The problem, how to get a person suffering from Alzheimer's disease to take their medication?
By Bob DeMarco
Alzheimer's Reading Room
Like many, I faced this problem with my mother, Dotty, who lived with Alzheimer's disease.
Over time, through trial and error, I finally learned an effective way to deal with this problem.
Let's start by examining the dimensions of the problem.
Have you ever tried to explain to someone suffering from Alzheimer's disease why they should take their medication?
Do you end up going into some kind of long explanation why they should take the pills? As you do this, are you trying to reason with them?
After trying to reason with them do you finally become exasperated? Maybe a bit irritable? Sometimes at "wits end"?
Do you find that the more you try to reason with a person living with Alzheimer's disease the more resistant they become too what you are trying to accomplish?
Did you ever wonder why they become more resistant?
For example, did it ever dawn on you that by supplying to much information they become confused?
Information overload is not a good thing for someone who is deeply forgetful. It tends to confuse them. Once confused they really don't understand what you are trying to do. Ask yourself, can you operate effectively when you are confused?
How do you sound when you are trying to give someone living with Alzheimer's their medication? Does the sound of your voice change as you become irritable or exasperated? Do you start to lecture? Do your words sound harsh in any way?
Let's reverse the paradigm.
How do you react when someone speaks to you in a harsh tone of voice? Are you more or less likely to do what they want? How do you react when someone tries to force you to do something you don't want to do?
It is important to go out of yourself and to start thinking about what the person living with Alzheimer's might be thinking and feeling.
It is important to look at their face and try to determine how they are feeling. It is important for you to understand that their brain is sick and as a result they don't think and absorb information the same way that you and I do.
Here is something I learned. When you want to get someone living with Alzheimer's to do something the less you say the better the outcome.
The best approach is to use nonverbal communication.
When it is time for my mother to take her medication my goal is to get her to take the medication without saying a single word to her.
This is important -- never hand an Alzheimer's patient more than one pill at a time.
Use a small, light, glass of water.
Make sure the patient is sitting up in a sturdy, comfortable place.
Without saying a word, hand them the glass of water. If they ask what it is for, ignore them.
Hold the first pill out in front of them so it is easy to see. Give them a chance to absorb the information into their brain. Don't hurry.
If you are having a problem getting the patient to take the medication it is likely that the patient will say something negative. Ignore the words. Don't say anything. Just hold the pill out in front of them.
It is not unusual for my mother to tell me I am trying to do something bad to her. Or, she doesn't need any pills, she is healthy. Or, any of number of reasons why she doesn't need or want the pills. She often refers to them as synthetic life.
I stand there and I don't say a word. Even though she might be saying something very negative about the situation, or the medication. I wait for her to take the pill out of my hand.
Second pill. I hold out the second pill. She takes it, and takes a sip of water.
Third pill. Same story but I change it up. I finally say in reference to the glass of water, big drink. Big drink, my only words. Obviously, this means take a big drink of water.
You might be wondering why I say big drink. Alzheimer's caregivers often have trouble getting the patient to drink water. If you can get them to drink the entire glass of water, or most of it, you are also working on and solving that problem.
Once my mother takes the pills it is now time to add a healthy dose of positive reinforcement. I say something very positive to her. Usually about the water. Then I give her something she really likes.
In the morning, I give her coffee. My mother loves coffee and always has. So after she takes the medication I give her the coffee. I always say something positive. Here is a nice fresh, hot cup of coffee. It is really a nice sunny day outside today. Lay it on thick. Try it.
I want to make this clear.
I am using the combination of nonverbal communication and positive reinforcement to set up a pattern. The positive reinforcement in this case is the coffee. However, that needs to be reinforced by a stream of positive words.
At night, I usually start by saying -- its ice cream time. This puts my mother in a positive frame of mind. She loves her ice cream and almost always says something positive about the ice cream.
I get my small, very light glass of water and the pills. I do what I described earlier. I listen to her negative comments and keep my mouth shut. I hold out the pills one by one. After she takes the last one, I say big drink.
I then bring the ice cream and say those very positive words. When she finishes the ice cream I ask, how was it? Most of the time she says delicious. I leveage that up with a nice positive steam of words (consciousness).
I turn the situation positive.
Back to the problem. If the Alzheimer's patient won't take the pills then you need to recognize that what you are doing is not effective. You need to search for a way to turn the taking of medication into a positive experience.
Here is your goal. To establish a pattern, and a pattern of behavior, that is going to be effective and long lasting.
Let me warn you. The solution I am suggesting might not work immediately. It takes time and focus to establish an effective pattern and change behavior.
Think of it this way.
If you are out of shape and you want to start running it is not likely that you will be able to run a couple of miles comfortably. However, if you start first by walking, then by walking fast, then jogging, you will finally reach your goal of being able to run comfortably. Once you can run comfortably, you can increase how far you run by a small increment each week until you reach your goal.
It really is up to you.
You can continue to complain about the person living Alzheimer's over and over and over. Or, you can change the rules of the game. You start this change by changing the way you deal with the problem.
Take a few deep breaths. Think about how you are going to accomplish your mission. Learn to say less. Nonverbal communication is more effective than a lot of words.
Now go do it, and when you accomplish your mission -- let me know.
Comments, insight and advice from the Collective Brain of the Alzheimer's Reading Room are welcomed below in the comments section of this article.
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Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The ARR knowledge base contains more than 3,811 articles with more than 306,100 links on the Internet. Bob lives in Delray Beach, FL.Original content Bob DeMarco, the Alzheimer's Reading Room