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Mother with Dementia stock piling paracetamol

iMad

Registered User
Aug 29, 2016
11
Does anyone have any advice they can offer for this tricky issue? My mother (77) has vascular dementia with Alzheimer's. My father is her carer and gives my mum her medication including any painkillers if she needs them. Over the last few months I have noticed that she keeps mentioning that she has taken paracetamol for something and when I ask her where she got them from she points to her chest of drawers in her bedroom. When I ask why she has got paracetamol in her room she becomes very defensive and says 'oh I only had a couple, they have all gone now'. If I ask her when she last took paracetamol she gets very confused and one minute she says she took them last night and the next minute she says it was a few hours ago. When I tell her that she should not be taking them herself as she can't be sure how frequently she is taking them she becomes aggressive saying she is not an idiot and she can remember taking a few tablets. A few days ago whilst she was downstairs I crept up to her room and quickly searched through the drawers and found little packets of paracetamol tucked away in lots of places so I gathered them up (the ones I could find) and hid them, informing my dad where they were. For months she has been feeling unwell and I have a suspicion that she has been taking too many of these pills and slightly overdosing on them as she cannot remember when she has taken them. I am worried about how she will react when she goes to look for them because she blames my dad for everything and gets very aggressive with him and he is quite frail. I will have to keep checking her room on a regular basis but I am also worried that I have not found them all and that she can still help herself. I can't ask her about it as it will just cause a big argument and she won't come clean if she does have any more. Sorry for the lengthy post, I can ramble on a bit.
 

cragmaid

Registered User
Oct 18, 2010
7,942
North East England
Hello, I'm sure you probably know, but even a small overdose of one or two extra pills a day can cause lasting, and serious damage to someones liver. It is possible to O/D on a minimal ( 8 in twenty-four hours) dose if your liver is vulnerable.
You must emphasise to your Dad to write down the time when he gives her painkillers and to refuse to give any more for 4 hours. If she truly is in pain, then you need to arrange a visit to or from the GP.
 

Beate

Registered User
May 21, 2014
11,841
London
How was she able to acquire that many Paracetamol? You're not usually allowed to buy more than two packets at once in a supermarket so this must have been going on for a while. It's no use trying to reason with her, but more supervision is needed and any medication should be stored where she can't find it. Additionally, perhaps take her to a doctor to check her out.
 

Amy in the US

Registered User
Feb 28, 2015
4,619
USA
I wonder if bringing in carers to dispense medication, would remove some of the burden and responsibility from your dad. I'd be careful to "blame" this on the doctor or the NHS or anyone other than you and your father!

Definitely let the GP know about this ASAP and keep track of what doses she's taking, and have a search (while she is out of the house) to remove medications. I will write more later but went through this with my mother and it's very stressful.
 

chris53

Registered User
Nov 9, 2009
2,929
London
Good afternoon iMad,a warm welcome to you here on Talking Point,yes a rather tricky and sensitive additional worry for your mums wellbeing, am hoping your mums GP will be able to advise,they really need to know and have this on record:rolleyes:could you "replace" her secret stash with a harmless placebo? many children's sweets look like pills:eek:
Hope you can sort this out soon
Please keep posting and take care
Chris
 

iMad

Registered User
Aug 29, 2016
11
Thank you cragmaid. Yes I am aware that it is easy to overdose even on small amounts and recent tests on my mother did not bring up any problems thankfully. Although I still think this was the reason she was unwell, as there was nothing in the results that pointed to anything else. My dad is very good at administering her medication. He does not have memory problems. We did not know she had the extra pills as she had hidden them in very small amounts in various places around the room. At a recent visit to the GP he gave her stronger painkillers which I have asked my dad to keep somewhere where she can't get access, but she is very sneaky and watches and hears everything that goes on so I don't think it will be long before she finds them. There are only so many places in the house that they can go.
 

sleepless

Registered User
Feb 19, 2010
3,223
The Sweet North
Thank you cragmaid. Yes I am aware that it is easy to overdose even on small amounts and recent tests on my mother did not bring up any problems thankfully. Although I still think this was the reason she was unwell, as there was nothing in the results that pointed to anything else. My dad is very good at administering her medication. He does not have memory problems. We did not know she had the extra pills as she had hidden them in very small amounts in various places around the room. At a recent visit to the GP he gave her stronger painkillers which I have asked my dad to keep somewhere where she can't get access, but she is very sneaky and watches and hears everything that goes on so I don't think it will be long before she finds them. There are only so many places in the house that they can go.
Your dad could buy a lockable medication box, then keep the key on his person or in a safe place. I would think this would be even more imperative now that stronger painkillers are being prescribed.
 

