But she is refusing to take her pills. In fact, she’s been hiding them. The last time you went to visit and found her stash, you got into a terrible argument, as bad as when you were a teen—except this time you’re doing the lecturing and she’s the one putting up a fight.
What can you do? The answer may surprise you. If your loved one is able to understand the consequences of not taking medications, then she actually has a right to refuse them.
Take the Time to Find Out Why
There are many reasons why an older adult may not want to take medications—some quite reasonable and others due to failing cognition. Determining the cause is a crucial first step, both to respect your loved one’s individuality and to be sure there aren’t serious underlying issues that need to be addressed separately.
That means sitting down with Mom and having a calm, supportive conversation to find out what’s really bothering her about her pills. Ask what she doesn’t like about the medications and why she refuses to take them. If your conversations have become too charged or you need someone to help mediate, bring in another supportive family member, friend or an Aging Life Care Professional™ to help.
Determine What’s Really Necessary and Any Alternatives
Here are some of the answers that your loved one may give you, and what you can do to help:
- Too many pills: All too often, over decades of doctor’s visits, older adults can acquire a long list of medications. Some may be necessary and others, not. She may just be sick and tired of having to take so many pills. Bring a current list of meds to her next doctor’s appointment and ask what each is for and which are truly necessary for her health and quality of life.
- Hard to swallow: Some pills are huge and uncomfortable to swallow, especially if your loved one suffers from dry mouth. Talk with her doctor or pharmacist to find out if the pill in question can be crushed and mixed into food, or whether it is available in liquid form. Mixing a crushed pill in ice cream or other favorite food can make all the difference.
- Unpleasant taste: Let’s face it. Some pills and liquid meds taste awful. See if there are other equivalent options, assuming the medication is really necessary.
- Stomach upsets: Medication can be hard on sensitive stomachs. Find out if there are good alternatives or whether there are ways to buffer the stomach with food or antacids against side effects.
- Too many tests: Some medications, like Warfarin, require frequent blood work to assess levels. Your loved one may hate getting stuck by needles. If she is at risk of strokes, but refusing her meds, check with her doctor to see if an alternative, such as a baby aspirin, may actually be sufficient to minimize risks of blood clots (especially if the alternative is her taking no preventative meds at all).
- Fear of risks: Your loved one may have “heard from a friend” that a particular medication resulted in a stroke, or that a diuretic will make her have to run to the bathroom too frequently. She may also have experienced discomfort—dizziness, drowsiness, stomach upset—after taking a certain med and be afraid to take it again, even if the discomfort was actually coincidental and unrelated to the pill. We all have our anxieties about side effects. Work with her doctor to help her understand the real risks versus rumors.
What to do if your loved one is struggling with Alzheimer’s or another form of dementia and is fighting medications that are essential to her health? This requires a partnership with her physician, to determine her level of competence and appropriate care and treatments. An Aging Life Care Professional™ can help you to assess her needs and whether it is time to seek alternative living arrangements with nursing support for medications.
Respect Your Loved One’s Right to Refuse
Often, however, the situation is more gray than black-and-white. We live in a culture that is obsessed with medications—a pill to solve every problem. As we age, however, we all have the right to decide if taking dozens of medications a day is how we want to live, if we want to seek out alternative treatments, or if we just want to put up with ensuing health issues.
You may not agree with your loved one’s logic, but if she clearly understands the consequences of refusing medication, she also has a right to make a decision with which you disagree. A power struggle, arguments or any attempts to force medication on your loved one will only make a difficult situation much worse. If you approach her with a clear intent of meeting her half-way, then you both have a better chance of reaching a good—if not perfect—outcome.
President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.
For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.
Image Credit: Cathy Kaplan