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 Spitting out meds 
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Spitting out meds
Derek has been spitting out his medications lately. It doesn't matter whether
they are whole or crushed, in pudding or not, he will hold them in his mouth for
maybe ten seconds and then they gradually come oozing back out. Last night I
verified with the nurse the meds that had definitely been ejected and she
brought more which I was finally able to administer but it took about half an
hour. This doesn't seem to me like a conscious rejection of his medications, at
all, but a spontaneous action. He has always been a really good 'pill taker' in
the past. Has anyone else had this happen and what did you do about it?

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Sep 07, 2011 8:05 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3406
Location: Vermont
Post Re: Spitting out meds
Pat - does he make any faces or say anything at all to indicate he doesn't want to take the meds any more, or do you think he can't swallow them? What if you hid them in something he likes, like ice cream, applesauce, yogurt or something else he doesn't need to chew? Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Wed Sep 07, 2011 8:21 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Spitting out meds
They put them in pudding, which he likes but he somehow notices that something is in there. He holds food in his mouth for a long time, too but usually swallows it. It's just part of the bradykinesia, I guess. Takes a while for the response to come. But the pills, even when crushed, seem to create a texture or taste he doesn't want or that he thinks doesn't belong there. He's not really 'with it' so it's awfully hard to say. :cry:

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Sep 07, 2011 8:52 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3406
Location: Vermont
Post Re: Spitting out meds
It reminds me of when I used to have to give my pets meds. No matter how hard you tried to hide them, they could find a pill inside the largest meatball, or whatever. I'm guessing his sense of smell and taste might be hyper-acute? Quite a while ago there was a discussion on here about this and I think the person was able to "hide" the meds in milk shakes and fruit smoothies. Perhaps something where he's drinking with a straw might solve this? Then maybe the meds won't be noticed by so many taste buds and the liquid will go right down? I remember at some point my dad didn't want to take his meds any more and I told him he had to do it because it would make him more comfortable. He was able to understand that at the time. I'm sure you must be quite frustrated. Does he still really need the meds he's currently taking him, in other words, do you think they are helping him or is it more like a habit that the dr. keeps prescribing them whether they are doing anything or not? Kind of hard to know I'm guessing. Hang in there, Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Wed Sep 07, 2011 9:04 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Spitting out meds
This could be happening because Derek is subconsciously aware that he's experiencing dysphagia.

Perhaps all meds can be re-evaluated, and convert all the critical ones to other means of administration.


Wed Sep 07, 2011 10:35 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Spitting out meds
You may be right, Robin. Tonight I was able to give his pills one at a time, whole, in a spoon and he swallowed them, though it took a while. He was not as tired as he often is in the evening and I think fatigue severely affects his swallowing. I hope it's not a precursor to dysphagia--something I've been dreading for so long. :cry:

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Thu Sep 08, 2011 12:02 am
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Joined: Sun Oct 21, 2007 4:18 pm
Posts: 835
Location: Acton, MA
Post Re: Spitting out meds
Pat, Frank will spit out any pill that isn't crushed. Most of his pills have been eliminated so I only have 3 a day to get down him. I crush them and mix them in a small amout of ice cream with a larger portion of just ice cream, and then put it back in the freezer until after he has supper. I give a very small amount of the Med-ice cream with a little bit of Suzy Q, for texture, and then some non-med ice cream then repeat. I "think" returning it to the freezer may soften the crushed med, but SO FAR, it's working.

I'm beginning to have difficulty with transfers and think of you and Derek, I'm not sure what's in our future.

Good Luck,
Gerry

_________________
Gerry 67, cared for Frank 71, married 49 yrs; dx 2004, passed away October 26, 2011.


Thu Sep 08, 2011 7:07 am
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Joined: Mon Feb 21, 2011 9:55 pm
Posts: 355
Post Re: Spitting out meds
Pat, can you get any of his meds in liquid form - I know you may not get them all, but some in liquid form may help him cope with the others - there wouldn't be as many to take. I couldn't have managed Dad's meds otherwise,
Ger x

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cared for Dad who passed away on January 28th 2013 R.I.P.


Thu Sep 08, 2011 2:20 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Spitting out meds
Thank you all for your suggestions. What is apparently happening is, in the evening [around 7:00 PM] he is often very tired. Even when he tries to drink liquid, through a straw or otherwise, it often comes running back out, too, so I don't think liquid medications would help in his case. Maybe his medication schedule could be rearranged so that all he has to take at night is the Seroquel. He was tired, this morning, too and barely ate. I don't know if there is any point in getting another swallowing evaluation. He had one in December that was OK.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Thu Sep 08, 2011 3:03 pm
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Joined: Tue Mar 29, 2011 3:02 pm
Posts: 386
Location: East TN
Post Re: Spitting out meds
Pat…

not to try to compare exactly with Derek…but some similarities….

my swallow test was fine also….last month at Mayo…

I am not having anywhere near the troubles you describe….but….

my supper meals do not stay down in the esophagus and rarely go all the way down to the stomach the first try….but…I am fooled into thinking it has….

when tired..I find all of my problems are worse….

but…definitely swallowing is harder when tired…

also more hiccups….more involuntary puffing….more snorting...

more choking….

things are definitely more interesting when I am tired….

_________________
Craig - Patient - Male - 56 years old - Lewy Bodies diagnosed on March 23, 2011 - cognitive disorder NOS dx 2007 - RBD REM dx 2007 issues for 20+ years - intention tremor 1974 - other issues many years


Thu Sep 08, 2011 4:26 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Spitting out meds
Thanks, Craig. I really do believe fatigue has a lot to do with it.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Thu Sep 08, 2011 4:41 pm
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