Hiding meds in food: illegal?

Nurses General Nursing

Published

I'm new here so I hope I am posting in the right place. My adult son who had a brain tumor removed over 10 years ago is currently physically and mentaly disabled. He lived at home with me for 8 years, but considering my age and diminishing health, I could no longer take care of him. I live in a somewhat isolated area, and their are no places for some one like him. He is not elderly, but I was finally able to get him into a nursing home close by. I became his guardian because the damgae to his brain from having the tumor removed, some what mimics alzheimers, he is very stubborn and he does not have the cognitive functioning that is required to make a logical decison. Being his guardian I reguested that they hide his medication in his food. Unfortunately the head nurse on that wing refuses to do that. She claims it is deceitful and illegal. Because their is a danger of blodclots, he is supposed to take coumadin. Now his feet are all swelled up and I fear he may get a bloodclot and die. But still the nurse refuses to put the coumadin in his food. Other then that it is a good nursing home, and their are no other nursing homes in the area. They are telling me that I am requesting they do somthing illegal. Well I feel refusing to do what I requested (for his survival) is illegal. I fear if I get to persistent they will find a way to transferr him out of there. I don't know what to do?

Specializes in Clinical Research, Outpt Women's Health.

Having a heart is not giving medical advice. This from cynical old me. :smokin::smokin::smokin::smokin::smokin:

Up Vote Up Vote ×
Specializes in Spinal Cord injuries, Emergency+EMS.

is the patient mentally competent ? it appears not

what is in his best interests ?

does the person with power of attorney and the responsible Doctor agree , have the appropriate legal and Advocacy / social services steps been taken ...

covert administration of medication to someone who is mentally competent is illegal wherever you are , but if someone is not mentally competent and all the necessary legal and ethical steps are taken it may be appropriate ...

Up Vote Up Vote ×
Specializes in Clinical Research, Outpt Women's Health.

If you read the original post it was established that they are not competent.......

Up Vote Up Vote ×

i know ony of one case were after psych review, the conusltant pharmcist and pt nok all agreed to covert adminstration of oral meds including haldo.l (pt had vasular dementia, was very aggressive and umcompatartive) so that we could adminster some sub cut meds(insulin). DM not wel controled as pt refused (would bite scratch and draw clood from staff, blood sugar monitoring insulin admin and loved food Was an acute qadmint from NH due to this. yes we had tried that other non pharmocological efforts, as im sure the NH was. Our pharmcist and doctors felt sorry for the nurses.

Up Vote Up Vote ×
Specializes in Gerontology, Med surg, Home Health.

I had a guardian once order me to shove antipsychotics down his uncle's throat. Um, sorry buster, not going to happen.

This is a difficult question. Legally (I'm not an attorney so don't quote me) we're not supposed to hide meds in anything. BUT...if the guy needs the meds to save him from shooting a clot?

It's easy for us to say do this or that, but it comes down to the nurse on the floor. I'd call the doc and get an order to crush and mix with ice cream or pudding. If he still won't swallow there's not much you can do.

You can try Lovenox but giving someone an injection if they don't want one is worse than trying to get PO meds into them.

Up Vote Up Vote ×

Can the guy act on his rights?

Does he have a medical POA?

Do you have to do more potential harm than good?

Is the MD involved, knows the guy is refusing meds?

(if yes, I'm sorry- just don't like to quote everything, and chemo effects STM).

This isn't something I'd mess with without the doc giving orders, and it being charted that the doc had been notified... JMHO

Up Vote Up Vote ×
Quite possibly so.....and in most states, if not all states, it is illegal to give meds in a secretive manner to fool an alert patient or a competent patient. This is about an incompetent patient that as been deemed by the courts to be of unsound mind and are incapable of making decisions on their own......and therefore have a court appointed person to make the decisions for them. So if the guardian says "hide the pills in his food" they are actually saying "hide my pills in my food". Just like a 2 year old who doesn't want the shot and they are throwing a tantrum you hold them down and you give it to them anyways. Why? because they are not capable of understanding to make a decision based on information at their level of understanding......an appointed guardian is the same thing. It places the patient back at 2 years old and his mother knows what's best and makes decisions....even though an adult body is in the bed.

This is not a confused little ole lady with peroids of confusion....this is a brain damaged individual that need someone to look out for him. I think facilities that don't deal with TBI patients don't understand the full nuances of the injury pattern and the legalities of having a guardian. Just like a legal guardian of a minor......the guardian makes the decisions of the minor and the guardians decision rules. Of course a patient has the right to know what goes in their body ....... If they can understand what that is......

I think the, I believe the OP said "head nurse", needs to sit down with the MD and administrator and figure out a game paln how to care for this patient and exactly what they can and can't do.....I just don't think they have ran across this senario before and aren't aware what they should do..

good to know that there is an exception. Thank you for taking your time to explain it :)

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I had a guardian once order me to shove antipsychotics down his uncle's throat. Um, sorry buster, not going to happen.

This is a difficult question. Legally (I'm not an attorney so don't quote me) we're not supposed to hide meds in anything. BUT...if the guy needs the meds to save him from shooting a clot?

It's easy for us to say do this or that, but it comes down to the nurse on the floor. I'd call the doc and get an order to crush and mix with ice cream or pudding. If he still won't swallow there's not much you can do.

You can try Lovenox but giving someone an injection if they don't want one is worse than trying to get PO meds into them.

Yet we crush meds in food all the time to get the elderly to swallow the pills they can't. We give meds with flavor or crushed in ice cream for toddlers all the time whether they want it or not.......to not be forcomming with someone who is unable to understand and comprehend the importance of taking the meds and putting them in food, I feel, is the right of the legal guardian....and the legal prudent thing to do. This is more than just a family request. It's an incompetent patient and a legal guardian advocating for her son. Legal guardians are appointed for those who cannot make decisions for whatever reason. The legal guardians has become the go to person for permission just as it would be any minor or incompetent person. I agree with the Lovenox but I my experience comming at someone who cannot understand concepts will only increase the agitation and make it more traumatic for them.

Legally we are not allowed to dupe competent people into taking meds just because they are being obstinate......the the incompetent need someone to decide for them and the guardian is the one who legally can. Just like everytime one has forced their child to submit to a vaccination.....we are giving them a med that was technically "against their will" but we do it for the own good because they can't decide for themselves......just like this mother wants to as the legal guardian of her TBI child who has been declared incompetent. I am not a lawyer either and whenever this has come in in practice....staff and MD's need to be educated by the hospital lawyers and the social worker what the legal obligations lie. The OP is talking about the charge nurse opinion and refusal I think a meeting with the MD and case worker after checking with her lawyer will help her alot in her quest.......just my :twocents::twocents:

ps...you're welcome healthstar!

Up Vote Up Vote ×

I would not have a problem with OP's request to put medication in food (small amount). But I would also inform Patient that medications were in there spoonful of food I was trying to give. If accepted good!!! If still refusing MD would be notified...

Up Vote Up Vote ×
Specializes in LTC, Disease Management, smoking Cessati.

Have the Doctor write an order to mix meds in applesauce ect....

Up Vote Up Vote ×

I'm sorry, I find this message board confusing. I was trying to get some recent input on hiding meds in food.

Up Vote Up Vote ×

So far all I have found is old posts back to years ago. It's just to confusing for me?

Up Vote Up Vote ×
+ Add a Comment