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Mom was diagnosed with vascular dementia a little over a year ago. She is 77, my Dad is 79. My mom has always been a very strong personality, I mean strong!


Over the last year she is increasingly becoming aggressive and angry. She makes up stories and believes them to be gospel especially about drugs. She curses my Dad out over every little thing until he backs down and leaves her alone.


She barely eats, like say, she eats 2 eggs for breakfast she'll go sometimes til the next evening before she takes a few more bites of food. And she flat out refuses to take her dementia medication, I mean she will get so aggressive and angry we end up backing down for fear she'll stroke out.


She wakes up in the morning in or around the middle of stage 4 and every hour she slides, by dark she is in the middle of stage 5 if not near the end of that stage.


Does anyone in here have a LO that is this hard to deal with?


No matter how we've tried to talk to her about her meds she gets so irate that we fear she will seriously stroke out, we tried calmly talking, being a little assertive, ignoring it for a few days... nothing works. If you ask her if she took her pills she will tell you yes, if you check you quickly see she is lying. Then the next day the pills go missing, takes us days to find them. Dad even tried waking her at 5am (since she is calmer than a cucumber in those hours) and she was taking them with no problem, 4 days later she took them from him and threw them screaming she doesn't want them anymore. That was the last time she took them.


We took her to a neurologist and she walked out and refused to go back in. We are at a loss at this point. She is so hard to deal with or talk to it makes it incredibly difficult to get her to do anything.


Here is an example on what we deal with: she is telling us a made up story that never happened... she will ask us for a name or place, if you say you don't remember she gets angrier than a badger, if you make up whatever it is she asked you she gets incredibly angry and starts to curse you out, if you ignore it like you didn't hear her she starts calling you names and belittles you.


If we do get her to take her medicine for a few days in a row (which hasn't happened in about 6 months, up above) she is good... calm, not mean, she eats, can hold a conversation, more willing to do what she needs to do, and even takes her evening pill on her own!!


We are at an absolute loss on how to get her to take her medicine and eat. Those 11 steps from Alzheimer's to get them to take their meds would never ever fly with Mom, literally, she is meaner than a badger on a good day.


Thought about crushing pill and putting in food, again 2 problems with that, 1) she barely eats and 2) she feed her dogs her food.


The family Doctor, the only one she agrees to see, tells us every 3 months at her check up, that we need to get her to take the medicine... we know this, he knows this, everyone knows this but, HOW do we do it, is the question. Any and all suggestions would be greatly appreciated, especially from those that deal with the same aggressive rattlesnake.

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My mother has vascular dementia and delusions and is a narcissist. I get your drift lol! ( last dr appointment she told the dr the dr was , stupid, full of sh***, accused me of stealing etc in the span of maybe 10 mins lol.
With delusions you need to change the subject. If she thinks the meds are bad you aren’t going to change her mind. Is she like this with any medication? Why doesn’t she eat? Is she just not hungry?

its a tough tough tough thing to deal with. I wonder if she would take them from a health care aid. My mom is sweet as pie to the ALS staff. It’s just family she’s mean to lol.
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Some pills cannot be crushed. Mom's facility put the medication in pudding or yogurt. But I guess you have tried that. Hopefully someone else on the forum knows. We do have some nurses.
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@Jannner it's all medications. She has diabetes and is supposed to take pills for that also, but at this point we just want to get the dementia meds into her because again, once she starts taking them everything else falls into place.
She doesn't eat because she's not hungry. So if you try and get her to eat she just gives it to her dogs
**She is stuck on believing the drug companies are only out to make money and they don't care about the person or their well being. She also swears its Dad who has dementia not herself. Dad, myself and my sister are literally up agaisnt a brick wall named Carole
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Blessed2B Apr 2019
I understand you completely. My brick wall his name is Joe he will not take anything he thinks it’s a medication. I have tried everything until I realized he will ask for a drink . One day when he asked I crushed his medication melted it in little a little hot water and poured his juice on top and mixed it up. I handed it to him and walked away. I realized if I give it to him normally he will drink it. Try giving mom her beverage of choice and not mentioning medication at all. Talking to him about why he needed the meds did not work. So now I don’t mention it. Maybe this will work for you I hope so.
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I'm not sure who is your mother's DPOA and Healthcare POA, but, perhaps they should explore professional care. Who is caring for her in the home? Some people are very resistant to care and it may not be feasible to manage their care in the home or with family members. It sounds like the family is tapped out of ideas. Are you having other issues with her such as bathing, toileting, changing, etc? Sometimes, people who have dementia cooperate better with non-family members. Also, this could be a phase and she may come through eventually.

