Managing Medications

I remember once telling a friend that if I ever had to start managing mom’s medications then I’d know things were bad. To me, mom not being able to pour her pills meant her mind had deteriorated enough that she’d lost a skill she should be able to do without thinking. She was a nurse. She’s always managed her medications meticulously. She understands the importance of taking medications regularly.

I started pouring her pills for her a few years ago. It’s one of those things that eased it’s way into our lives without fanfare. One week mom was pouring her pills, the next I was. It wasn’t a big deal. It was me trying to do something nice for her. I saw her struggle to follow her medications list and get the right pills and the right number of pills in the right box. I decided to take over so she didn’t have to struggle. She thanked me. She was relieved. She appreciated the gesture. No big deal.

Is last night’s step a big deal? It seems so. A little more than me pouring her pills.

Last night I collected her three pill boxes, all her pill bottles, and her insulin pen equipment and stashed it all in my office. She no longer gets access to any of it. Things have gotten that bad.

Changes come gradually. Rarely is there some dramatic moment of upheaval. It started with me checking daily if she did her insulin and took her pills before dinner. Then reminders to take her medicine before bed. Checking if she took her pills in the morning. These things creep up. But now there’s been a bit of a dramatic shift.

Last week she missed her morning pills three days. Skipping pre-dinner pills is nothing new. I almost always remind her to take her bedtime pills. But yesterday she took her pre-bedtime pills before dinner and skipped her dinner-time pills. She couldn’t remember if she took her morning pills. She forgot she needed nighttime pills. Straw-camel-back. Know the expression? Mixing up her pill boxes was the straw that broke the camel’s back.

Last night before I went to bed I put her morning pills in a dish next to her kit for checking her blood sugar. About an hour after she got up this morning she came to me concerned because she couldn’t find her pills. I went to the kitchen and found the empty dish. She’d taken her pills and forgotten she had. Crisis averted. Also, proof she can no longer manage any aspect of her medications. That’s where we are now.

So have things gotten bad? Are we in the kind of trouble I once thought this stage would indicate?

Not really. I’ve known for a very long time that she can’t live alone. Taking over for her has been so long and slow a process that it’s not the least bit jarring when the next little stage comes. Instead of medication management being an indicator of dementia, it’s merely a side effect. That she has dementia is nothing new. So I was wrong. Mom no longer being able to manage her medication is not a harbinger of doom. Can I claim that as growth rather than misguided arrogance? I hope so. I’m going to. I need to cling to some shred of self-respect. Now let’s work on my humility, because clearly I know nothing.

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