Why would someone with Alzheimer’s refuse medication?
Getting someone with Alzheimer’s disease or dementia to take their medicine can be an ongoing challenge for many caregivers.
Refusing to take medication could be a response to being confused or feeling afraid of what they’re being asked to do.
Your older adult might also feel like they don’t have any control over their life, which could make them generally angry or resistant.
To make this important task easier and less stressful, we’ve got 11 tips to overcome challenges and convince someone to take their medicine.
11 ways to get someone with dementia to take medication
1. Create a calm and quiet environment
When it’s time for medication, start with a calm 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 your older adult 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
Many seniors take multiple medications. Sometimes doctors forget to regularly review medications to see if they’re still needed.
The last thing you need is to try to get your older adult to take more pills than absolutely necessary.
Speak with their doctor to see if any medications are no longer needed and could be safely discontinued.
Fewer pills = less hassle over taking medicine.
4. Make pills easier to take
Some pills could be too large and hard to swallow.
Talk with your older adult’s 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.
Make sure to ask before crushing any pills because not all pills are crushable. Some can become less effective or even unsafe.
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.
For example, they could feel distressed when they see a lot of pill bottles. In that situation, you could keep their medication bottles out of sight and only bring out the pills they need to take at that moment.
Similarly, if seeing all the pills they need to take makes them anxious, you could give them only one pill at a time and keep the rest 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 Tic Tac candy.
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.
For example, if your older adult typically gets sundowning symptoms, avoid giving medication in the late afternoon or evening unless the doctor absolutely requires it for an important medical reason.
Think about the times of day when they’re in the best moods and adjust their medication schedule to meet those times.
Of course, before making any changes to their medication schedule, talk with their doctor to make sure the new schedule you’d like to use is safe and won’t cause any problems.
10. Stick to a daily routine
A daily routine can do wonders for someone with dementia.
With a regular schedule for taking medication, your older adult will likely get used to it and become more cooperative over time.
Give them their pills at the same time every day. Do it in the same place, like when they’re relaxing in their favorite chair, and use the same cup for water.
For some people, making medication part of their after-meal routine works well because they’re still in “eating mode.”
11. Offer a treat
Young or old, we all love treats. You might consider offering a treat as a reward for taking their medication.
For example, put a small piece of chocolate in front of your older adult and say that it’s their treat after they finish their pills.
It might even help take away any bitter taste the medicine leaves and associates something positive with taking medicine.
Recommended for you:
- Responding to 4 Common Dementia Accusations: Stealing, Poisoning, Being Held Prisoner
- 6 FDA-Approved Medications for Alzheimer’s Treatment
- Solve Challenging Alzheimer’s Behaviors with Expert Communication Tips
By DailyCaring Editorial Team
Image: GPonline
jean taylor
my alz patient occaionally refuses pills, and tells me to take them. her daughter changed the time to before meals so she’s primed to be eating and taking these first.
on their wanting to control pill box: provide fake pills in box to give them control of pills, swapping out the days real pills each time. I tell patient the eye drops have to go into the frig when she wants to keep them and she accepts this.
Could you petition the drug companies to make gummies for everything? that would solve many problems and we could ‘have a treat’ together instead of medicine.
What about that stuff that thickens liquids for people that have trouble swallowing?
handing out one pill at a time is great! they do get overwhelmed with many pills. and thanks for telling people to eliminate meds. There is no point in taking excess vitamins at this time.
DailyCaring
Great tips, thanks for sharing! It’s a wise idea to change the timing to match when she’s ready to eat. And to give her the feeling of control with the fake pills and the fib about the eye drops.
It would be fantastic if all medications could be made in more tasty formats like gummies. Unfortunately, many likely wouldn’t be effective or safe when taken in that manner. However, you may want to speak with the pharmacist to find out if any of her medications could be prepared in different ways to make them taste better or easier to take. For example, if it’s a liquid medication, sometimes flavoring can be added to make it taste good.
For people with trouble swallowing, pills that can be crushed (check with doctor or pharmacist first due to safety and efficacy issues for some meds) can be mixed in with a little bit of applesauce to make them easier to swallow. Liquids can likely be thickened with products like Thick-It – but always check with doctor or pharmacist before modifying any medication.
So glad our suggestions have also been helpful!
Robyn Shannon
I found that at timer pillbox such as the LiveFine Automatic Pill Dispenser, though expensive, has been a godsend for family. The cover locks, so pills can’t “spill” or be “tampered”. It has a fairly loud signal/alert so people can hear and will ring up to 30 min before stopping. It will rest itself once the pills are taken and my family member could only access the specific pills necessary at the accurate time. They are quite expensive ranging from 69 – 89 + dollars dependent on where your order (I got mine on Amazon) but we all chipped in (kids) and bought it. I has worked consistently for 2 years at this time without any issues or any missed pills. LOVE IT!!