iMad

Registered User
Aug 29, 2016
11
Thank you Beate. I think this has been going on for a while but it is only recently that it has come to light. She does not have packets but little bits of the blister pack. She cuts them down to two and four which makes them small enough to tuck in things like socks, which makes them harder to find. Now that I know she is doing it I can check more often but she can hear me when she is downstairs so it is tricky. Her hearing is beyond amazing. As I can only visit a few evenings a week it is not something I can do when she is not there.
 

iMad

Registered User
Aug 29, 2016
11
Hi sleepless. Yes that will probably be the next step. My concern is what her reaction will be to not being able to squirrel her stash away.
 
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Spamar

Registered User
Oct 5, 2013
7,030
Suffolk
But where is she getting them from? As Beate said, a supermarket will only sell you two packets.

Hi, Maureen, I get 2x 200 paracetamol every month! Though I don't have them every month, only when I have to. I've also got codeine for emergencies. We used to be able to get prescriptions 2 months in advance, but apparently because of government edict, it's now every month! That's a pain in itself! Apparently it's meant to save vast amounts of tablets, but if you need them, you need them. If you're not going to take them you will still get them.

Apologies iMad, for going off topic.
 

CollegeGirl

Registered User
Jan 19, 2011
9,525
North East England
2 packets is still 32 tablets, and since there are many different shops that sell paracetamol, it's easy to buy two packets in one shop, go next door to another shop and buy two more, and so on. If this is what's happening, I'd think it would be very easy to soon rack up a considerable stock of tablets, unfortunately.

It must be very worrying for you, iMad.
 

Bod

Registered User
Aug 30, 2013
1,212
Has she tried the pain control patches?
Removes the need for tablets, change once a week, different strenghts available.
Needs a Dr's perscription, so getting too many is very difficult.
Seach and remove all hidden medication, switch to "Dosset" boxes from chemist.
Having had to look after FiL who was addicted to pain-killers, I know how difficult this can be, We had a locked box, I had the only key!

Bod
 

iMad

Registered User
Aug 29, 2016
11
Hi CollegeGirl. Yes it is very easy to get them in the shops. You can pick them up almost anywhere. The local shops are only a 5 minute walk away so it wouldn't be hard for her to pick them up. She is not housebound. Although my dad is with her for most of the day there are still times that she can go out on her own. Although I suspect she has just been sneaking them out of the box at home every now and then so it was not noticeable. I went back again a few evenings after the first batch I found and I found a few more put back in the same places. Probably a total of about 6 tablets. So she still found a way. I find it odd that she didn't say anything. I put it down to the fact that she may have forgotten and thought she had finished them. But I feel one day she might realise and then we will have to deal with that. I don't know whether to lie and just say they have all gone or be honest and tell her we found them and took them away for her safety.
 

nmintueo

Registered User
Jun 28, 2011
847
UK
Tricky one; you can't watch her 24/7.

I like the placebo idea, too. But in this case, getting sweets that resemble paracetamol sounds unlikely to work:
  • She's walking out to the local shops and buying her own (and she's doing that even though there are already plenty in the house)
  • She's cutting up blister packs, so finding something that looks like the real thing is much harder
  • A bare sweet that looks like a paracetamol will taste nothing like it, so will be unlikely to fool anyone.

If it were just one local pharmacy, you might ask if there's anything to do to help (such as inform you if she comes in), but if there's a bunch of shops she can go to, that seems unlikely.

I'm guessing she uses cash, so you couldn't watch her card purchases and know when she's bought something somewhere.

Could you get away with something like a GPS tracker in her handbag so you know when she's gone to the shops?

Information at http://patient.info/doctor/paracetamol-poisoning says "Commonly, patients are asymptomatic for the first 24 hours or have nonspecific abdominal symptoms (such as nausea and vomiting)" -- are those the symptoms in this case?

I suspect she has just been sneaking them out of the box at home every now and then so it was not noticeable.
If these are the usual 500mg tablets, any chance of replacing them with 200mg tablets, if you can find them, to reduce intake? Or might it work if you substitute low-dose aspirin tablets (75mg instead of usual 300mg)? Can your doctor offer any advice?
 
