Swallowing tablets

[noelphobic]

My mum is on a 'cocktail' of tablets 5 times a day for her Parkinson's, thyroid condition and (alleged) epilepsy. For quite some time now it has been a struggle for her to swallow them. When she still lived at home her hands were so shaky that you couldn't just hand them to her you had to actually put them in her mouth and watch very carefully in case one dropped out. Less than 2 years ago my sister and I started taking turns to go there to give her her medication as my dad could no longer do it.

She has now been in residential care for over a year and in her present nursing home for about 2 months. On 2 occasions recently I have been there in the evening at medication time. One of the night staff asked me to give my mum her medication. It was crushed up and mixed in water, served in a 'baby' cup with a straw. It was a bright blue colour, cocktail like apart from the lack of an umbrella and the foul taste - I tasted it myself the first time! The care assistant asked me to give it her tonight but my mum really struggled with it, although she did eventually manage to drink most of it, with much pulling of faces and moaning and groaning!

I don't really like her having her medication this way. It tastes horrible, takes ages for her to get it down and, more importantly, I worry that she might not manage to take it all for one reason or another. The first time I gave her it the care assistant said that if she didn't manage to take it she would give her it in the normal tablet form later. I was worried that she would only manage to take some of it in which case it would not be possible to gauge how much she had had and give an appropriate dose in tablet form.

I have heard that certain medication can be obtained in liquid form and am wondering whether this would be a good idea. I am worried that if I ask for this to be done I am somehow hastening her decline in that I am 'encouraging' her to lose the swallowing reflex. She still manages OK with 'normal' food and drink but I just wonder whether it would be a good thing to change to liquid medication or not.

Any advice much appreciated as always.

 

[zan]

Dear Noelphobic, I wouldn't think that it would affect your Mum's general swallowing adversly if she had liquid medication, as she is eating a variety of foods and so she is maintaining her swallowing reflex.I can understand your concerns about her only swallowing half of her medication. We had the problem with Dad's painkillers. Liquid medication can be dispersible or syrup. Syrup will only mean that your Mum has a small amount to swallow which isn't too difficult to control. If it is dispersible it may have to be dissolved in a minimum amount of water, which is where the problem can occur. I wouldn't want to drink a glassful of something that tasted foul, so if you don't really know why you need it, it must be awful for your Mum. If your Mum's tablets are the dispersible kind, you could try dissolving them in the smallest amount of water so she only has a little drop to swallow then give her a good drink after of something nice, so , in effect they are being mixed with plenty of fluid once in her stomach. Always a good idea to check this with a pharmacist as some do need lots of water to prevent damage to the throat . They seem to be very willing to give advice on this nowadays and I've found them very helpful. If the tablets arn't actually dispersible, but the staff are trying to mix them with water to make them easier to swallow, be careful. Some tablets are coated so that they shouldn't be crushed - again a pharmacist would give advice. Crushable, but not dispersible tablets sometimes go 'down' better in a spoonful of jam or other nice tasting food to disguise their taste, again followed by a good drink.Hope this is of some help. If the home know their stuff they will already have talked to the pharmacistthemselves, but you never know. Good luck from Zan

 

[McK]

Pills

You could ask the staff to crush the pills and mix them either in pudding or ice cream. I found this much easier than mixing the pills with a liquid. Just a suggestion. Good luck. Mck

 

[dmc]

Hi noelphobic
we had the same problem with my mum last week she finds it increasingly diffucult to swallow tablets and holds them in her mouth or chews them or spits them out altogether!
some members of TP advised putting the tablets in with a fruit drink or crushed with food but our cpn managed to get most of the medication in medicine form with small syringes and were finding these a big help.
good luck

 

[noelphobic]

I asked one of the daytime nurses about this today and he told me that he never has any real trouble with giving my mum her tablets in the conventional manner ie puts them in her mouth and gives her a drink of water! He said that he sometimes uses a spoon and I have seen one of the other staff doing this - they get them to the back of the throat this way. I told him I wasn't happy about mum having her tablets mxed in water and asked him to pass the message on to the night staff. He said he would have a word with whoever came on duty that night but that obviously that wouldn't get to all the night staff. It may only be one person that does it because it is the same person who asked me on both occasions. Now I feel that it looks as though I am telling tales, even though I asked the night nurse who I should see about the medication and the person I saw was one of those she suggested! I think that because we had problems with the previous home and still have an ongoing complaint I am paranoid. I don't want to let anything pass by if it impacts on my mum's care but on the other hand don't want to have an adversarial (sp?) relationship with the staff. I was quite pleased when I heard that one of the senior nurses had been promoted to assistant manager as I felt I had developed good communication with her. Then I realised that her promotion may well means she changes from working shifts to working office hours and I will rarely see her as I work office hours myself!

 

[noelphobic]

The plot thickens - literally

We went to the nursing home today at tea time and one of the staff asked me if I would like to give mum her medication. It looked as though it had been dissolved in water again and I said that she had had problems in the past taking it that way. The staff member then said she would take it away and 'thicken it up'. We couldn't understand what she was going to do with it but she reappeared with this thick blue paste in a cup. She didn't ask me to do the honours again, she spoon fed it to my mum and gave her orange juice inbetween. The weird thing was that my mum was pulling faces when drinking the orange juice but tolerated the blue goo better!

Now I really am confused! What was done to the blue liquid to thicken it? Why can certain staff give it in tablet form and other staff can't?

I think it was Colonel Mustard in the study with the dagger!

 

[zan]

Dear Noelphobic, At one time my Dad was aspirating liquid into his lungs and the nurses gave him thickened water. Apparantly there is some kind of powder or granules that can be mixed with the fluid to thicken it, in a similar way that cornflour thickens sauces but without the heat.

I would ask to speak to the person in charge and make sure that all the staff are aware of what they should and should not be doing,

Good luck from Zan

 

[noelphobic]

Zan

I am sure you are right and I will take your advice. It's just difficult working office hours as that is when the 'management' are there. I will try to phone up next week.

Thanks for the advice and I hope you are as OK as you can be under the circumstances.

Take care.

 

[McK]

Instant Food Thickener

Dear Noelphobic - Hormel makes an "Instant Food Thickener" that can be used to thicken hot or cold food or beveridges. It's in powder form and comes in 6.5g packets. You can use one or more packets to make the liquid the consistency of honey. I've been using the thickener for over 2 1/2 years now in all of the liquids that my wife takes. You can check out further info at : www.hormelhealthlabs.com. Best Wishs, McK

 

[Dearth]

We've used one on the ward I used to work on called 'Thick And Easy' - aosl can be used with hot drinks too such as tea and coffee.

Found a link for you re: this - hope it's of some use.

http://www.dcdistributors.com/thickandeasy.mgi



N.

 

[Dearth]

Another link, as that one is U.S. specific...
http://www.westonshealth.co.uk/acatalog/Westons_Health_Thick___Easy___14514.html

As you can see - it isn't cheap though!

N.