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Yes this is "normal " progression of dementia. Like my mother was, he is in danger of wandering out of the facility he is in presently.Those places are not meant to house people in his stage of dementia. He needs more management and on site services.
He does need to move but into a secure facility where he is monitored 24/7. They do everything for him like giving meds, baths, checking in on him frequently and doors are locked after 7 p.m. so he can't wander in the night. My mother is quite happy in her setting in a place like it.They aren't hospitals like the Cuckoos Nest.
He wants to move so let him pack and then drive him to his new secure facility.
Thank you for all the replies! He has vascular dementia.
We are going to try to get another urine sample on Thursday. My husband is taking him for an Echo, so he's going to get there early so if he can get a sample they can drop it by his primary.
He just saw his primary week before last (where he spent 40 minutes in the bathroom trying to work up some urine) and all his bloodwork was done and his meds reviewed.
I have been nothing BUT a squeaky wheel about his meds. I have spoken with the supervisor and my husband called the head of the company to complain. The supervisor says they are watching him take his meds, but I don't believe them. That's why we are going to have his dog walker do it. They were just filled on the 28th, so we have to hobble through until then when I can go back to filling the meds myself. I was hobbled because the facility didn't want us in more often than once a month because of Covid. Now they are offering weekly testing to those of us who are essential, so we are once again allowed in more often. So during the time we were unable to go in, we were unaware that the CNAs were not getting his meds into him. My dad actually told on himself when my husband was taking him to his doctor's appointment and told my husband that he had been throwing his pills away. That's when I jumped in. They were requiring blister packs from the pharmacy rather than my filling the pills in pill a day dispensers. I basically had my med controls taken away because of Covid, so I don't even know what pills he's getting and what pills he's not (I corrected that on Friday when I went in). Now his pills are right for the rest of the month as long as they are given to him and they ensure he takes them.
Since I posted this, we tracked down the dementia alliance for our area. Turns out that his neurologist's specialty is not dementia. His previous doctor at this practice left and they transferred my dad to this new doctor. We were able to get him an appointment for January with a Memory Care type of place with a doctor who specializes in dementia.
We are trying our best. Sometimes we feel overwhelmed because we honestly have no clue what we are doing. Thank goodness my husband likes to talk on the phone, he tracked all of this down today. I am very fortunate he is here to help me!
Thank you again for all the responses, it's both a relief and saddening at the same time. I hate to see his confusion.
It sounds to me like you are doing the best you can. The CNA is not following proper procedure fir dosing meds. You can complain to the State regulating agency, but you need documentation. The blister pack meds are standard with care facilities. I am surprised a facility would allow you to take charge of your dad’s med dosage.
Doing what you are doing IS overwhelming. It sounds like you have found a better doc. Good luck going forward.
Hi all. This is a new one and I don't know if it's just may dad's dementia progression.
My dad lives in an independent/assisted living facility and has been there for almost 2 years now. He needs to be there, he's fallen several times and has been using a walker for over a year. They have on-site physical and occupational therapy and he gets both weekly.
With Covid, we had to cancel all of his doctor's appointments earlier in the year, but in the last couple of weeks were able to get him into his primary care doctor, his cardiologist and his neurologist. We got him into the neurologist because he's showing some strange behaviors. We have been trying to get a urine sample for his primary, but that's been difficult to do because he's incontinent and no longer really controls his urine flow (he wears pads and pull ups).
[snip]
It's really sad to see how confused he is right now. We had a new CNA group come in back in July and they have been administering his meds. We found that my dad had been hiding his pills (though we told them they HAD to watch him take them). Our dog walker used to be a social worker and we are going to pay her to give him his meds because I am not sure if some of his issues are medication related and I just don't trust this new group of CNAs. When I went in the other day, I found pills on the counter and they couldn't explain WHY they were there.
Is some of this normal dementia progression? It's just my husband and me taking care of him, the brother who visited lives several states away.
I agree with others that it sounds like a normal progression. But only doctors can diagnose it.
About getting the urine sample, suggest to the nurse to put a catheter into his bladder. The urine will go into a urinal bag; and the nurse can get urine from the bag. Make sure everything has to be handled carefully, so the urine won't be contaminated. This procedure may not be easy if your dad is agitated, and if he resists to have the catheter to be inserted into his body. The nurse and you may need to be there to explain it to him delicately.
About medications, you cannot let your dog walker, who used to be a SW, to give him medications because she is not a trained nurse. At my workplace, even CNA's cannot give the residents medications, only the RN's and LPN's. When giving medications, the nurses have to stay with the residents and make sure they finish all of the pills. Sometimes they even have to check inside their mouth, on the sides and under the tongue. If some residents have difficulty to swallow the pills, they crush them and mix them with apple sauce.
