Why would someone with Alzheimer’s refuse medication?

Why would someone with Alzheimer's refuse medication?

Tuesday 29th June 2021
Tina Westlake

Refusing to take medication could be a response to being confused or feeling afraid of what they're being asked to do, they might also feel like they don't have any control over their life, which could make them generally angry or resistant.

Try some of these tips to see if they help -

1. Create a calm and quiet environment
Make sure there aren't any loud sounds like TV or commotion like lots of people around. You could also try playing soft, soothing music. Before you start, take some deep breaths, and do your best to stay calm throughout the process. If you're agitated, frustrated, or angry, it's likely they'll be able to sense it and that can cause them to become agitated and less likely to cooperate.

2. Be alert to side effects or illness that make them feel sick or uncomfortable
Someone might refuse to take their medicine if it makes them feel sick, uncomfortable, or if they have an illness. Many medications cause unpleasant side effects like nausea, stomach aches, agitation, or dizziness and they might not be able to tell you that there's a problem. If you suspect this could be the issue, speak to the doctor about how to improve the situation. They could also have something else going on like dental problems that make their gums or teeth hurt, poorly fitting dentures, a urinary tract infection, a cold or flu, or a sore throat.

3. Eliminate medications or supplements that aren't absolutely necessary
Give medication in order of importance - more likely to take the first few pills than lots of them, so always give important ones first, laxative ones whilst important are not for life threatening conditions so its not so bad if they miss this one. Ensure regular medication reviews are completed to check meds are still required, if not discuss with GP about these being discontinued - fewer pills = easier to encourage.

4. Make pills easier to take
Some pills could be too large and hard to swallow. Talk with doctor or pharmacist to see if any of their medications could be changed to a liquid formula or if you could crush the pills and add them to applesauce, yogurt, or food.- This step requires written authority on prescription by GP and cannot be done without this as classed as covert medicating. Some pills cannot be crushed as they become unsafe - ie enters blood stream incorrectly and can have serious consequences even death. Again this has to be written into prescription and is under direction of GP only.

5. Use short sentences and don't explain or reason
Don't get into a conversation about why they need the medication or explain why it's important that they need to take their pills. Reasoning with someone with dementia simply doesn't work. Instead, use short, direct sentences to help them accomplish the goal. For example, you could just hand them the pill, demonstrate what you want them to do by putting a pretend pill in your own mouth, and wait patiently for them to put their own pill into their mouth, then say "Big drink of water."

6. Look for things that trigger distress
Sometimes other things about taking medication can upset someone with Alzheimer's or dementia. EG they could get distressed at the sight of their blister pack, so only hand them one tablet at a time and keep the box out of sight.

7. Be their medication buddy
Taking your own medicine at the same time they do can make it more of a buddy experience. You might say, "It's time for our medicine. Here's mine and here's yours." If you don't take any medications, see if you can get away with "taking" a harmless food item like an M&M or Skittles candy.

8. Don't force it, try again in 10-15 minutes
Sometimes there's nothing you can say or do to get your older adult to take their medication. If that happens, don't try to force it. Leave them alone for a bit so you can both calm down. In 15 minutes (or so), give it another try.

9. Find the right time of day
People with dementia often have "good" and "bad" times of day. Trying to give medicine during one of their bad times isn't likely to work. Often morning meds are easier to take straight after breakfast with a drink, whilst still relaxed maybe watching their favourite programme.
If evening meds are required, waiting just before bed may be too late as they are becoming too tired, instead try earlier maybe with a little supper and a nice relaxing hot drink, start the wind down procedure, get into a routine and stick to it.

If its becoming a real problem due to being too tired it might be worth discussing with the GP to see if the meds could be taken at a different time, but do not alter the times without first discussing it with GP as they are usually set at a specific time for a reason (ie number of hours between doses etc).

10. Stick to a daily routine
A daily routine can do wonders for someone with dementia. By sticking to the same time/routine over time they will more likely accept it. Make sure you give them in the same place as well, so if they are happy sat in front of Dolly Parton on the tv whilst sat on their sofa, stick to that, even use the same colour cup - ie blue cup of water = meds. Some people take them best after food, as they are still in the "eating mode"..

11. Offer a treat
Consider offering a treat as a reward for taking their medication. EG favourite bar of chocolate or sweet, get it out ready and tell them its for once they've taken their tablet as a treat or to take away the taste. Or if a favourite activity works use this as a bargaining tool. - Lets just take your tablets then we could go for a nice drive etc

I hope this article helps you and your loved ones.

If you have any questions, feel free to drop a question below and we'll get back to you.

Tina x