visit.
In the long run, extending her life may not be the wise idea you think it is. Living with dementia and all the headaches & heartaches associated with brain dysfunction is not something most people want to do. If she decides to stop taking her meds, so be it. She will let the chips fall where they may and it's up to her siblings to intervene to save her life if they so desire, 'unavailable' though they may be. There is only so much you can do as a family friend. If you feel she's in danger as a vulnerable adult living alone, call APS to do a wellness check on her. If they feel she should not be living alone, THEY will see to it that she's placed in a Skilled Nursing Facility for her own safety.
Wishing you the best of luck detaching from this situation with love, realizing there's nothing you can do for a person who does not want your help. As long as she's still considered competent, there's nothing ANYONE can do to save her from herself. It's her right to live as she sees fit, and to die the same way, if it's in the cards for her to.
The bottom line is, as much as you would like to see your family friend listen to reason, you can’t force her to see things from your perspective.
You have offered your help. She has shown you that she isn’t interested in following your advice. So eliminate the sentence, “I don’t know what to do.”
There isn’t anything left for you to do except to step aside and allow her to take over the reins. Perhaps her care team will be able to persuade her.
It’s disappointing and even unsettling to us when we have someone’s best interests at heart and they refuse our help.
You can remain being her friend if you wish. Leave it at that though because anything more will cause nothing but frustration for each of you.
Gena / Touch Matters
My mother that has Vascular Dementia started not trusting pills around year 4. It caused arguments every night and was very stressful for both of us. It's not her fault her ability to make rational decisions is not very good and she may have developed trust issues or is not fully understanding the overall importance of what you are trying to ask (she sees it as make) her do and the impact on her health. Since she's not understanding she may see it as a threat and just refuse.
Don't get frustrated or pushy with her as it will make it worse in the short-term and future. You can try and get very very very patient and spot those certain times and moods they are willing to take medications. Her doctor also told me to grind up the meds and put a little in her morning coffee or evening desert. The later stages are where are now as she will spit pills out if you give them to her at the wrong time.
You are very right that these meds are very important, and good luck believe me I know how hard the meds game really is.
Sorry, as long as everyone feels she is competent, then she can make her own decisions, good or bad. Drop the telling her all the time.
Some folks CAN'T be helped. They have capacity to make decisions for themselves and insist on making BAD decisions. You can't stop that.
Visit as a friend. Don't nag.