sneaking meds in food

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Is it legal in a dementia unit to sneak meds in patients food? They want me to put morphine in her soda and sprinke another dementia med on her food. (she is a really difficult patient aggression and refuses to take meds)

Don't get confused between actual conscious rejection and the symptoms of disease that the patient is exhibiting. If you confuse the two, you need to regroup.

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Specializes in LTC Rehab Med/Surg.

Pt was confused. Family wanted med given.

Watching the pt struggle to breathe, watching ANY pt struggle to breathe is almost more than I can bear. The huge eyes, the restlessness, the sheer terror that emanates from them.

I won't answer your question as you have both barrels loaded. I asked the question simply because it's not always as easy as it sounds to sneak or not to sneak a pt a med that is vital to their care.

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From my understanding it is not wrong. The person have an altered mental status and therefore it is implied consent. If the person was in their right state of mind, then that's when it is wrong.

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Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

A very fine line.

If the doc & NUM agree it should be OK. However having said that, legally we are not supposed to restrain people with anything, unless they are a danger to themselves or others.

I do believe myself in chemically restratianing people. Until you have been attacked & choked/had your head bashed, it's very scary when these types of patients decide you are their target for the day.

U need to check who has POA. I would give it myself, because with aggressive patients - down under anyway - we are allowed to use force as necessary to protect ourselves, even if it means hurting the patient.

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ILL check for power of attorney, but still concerned what the state says about it. Where can you find the laws/regulations for medication administration?

The POAH has the right to make the decisions if the resident can't act on her rights.

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power of attorney. the patient's legal decision maker when they are unable to make their own decisions.

Nope. DPOA is Durable Power of Attorney (financial matters)

POAH is Power of Attorney for Healthcare

As far as the Colace- fecal impaction is a sentinel event that has to be reported to the state (they're going to get it anyway if it's during the time of an MDS (unless the reference date can be adjusted to avoid it). If the resident has chronic constipation, this would be worth a battle :)

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COPD pt who can barely breathe and talk at the same time. That's their baseline. Pt refuses the routine Ativan......I don't even remember the reason.

Without the Ativan they eventually progress into a full blown anxiety attack, sats in the 70's and it takes HOURS to get them stable.

Would you sneak them the Ativan the next night, or go through the same scenario again?

If they are their own responsible party, I would NOT sneak them the med if they refuse it. I offer, remind them of the night before, ask what is really going on, and document. When the doc gets p-o'd about the same song, second verse, I let him know (gotta let him/her know about refusals anyway).

Another option, for those who have oral hypersensitivity/tongue thrusting; liquid meds.

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Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

When I was in our law class, I remember our instructor saying that even if someone has POA over a confused/dem/alz patient, then they IMPLY consent by signing them into a facility & giving the doctor license to write up their meds.

So I wouldn't say it was illegal or anything. The family/POA KNOW that the patient will be given care & that includes medication. I mean, if the med dose was too high or whatever, that is a different story. But I really think you have no legal problems here. Just document in the notes that is how you gave it, and that is how you were instructed to give it.

Like I said discuss with your DON/NUM and doc if u aren't happy doing this.

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Sure, hide the meds in their food, which makes the food taste funny.. And then wonder why they stop eating. Seriously, if someone gave your food with something hidden in it,what would you do that next time that person offered you food?

Depends on the short term memory; if someone is REALLY out of it, and not refusing the applesauce w/meds, I'd give it. If they refuse, then find the POAH....what they say goes IF the patient can't act on their rights. If they are still their own responsible party, then they have the right to refuse, and I wouldn't give the meds.

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Specializes in Gerontology, Med surg, Home Health.

Carolmacca...we in the States are NOT allowed to force anyone to do anything in LTC and we certainly are not allowed to hurt them. And, yes, I've been hit ,kicked, and a resident tried to choke me.

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Carolmacca...we in the States are NOT allowed to force anyone to do anything in LTC and we certainly are not allowed to hurt them. And, yes, I've been hit ,kicked, and a resident tried to choke me.

If they can act on their own rights and they are their own responsible party, I absolutely agree :)

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My main concern besides the patients is my license, I just got it, worked hard for it and its not worth losing it over this. She can be a danger to other patients, she gets agitated and picks on people. But she does it regardless of the medication. There is no mention of this in the mar/tar only the nurse orienting me has told me to do this. Im afraid to go to the supervisor now because Ive already given it to her in her food because I was told to by my preceptor, only to rethink it when I got home. Guess I will check the POA and write a note to the doctor.

Thanks for all the replies, its good to talk to other nurses!

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