Also, with her condition, it may be that she should not have the ability to feed the dog. Her and food in one area and the dog elsewhere, until her food is eaten. The person who is sick and brain damaged can't run the show indefinitely.
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Jannner Apr 2019
Lol my mother has a cat who is dying from kidney failure. ( vet says since she isn’t in pain, keep her alive to keep my mom from freaking out) The ALF won’t take care of pets so we pay for a pet sitter to come everyday. Not only has my mother still insisted on giving the cat human food that totally messes her up but started taking the cat’s fish oil lol. All the while of course insisting no one but her knows what they are doing. Aren’t delusions grand lol?!
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You are most concerned about your mother taking her dementia meds, because if she does she is likely to eat, take the diabetes meds, and behave more reasonably. It might be worth putting it to your mother the other way round. If she doesn’t eat and take the diabetes meds, her life is at risk. You will be forced to put her into a nursing home because of this risk, because it is common experience that people are more likely to comply when they are in formal medical care, and you are risking legal liability. This is likely to be a real threat to your mother, so long as she believes you. She may decide that it is better to take the meds than to risk having to enter a NH.

If she eats and takes only the diabetes meds, you still have difficult behaviour to cope with, but it is more than possible that she will take the dementia meds if she takes the others. And if she won’t co-operate at all, the threat is not much of an exaggeration – you may indeed be forced into this. It sounds as though her biggest sticking point is accepting that she needs the dementia meds, so it may be easier to tackle it from the other direction.
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She is going through stages of dementia and this will get worse before her condition means she becomes more peaceful and compliant - assuming it isn't that the violence just gets worse. Its a horrible situation and one never knows quite how it will develop, just that the person is not the person you knew, nor the person they would want to be. Start looking for a home for her, and move her when you find the one you are happy will provide the care you want for her - sounds harsh but this will not improve and much though she is loved that is something that has to be accepted and dealt with in a way that cares for her and retains sanity, safety and better memories for everyone else. I really wish you well at this very hard time.
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Jerzeevibes94 Apr 2019
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What anti-vascular dementia medication is this that works so brilliantly if only your mother would take it? It's news to me that there is one.

I think I remember - do I? - that aggression and unreason and a *seriously* foul mood are symptomatic of diabetic hypos. I should go back to her doctor and ask for a referral to a specialist diabetes clinic, where you can get advice on managing the "challenging patient."
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Zdarov Apr 2019
I agree here, my mother has vascular dementia which surely resulted from poor control of diabetes. The ups and downs of blood sugar does this Jekyll/Hyde thing. For her, steady eating and water work about as well as her maintenance medicines.
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Does she still drink coffee or yes? Maybe you could mix her medication in that? It's hot and will mix better. Hopefully she doesn't give coffee to her dogs.
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P.S. what medication are you giving her that works do well? Would really like to know for my mom. Thanks.
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I forgot that some pills can't be crushed but you said you thought of putting in her food but she feeds it to the dogs. If they can be crushed still think coffee, with cream and sugar would work.
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Time To Talk Turkey with a Facility, A Social Worker, To Get mom in Somewhere...Contact Adult protective Services for More INFo, You have a Problem for yourself and Sad Dad as well.:((
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jerzee, I have one of these but she lives alone. I just want to pitch in that your father deserves to live better than this! which I know you know. I spent my life stepping on eggshells with my mother, but I challenge her more now. A couple weeks ago while she was resisting meds or food or something once again, I said very loud and clear – Let me ask you a question, how do you think you’re doing? Because you’re not doing well you’re not managing this at all and it would pay you to get a little more humble and pay attention to what others who care for you think. I know you don’t welcome a confrontation but she’s combative anyway. So it’s just a thought: practice your tactic and your words on your own, and be ready for a time (and there further times) that you escalate the conversation and keep your backbone. She gets with it or she will be hospitalized for dehydration and malnutrition. Because she will. So ask her which she prefers, compliance at home or being given these things by nurses while she lies in a bed. I say to mom, I wouldn’t have it this way and I’m not the one that made it this way, I’m just telling you how it is. I honestly do think it’s okay to be clear about her choices, and let her choose. Maybe you being the ‘bad guy’ more often will help your dad.
It only occurred to me recently to let mom know that a nursing home is one of her choices, she could be very comfortable living like that, and ought to consider it. But I call it the hospital because I think that goes down easier.
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Jerzeevibes94 Apr 2019
Thank you!
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My dad has vascular dementia. When you say her "dementia meds" several of us have asked you what medications that is. There is no medication specific for vascular dementia. Perhaps you are talking about an anti anxiety agent or a antidepressant?? Sadly you truly cannot reason with someone with dementia. We keep hitting brick walls when we think we can. It sounds like you have a damned if you do and damned if you don’t kind of situation.
They often think they are right and we are wrong or just trying to be argumentative.
Her behavior is pretty upsetting for you I know. I do wonder if you’ve had her checked for a UTI because it can make the dementia much worse.
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anonymous903302 Apr 2019
Such a good response.