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Beate

Registered User
May 21, 2014
11,841
London
Why not? Why can't she be supervised more? There came a time when my OH could not be left alone anymore, and I was working full time then. Together, SS and I agreed on and arranged a support plan that got him a day centre place five times a week and sitting service through Age UK during the times before and after my office hours that weren't covered by the day centre hours. The rest of the time I looked after him. I still do. He's never left alone now. Social services have a "duty of care for a vulnerable adult at risk". Going out alone and buying enough paracetamol to overdose on is a serious risk. So please try and get more support via Social Services.
 

Sue J

Registered User
Dec 9, 2009
8,035
Hi iMad

I have experienced this with my friend and also do it myself! since my symptoms began.

Her pain is evidently not under control. It is likely she cannot express when she has pain to others because of:

Her symptoms affecting her communication abilities
Her wanting/needing to remain independent and do things for herself
Inability of her brain to recognize that she is ill and needs painkillers.

The fact that you find lots of little packets is because she forgets what she has already, the fact that they are cut into twos to me shows some understanding on her part that she must only take a couple.

With my friend what helped was getting a prescribed dosette box - with lots of reinforcement that the only tablets to be taken were the painkillers in the box - at first the pharmacy didn't want to put them in but it works.. My friend was initially reluctant to do this saying 'I don't need all those tablets' but once her pain came under control she realised she did - she still forgets sometimes:rolleyes::( and it was a huge relief to me not to have to constantly speak to her every 4 hours to assess her pain control and try and explain what to take - whilst battling my own symptoms! I did have to warn her pharmacy to not let her buy any tablets and remind her she got them in her dosette box.

I began by buying boxes every time I was able to get to the shops - for fear I didn't know when I'd next be able to go and this is much better since my GP has prescribed them for me in 200s! (no they don't understand my dementia symptoms but I do) whilst I still get in a bit of a muddle it has taken away the fear of never having enough and with the help of my home help and writing down (when I can) what I take it works better - not ideal but better. I forget what to do though when I don't feel quite right and can take a long time before I realise I need to take something by which time the pain has taken hold and harder to get under control. If you can try and observe when you think she is showing signs of pain and see if there is any pattern as it may help in making sure she gets them at the right time to avoid her having to search for them. I wouldn't go down the placebo route as I don't think it would work, it wouldn't with me or my friend - not all the marbles disappear overnight;):D the fact that I think you said her results are OK would indicate she may still be smarter than you think - despite our confusion at times we can still follow some instincts - its riskier but not always absent, have had to learn this with my friend and myself.

Don't know if it helps but hope something does.
Best wishes to you
Sue:)
 

Ginny Hendricks

Registered User
Feb 18, 2016
17
My father, who had been taken warfarin reliably for years, suddenly began to stockpile packets and take the wrong dose (although he could still say what his dosage should be) with resulting odd blood tests: it's fortunate that this drug requires regular testing. We took the packets - twenty in all, some full, some part-used - to his doctor and told him about his other strange symptoms such as hallucinations and a marked stoop/shuffle (I'd already concluded he probably had Lewy body disease) which prompted the beginning of the diagnosis process.

Your mother has already been diagnosed, of course, but more help is needed it seems, so I strongly suggest that you show all the pills you've found, if you still have them, to her doctor or social services as evidence of this - take a photograph too - and see what can be done.

My father's now in a home but my mother, recently diagnosed with Alzheimer's, is still at home with a great deal of help from family and paid carers; we have to hide her medication and put the correct dose out for the carers to give her.

Good luck, Beate. I hope you manage to sort this out.
 

Beate

Registered User
May 21, 2014
11,841
London
My father, who had been taken warfarin reliably for years, suddenly began to stockpile packets and take the wrong dose (although he could still say what his dosage should be) with resulting odd blood tests: it's fortunate that this drug requires regular testing. We took the packets - twenty in all, some full, some part-used - to his doctor and told him about his other strange symptoms such as hallucinations and a marked stoop/shuffle (I'd already concluded he probably had Lewy body disease) which prompted the beginning of the diagnosis process.

Your mother has already been diagnosed, of course, but more help is needed it seems, so I strongly suggest that you show all the pills you've found, if you still have them, to her doctor or social services as evidence of this - take a photograph too - and see what can be done.

My father's now in a home but my mother, recently diagnosed with Alzheimer's, is still at home with a great deal of help from family and paid carers; we have to hide her medication and put the correct dose out for the carers to give her.

Good luck, Beate. I hope you manage to sort this out.
I'm not the OP, iMad is.