Refusing meds

Specialties Geriatric

Published

I work in a LTC facility on the Alzheimers unit. There is one male patient that refuses his meds everytime for me. I am very friendly and sweet to him. I try several attempts and even tried crushing it for him. I have been here a month so I thought he would be used to me by now. The other nurses don't have any problems with him. I put refuse on the MAR and I also write an entry in the nurses notes. Its not good for him to miss his meds. Could I get in trouble? What else could I do?

Specializes in home health, dialysis, others.

Is there anyone else who could go with you to give his meds? You know how distrustful some Alzheimer's pts can be. So try to find another person to help.

Specializes in Acute Care, Rehab, Palliative.

I would say that you have done all you can do.It is within the patient's rights to refuse his meds.Documenting is all you can do. On my unit we have a long time patient with a head injury and he refuses his meds quite frequently.All we do is document. I guess another thing would be to get someone else to give them.

Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

Have you asked the other's what they do to get him to take his meds? You cannot force him to take his meds, so document.

Specializes in LTC.

Document the refusal. They refuse, they refuse. I have alot to do. I am not forcing anyone to take meds they don't want.

Do ask others how they get him to take his meds.

I have a patient who gets very agitated and disruptive. The only possible way to get a morsel of PO meds in her is crushed very finely(pick out the shells) and mix in ice cream. I get her excited about the ice cream and let her pick out the flavor.

In my facility we have a policy that if the patiente refuses his meds for two days we have to notify the physician. When one of my patients refuses his meds I do not insist and come back later if he still refuses I leave him alone and come back a 3rd time Usually he take it. Another important point is make eye contact with the resident when talking to him. Good luck.

I have found that if I approach the resident with respect (not to imply that you don't) and explain, "Good morning, Jack. Are you ready for your blood pressure meds?" Giving them the choice and explaining what the drugs are (or one of them) helps a lot.

The alternative, already mentioned, is ask someone he will take them from to give them. We do that all the time.

Specializes in Geriatrics.

I have a confused Pt that refuses to take meds from me (or any other Nurse), I get his favorite CNA, Hand her the meds & stand just out of site of him, but where I see her, (I do not do this if Narc's are involved). He will gladly take the meds from her but if he sees me he wont take them.

With some, not all patients, I have had some luck with the "if, then" statements. Say something like "if you take your meds now, then I can get you a popsicle". Try to find something they really enjoy and set it up that way. They are still making a choice, but you are providing an incentive.

Specializes in LTC.

Crushed meds in chocolate pudding has worked wonders with the few stubborn patients.

Specializes in LTC,Hospice/palliative care,acute care.
I work in a LTC facility on the Alzheimers unit. There is one male patient that refuses his meds everytime for me. I am very friendly and sweet to him. I try several attempts and even tried crushing it for him. I have been here a month so I thought he would be used to me by now. The other nurses don't have any problems with him. I put refuse on the MAR and I also write an entry in the nurses notes. Its not good for him to miss his meds. Could I get in trouble? What else could I do?

When you have a spare minute (as if ) try getting him a drink and a cookie and just sit with him and engage him in conversation. You might be able to build a rapport with him. He will remember the feelings you give him at those times and may then start taking his meds for you. Also what works for everyone else may not ever work for you. If he takes his meds crushed try giving them to him whole-one pill at the time in his hand. Or crush them and hand him the spoon and pudding and start chatting-about anything,the heat,your pets,whatever. Sit beside him-don't be sweet. Be professional,maybe being a little authoritative may work with this guy. You have to be flexible and try lots of different approaches until you hit on something that works- and with patience you probably will. Keep documenting all of your interventions-in my facility we have a policy that states we must notify the doc when a resident refuses meds more then 3 times .

Specializes in Gerontology, Med surg, Home Health.

Does he really need all those meds? I've dealt with lots of residents who will take one or two but refuse to take any more. I ask the docs to get rid of all but the most essential meds. It really helps.

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