Every morning, Steven* would boil water for his mother’s tea, steep a bag of her favorite breakfast blend and leave her mug steaming at the kitchen table, where she liked to sit and watch the birds at the feeder. He kept her bottle of Lisinopril on the end table, next to his keys, and before he left for work, he’d shake out one of the oblong pink pills and set it next to Marie’s* tea, hoping maybe this time she’d take it.
But lately it seemed that nearly every night he’d find the pill sitting right where he’d left it. Marie would wash and put away the mug, but the pill she’d leave untouched, a defiant message. As if she wanted him to know she hadn’t forgotten, but instead had made a choice – a refusal.
Most nights, he didn’t have the energy to argue. He wouldn’t force her. He’d put the pill back in its bottle and hope the next day would bring them better luck.
Marie’s doctor had referred her to myNurse for help with her high blood pressure, explaining that the program and its coaches had helped others like her build healthier habits around diet and exercise and bring down their average blood pressure. Even if the program simply encouraged Marie and Steven to pay a bit more attention to her day-to-day readings, the doctor said, that could go a long way toward reeling in her high blood pressure.
Indeed, it was only thanks to the blood pressure monitor myNurse had given them that Steven saw just how bad his mother’s numbers had gotten, spiking more and more in the last few weeks – 180/80, 150/100 – her trendline jagged with high readings.
Marie wouldn’t say why she was refusing her blood pressure medication, but Steven thought their recent move might be the culprit. It was a move she’d resisted, anxious over leaving behind the few friends she’d had at the church, the familiar neighborhood. Not only was she refusing medication, but it seemed she’d also grown depressed, spending most of the day at home, watching television, keeping to herself and ignoring her old hobbies.
Steven was at a loss. He shared his frustration with Jenny, Marie’s myNurse Wellness Coach, on their regular calls. And though Jenny had emphasized that continuing this way could have disastrous consequences for Marie’s health – including a major stroke or heart attack – Steven said he didn’t want to force medicine on her, that that would only make things worse.
But as time went on, he said, he’d started to lose faith. Did he have what it took to take care of her? Sometimes, he admitted, he even wondered if it would be better if she did have a stroke. That way, at least, she could be in a hospital and get the sort of care he couldn’t give.
Jenny knew that Steven and Marie needed more than just textbook medical advice. They needed honest emotional support from someone they could trust.
She assured Steven that he was far from alone in facing this challenge. Medication nonadherence for patients with chronic diseases is extremely common, affecting as many as half of patients prescribed medications for conditions like diabetes and high blood pressure. Plus, depression in older adults can be a big roadblock when it comes to sticking to medication.
Marie’s refusal, Jenny emphasized, was not a reflection on Steven as a caretaker or a son. It was instead a symptom of Marie’s current outlook. She was in her 80’s, her life had been disrupted and she’d left behind friends and familiar routines. That could make it easy for anyone to lose motivation, fall into negative mindsets and wonder what the point was of keeping up with things like healthy eating and medication.
Jenny suggested a new approach. Instead of beating himself up for his perceived failures, Steven could focus his energy on finding healthy outlets for Marie to stay busy and get social connection – maybe visiting the new church he’d mentioned or asking the family members that lived nearby to come by or call more often.
Meanwhile, Steven could try a new technique with the medication. Instead of leaving it on the table for Marie to take herself, he could actually place it in her hand – encouraging her without it feeling forced, while still giving her the choice. And perhaps, Jenny said, as Marie’s mood improved, Steven would have more luck getting her to take her medication.
Steven did his best.
He took Marie to the new church, encouraging her to get out of the house at least once a week, to get to know the other parishioners and make a few new friends. He arranged regular visits from Marie’s family and bought her some activity books to try out when she was at home alone. She’d always loved puzzles and art.
And each morning, after he made her tea, Steven would wait for Marie to come downstairs and sit at the table to watch the birds. Before he left, he’d place the medicine in her hand, give her a squeeze and wish her a good morning.
Over time, Steven found the pill waiting for him less and less in the evenings. Marie’s blood pressure started to stabilize, and Steven started to feel a bit more upbeat, a bit more hopeful.
He still keeps in touch with Jenny about Marie’s progress, updating her via phone and text.
“Hi Jenny,” he usually starts his messages. “I just wanted to let you know where we’re at today.”
* Member stories are inspired by real interactions between our members and Wellness Coaches, but member names and some other details have been changed to protect privacy