Refusing meds

[penlight32]

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?

[pamelafrazierlpn]

Some times you have to ask for help from the other nurses. If he likes someone else better, ask them to give him his meds, let that person give them and sign out for them. That way you won't have to keep signing refused. Then let the other nurse TRY and explain to him that you're there to help him.

[cebuana_nurse]

I have a diabetic and demented patient who keeps refusing her meds even fingersticks. She is an elopement risk too which costs much of my time having to run to the main entrance to get her. Good thing she has an EXI monitor. I get lucky once in a month for her to take her medicine even her insulin coverage. Her MARs has lots of refused all meds written on it and documentation of her refusing her meds as well as faxes to MD's everytime she refuses it. We did try asking her MD to get rid of her vitamins and he says that he can't because she is not on hospice. It sucks that we can't do anything other than documenting and trying our luck for them to take it.

[tewdles, RN]

I completely agree with capecodmermaid...time to review his med list and downsize it. The old guy doesn't want to take his meds and so we should make sure that we are not encouraging any that are not essential to his quality of life.

When I am old and demented and refuse my meds, please review my advanced directives and just let me be...

[Txnursekristi]

To comply with public health, we have to explain to the patient the possible side effects of refusing each medication, (yes, even advanced alzheimers/dementia patients), then document the refusal, document the "education", and notify the POA and the physician. Then, we continue to document the refusal on the MAR with each dose, and also document in the nurses notes weekly and notify the POA and physician weekly.

[tewdles, RN]

I have a diabetic and demented patient who keeps refusing her meds even fingersticks. She is an elopement risk too which costs much of my time having to run to the main entrance to get her. Good thing she has an EXI monitor. I get lucky once in a month for her to take her medicine even her insulin coverage. Her MARs has lots of refused all meds written on it and documentation of her refusing her meds as well as faxes to MD's everytime she refuses it. We did try asking her MD to get rid of her vitamins and he says that he can't because she is not on hospice. It sucks that we can't do anything other than documenting and trying our luck for them to take it.

what a cop out from a physician...

[CapeCodMermaid, RN]

That's absurd. Does that doc read the studies about vitamin absorption in elders? Most vitamins are worthless. Thank goodness my docs are reasonable.