I have learned that we have to live in their reality, not try to impose our reality on theirs. Not that I have the patience to do that all the time.

Yes, undiagnosed UTIs can result in frightening and verbally abusive behavior and things you never, ever saw your loved one do or say. And, undiagnosed serious UTI can also kill. Unfortunately, most people do not understand that it can take 48 hours at least for the urine test to go through all the lab protocols to find out if there is a UTI. So, you go to the doctor, or the ER, and they take urine, and you go home.....with no meds.....not even a light, preventative anti-biotic.....please realize this....then you have to chase them down to find out if there is, actually, a UTI. Yup....you have to do it. And, with the elderly, they will rarely give antibiotics "just in case" because tolerance levels can escalate easily making them almost immune to the generally prescribed antibiotics. Then, let's say there is UTI, and the meds are for 7-10 days....and you want to know if it has resolved itself. Guess what? Nobody will re-test the urine until 5-10 days after the last day of taking the antibiotics. Sorry......just reporting my experience. Several experiences.

Also, if your LO has dementia, or is stubborn, then it can be impossible to get him/her to pee in the cup. You're going to have to insist on a straight catheter, and do not be shy about demanding that. Please.

Generally, maybe this can help.

I don't want to do or say anything that may not be within the rules of this forum,

But there is a book, "The 36-Hour Day" that was recommended to me by several health care providers about 3 years' ago. The authors are Nancy L. Mace and Peter V. Rabins. It's in paperback. You don't have to read front to back. Use the index. There is a reason that it is viewed as almost the bible for families caring for dementia, Alzheimer's and memory loss...and I don't mean "bible" religiously. It is not a religious book. It is not meant to replace personal interactions with others having the same issues. It's just a great resource. Please read it at your local library or buy it.
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I understand where you are coming from. At one point with Pop he was so bad that he either had to start taking his medications or we were going to have to put him in a care home. Like you, we tried everything, that everyone suggested and all the stuff suggested online. Someone suggested we get tough and be truthful with him. Some would call it cruel, but removing him from his family and all he knows would have been harder on him. Truth is truth and he at least deserved a chance to stay at home. After consulting all our adult kids and making sure we were all on the same page we took the tough-love approach. Basically we said "here are your medications, you must take them or we are going to put you in a care home. We all love you and want to help but you need this medication and you must take it or we can't help." Everyone told him the same thing. It worked. If it had not worked we would have put him in care a home, we would have had no choice. At first, we had to do this each time we gave him his meds. He was still belligerent and he would forget what we had said the last time. Then the meds kicked in and he became more reasonable. Now the meds are a habit, part of his daily routine, and he no longer fights us on it. We handled the food situation the same way by telling him he had to eat, he could have whatever he wanted but he must eat or he would be hospitalized. That worked too. If he only wanted chocolate cake three times a day I used the juicer to puree veggies, added that juice and the peth from the veggies along with protein powder and whipped it up into the cake. LOL whatever works? I think, allowing her access to her own meds is a really bad idea. They need to be given to her, probably, one pill at a time. Hopefully by someone other than her husband. I hope you find a plan that works.
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anonymous903302 Apr 2019
So true. Must hide the medications. Even before the NH, when my mother had 24/7 caregivers, we ended up putting the meds, and even the vitamins, in those huge day and time boxes, on top of the fridge, way back, where she could not reach. But, I did give her a copy of the med schedule that I prepared for the caregivers, so that my mother could read what she was taking and at what times and why she was taking it. Not that she always understood it.....but she felt more in control and kept that list right on her bed.