You can bring the issues to the manager, clinical team leader, and even to the administrator.
Last edited by AnOrdinaryCitizen; 11-17-2020 at 10:54 AM..
What a difficult road you are on. I am so sorry, OP. I am sorry for your entire family. It's sad, and it's long term, and it never really improves. And it ends in death.
Wow, I'm being a downer, but after going through Alzheimer's with my MIL, and then vascular dementia with my mom, I feel pretty qualified to make such statements.
You are not alone, and I hope you can find a good support group.
Anyway, you've gotten lots of good advice here. I do think he may have a UTI that's making things worse, but this is also classic dementia progression.
When my mom began fighting taking her meds, I finally just said, "OK, don't take them." And she died the next year. But she was dying anyway. I mean, in the total scheme of things, it wasn't worth the fight to me. To prolong a miserable life? I don't think so. But maybe your situation is different. I'd just say weigh the pros and cons. For my mom, she sincerely believed that the meds were designed to kill and/or control her and she was so worked up about them, and so belligerent, that I finally just took her to the doctor who said, "OK, I recommend them but I can't make you take them," and I said, "Me either." So she stopped taking them.
When my best friend's husband went under hospice care, they stopped all his meds other than pain relief, and he actually improved at first, but that improvement was short lived. He did die a few months later, but he had a clearer mind and fewer symptoms from medications, and he was GOING to die, so in a way it was better if that makes sense.
Just something to consider. Not sure what meds your dad is on but if he's on memory care meds, those tend to run their course and lose their effectiveness as the dementia progresses, so that's one to seriously take another look at.
About medications, you cannot let your dog walker, who used to be a SW, to give him medications because she is not a trained nurse. At my workplace, even CNA's cannot give the residents medications, only the RN's and LPN's. When giving medications, the nurses have to stay with the residents and make sure they finish all of the pills. Sometimes they even have to check inside their mouth, on the sides and under the tongue. If some residents have difficulty to swallow the pills, they crush them and mix them with apple sauce.
You can bring the issues to the manager, clinical team leader, and even to the administrator.
This. State laws are very strict about how much CNAs can really do in terms of meds. It could be that the CNAs working for you are only allowed to open the container and not even take a pill out.
There is a lot written about the subject and the advice is normally to talk to the prescribing physician, explain that your dad won't take meds and ask if there is alternative format (liquid, or a flavored chewable). There are a lot of reasons elderly people hide meds in their mouths or spit them out, often it is too difficult to swallow or leaves a bitter taste and that's why.
This. State laws are very strict about how much CNAs can really do in terms of meds. It could be that the CNAs working for you are only allowed to open the container and not even take a pill out.
There is a lot written about the subject and the advice is normally to talk to the prescribing physician, explain that your dad won't take meds and ask if there is alternative format (liquid, or a flavored chewable). There are a lot of reasons elderly people hide meds in their mouths or spit them out, often it is too difficult to swallow or leaves a bitter taste and that's why.
First, I typed this out last night and my internet decided to disconnect. He is negative for a UTI.
Second, we are not hiring the social worker/dog walker as a CNA. She's not pretending to be one. We can hire whoever we choose to give him his meds, while the medical help they offer there is recommended through the facility, they are not associated with them. It's independent from the facility. We are not talking about an actual assisted living place, it's independent living with additional services offered (at a cost).
We've used applesauce, pudding, cranberry juice, everything we can think of. He doesn't take his pills because he doesn't like taking pills. Back when he was younger (40s-50s) he would refuse to even take anything back then. It was a matter of pride for him to get through everything without medication -he's a (now) 10th degree black belt in tai kwon do-. The first 7 or 8 degrees are earned, the rest are honorary and his tai kwon do master gave him his last levels out of respect for him.
Last edited by goldenlove; 11-20-2020 at 03:49 PM..
I think what we are saying is having an untrained person select, pick out, and ensure it is taken medicine (not family) is opening them to huge emotional and legal issues. What if something happens regarding pills and your Dad is hurt or dies or just the person thinks they did it?
My mother in law thought she would help a friend and ensure she took her medicine. Her friend was on dementia medication and others in an independent living situation. We did talk to her about these issues and knew that she would be totally crushed if anything happened to her friend. If your dog walker makes a big mistake, she is open to being sued. Of course, you will say you will never do it. She should think of it.
I think what we are saying is having an untrained person select, pick out, and ensure it is taken medicine (not family) is opening them to huge emotional and legal issues. What if something happens regarding pills and your Dad is hurt or dies or just the person thinks they did it?
