Giving meds crushed in applesauce

[anastasia158]

As we all know, when someone takes oral meds, they take them all at once with water. Today I was administering meds with my clinical instructor. I was to give crushed meds in applesauce. I had them all crushed and was thinking that I could place all the crushed meds in applesauce, mix it and feed all of the applesauce to the patient.

However, my instructor had me separately mix each medicine in its own plastic cup of applesauce. This ended up being time consuming and I am trying to figure out why that would have been necessary. My instrictor ended up getting upset with me over how putzy it ended up being.

[Penelope_Pitstop, BSN, RN]

I like the idea of using pudding. I may try that next time.

Pudding works WAY better, I think. I'll use applesauce if that's what the patient requests. Although I think applesauce works better with liquid meds, for example.

As for clinical...do what your instructor wants unless it is unsafe.

[Forever Sunshine, ASN, RN]

As you get to know your residents you get to know how they take their meds.

If applesauce doesn't work try a pudding. Chocolate pudding does wonders with combative patients who you need to get that xanax/ambien into. Ice cream is a last resort.

[signet, LPN]

When I started working in LTC in 2005. I was on orientation and partnered with an experienced nurse. The hall had about five demented residents that refused to take their meds. This nurse showed me her method for getting the meds into them. The one lady would keep her mouth shut tight. The nurse would crush all the meds in one spoonful of applesauce, then hold the residents nose. When she opened her mouth to breath in went the spoon. I know how wrong this is, but that's the way they did it. When I got out on the floor on my own I would not do this. Those residents who refused their meds didn't get them forced on them. After circling them on the MAR and documenting refused, I was told by the supervisor not to do this. According to policy if they refused more than two times in a row, the MD had to be notified. After this I would chart the meds as given. There's a lot of lying that goes on in most LTC's.

[joanna73, BSN, RN]

Ok in the real world, I have 34 residents, most of whom take crushed meds. Unless I cannot crush that particular med (ie enteric coated, timed release), all the pills are crushed and given in one or two quick spoonfuls. I've been working LTC for close to a year, and have had few issues with this.

Otherwise, if I crushed each pill, the residents would not get to sleep. I'd be there for HOURS. Some of my residents have 10 pills or more, so just imagine....!

[joanna73, BSN, RN]

I also don't force residents to take meds. If they won't open their mouth, or say no more than once, I document "refused". One lady says no, so I'll often go away for 5 or 10 min and try again. Usually the second attempt works. We also have crushed meds and put in milk for a resident. She doesn't take them any other way.

[UtechR]

depends on the meds

[morte, LPN, LVN]

You must have been a student nurse in the 1960's. This kind of treatment hasn't been allowed in a long long time.

Cape, Carol isn't in country....

[CapeCodMermaid, RN]

Curious, what is this in reference to?

I've seen both schools of thought in the past 10 years :)

I am paraphrasing but one poster wrote LTC is horrible because they hold people down to force feed them.

[SweetseRN]

I think RNperdiem gave PERFECT advice.

[xtxrn, ASN, RN]

If your facility has jelly/jam in the little restaurant plastic 'tubs' (very small- like a teaspoon), the concentrated flavor also helps.

[xtxrn, ASN, RN]

I am paraphrasing but one poster wrote LTC is horrible because they hold people down to force feed them.

Got it :)

Different country, different rules? Still not something I'd care to do (and legally couldn't here in the US).

[RainMom]

Xtrn, the jelly trick is one my self-described "old ICU nurse" of a clinical instructor showed me with one little lady in med/surg that was giving me a bit of a hard time. She was able to swallow them & didn't need crushed, but was confused. Worked wonders.

Also, during a few days of med pass on an alzheimer's hall for my LPN exit, I was shown to crush everything and mix with chocolate or vanilla pudding, just a bite full. Only had a couple incidences where the resident didn't want it but after a little distraction by talking about some odd topic or walking away and coming back after a couple minutes, they always took it, no problem.