Also, so true, about food. At this point in life, let him eat whatever he wants, and whenever he wants. As long as he eats! My mother refused to eat a whole, nutritious meal, but would snack on oatmeal raisin cookies, and cheese-itz (way too salty I know), all the way up to midnight. For some reason, though, if me or my sister brought her a meal or sandwich or salad from someplace she liked, she ate all of it. She just would not eat normal meals if she was at home alone with the 24/7 caregivers. Now, at the nursing home, she eats. Mostly. And, on the day she says she has no appetite and did not eat, I know that she goes into her stash of cookies and crackers, because I am the one brings that stuff there to keep her stocked up!

A little negotiating (bribery) can work, too. Such as, I know you are having pain, but the doctor said that you have to drink this whole glass of water and take this pill before I can give you the cookie(s).
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It is a difficult situation. Have you tried crushing the medicine and burying it in her food. For example if she likes fig or fruit bars put the medicine in the cookie, or if the medicine will dissolve mix it in a sweet drink. I have also chopped pills and hid them in a prune. Be creative! Sometimes the patient will not even know the difference.
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Have the meds made in to a liquid form like they do for children. Your physician and/or pharmacist should help with that. Then maybe make a smoothie with the meds in it or in the scrambled eggs. A medication patch might also be available. Your mother's physician MUST help you! The Alzheimer's Association has a 24/7 help line and they offer wonderful support. They help families deal with ALL kinds of dementia - not just Alzheimer's. Try not to engage in a battle. Good luck to you and your family.
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I found that there comes a point in the stages of dementia that unfortunately this not taking meds and not eating is just a part of the dementia. My mother was in the hospital 2x October 2018, she went down hill rapidly after the second stay. I share this not to upset anyone but she never recovered. She either refused to eat or barely ate a couple of bites, this did instigate her hospital stays. In the end I worked with the memory care facility and put her on hospice care. By December 19th she was gone. Encourage them to eat/ drink and take meds but my experience was this was the latter stages of dementia. I pray this is not your case. Dementia is ugly, wishing you peace in this journey.
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Zdarov Apr 2019
Bless your mom and you, wjared, that had to be very hard. I’ve thought about this too, their lack of desire is natural as well.
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What medication is it, exactly? It doesn't seem like the daily fight and stress is worth it.
You can't MAKE her eat if she doesn't want to eat. Also don't worry about what she is eating, just make it appealing. If she likes milkshakes and french fries, provide them! Calories are what she needs at this point, the nutrition part is really after the fact.

