Dealing With Aging Parents: Medication Non Compliance
Dealing with aging parents can be a delicate balancing act, especially when it comes to managing their medications. In this blog post, we explore the challenges of non-compliance and the emotional toll it takes on family dynamics and caregiving.
Judy writes,
Balancing the role of caregiver for aging parents can often feel like a delicate tightrope walk. Avoiding the perception of "parenting" your own parent requires finesse and sensitivity. Last week, while accompanying my mother-in-law (MIL) to her checkup, my husband took his father (FIL) on their routine grocery-shopping trip. This gave MIL and me a chance to have an open conversation, touching upon various subjects.
One pressing matter was FIL's lack of adherence to his prescribed medication regimen. Our experience with Alzheimer's medications had been a series of unsuccessful attempts. The initial medication was discontinued after a mere 3 or 4 days due to perceived side effects. The question lingered: Were these side effects a result of the medication, or possibly linked to the bacterial infection he'd been battling all summer?
After receiving potent antibiotics for the infection, FIL had to cease their use due to difficulties swallowing the large pills. Following a consultation with his doctor, we received permission to crush the capsules, despite their "DO NOT CRUSH" label. Resuming the antibiotics improved his stomach condition, but the Alzheimer's medication was left untouched.
In response, the neurologist prescribed a different medication, one typically introduced only after a patient has adapted to the initial medication. This second medication often causes stomach discomfort, which the first medication helps alleviate. Instructions were given to manage potential stomach issues by combining the new pills with omeprazole. However, FIL discontinued this medication too, within a few days, claiming it was per the doctor's advice due to discomfort.
This crucial information only surfaced during our conversation last week, leaving me under the impression that he was continuing his medication when, in fact, he wasn't. The next step involves a discreet attempt to introduce the crushed pills alongside his other medications to gauge his reaction. It's apparent that he may resist complying with any of Dr. Neuro's prescriptions. His emotions of fear, anger, and resentment are concentrated on the neurologist, who diagnosed him with Alzheimer's. Denying, avoiding, and rejecting the diagnosis seem to be his coping mechanisms.
While this reaction might be considered "normal," it certainly doesn't simplify matters. An upcoming appointment with Dr. Neuro is looming, and we anticipate FIL's reluctance to attend. I've devised a plan that involves shifting his Alzheimer's care to his primary care physician (PCP) if he declines to see the neurologist. Collaboration with the neurologist would still guide his treatment plan.
Regrettably, even if we succeed in administering the medication, its efficacy remains uncertain. FIL's facade of strength diminishes during our visits, giving way to moments of silence and apparent mental decline. While not drastic, the changes are palpable each week. He is a far cry from the once-adventurous man who explored national parks and embarked on glacier hikes and family vacations, documenting them with enthusiasm.
The mountain ahead is steep, and the journey challenging for both my husband and MIL. My role is to provide assistance wherever possible, acting as their safety net during this arduous climb.
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