March 1, 2024

Tips for Medication Refusal

Thank you for watching this video, with tips to help when a person with dementia is reluctant to take medications. The audio that you’re listening to is being accompanied by a video from the Zinnia Activities of Daily Living channel titled, ‘Time for Medications’. You may want to watch that video with your loved one prior to offering medication so that they can see others taking medications successfully.

Many caregivers of people with dementia struggle with frustration brought on when the person being cared for doesn’t want to take their medications. As a caregiver it’s important to get curious. Why are they so resistant? Is the medication hard for them to swallow? Does it taste bad? Do they feel unpleasant side effects after taking the medication? Do they not believe that they need medication? Or think that they already took it?

If the issue is with the actual process of taking medication; it’s hard to swallow or tastes bad, speak with your physician about alternative forms of medication. Is it available in liquid form or as a patch? Can the pill be crushed and mixed with pudding or applesauce? Of course, never resort to crushing pills without first checking with the doctor.

If the medicine causes unpleasant side effects, check with your doctor about possible changes in medication or strategies to alleviate side effects. And don’t forget to look at other conditions that might make a person not wish to eat anything, including pills. Do they have a sore tooth, or throat? A stomachache? A urinary tract infection? Is this a new behavior? If so, what has changed since the last time they took medication?

If the person you’re caring for doesn’t believe that they need medication, try to avoid an argument in which you tell them what they need to do. No one likes being told what to do. It can be helpful to remind them that you love them and simply want them to be their healthiest selves. It can also be helpful to remind them that you are not the one making the rules – you are simply helping them follow the doctor’s orders. Can the doctor provide a written note that you can show your loved one at medicine time, reminding them that they need to take their pills? Or, when you are visiting the doctor, can you create a brief video on your mobile phone of the doctor reminding your loved one that they need to take their medications? If there is someone other than the doctor who your loved one is likely to listen to, the note or video can be from them, instead.

If the person’s cognitive impairment is such that they don’t understand what you are asking of them, use short simple sentences and mimic the action of putting the pill in your mouth and taking a good drink of water. Consider taking your own medications, or something that resembles medication, at the same time that you offer theirs.

Before offering medications try and create the best mood and setting possible. Avoid unnecessary distractions, and check in with your own emotional state. Are you modeling calm and ease, or frustration and anger? Consider putting on favorite music, enjoying a cup of coffee or tea together first. It can be helpful to take a few deep breaths together. And perhaps offer an incentive – a favorite treat once the medicine has been taken, or watching a favorite show.

If the person continues to be resistant, don’t let it turn into an argument. Simply stop, then try again in 15 minutes or so. A few deep breaths in between efforts could really help. And consider watching the Zinnia video, ‘Time for Medications’ with your loved one so that they can see other people taking medications and being okay with it.

Are some medications critical and others less so? If that’s the case – start with the pills that simply must be taken.

Medication taken the same time every day is more likely to be taken successfully. Build it into the routine. Some caregivers prefer offering pills just after a meal when their loved one is still in the mood for eating things.

Are all those pills absolutely necessary? It’s a terrific idea to do periodic medication checks with your doctor. Assess which medications are necessary, and which can be let go. As dementia progresses it is not unusual to drop some medications off the list, with a doctor’s assistance. Fewer pills to take means fewer pills to fight over.

And consider whether the sight of LOTS of pills is part of the problem. It may be easier to simply offer one pill. Then, a few minutes later, offer another. Then another.

Thanks so much for helping the person you care for take their medications. If you find that medication time is causing you to feel overwhelmed and anxious – consider whether there is someone else who can help with this task. Even a family member who lives far away might be able to do a daily phone call or two to help with medication management.

Don’t forget how amazing you are!

Take good care!!

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