I need help !

spiderman · Nov 19, 2004

YOu need to get your psychologist involved and develop a behavior plan to address these refusals. This is not a nursing problem but a behavior one.

I work with DD clients who are considered High care. My problem is this, I have a 33 year old client with CP, seizure disorder and self abusive behavior. He is on some pretty important medications to keep him from hurting self and others.
He continually refuses his medications, We have tried everything from putting them in pudding, applesauce, food of all sorts. My last attempt was to melt them and put them in his favorite drink. He some how, knew they where in the drink and refused to drink it. He is nonverbal, but I'm sure understands more than we think.
Does anybody have any other ideas we can try to get this young man to take his meds?
P.S. Thank you for all the nice welcoming notes.

Wyorn45 · Nov 20, 2004

YOu need to get your psychologist involved and develop a behavior plan to address these refusals. This is not a nursing problem but a behavior one.

Thank you so much for your suggestion. Unfortunately, the entire team has delt with this on all levels. The psycologist is also beside herself. This young man functions on the level of about a 2 year old, if that. So far, there is no behavior plan that has worked for him. If we could only get his psych meds in him, he would be better off...so the problem is med administration. HOW?

Euphrosyne7, MSN, RN · Nov 20, 2004

Interestingly enough I work at a group home and there is an individual there that sounds a lot like one guy we have. He also takes a ton of meds and has the problems you are describing. He also does understand more than people may give him credit for. Does he communicate by any sign language at all??

He frequently refuses meds but only from certain people (all staff is med trained)......everyone told me that I should expect a hard time from him but I have been there since August and not once has he had a behavior or refused meds or treatments from me.

What the procedure there is that if he first refuses, he is asked if he needs "some time".......he is left alone for 5 minutes or so and then approached again. Some of his meds are liquid so staff might say time to get a shot........save some for me......and joke with him a bit about it.........also there is a plan in place where if he follows all rules for X amount of days in a row, he gets a grab bag......which is a bag filled with stuff he likes, and he gets to pick out one thing.....The other thing is that everyone is consistent with where meds are given out so that one day he is not receiving meds in the bathroom and another day at the med closet.

It definitely is a behavioral problem but you need to see why it is happening and what triggers it........if you can stop it before it gets to the point of a full blown behavior, you should be able to get him to take his meds. With the particular person in my home, it is usually specific staff that is the trigger for some reason or another. Sometimes I will say let's play a game, and then in 10 minutes it is time for you meds...is that a deal??? And then you can remind him that he made a deal with you........he might need to feel that he has more control over his life than he does now therefore he is taking what he control he perceives he has by refusing meds. If you are trying to trick him into taking meds, he is just feeling less control than ever over his situation which is probably making him more angry and so now not only is he feeling like he is not in control of his life but also he will not be trusting of those who are trying to trick him into taking meds which doesn't help things.

You might also try to ask him what is wrong?? Then give him a choice of two things.....are you mad? are you sad? (if he can signal yes or no).....you really need to get to the root of the reason why he won't take meds........I always approach the residents where I work with respect and courtesy and none of them has had any behavioral problems while I have been there yet.

Hope this helps somehow and good luck.

akcarmean, LPN · Nov 20, 2004

cniro7 you listed some very good ideas. Thanks for sharing. I am sure they will be helpful in the future.

Angelia