Med crushing

Tookie · Nov 22, 2002

Aus nurse

I'm thinking jelly?????? , I usually use jam!

Until I realised that is what you were talking about. Down here, jelly is jello!!! Was trying to imagine crushed meds in that lol.

I use porridge if breakfast time, custard, mashed vegies if available, depending on meal times or jam (jelly) if not at a meal time.

I'm with you there, we also use yogurt as well as not everyone likes the sweetness of jam/jelly.

tinkertoys · Dec 2, 2002

I have a couple of patients who will spit out their meds without fail unless they're crushed finely, mixed in a little pudding, and then thinned with a supplement shake. I give it to them in their little med cup with a straw, adding more shake as needed until it's all gone. They don't even know they've taken their meds, plus they get a calorie boost! I try to find out what their favorite flavor is (usually chocolate or strawberry). It also helps if the shake is really cold.

donmurray · Dec 2, 2002

This is not a flame, but if they don't realise they had their meds, then how did they give their consent to the treatment? This has been an issue in the UK recently.

adrienurse, LPN · Dec 3, 2002

I prefer to think of it as aiding the swallowing of the medication -- not concealing. These are people who for the most part have swallowing difficulties and wouldn't be able to swallow whole pills. People with severe dementia seem to like the texture of mushed up things. BTW, with my patient base they were judged incompetent a long time ago. As long as their family agrees to the treatment, we provide it. We are also mindful as to give these people only the medications that are essential for symptom control. Unethical? I don't know.

I am not in the habit of hinding medication to coerce the person to take it (eg. lorazepam to settle them down). This is really a last resort kind of thing.

CapeCodMermaid, RN · Dec 3, 2002

they all take way too many meds whether they are crushed in applesauce, pudding, or ice cream.

zdatny · Dec 3, 2002

I work in a residential aged care faciliy where I look after 24 mobile residents with dementia. Having trialled all the usual methods of secreting crushed meds, I've finally hit on a reliable method. I make jam sandwiches, putting the meds in these. If the resident won't take the sandwich when first offered, I try again, telling them its "chocolate". That's the magic word.........chocolate!!!!!!

debyan · Dec 3, 2002

Applesause pudding ice cream chocolate peanutbutter anything that will work and after working with the disabled children for 10 + years . Now I work in a geriatric field and I have the habit of telling them everything I give them like I did the ( kids) anyway and why, like here is you heart medicine to keep that ticker running strong. I don't even know if they understand me but they know usually more than they want to know. :) deb

nursedawn67, LPN · Dec 3, 2002

Where I work we usually use applesauce on occasion I have seen yogurt used.

night owl · Dec 12, 2002

Originally posted by psychnurse.com
Choc pudding=med compliance

Always works for me!

aimeee, BSN, RN · Dec 19, 2002

Chocolate pudding does a better job of disguising the awful taste, but then you run into people who don't like chocolate! (Yes, its true, there are actually some people who don't like chocolate, incredible as it seems!) If you have chocolate and vanilla pudding, and applesauce on your med cart you pretty much have your bases covered. The applesauce is not as sweet and doesn't coat the med particles like pudding does but the additional water in it seems to help some people. You'll get to know what works best with who after a while.

renerian, BSN, RN · Dec 19, 2002

Alot of people use jelly.

renerian

donmurray · Dec 22, 2002

I still have concerns around this subject. In the UK, all meds are individually licenced for use, and that includes the form of presentation. If you crush a tablet, or open a capsule before administering it, you are then technically administering an unlicenced medication.

On the practical side, many meds are timed-release, or packaged to survive passage through the stomach before they begin to act. This function may be impaired, if not negated, by crushing. Crush a sustained-release tab, and the patient gets the whole dose at once! Crush an enteric-coated tab, and the constituents may be destroyed by gastric acids so that the patient gets no dose at all. Crushing meds with a hormonal content, such as Tamoxifen, exposes the staff member to the active ingredients of the drug. If a patient truly has a swallowing problem, then there are a variety of presentations available as alternatives to the tablet form. Most meds are available as liquids, for example.

The other aspect, which I touched on before, is that of consent. Fine if the patient is A&O, and aware that they are receiving their meds in whatever foodstuff is used, but if they are not, then you may be denying them their rights. Starting from the premise that everyone has the right to accept or refuse a treatment, covertly giving a medicine may be a method used to bypass that right for the sake of the nurses' convenience in getting the job done on time.