Husband has dementia, takes wrong medication from pillbox and refuses to allow me control of box even though I fill it weekly. Suggestions?

Deenie, I think this is your first question here. Welcome! You'll get a number of perspectives and insights from others who have been in your situation.

I suggest that you also seek out local people to talk to. Have you ever tried a support group for caregivers of persons who have dementia? That is largely what got me through ten years of caring for my husband with Lewy Body Dementia. That and online groups like this one. And a wonderful specialist in dementia.

In your profile you say you just sit at home with your husband all day. What if you HAD to go out, for example, for dialysis? What if it were a matter of life or death for you to get out regularly? You would find a way. You might need help to figure out what is available. You might call the senior help line run by you Area Agency for Aging. You might talk to your clinic's social worker. But one way or another you'd figure out how to manage your own health needs in spite of having a very needy husband.

Getting out regularly IS necessary for your health. I urge you to treat it as such. I know from experience that taking care of a very sick husband who has dementia is very meaningful and rewarding. I would do it again in an eyeblink. But let's be honest: it is also very draining and traumatic and stressful. You must have help. You must be able to turn that responsibility off and do other things that make your heart glad, too.

Now, about the pillbox. Does he consistently take pills out of the wrong box? If he does it every time, then fill the boxes accordingly. Put the night pills in the box labeled Morning. But if it is haphazard, sometimes morning pills in the morning and sometimes night pills in the morning, that will be a little more challenging.

First, make an appointment at his pharmacy to go over this medications. (My clinic system has a pharmacist on staff, which was wonderful. But I have also worked with the person at the drug store with excellent results.) Are there any meds where it really matters if he takes them in the morning or evening? Probably with most it only matters that he takes them once a day or twice a day, and the am/pm designation is mostly a matter of convenience. The ones he takes twice a day are no problem. No matter which box he uses he's getting timely doses. The once-a-day pills (which should be taken every 24 hours) might be taken 12 hours apart or 36 hours apart if he is taking them out of the wrong box inconsistently. Discuss the consequences of that with the pharmacist. We say pick your battles. Learn whether this is a battle worth fighting.

Out of all his pills there may turn out to be only 2 where it is critical that he take them at a particular time every day. Put those two in a different pillbox. Different size or shape and color. Place that box on his night stand or at the breakfast table. Let him be in charge of the other two boxes. Focus on just those two pills where timing is critical.

Is he taking pills out of the wrong box willfully, as a rebellious gesture? Is he doing it out of forgetfulness? If the latter, make sure the boxes are different colors and stored in different places. Morning pills are in the yellow box on his nightstand. Evening pills in a blue box on the table where he eats dinner. If he wants to cooperate, this will make it easier.

He is angry and controlling. Bad combination! I do understand the anger. It amazes me that anyone with dementia isn't angry all the time. What a dirty trick their mind is playing on them! But natural though it seems, being angry all the time is tiring and discouraging. Discuss this anger with his doctors. There can be help with mood issues. That would be good for both of you!

I hope you get some good ideas here! Just knowing that you are not alone can be helpful.

Come back here often. And seek out more local help, too.

Another idea about the pill box. Buy another one that looks different and keep it hidden. Let him use up the one he 'controls'. Then fill it with pills that won't hurt him, like vitamins. The pharmacist that you use will probably be able to help, even by making up dummy pills. Experiment about how to get the 'real' pills into him. Perhaps crush them and put them into something he eats that is strong tasting like they do in most nursing homes, eg jam. The pharmacist may help with this too - just pick a slack time to go in and talk about it when you buy the second box.

It might be good if you could give more details about the 'angry controlling' aspects. If your Dear Husband kills himself by taking the wrong medication, well it may be the easiest way out for him and for you. If DH kills you, it is a disaster all round. You will get lots of sympathy and ideas here.

Best wishes, and come back again.

Hi Deenie
just a couple of thoughts. See if any of his meds can be combined. Example. Namzeric instead of Aricept and Namenda.
See if any can be prescribed in ER-extended release.
Check his blood work and see if he is getting enough to manage the condition if possible. Like is his thyroid in range, blood sugar controlled etc. I know not all meds have a correlating test but the ones that do will let you know if he’s getting enough of the drug to be therapeutic. Discuss this with his doctor to understand where to be more concerned.

How long have you had this problem with him over the meds? Is this relatively new behavior? Perhaps it will resolve as his condition progresses.

Get your children or grands involved. He may not remember them but keep them up to date and let them know he needs their help. If something happens to you, they need to have a plan.

See if your husband’s doctor will order HH to come in and set the pills up, take his vitals and see if they can help stabilize the situation through this rough patch. Every layer of help takes some of the stress off of you.

Check out Teepa Snow on YouTube. Try reading “Being Mortal. Medicine and what matters in the end” by Atul Gawande. I hope you know you aren’t alone and do come back and let us know how it’s going.

Deenie, talk to his doctor about what is going on.

Either he doesn't really need the medication, but although his messing it up isn't a problem the constant anger over it still is;

Or he does really need the medication and, since he won't let you take charge of it, some other way forward needs to be found.

Either way, it does sound as if his mental impairment and his behaviour have reached a stage where it is not safe or reasonable for you to be trying to care for him on your own.

Maybe start crushing the pills and putting them in his food.  If some pills are gel based, ask the pharmacist for crushable pills.  Also confirm with them that his current pills can be crushed.  We do this and add to mom's applesauce.  If he starts to ask where his medicine is tell him the doctor said he doesn't need them anymore.  It's okay to fib.  Their safety is the most important thing and as this disease progresses we do what we have to, as I'm sure you know.

I have been seeing a commercial on TV about meds that are packaged in small envelopes with the date and time to be taken printed on the envelope.
If this available in your area it might be helpful. Sorry I don't know the name but maybe a pharmacist could help with this. I remember rehab had all of the DW's pills on a large card to help the nurse administer the meds without mix ups.
I like the envelopes best.
I hope someone else on here has more info on this product.