[Karen W. (OP)]

My mother in Law whom I love regardless of our Marriage problems  is refusing to take her three or 4 medications. She is Diabetic has a ulcer and High blood pressure and suffers from vertigo and has been falling  a lot!

The doctor prescribes a med she will take 1/2 a pill then refuse any more because she says it did not work and it was only half of one dose that should be taken every day some twice a day! She says it could do this or that or this or that side effect wise.. OH my... I told my husband she is to the point where he will need to him or other care person to step in  because she is not taking her meds!! We keep taking her to the hospital where they tell her to take her meds!

So frustrating!!! I feel she is unable to do this herself any more, as she just refuses her dose. I think she needs an in home person to stop by and administer her meds for her. or at least make sure she takes them in their presence.

 I have told my husband to just flat tell her she either takes them or someone will be assigned to help her at home.. she buys the meds but then does'nt take them.. I know people can refuse their meds, but this is not that kind of refusal.. It is just that she does not understand that she really will feel better if she takes them.. She says Oh Karen I am really not feeling good, I just don't know whats wrong... Her blood sugar is out of control.. and I am running out of patience.. I am not a threatening person but when do we say call in the help? An Aide or a nurse? I need help!!!

[another_someone]

It is a difficult question.

The problem I think many people have (and it is understandable) that they feel they are losing control of their lives.  They feel that doctors are taking control of their body through the application of the medication, and they are losing any say over what goes into their body, and what it might be doing to it.

The only way I can see around this is to give your MIL the feeling she is taking back control.  That is what she is subtly trying to do by refusing to take the medication; and the only way around that is to get her to feel:

a) She has the right not to take the medication, and that her taking the medication is her choice, and not something forced upon her against her will.

b) She understands what the pills are meant to do, so that she is able to give informed consent (and even to discuss whether she feels she wants slight changes in the regime).  I am not saying that the doctors have not 'informed' her in a formal way, but that is not the same as her actually understanding the information, and so in a practical way, feeling informed, and feeling in control.

[Karen W. (OP)]

Yes we went over it with her again today and I sat down and looked at the last perscription from the hospital night before last. He sent her home with some pain medication which actually causes vertigo! She went in because she felt her head was under pressure  she decribed feeling like some had their foot on her head..LOL.. The doctor thought she was having a migraine so gave her pain medication thing this was the reson for the pain... She was in NO pain at all! She was dizzy and her head felt as if someone was squeezing it not painfully mind you just lightly.. I have had this with my new meds and now it has disappeared and my blood pressure is down.. So this time she really did not need the new pill she just needed someone to help her tell the doctor what was wrong.  We did tell her today that from now on someone will go with her to speak to the Doctor as she always comes back upset and says she doesn't understand what he said.. She needs help! She said ok to this so out of 5 of us someone will go and hopefully she will start taking her other meds too!


Thanks George I used some of your ideas on the way over tonight I think that was helpful. Thank you!

[RD]

A vicious circle: poor diabetes control leads to cognitive dysfunction - cognitive dysfunction leads to poor diabetes control.

Cognitive Dysfunction Is Associated With Poor Diabetes Control in Older Adults

RESULTS
Sixty patients (age 79 ± 5 years, diabetes duration 14 ± 13 years) were evaluated. Thirty-four percent of patients had low CIB (≤5), and 38% of patients had low CDT (≤13). Both CIB as well as CDT were inversely correlated with HbA1c, suggesting that cognitive dysfunction is associated with poor glycemic control (r = −0.37, P < 0.004 and r = −0.38, P < 0.004, respectively). Thirty-three percent of patients had depressive symptoms with greater difficulty completing the tasks of the IADL survey (5.7 ± 1.7 vs. 4.6 ± 2.0; P < 0.03). These older adults with diabetes had a high incidence of functional disabilities, including hearing impairment (48%), vision impairment (53%), history of recent falls (33%), fear of falls (44%), and difficulty performing IADLs (39%).


CONCLUSIONS
Older adults with diabetes have a high risk of undiagnosed cognitive dysfunction, depression, and functional disabilities. Cognitive dysfunction in this population is associated with poor diabetes control.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1615865

If cognitive problems persist after glycemic control has been reestablished consider the possibility of senile dementia.

[Karen W. (OP)]

Thanks RD I will keep that in mind I do believe there is some cognitive impairment from before  all of this. I went last night and she had a simple form to fill out about getting help from social security to help her pay for medications, very straight forward form and she could not fill it out! She could answer the two or three questions they asked but for some reason when she put it in her hands she got a very blank look on her face and said "oh... i just don't know what to do with it... I said just fill it out... she looked through the pages which had basic questioned and blank boxes to be checked and she became flustered and said I can't do it will you help me fill this stupid thing out?"

I will keep my eyes open.. Thanks..

[RD]

From what you have said your MIL apparently has problems with comprehension and memory.
However it may be worthwhile evaluating her vision : if she cannot see the print on medicine bottles she would not be able to self-medicate, or fill in forms. Magnifying glass / magnifying sheet may be of help to read small print.
 
If she does have memory problems a checklist may help her - in large print if necessary.

http://www.magnifyingglasses.co.uk/acatalog/Online_Catalogue_Page___Sheet_Magnifiers_8.html

[Karen W. (OP)]

She just had cataract surgery and is seeing fine.. It has been a few months but she was angry afterwards because she had not seen well for years and after the surgery she saw her face was really wrinkled and said she wished she had never had the surgery cause she looked old now! ..She reads well enough that she does not need her old glasses and she reads quite a lot.. She goes through books like crazy!