As a continuation from last week — M.K. is frustrated because his mother who has Alzheimer’s disease and a bipolar disorder refuses to take her medication.
He is looking for ways to overcome her resistance. He also wants to know if he is genetically vulnerable.
The Alzheimer’s Association, DailyCaring.com and others organizations offer several tips for what is called “medication compliance.”
* Try to create a calm and quiet environment. Consider playing soothing music and eliminate loud sounds like the television; close windows if the outside noise is too loud.
* Try to determine if side effects or illness is making the person uncomfortable. Some medications may cause stomach aches, agitation or dizziness. Additionally the individual may not be able to articulate reasons for the resistance and therefore expresses the anticipated discomfort by just saying no.
* Check for a possible dental problem, a cold or sore throat.
* Eliminate medications and supplements that are not absolutely necessary. Check with the person’s doctor if any medications can be eliminated.
* Don’t over explain. Use short sentences and don’t discuss the importance of taking the pills.
* Don’t force it. Leave the person alone for a period of time and then try again in 10-15 minutes.
* Find the right time of day. Those with dementia typically have good and bad times of the day. Giving medication during a bad time won’t work. For example there is something called sun downing syndrome, a symptom of Alzheimer’s disease and other forms of dementia. It’s also known as “late-day confusion” which gets worse late in the afternoon and early evening. Fading light seems to be a trigger.
* Stick to a daily routine. Give the pills at the same time every day, in the same place and use the same cup for water. You might select a time when the person is comfortable such as sitting in an easy chair or after the person has eaten a meal – while in the “eating mode.”
* Offer a treat as a reward. A piece of favorite chocolate might do the trick. It could also counter act a bitter taste from the pill.
Many of these tips assume that someone is with the individual. Clearly that’s not always the case.
Debra Cherry, Executive Vice President of the Alzheimer’s Greater Los Angeles, notes that the organization teaches a three-step approach to understanding and adjusting to the behavioral symptoms of Alzheimer’s Disease and Related Disorders (ADRD). It is called IDEA!
“ID-Identify the behavior. In this case it is refusal to take a pill for Alzheimer’s disease and a bipolar disorder.
E-Explore alternative reasons for this behavior. Is it a new behavior? Has she always disliked this medication? Is the pill too large? Is it bitter? Are you giving it to her when she is tired and irritable?
A-Adjust your approach. Try new strategies. Brainstorm. Use trial and error to find an approach that works.”
Cherry recommends the following link for caregivers: www.alzgla.org/ CaregiverTipSheets.
If your mother continues to refuse taking her medication, consider asking yourself two questions: Is your mother a danger to herself? Does she present a danger to others?
Donna Cohen, Ph.D. clinical psychologist, pioneer in research on Alzheimer’s disease and one of the original founders of the national Alzheimer’s Association provides some advice to caregivers of dementia patients who resist overall care and advice. She is quoted as saying on On.Care, “As long as seniors are not endangering themselves or others, let them make their own choices…”
At some point, “You need to accept limits on what you can accomplish and not feel guilty.” Before taking this approach, make sure to consult with your mother’s physician. Note at some point a caregiver or assisted living accommodations might be in order.
Regarding genetic vulnerability — Age is considered a risk factor for Alzheimer’s disease. Having a parent with the disease is not a guarantee that you also will have it. In some cases genetics may play a role for early onset which would be under age 65.
There is some hope given current research and a new initiative launched by the XPRIZE Foundation; its mission is to bring about radical breakthroughs for the benefit of humanity. The Foundation is sponsoring a global competition for scientists to eradicate Alzheimer’s disease. More than 100 leading neuroscientists, advocates and technology experts have already contributed their ideas and insights.
The XPRIZE for Alzheimer’s disease was conceived by Ken Dychtwald, Ph.D., President and CEO of Age Wave, and XPRIZE Founder Dr. Peter Diamandis.
Thank you M.K. for your important question. And best wishes in finding the right approach to optimize the health and well-being of your mother.