Adminstering meds to geriatric patients

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What is the most appropriate action when dealing with a geriatric patient who refuses to take oral medications? Specifically, they refuse to communicate in terms of discussion and language, but refuse by turning their heads, saying "no" or "leave me alone." My clinical instructor got angry with me because I didn't want to force the medication in the patient's mouth. She had already tried and the patient spit it out. When I tried, the patient shut her mouth, refused to open it, and said "no." The patient was 95 years old with renal failure, dehydration, and anemia. Nothing in her chart indicated that she suffered from dementia. Although the patient wouldn't speak, I got the feeling that she knew that she didn't want to take the meds, and I didn't want to actively force her mouth open and cram the stuff down her throat like she was a dog. I wanted her last few days or months on this earth to be one of peace, love, and comfort, and not for her to remember someone standing over her forcing her mouth open and cramming some awful tasting, drugged applesause down her throat.

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

I applaud you for you advocacy. That patient has every right not too want to be assaulted with meds. It may be good for her; it may prolong her misery; but really is there any one who wants to live like that?

If she is at all competent to make decisions, I think she has made hers.

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The residents have a right to refuse meds, just make sure that you document that pt. refused after several attempts. If pt. refuses 2 days in a row, we contact M.D. and document. Unless meds are dc'd, we continue to offer and document each event. Some of my pt. take 10-15 pills daily, if I had to take all that, I would probably get fed up and refuse too!!! Especially if they have to be crushed and mixed with apple sauce. Yuck!!!! Sometimes, I will REALLY encourage and cajole a pt. into taking meds, but, if they just flat out refuse, I figure they have lived a lot longer than I have and I have to respect their wishes for whatever reason.

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i don't think she could make it any clearer that she doesn't want them- it is her right to refuse. circle the meds and write pt. refused. keep md updated. NEVER try and shove the meds down their throat (you should tell your instructor that). you have good instincts.

leslie

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I agree. Notify the physician and DOCUMENT each time.

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It is a challenge.I had a resident last night who wouldn't wake up for his 10p med for nothing. He was snoring loudly with his mouth wide open. I went to get someone to help me wake him up. We figured that at bedcheck he would wake up long enough for us to give him his med. He got changed and repositioned but did not wake up. I was told that it was a crap shoot everynight regarding to whether or not he'd wake up. But I don't blame him. If I am sleeping soundly, especially that time of the night(nursing home residents go to bed early) I would not want someone bothering me.[

What is the most appropriate action when dealing with a geriatric patient who refuses to take oral medications? Specifically, they refuse to communicate in terms of discussion and language, but refuse by turning their heads, saying "no" or "leave me alone." My clinical instructor got angry with me because I didn't want to force the medication in the patient's mouth. She had already tried and the patient spit it out. When I tried, the patient shut her mouth, refused to open it, and said "no." The patient was 95 years old with renal failure, dehydration, and anemia. Nothing in her chart indicated that she suffered from dementia. Although the patient wouldn't speak, I got the feeling that she knew that she didn't want to take the meds, and I didn't want to actively force her mouth open and cram the stuff down her throat like she was a dog. I wanted her last few days or months on this earth to be one of peace, love, and comfort, and not for her to remember someone standing over her forcing her mouth open and cramming some awful tasting, drugged applesause down her throat.
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I agree. Notify the physician and DOCUMENT each time.

I concer . I sometimes try again later .Sometimes when you go back later they will take the med just not now. If they still refuse document .

You did the right thing. :nurse:

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