DailyCaring
Thanks for sharing your experience! We’re so glad that this timer pillbox works so well for your family member.
Anon
I have visited my Aunt at residential care home. I noticed care giver placing pills directly on tongue with her finger tips. Care giver is holding other pills in her palm. She asks my Aunt to swallow and show her she has swallowed by saying ah. Over my shoulder another care giver is saying she didn’t swallow cause he sees her hiding it with her tongue. Weirdest experience I’ve ever had.
DailyCaring
That does sound like a strange and unsanitary technique for a care staff member to be using.
Debbie
My sister had a stroke but since then she refuses to swallow her pills even if given in pudding, honey or jello. She will hold it in her mouth for a long time and eventually spit it out. I have thought about plugging her nose so the has to swallow so she can breathe but I’m afraid someone will accuse me of abusing her. What do you think?
DailyCaring
You mean well, but that sounds like a dangerous strategy as well as being abusive. She could choke or aspirate, which would likely cause serious health problems.
Hopefully, using some of the suggestions above will help. Often, if you crush the medication (assuming the doctor or pharmacist says it’s still effective when crushed) and stir it into a small amount of food with a stronger flavor, the person won’t notice that it’s in there.
You could also speak with the pharmacist to see if there’s a different formula for the medication that might make it easier to hide, like a liquid.
Tina
My mom recently had a stroke in Feb 2022 and same thing she hold medications in mouth. She has gone so angry and think we’re doing things to hurt her. It has been so hard this past couple of months.
DailyCaring
We’re sorry to hear about this situation and hope that the suggestions in this article are helpful.
Jamie thimons
I am a CNA that takes care of patients with Dementia everyday. It’s a battle for them and all you gotta do is not change their routine on a day to day basis.keep them as calm as you can and put yourself in their shoes !! It’s a disease that a lot of will encounter eventually without any knowledge of it .. love them and treat them as you would your own !!! ♥️♥️♥️♥️♥️I love my job!!
DailyCaring
Wonderful advice! Your patients are lucky to have someone as kind and compassionate as you to care for them 💜
Tony
I do need more tips to help my wife to take medications
DailyCaring
We hope the suggestions above are helpful!
Anne-Marie Lafleur
good morning. Unsure if after 2 years this message will still be pertinent. But, I do encourage you to look for TEEPA SNOW’s technique, the HAND UNDER HAND. If after trying all the above tricks, still not helping, look in for her trick. It does fantastic with many other tasks that you may need to do for your loved one.
Take care. good luck! Anne Marie
DailyCaring
Excellent suggestion, thanks for sharing!
Here’s a video that shows Teepa Snow’s hand over hand technique – https://www.youtube.com/watch?v=Wn1OEfQt0ow
Becky
I have been taking care of my mother who has dementia for the past 3 years now she’ll be 83 in July it’s to the point to where she doesn’t move around much and now she has contracted a couple of bed sores what is the best medication to use for bed sores
DailyCaring
It’s important to contact your mother’s doctor right away to ask them about proper treatment for her bed sores. If not treated properly, they can become serious or life-threatening.
We’ve got a couple of articles with more information about bed sores:
— 3 Helpful Tips for Bed Sores Prevention and 2 Common Treatments https://dailycaring.com/3-helpful-tips-for-bed-sores-prevention-and-2-common-treatments/
— Bed Sores 101: Causes, Stages, and Early Detection https://dailycaring.com/bed-sores-101-causes-stages-and-early-detection/
Grace
What do you do when someone demands their pillbox. They are not competent enough to put the pills in the box properly nor do they remember to take the pills. They want to be in charge of their medication and it is a daily demand. They take their pills without issue, but want to be in control of them. This is the situation with my mother in law. We are having trouble getting doctors to diagnose her with anything other than traumatic brain injury, but she has no idea what day of the week or month it is. She doesn’t know what goes on from hour to hour. We have tried giving her pillbox back to her on several occasions but she ends up taking more than she should. I think because she forgets that she already took them because she has no concept of time.
DailyCaring
It’s natural for someone to want to control their medication, even if they’re not able to correctly manage them.
Since your mother-in-law has cognitive impairment, she definitely needs help managing her medications and supervision when taking them. You may have to experiment to find ways that will allow you to not upset her and keep her safe from over- or under-dosing.
Depending on her level of impairment, some ideas will work better than others. But the only way to know for sure is to try. One idea is to give her a fake pillbox with fake medication (tiny candies like tic-tacs or similar). That way, she feels like she’s in control, but when she “takes” her medication, it won’t harm her. Then, you’ll need to find ways to get her to take her real medications in a way that won’t make her suspicious — maybe by crushing them and putting them in small portions of food (assuming the pharmacist says that’s ok).
You could also try making it easier for her to know what day and time it is. This doesn’t work for everyone and depends on her level of cognitive impairment, but may be worth trying. For example, many people have said that a clock like this one (https://amzn.to/2nm36OD) is very useful for people with dementia. A jumbo-sized wall calendar like this one (https://amzn.to/2LSu5zc) could also help.
