Help. 92 year old suddenly unable to manage meds.

[Inthechillyhoursandminutes]

Right up front, this is not my DF but the DF of a close friend.

That friend lives 10 miles from his DF, works evenings / nights and has supported DF with shopping, hospital visits, work around the house, entertainment etc. for the last 20 years. That necessitates a visit most days.

Suddenly, and with no warning his DF has started taking his meds randomly and developing anger / irritation symptoms.

We have bought pill boxes which my friend fills on a weekly basis, but have realised that is not working because his DF doesn’t know what day of the week it is. So we have bought a day / date digital clock which sits next to the pill boxes. Still pills are being taken randomly. Several lots of morning pills on one day, but no afternoon drugs etc.

Now this week, my friend is receiving phone calls at work with DF shouting at him that he is sabotaging the pill box. Also accusations that the phone or TV has been sabotaged.

Obviously this is causing concern, especially as his DF is an Insulin dependent Diabetic.

Today, in need of help. and to understand what is going on, my friend phoned his DF’s GP to ask for advice and if necessary an assessment for his DF. The receptionist advised that this issue is not something a GP can help with.

So I am hoping (with the permission of my friend) that the combined wisdom of MN might be able to point us in the right direction. Where does my friend go to access help with his DF? What resources are available in this situation?

He is not able to live with DF, needs to work and is being run ragged trying to deal with the increasing demands and anger coming from his DF. He can never get a day off, go on holiday etc. and now even his sleep is being increasingly disturbed by the phone calls.

He needs social care assessment
Carers in each day to do meds
Dementia assessment
Look into care homes
It will only get worse or he will be found dead if nothing is put in place
Maybe he needs to be in care home now

Pass on local age uk number

What about a pivotell? Won't help with ay injectable or liquid meds but good for pills. But tbh sounds like he needs professional carers

He needs to see GP and be assessed for UTI, sugar level and referal to memory clinic.

And yes gp should be visiting and referring for social care and assessments
Some gp have designated elderly care nurse who visits and refers

I think unfortunately the answer is probably that he needs to look at getting carers in to give the medication.

It was the one line I was adamant on when my father died, as he used to supervise my mother taking hers. Not only is she is visually impaired so can't really see what tablets are in what packets, she can easily lose track of the day and time and so simply couldn't reliably manage to take the correct dosages of the correct medicines at the correct time herself. We thought of a number of possible solutions such as weekly pill boxes, alarms etc but her being supervised was the only one that was realistically workable. .

Can anyone advise how my friend gets a social care assessment?

Is that only through a GP (receptionist seems to think it is not a GP issue) or can my friend refer in some way?

And can anyone advise how that social care is funded? DF lives on his Pension / Pension Credit so no spare cash. Friend has just enough to cover his own Rent / living expenses etc. Again nothing spare.

I can barely manage to keep track of how many ibuprofen I've taken in a day, the poor man bless him, as pp have said he needs carers or assessment for residential x

Contact local adult social services and ask for an assessment. Go on the local council website, they should have contact details there.

Funding wise he’ll be assessed and if he has savings over a certain threshold (can’t remember exact amount but think it’s about £28k) he will have to self fund - we’ve just been through this with my dad. If he doesn’t have the means the local council will pay but obviously you have to take the carers they offer.

Does your friend have LPAs in place?

Look up the number for the local council for their adult social care services. Ring them and explain what's happened and say you don't think he is safe living as he has been, it's taken a sudden down turn and can they do a care assessment ASAP.

Part of the assessment will be financial as well as his welfare. If he has little money and no savings, the council will pay, but they'll need to take details to get to that conclusion.

Adding to the above though, I would contact the GP to say he needs urgent help from the diabetes team as he'll be unwell if he's not managing his insulin and other meds properly. Ask if the district nurse team could add him to their rota for daily calls for this. You or his son will need to be politely assertive in all this and not be fobbed off.

Sudden change, out of the blue behaviour.
Insulin dependent.
He urgently needs to be seen by a doctor.
My sil lives alone, memory issues, has nurses visiting every day to test bloods and administer insulin.

Well , not necessarily a GP., as holes says diabetic team would be something.
Gosh it makes me angry that someone in their 90s with insulin dependent diabetes and a relative ringing the GP to raise concerns is fobbed off.

I work for social care. Social care aren't allowed to help if giving medication is the only issue. Carers can prompt but only if its part of a larger care package. The GP actually can access a budget for a health care package in this situation. But they don't do it very often. As others have said though he does sound medically unwell so does need to see a doctor.

For a sudden change like this, always think UTI first. And with diabetes as well, a thorough check by the GP is essential.

I agree GP should be doing a physical exam, testing for UTI and potentially Alzheimer’s.

On a side note, the GP can also request prescriptions be dispensed in dosette boxes. These are better than the pill boxes that have to be filled by hand. Each set of pills is sealed. These are much easier to manage.
https://www.nhs.uk/conditions/social-care-and-support-guide/practical-tips-if-you-care-for-someone/medicines-tips-for-carers/

But if they are struggling with day and time a pivotell means they can only access the right meds at the right time.

Has the father developed ketosis
Sounds like exh who was diabetic

@Inthechillyhoursandminutes I think country girl is suggesting something like this.something like thi

Attendance Allowance would pay towards carers. Age UK can help with that.

Thank you for all your thoughts and suggestions.

I have passed these on and will be seeing my friend today to discuss what he can do next.

It will help enormously to know that he was right in approaching the GP and will give him confidence to pursue that avenue. We will also investigate the assessment and care options you have suggested.

That's the sort of thing. My mum with dementia has 1 after she too 4 days worth of tablets in 1 day but insisted she'd only taken 1 day

Social Services supplied mum's on loan

Hi, Im a nurse in Scotland. We can organise district nurses to go daily to administer insulin if patients are not capable. If this a new or sudden change he needs to be assessed by Dr. Sounds like he us probably needing a care package started

If he has ketosis (exh would get confused and angry) he needs a hospital. Administrating insulin daily isn’t going to do much , even if he hasn’t gone into ketosis
Insulin has to be administered several times per day. It isn’t just 1 injection per day

He might of course have just a urine infection

I think rule out the physical before thinking of dementia

He might well have dementia but if he hasn’t been showing signs for a while and just started to act the way he is then a physical examination is the way to go