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Dad has feeding tube in stomach which all his meds are taken through. Mom needs help daily to crush meds and once a week to sort meds in pill box. All skilled nursing has a min number of hours at an hourly rate when all that is needed is half an hour a day. Any ideas?

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Is it possible to get your dad's medications pre sorted? Some pharmacies will do that. And I would also check to see what meds can be ordered as a liquid. That would be so much easier.
to sort meds, to grind meds there does not need to be a Nurse or other medical staff person do that. It is only if the medication has to be administered by a caregiver hired through an agency. (if you hire someone privately you can instruct them to administer medications)
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My aunt will be 92 on the 30th. She still lives alone. We have a nurse coming once a week to check on her meds. She misses them often. Adult Services is involved but says there's nothing they can do because the doctor says she's fine mentally. She's had several falls, fractured her arm last year, and spent over 100 days in re-hab due to that. Isn't supposed to drive, but continuing to do so. She's been advised to go into assisted living, even sent a check to me & I took it to the nursing home, but she changed her mind at the last minute. She even put her home on the market for two days & then took it off.
She is in Tenn, I'm in Ohio, over 300 hundred miles away. What can I do?
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OOMEZOOME Sep 2021
The meds are the hard part. Obviously, she can see okay, so put a camera by her meds. You’ll get an alert when she’s by the camera. You can then see if she took her meds. My dad is 92 and I put his meds in little cough medicine cups. It’s easy for him to pickup the cup and kind of drink the pills. His dexterity is bad due to stroke. Since you’re far away, I’d get cameras inside and outside the home. Get a smart lock on the door that you can control, in case you need to have a caregiver come to help her. It’s such a hard situation. Make sure she is using a walker and hire someone to declutter her house, enough so she can get around without tripping over stuff. The cameras are not that expensive, and they have been a complete lifesaver for me. Being able to keep an eye on my dad from my house or when I’m running errands has been invaluable. I think with the cameras, I can keep him in his house, instead of putting him in an expensive home. Can you find a way to get the pharmacy to send your aunt prepackaged meds, so they are easier for her to organize and take?
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Talk to doctor and/or pharmacist about switching to liquid medications. They are easier to give via feeding tube. Crushed medications tend to clog the tube. If that happens, a little soda pop tends to clear is out.

Also, some pharmacies with package pills into clear packets with labels of medications, who they are for, and time of day.
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There are dispensers that can be locked (I didn't lock mom's, she wasn't able to open it) and have timers, etc. Depending on how many medications, it can be set up for up to 4 weeks, so if you help her, you wouldn't have to do it weekly.

Another issue is crushing the medications. I realize this is a special case (feeding tube), but some medications should *NOT* be crushed. Talk with the pharmacist about that and also ask about getting liquid medications so no crushing would be required. Of course that negates the dispenser, but it would eliminate the crushing need. A chart might be a good idea if they can be formulated as liquids (not all pharmacies can do suspensions, but they are out there!) so she can mark off what's been given.

Unfortunately it would require a nurse, not a CNA, to "handle" medications, and they are probably less likely to work in short stints. Check with the pharmacist to see if any can be compounded (and ensure they can be crushed too.) If no compounds, then check out the medication dispensers. If there are too many for one dispenser (slots can be set up for multiples per day, but it reduces the total number of weeks down, depending on how many/day), then get two. For crushing, what about a very small food processor?
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I would look into Angel care or one of the others that provide care. Also look into liquid medication for your mom who has to crush her meds. We had to look into care for my brother in law who can't take his medicines right. I found an agency that would provide care but would have to pay for an hour its better than other places and the price was around $11. Also look into Medicare they may have a program that has in home care where they will pay someone to come in. I know the state of Iowa has a program that does this they pay someone to come in to take care of them I found this out by doing someone's taxes.
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If it is a matter of having the physical strength to crush your dad's meds, I got a very nice pill grinder through Amazon that was easy to use.
When my mom started having trouble swallowing pills, we crushed everything on the doctor's orders, including the pills that said "do not crush" on the packaging.
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You can usually hire someone for a 2 hr minimum..

Best idea is to find a Nurse on your own close by to see if she/he would be willing to do it once a week for an agreed upon price.

