Med crushing - page 2

Hi! If your LTC is anything like where I work, there are alot of meds that get crushed. My question is- do you put them in applesauce or what? I use that or pudding, occasionally ice cream, but one... Read More

  1. by   tinkertoys
    I have a couple of patients who will spit out their meds without fail unless they're crushed finely, mixed in a little pudding, and then thinned with a supplement shake. I give it to them in their little med cup with a straw, adding more shake as needed until it's all gone. They don't even know they've taken their meds, plus they get a calorie boost! I try to find out what their favorite flavor is (usually chocolate or strawberry). It also helps if the shake is really cold.
  2. by   donmurray
    This is not a flame, but if they don't realise they had their meds, then how did they give their consent to the treatment? This has been an issue in the UK recently.
  3. by   adrienurse
    I prefer to think of it as aiding the swallowing of the medication -- not concealing. These are people who for the most part have swallowing difficulties and wouldn't be able to swallow whole pills. People with severe dementia seem to like the texture of mushed up things. BTW, with my patient base they were judged incompetent a long time ago. As long as their family agrees to the treatment, we provide it. We are also mindful as to give these people only the medications that are essential for symptom control. Unethical? I don't know.

    I am not in the habit of hinding medication to coerce the person to take it (eg. lorazepam to settle them down). This is really a last resort kind of thing.
  4. by   CapeCodMermaid
    they all take way too many meds whether they are crushed in applesauce, pudding, or ice cream.
  5. by   zdatny
    I work in a residential aged care faciliy where I look after 24 mobile residents with dementia. Having trialled all the usual methods of secreting crushed meds, I've finally hit on a reliable method. I make jam sandwiches, putting the meds in these. If the resident won't take the sandwich when first offered, I try again, telling them its "chocolate". That's the magic word.........chocolate!!!!!!
  6. by   debyan
    Applesause pudding ice cream chocolate peanutbutter anything that will work and after working with the disabled children for 10 + years . Now I work in a geriatric field and I have the habit of telling them everything I give them like I did the ( kids) anyway and why, like here is you heart medicine to keep that ticker running strong. I don't even know if they understand me but they know usually more than they want to know. deb
  7. by   nursedawn67
    Where I work we usually use applesauce on occasion I have seen yogurt used.
  8. by   night owl
    Originally posted by psychnurse.com
    Choc pudding=med compliance
    Always works for me!
  9. by   aimeee
    Chocolate pudding does a better job of disguising the awful taste, but then you run into people who don't like chocolate! (Yes, its true, there are actually some people who don't like chocolate, incredible as it seems!) If you have chocolate and vanilla pudding, and applesauce on your med cart you pretty much have your bases covered. The applesauce is not as sweet and doesn't coat the med particles like pudding does but the additional water in it seems to help some people. You'll get to know what works best with who after a while.
  10. by   renerian
    Alot of people use jelly.

    renerian
  11. by   donmurray
    I still have concerns around this subject. In the UK, all meds are individually licenced for use, and that includes the form of presentation. If you crush a tablet, or open a capsule before administering it, you are then technically administering an unlicenced medication.
    On the practical side, many meds are timed-release, or packaged to survive passage through the stomach before they begin to act. This function may be impaired, if not negated, by crushing. Crush a sustained-release tab, and the patient gets the whole dose at once! Crush an enteric-coated tab, and the constituents may be destroyed by gastric acids so that the patient gets no dose at all. Crushing meds with a hormonal content, such as Tamoxifen, exposes the staff member to the active ingredients of the drug. If a patient truly has a swallowing problem, then there are a variety of presentations available as alternatives to the tablet form. Most meds are available as liquids, for example.
    The other aspect, which I touched on before, is that of consent. Fine if the patient is A&O, and aware that they are receiving their meds in whatever foodstuff is used, but if they are not, then you may be denying them their rights. Starting from the premise that everyone has the right to accept or refuse a treatment, covertly giving a medicine may be a method used to bypass that right for the sake of the nurses' convenience in getting the job done on time.
  12. by   Kimburly
    Whoa, you must work with mentally competent adult patients exclusively! It is pretty near impossible to get consent from a dementia patient, especially in the end stages, but butts would be hung out if that stopped them from getting their cardiac meds and caused death!
    I worked 5 years in LTC and the majority of our residents couldn't have consented to each pill. And can't swallow whole pills, so crush and mix is the only way to get them in. Most liquid forms of meds require a pretty large amount of liquid for a comparitive dose and believe me none of them taste good!
    Now I work peds and we still crush meds, and parents are consenting to treatment. We mix in cherry syrup or chocolate syrup. But we aren't giving as many meds to each patient as in geriatrics. Many pharmacies have a variety of syrups to mix meds in, if you can get your facility to invest it may work for some patients who don't need a lot of meds at once.
  13. by   nursedawn67
    The doc reviews the chart and determines if the drugs they are on can be crushed and then orders it, many times if cannot be crushed it is either given in a liquid form (if available) or that one med is given whole or the doc just decides to d/c it or change to something crushable. Meds are not crushed to decieve a patient they are crushed d/t swallowing difficulties or occasionally a patient just finds it easier to take their meds in applesauce and some dementia/alzheimers patients will not take their meds and the meds need to be crushed in order to ensure they get them.

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