Tell me what kind of intervention or words have helped and what your situation has looked like with a confused patient that absolutely refuses to give up control of his/her meds. Tomorrow when I visit I will count his meds and see if he is taking them correctly. Family just now called and said that they *think* patient is taking his decadron 4mg 2-3 times a day when it is ordered to take daily. I"m sure he is taking it more because of pain control. We decreased the decadron and increased alprazolam because he has been manic. Working 18 hours a day out in the machine shed, mowing the yard etc. Family has their hands FULL! He is on morphine ER 60 mg BID. And then breakthrough morphine IR 1-2 tabs Q4 hours. When I visit he always declines the need to increase his meds and says that his pain is mild.
I will talk to the supervisor, but do you advise me to go in and say "this is how its gonna be" ask him if he trusts my and his doctor's judgement? I could see him getting absolutely irate about this and even combative. He is so terribly independent!! The family has hired 24 hour caregivers for him.
I have offered and pleaded and begged to fill his med boxes weekly for him. He refuses to give up control I believe because he messes around with them. Maybe we could discontinue everything except for comfort and anxiety meds?
Tell me your experiences!!!