Difficult Resident to Pass Meds. Advice?

[Newgurl17, CNA, LPN]

Hey everyone,

So I've been working in a long term care facility as a nurse for 9 months now, prior to this I was a cna on call for a year and prior to that I was volunteering at care homes. I'm still a shy person, always have been.

There is this resident that we have to work with on the unit who is tricky to pass meds. When I was being oriented, I was told we have to "treat her like a queen" so we basically have to be really nice and give her compliments, then she will take her meds. This resident is difficult for everyone to pass meds and apparently, she doesn't do well with new people (a.k.a. me).

It has become increasingly difficult for the nurses to administer this lady's medication to the point where they started to crush all her meds and put it in cranberry juice and apple sauce. She is also difficult with checking blood sugars and administering insulin. I think she used to get regular insulin, then got switched to nph. The nph she used to get in the morning, then she was refusing so much that it got switched to evening.

This resident then got suspicious that she was getting medications crushed in her food and drink, so the administration method got changed, so now we have to try giving her meds whole first and supervise. She is on buspar tid and quetiapine qid. At 0800 she also gets a blood pressure pill and I can just get away with saying that her pills are for her blood pressure. For her quetipaine and her buspar, I had been explaining that he pills are for her blood sugar, then she'll say that she hasn't had anything to eat and complain that she doesn't like her meal. I would then try to offer her something else to eat, she would accept, but STILL refuse! When this resident has a problem, she has NO PROBLEM expressing herself. My co-lpn ended up administering the medication to the resident, but she REALLY had to fight and argue with her.

How do you explain to residents with dementia what their buspar and quetiapine are for? How do you respond when residents say that they "don't take this medication" when you know they've been taking it for a long time? I explained that they've been taking the medication for a while and it's good for this reason but of course have been unsuccessful. I really don't know what to say?

[Tenebrae, BSN, RN]

I had a resident who told me they werent going to take their meds.

I replied "if you choose not to take your meds that is your decison. Please be aware however the only person who will end up getting hurt is you"

Never had an issue with this resident taking meds again.

Unless they are under some form of compulsory mental health treatment, or have been deemed incapacitated (eg due to dementia) and have an activated EPOA they have a right to decline their medications

[Newgurl17, CNA, LPN]

Thanks, Tenebrae! How do you respond when a resident states, "i don't need medication, i want to die"??

[CapeCodMermaid, RN]

Even people who have been deemed incompetent have the right to refuse meds