Refusing to Take Medications: Tips for the Alzheimer’s Caregiver

It is very common to hear from caregivers about the challenges of giving medications to someone with Alzheimer’s or other dementias. “When I give my mom her medications, she gets angry,” is an often heard statement. What is the best way to deal with this challenge so that medications are taken on a consistent basis?”

When confronted by this situation, or by any challenging behavior, it is important to remember that the behaviors of people with Alzheimer’s disease or other dementias that are commonly viewed as problems are actually attempts to communicate. Try to look at the situation from their perspective. Doing so is helpful in bringing the challenging behavior into focus and finding a solution.

Helpful Tips

When it is difficult to get a person with Alzheimer’s disease to take his or her medication, here are some approaches to consider:

• The first step in managing this process is to provide a calm environment. A person with Alzheimer’s needs you to provide that for them.  When it is medication time, be sure there is a calm environment in the house—i.e. soft music, no TV, little or no commotion. Be sure that you too are feeling calm.
• Resisting medications can be a response to feeling rushed, afraid, or confused about what they are supposed to do. Feeling a loss of control can also trigger resistance and anger. Try breaking the process down into steps, and reassuringly and calmly, explain what you are doing. Give them time. Any part of the process they can participate in should be encouraged. Perhaps you will need to pour the water into the glass, but they can pick the pill up from the table and put it in their own mouth. If they need assistance getting the glass to their mouth, gently provide that assistance.
• The physician and pharmacist are valuable consultants for the caregiver of one with Alzheimer’s. If you think your loved one would be more accepting of medications at a different time of day, consult with these two professionals, and with their agreement to a time change, give the medications during that time. As the caregiver, you know best about your loved ones’ most agreeable time of day, and can advocate for a change. These two professionals should always be consulted for any changes in dosages, times, etc.
• Consider other things that may be triggering the resistant behavior. Some with Alzheimer’s get distressed at the sight of all the pill bottles. Are there a lot of pills, and perhaps it is an overwhelming sight? If so, take the pills out of their bottles only when needed, and leave the bottles out of sight. Some caregivers obtain success with presenting only one pill at a time.
• Are some pills large and hard to swallow? Again, upon consultation with the physician or pharmacist, and when possible, crush the pills that are crushable and mix with a food. Applesauce or yogurt can be good for this. Not all pills are crushable, so be sure to consult with the pharmacist or physician first.
• Some medications are available in liquid form. Check with the physician and consider that option.
• If possible, take your medications together.  Make it fun.
• When all else fails, and it sometimes will, set everything aside for a few minutes, allow time for calming down, and then return to the medication task in 10 -15 minutes.
• Remember that behaviors will change over time, and what works for one period of time may need to be revised as the disease progresses.

Caring for the Caregiver

As a caregiver, you know the rewards and the burdens of caregiving.  Not enough can be said for giving yourself the support and respite you need to successfully continue on this journey as a caregiver. 

Consider joining a caregiver’s support group where you can meet regularly with other caregivers for mutual support, and where you can provide each other with tips, ideas and resources for caregiving.  It will remind you that you have others around you who understand your role as a caregiver.

Do something that rejuvenates you.  It is vital to your wellbeing, as well as that of your loved one with Alzheimer’s.