There isn’t a perfect solution and you may end up just having to endure her anger to keep her safe until this phase passes, but experimenting creatively will help you find strategies that can improve the situation.
LASAUNDRA DYSON
I am the caregiver for my 100 yr old Grand Aunt. Lately she’s started refusing her meds. Looks like every 3rd or 4th day. All she needs is her dementia meds and blood pressure pills twice a day. Oh, and Trazadone for depression and to help her sleep. She’s very lucid since I’ve changed her diet but being lucid is bringing out the ‘meanness’ in her. I’ll be contacting the pharmacist to see if I can crush these meds, but mixing it in her food will be a challenge. Next to applesauce I’m drawing a blank on what else I can fool her with. She loves diversity in her snacks.
DailyCaring
It’s great that you’ll be speaking with the pharmacist to find out what alternatives would work with her pills. That’s always important to do. Hopefully, some of the suggestions above will help the situation.
For additional snack ideas, creamy snacks are good candidates for pills that can be crushed. Keep the portion that contains the crushed pills small to make sure she will finish it all and get the full dose:
— Dips and spreads with crackers or cut veggies, there’s lots of variety in dips to keep the food interesting
— Yogurt
— Smoothies
— Mashed potatoes or sweet potatoes
— Soups
— Ice cream
— Pasta / egg / macaroni / potato salad
— Cottage cheese
Anonymous
Try Honey my mom is 83 and loves it
Gina
I wonder why it is so important for people with dementia to take meds?
DailyCaring
When someone has dementia, they will still have any other health conditions they had previously. For example, someone might have dementia and heart disease, diabetes, or another chronic health condition that requires daily medication.
Anonymous
crush the meds in applesauce or pudding and say, “the body of Christ” as you spoon it in – works like a charm
DailyCaring
That’s a great strategy to try with someone who is religious. Thanks for sharing!
Medication Management and Alzheimer’s – Alzheimer's and Dementia Care Services
[…] medication, always check with the prescribing physician to make sure it’s okay. If the person has increased difficulty taking medicines, ask the doctor if it’s okay to mix the meds into food or beverages, or if the medication is […]
Linda Alexander
These tips might work on a 90+ year old. Unfortunately my daughter is 55 and none of these methods works. If she doesn’t want her meds try every way in the world but she will not take them. If she wants to she will and only then.
DailyCaring
I’m so sorry you’re having a tough time getting your daughter to take her medications. Each person with cognitive impairment is different when it comes to what they’re willing to do, no matter their age. If these medications aren’t strictly necessary for health, it’s ok. But if they’re essential for her health, I would encourage you to keep experimenting to try to find a way that will encourage her to take her medicine. I would also encourage you to tell her doctor that this is happening, so they can factor that into her care. Perhaps they could offer alternatives that could work better. Big hugs, I know this isn’t easy 💜
Yashar
Great tips. Obviously it depends from person to person, but the waiting period of 10- 15 minutes never worked for me. From my experience, waiting for 30-45 minutes “resets the clock” and the medication situation becomes a lot easier.
DailyCaring
So true, it really depends on the person. Some may need more time and some may be ok with less.
Karen
If your person has trouble swallowing pills, try using something other than water … my mom coughs and gags horribly when she takes pills or capsules — regardless of size — with water. With thick juice such as prune or tomato, or a carbonated soft drink (she loves root beer), she hardly ever chokes.
When I mentioned this to her doctor, who is 70+ years old himself, he told us he gags when taking pills with water, too! Myself, I’ve always hated using water, due to the real or imagined taste of some meds, though have no swallowing problems as yet whether using water or something else. If/when I develop them, I know what to do!
DailyCaring
That’s a great tip! Thank you for sharing!
Phillip Jones
I agree with Ms. Chow about the image. Mr mother is 92. I’m pretty sure she doesn’t have Alzheimers because I went through 10 years of my Dad having Alzheimer’s. But her mind is slipping some. I put Mother’s pills in a 7-day Pillbox and sit the box on the table at the proper time. That way, I am not forcing my mother to do anything.
Connie Chow
Thank you Phillip! It sounds like you found a great way to help your mom with her medication.
Linda Godwin
The tips for assisting a person with dementia to take medications are great, however, I have a concern with the picture you used for this blog. A woman is holding a pill in her hand, practically shoving it in another woman’s face. If that happened to me, I not only would not take the pill, but might feel like swatting at the person holding it. It’s rude and demeaning. A better image would be the caregiver sitting beside the other person, face to face, and having the pill in a small glass or medication cup, and offering it to her hand, while showing her a glass of water. Offering, not pushing. Thanks for a great article!
Connie Chow
Thanks Linda, we’re so glad you found the article helpful! I’m sad to hear that you didn’t like the image, we never intended to portray any negativity.