Managing Medication (or not as the case may be!)

[Lzzyisgod]

I'm looking for inspiration for DF and managing his medications as my dsis and I have tried everything we can think of and nothing seems to be helping.

Background is Df was diagnosed with Parkinsons 13 years ago but recently seems to have deteriorated. To be fair he does seem to have an awful lot of meds to take through out the day but short term memory is increasingly an issue and we are finding endless piles of pills scattered all round his home and on the floor.

We have tried Alexa alerts , phone alarms, smart watch alert, dosset boxes (and an opener to making opening them easier), messaging throughout the day with reminders (but really is quote a big responsibility and not sustainable long term), post it notes, getting the meds out ready for him but all with very limited success. He has a carer who goes in once a day but even that doesn't seem to be enough and we are starting to see the knock on health effects of not taking everything as prescribed.

Is there any other bright ideas we could try? We've asked for a meds review to see if the whole day regime could be Simplified but we are almost at our wits end. At the moment I can't see any other option than having a carer visit more frequently.although he's still quite independent in many ways amd enjoys going out. Hes also very resistant to more visits - he has capacity at the moment to decline more help although we both feel he would benefit. It's causing significant worry though and I'm all out of ideas.

Many thanks

Have you tried a pivotell. They have an alarm and can take up to 4 slots a day. Only the current slot is accessible. Mum has 2 for morning and evening meds as she sits at the dining room table in the morning and in the living room in the evening and won't wear hearing aids.

Parkinson's meds are particularly time critical (in a care home or hospital they are supposed to not exceed a 20-minute deviation from the schedule). Visting carers are very unlikely to be able to manage that - their visit times can be extremely erratic.

Talk to the community neurological nurse, or encourage him to talk with them with you there. He should have their contact number, or Google them if he doesn’t.

the GP can provide the meds for the week in blister packs...so one row for each day of the week and a pocket for each time of day that has a dose prescribed for it. you just have to request it. they then have to be collected weekly and some GPs have a delivery service (usually run by volunteers)

that hopefully gets rid of the risk of overdosing and random pills scattered around

then you have to work on the how to get him to remember to take them

You seem to have tried every method that it is reasonable to suggest.

Could it be arranged with a neighbour, friend, family members, or a paid "visitor" to rotate and call in to administer them at the allocated times? It would only take a few minutes at a time. How practical this would be is another thing, but is something to think about.

Failing that and if he is deteriorating, full time care might be necessary at some point, where he will get his meds on schedule every day. Drastic I know.....

We had this issue with my MiL who has Alzheimer's disease. In our area theres specialist pharmacy team (the LIMS team I think) who deal with this kind of thing. A pharmacist comes to the house assesses the patient in their home environment and works out the best plan for medication, making appropriate adjustments, and also looking at things like dosset packs or Pivotell type devices. They do then follow up to make sure things are working out before they discharge.
I'm pretty sure they got involved as a result of a routine medication review so it's worth contacting the pharmacist at your dad's GP surgery to see if anything similar exists where he lives.

When DF was consistently forgetting to do his daily insulin injections leading to extreme confusion and hospitalisation, the district nurses started coming every day to administer it. We are in Scotland so it may well be different in England and probably different again in different parts of Scotland.
I would raise it with the GPs and also if he isn’t already on social care radar, raise it with them. To me it feels like a capacity issue - if someone is no longer capable of remembering their daily meds then what other issues are there? Your DF may not want additional carers or people coming in, but it sounds like there may not be much alternative apart from residential care.

My dad has a tabtime dispenser with an alarm and only the relevant slot open similar to the one mentioned above. I also prompt via text message. It is not Parkinson’s, noting pp mentioned timing of meds is critical, but have sort of taken the view with independence comes some chaos. Hope you find something which works for you.

Thank you ever so much everyone - apologies for the late replying (typically this would be the week something kicks off with the dc - talk about being the sandwich generation!)

I've ordered one of the timed opening boxes to try (and critically he has agreed to try!) We have tried traditional bluster packs but he struggles to open them (despite an gadget to make it open easier) and didn't open them in the order or even the right day of the week (more of a dexterity thing rather than not knowing what day it is). Crucially not all his meds can go into a pharmacy prepared pack but between us we are going transfer everything into the timed boxes (my sis is a nurse). There is an awful lot throughout the day to take at various different times - at least 6 different times of the day so it's not surprising it's overwhelming and probably.too labour intensive for his friends although many are super supportive.

The local Parkys nurses are very helpful and currently are monitoring him closely bith face to face and have him on their virtual ward.

Like many posters on here whilst I knew these years would be tough you can't really prepare yourself for quite how tough it can or will become. We both know eventually a care home is likely to be the safest option (he would decline to live with one of us and tbh everyone at both our houses works FT so doesn't solve the issue of increased care needs). Currently though I don't think he would meet the criteria for a residential home as other than the meds he's still fairly independent!

I think I shall become a frequent visitor to ths board though .....