Keep in mind, even tho you think it only takes 30 minutes, you need to keep in mind that it takes the Nurse driving tim e to get to and from your parents house which could tack on another hour or hour and a half which would total 2 hrs.

Also, think of it as a Service Fee these days for someone to come to your home is roughly $100-$150.

Or, you could make a trip yourself once a week to sort the pills.
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PillPack by Amazon 855-745-5725.
They deliver meds sorted by time of day and day of week in individual packets. Great service!
Not sure about the crushing part, but we have been using them to alleviate the sorting for years due to the number of meds my other half takes daily.
Give them a call. They are easy to talk to. Maybe this will make your life a little easier. I know it does mine.
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Lamb232 Sep 2021
Thank you so much. This is just the information I was looking for.
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Sometimes, the meds do more harm than good. Please contact a nutritionist . Most of all pray , 🙏🏽 pray and read Gods Word Daily. god Bless you snd Your Family.
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LoopyLoo Sep 2021
I am a big believer in prayer and taking things to God, but please don't imply meds aren't needed or do more harm. Or that faith is all you need. This is dangerous. Illness isn't a lack of faith!

The way I see it, God gave everyone certain talents. Me, I don't have what it takes to become a doctor. But many do because God made their brains that way! And they give that talent back to God by using those skills to help people... whether it's prescribing meds, treating illness, surgeries, or helping someone pass on comfortably. THAT is how God often works.
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Find a pharmacy that will dispense the meds in prefilled daily/time of day pill units. Mum will still need to crush them (you can also buy a pill crusher - this will do a number at one time)
https://www.amazon.com/Pill-Grinder-Stainless-Pulverize-Multiple/dp/B07D3X37L8/ref=sr_1_9?crid=OI1K1FXSYICV&dchild=1&keywords=pill+crusher&qid=1631032710&sprefix=pill+cru%2Caps%2C445&sr=8-9
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Is there a way to reduce the number of meds dad has to take daily? I know MDs hate to discontinue anything but an assessment by a geriatrician might identify some candidates to discontinue or decrease the dose.
Supplements may or may not be beneficial, and probably the tube feeding formula supplies enough of what he needs. Multivitamins and calcium are to help prevent or delay health problems - same with statins.
If you check on community websites such as NextDoor, your question might find a nurse or pharmacist who does this weekly profiling.
Depending on what sort of help Mom needs for crushing the pills, moving to liquids as much as possible is a good idea.
Have you been able to observe her crushing the pills, to see the details of her problem?
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My mother needed to take some medications on a daily basis. Fortunately I lived closed by and I would stop by on my way to work during the week and administer her medications. For weekends I would prepare the medications in a pill box marked Saturday and Sunday. I then would call her to make sure that she took her medications. I also would usually visit on Sundays and I could tell whether or not she took those medications.
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Sheilashine1: Imho, Visiting Angels has a three hour minimum shift. Is it possible that if you were to use their service, that your parents could benefit from the extra two and one half hours, e.g. light housekeeping and/or small meal prep?
Your profile states that you are caring for your father, Willue.
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I had the private phone number of a favorite aide that my Mom really liked. Once I needed help on a regular basis outside what Homehealth (and now hospice) provide, I called her and asked if she moonlighted. Answer was YES. She comes 1 hour at a time except Sundays (3 hours). She'll work 1 hr min or more. She charges me $25/hr if only 1 hour and $20/hr for 2 or more consecutive hours. If I need her, she can come in the morning and at night.
My suggestion would be to call a familiar aide and talk to them about private hire outside the agency. Also, tell them what you need and if they are willing to do it AND capable of doing it.
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If you speak with the PCP there maybe certain medications that are available in a liquid form. You may also find if you speak with the pharmacy they may have options that the doctors don't know are available. Found that out the hard way. Family friend has feeding tube, had some pills that were so large crushing them was near impossible and I was at the time pretty strong. The pharmacy said there was a liquid form of the medication. I was POA and spoke with doctor and he changed the prescription to the liquid and things were great. One thing you should to is see if any meds can be removed as they may not be fully necessary.
Best wishes
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