My mother in law thought she would help a friend and ensure she took her medicine. Her friend was on dementia medication and others in an independent living situation. We did talk to her about these issues and knew that she would be totally crushed if anything happened to her friend. If your dog walker makes a big mistake, she is open to being sued. Of course, you will say you will never do it. She should think of it.
I never intended for anyone to select and dose his meds. I will be filling them again (I thought I had posted that above, but maybe I forgot) so I am aware of what meds will be in the daily pill dispensers. I have no clue what the difference is between a former social worker, now dog walker, giving him his med vs a CNA (who is obviously NOT giving him his meds).
Thanks for the help here. There have been so many who have been super helpful, but when you are emotionally fragile already, judgment isn't what is needed. Once again I'll stop posting here. Again, I do appreciate those who have helped with great suggestions and helpful ideas.
I never intended for anyone to select and dose his meds. I will be filling them again (I thought I had posted that above, but maybe I forgot) so I am aware of what meds will be in the daily pill dispensers. I have no clue what the difference is between a former social worker, now dog walker, giving him his med vs a CNA (who is obviously NOT giving him his meds).
Thanks for the help here. There have been so many who have been super helpful, but when you are emotionally fragile already, judgment isn't what is needed. Once again I'll stop posting here. Again, I do appreciate those who have helped with great suggestions and helpful ideas.
To ease some misconceptions- A care giver can place the pills in front of the patient and observe the patient is indeed swallowing them or in some cases- inhaling properly or injecting properly. Correct that they cannot Personally place the pills in the patients mouth with applesauce or any other device. That is the Difference- one is allocating and observing . The other is administering the drugs directly.
Even when I was a CNA at a care center I could NOT pick up, remove or assist in medication distributing. If a pill was found on the floor I was to immediately document it and call the Nurse on duty. We did not allow any other patient to pick it up or remove it. It had to be recorded. If Our state ever did a pop in inspection and saw that we didn't record or deter medication mishaps, there would be state violations ....
Most here on caregiving are supportive, please consider that opinions and suggestions may vary - The intent to support is the foundation.
About medications, you cannot let your dog walker, who used to be a SW, to give him medications because she is not a trained nurse. At my workplace, even CNA's cannot give the residents medications, only the RN's and LPN's. When giving medications, the nurses have to stay with the residents and make sure they finish all of the pills. Sometimes they even have to check inside their mouth, on the sides and under the tongue. If some residents have difficulty to swallow the pills, they crush them and mix them with apple sauce.
Quote:
Originally Posted by wasel
This. State laws are very strict about how much CNAs can really do in terms of meds. It could be that the CNAs working for you are only allowed to open the container and not even take a pill out.
There is a lot written about the subject and the advice is normally to talk to the prescribing physician, explain that your dad won't take meds and ask if there is alternative format (liquid, or a flavored chewable). There are a lot of reasons elderly people hide meds in their mouths or spit them out, often it is too difficult to swallow or leaves a bitter taste and that's why.
Quote:
Originally Posted by goldenlove
First, I typed this out last night and my internet decided to disconnect. He is negative for a UTI.
Second, we are not hiring the social worker/dog walker as a CNA. She's not pretending to be one. We can hire whoever we choose to give him his meds, while the medical help they offer there is recommended through the facility, they are not associated with them. It's independent from the facility. We are not talking about an actual assisted living place, it's independent living with additional services offered (at a cost).
We've used applesauce, pudding, cranberry juice, everything we can think of. He doesn't take his pills because he doesn't like taking pills. Back when he was younger (40s-50s) he would refuse to even take anything back then. It was a matter of pride for him to get through everything without medication -he's a (now) 10th degree black belt in tai kwon do-. The first 7 or 8 degrees are earned, the rest are honorary and his tai kwon do master gave him his last levels out of respect for him.
Hi Goldenlove, yes, I know the social worker is not being hired as a CNA. I was referring to the fact that states often regulate how involved a CNA can be in giving meds. (I meant to bold the part I bolded above.) You had expressed that you were frustrated with the CNA team about it and since these threads are a source of information for many people in similar situations, it might be helpful for folks to know that sometimes directing this subject at the CNAs is futile. You haven't done anything wrong -- being in unfamiliar territory, it is not possible to be right or wrong.
My mother had Alzheimer's and we went through this even when giving her meds ourselves. I learned a lot from researching it and as I noted above talking to her Rxing doctor was helpful. (I'm not saying you haven't -- again this is a general statement for anyone.
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I was referring to the fact that states often regulate how involved a CNA can be in giving meds. (I meant to bold the part I bolded above.) You had expressed that you were frustrated with the CNA team about it and since these threads are a source of information for many people in similar situations, it might be helpful for folks to know that sometimes directing this subject at the CNAs is futile. You haven't done anything wrong -- being in unfamiliar territory, it is not possible to be right or wrong. 