As for the rest of it, I know it is extremely frustrating. From her point of view, she is also very frustrated and confused, with having a brain that no longer serves her well.
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Jerzeevibes94 Apr 2019
Aricept, blood pressure meds, diabetes meds
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If possible, crush pills or twist liquid out(may have to talk to dr to have them changed to pill form, not all pills can be crushed). Add(2 or 3 tablespoons) of applesauce, yogurt or ice cream in a SMALL bowl. Make this an evening/morning ritual.
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I agree. You cannot, nor should you try to make someone with dementia eat or take their meds because in the end you cannot make them. Take off the stress. Provide a variety of food and let her choose what or if she will eat. Be generous with treat foods. Saying to someone with dementia that eating this or taking that medicine will keep you alive means nothing and if there is any amount of reasoning left in their brain may make them decline medications. Think about it, would you want to take anything that would prolong dementia, the living hell ?
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My husband had vascular dementia, and one time accused the guy painting our house of stealing his meds, another time the pharmacist short-changed him. Kept insisting he could drive, but had visual problems that caused him to be unable to judge distances. I left taking his meds and eating up to him. Eventually he had a major stroke and died in hospice within 3 weeks as he could not swallow. We both had agreed to no gastric feeding tube. I really do not believe you should make people eat if they don't want to. Sometimes that is the only way they have of getting out of a miserable situation--their lives.
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We went thru something similar with MIL a couple of months ago. We found out that part of her not eating was straight out a control issue. She was tired on FIL telling her she needed to eat. Things got pretty bad between them. We ended up moving her from AL with him Into MC. It was hard on HIM about she was relieved. She was threatening violence against him. In her defense, he was micromanaging everything she did. Once he was not there to do that, she became more willing to eat and take her meds because he was not the one telling her to do so. They are BOTH a much happier and much more relaxed. He doesn’t feel he has to “take care of her” and she doesn’t feel like he’s forcing her to do things.
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My mom has very severe end-stage Alzheimer's but I manage by crushing her pills and dissolve them in honey. it may take forever but she eventually will take them. Make certain the pills are NOT time released. If so, have the doctor change the prescription so they can be crushed.
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Some of the medications for dementia depress a person's appetite. This could be happening to your mom. Perhaps a discussion with her doctor is in order. I have an aunt with dementia that is responding very well to a low dose of CBD oil. It has worked wonders. In the meantime, I would try to provide small, enticing snacks and drinks that have some nutritional value. I used to buy mom ensure clear which tastes like ordinary juice. Instead of a whole meal, just a couple shrimp with cocktail sauce. Little delectable bites and sips. Nothing overwhelming. Is she losing weight?
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Zdarov Apr 2019
Good to bring this up, I’m certain one of my mom’s meds is suppressing her appetite, it could be either metformin or januvia for her blood sugar.
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I believe that this may be her last bit of control. She has the right to refuse any and all meds. We found that Hospice will provide palliative care also. They are a great source of comfort for the patient and family. The patient does not have to be at deaths door either. Just check. The high pressure of some docs give quantity of days but not quality. Since we have enlisted hospice for both of my parents, they have a nurse check weekly and aide twice a week. The AL and MC provide all other needs. Good luck and prayers are with you.
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You should speak with her doctor.
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A person with dementia cannot be reasoned with. Her "lies" should not be addressed or questioned. Just agree and remain out of arguments with her. Perhaps a specialist can address her aggressive behaviors. If she is in the late stage, consider Hospice. It's a marvelous resource and let them give her her medications. Often Hospice care is sought too late.
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If you can wake her at 5am to take meds and she is calm, do so. Try to get that on schedule. I’ve found my mom is better when I can keep her level and have her eat protein regularly. Cottage cheese & yogurt do the trick. Keeps sugar stable and she’s much nicer too. So if you could give her a protein treat then too it might help. We try anything and yes, keep dog out of room at meal time. I always say ‘that will give the dog diarrhea’ which no one wants, usually works. All that said, it may be time for NH. Good luck and just do your best; it’s all you can do.
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I want to recommend a book for you-it is short, but it helped us a lot. https://www.google.com/search?q=when+reasoning+no+longer+works&ie=UTF-8&oe=UTF-8&hl=en-us&client=safari#imgrc=2OFEHDDTo3YOWM:
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You are going to have to face some hard facts. Your mother's behavior will only get more stubborn, more willful and go down, down, down. You cannot force her to eat or take the medication. The only way would be to physically restrain her and force her and I am not sure that is appropriate. Face the fact - there is nothing you can do. Perhaps you may have to consider resorting to a feeding tube. Tell her about it and what it would mean if she refuses to cooperate. It may also be her way of telling her body to shut down so she can say good bye. I am sorry you are going through this. And do NOT under any circumstances allow her to be so aggressive and angry and abusive. Tell her to stop at once in a very firm way. If she doesn't, walk out and do not go back for a long time. I can assure you this often helps with this behavior.
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