A grey area over medication

Discussion in 'I care for a person with dementia' started by 4boding, Sep 25, 2015.

  1. 4boding

    4boding Registered User

    Apr 18, 2014
    24
    Greetings,

    It's 06:30 am and the lady is flushing the loo for about the 1000th time! A week ago she started refusing her pills. Last time this happened I started crushing them up and putting them into drinks. When the GP heard about it she said it shouldn't be done, that mum still had the right to refuse/decide, even with 'diminished capacity'. So this time, I don't give them and here we are.

    It's perfectly clear the GP is trying to cover her own back, but by not giving mum her pills I feel I'm doing the same selfish thing; or would giving them without consent be the selfish thing?

    Who else gets into a tangle like this? :confused:
     
  2. marionq

    marionq Registered User

    Apr 24, 2013
    5,893
    Female
    Scotland
    Does the medication improve her day to day living? If so then do what is necessary to get her to take them. Doctors are qualified to distribute treatment but they don't live with the effects of a person with dementia who refuses the treatment.

    These behaviours directly affect you and your mother and you are in charge.
     
  3. tre

    tre Registered User

    Sep 23, 2008
    1,353
    Herts
    When my mum who had vascular dementia was in a care home she too refused her medication but at that stage she was only on statins so we just accepted it. However, the home advised that inorder to implement covert medication they would need the recommendation of a doctor. This was done with some patients I think. Perhaps you should go back to the GP and tell them the behavioural implications and they might consider covert medication.
    My husband who has memantine, keppra and pain relief now has all these in liquid form as he was struggling with the mechanics of swallowing a tablet with water. He was refusing the tablets but takes the liquid without complaint. Would this be worth a try?
    Tre
     
  4. lin1

    lin1 Registered User

    Jan 14, 2010
    9,320
    Female
    East Kent
    I had to give my mum covert medication a as she seemed to believe they were poison
    The GP was aware and did not disagree.
    However it is best to check with a pharmacist if the medications your Mum is on are safe to crush or cut as some are not safe if given this way.
     
  5. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,289
    SW London
    If there is no other reason why they shouldn't be crushed and given in liquid, then personally I would not worry about it. It's all very well for the GP to state the 'official' line, but the GP does not have to live with the consequences of no meds.
     
  6. Slugsta

    Slugsta Registered User

    I would entirely agree with the GP if your mum had the capacity to make a rational decision about the meds. However, if she could do that she probably wouldn't need them anyway! :D

    If the meds help mum settle, feel less anxious, get better sleep etc then you are clearly giving them for her benefit, not just for an 'easy life' (don't think many carers even know what that means anymore :( ) In your position I would check with the pharmacist and then, all other things being equal, go ahead and give the meds.
     
  7. looviloo

    looviloo Registered User

    May 3, 2015
    463
    Female
    Cheshire
    My dad complains about taken his numerous medications (he has heart problems as well as dementia) and insists on chewing them. He's in a care home and they are aware that he does this... I've been told that it's ok for some tablets e.g. paracetamol, but not others. I've tried to explain this to dad but of course, he doesn't understand and in all honesty I'd rather he takes the tablets any way he can rather than not take them at all. Some medication can be given in liquid form... I'm going to pursue this for dad at some point... perhaps it might be a solution for your mum? Maybe tell her it's a cough syrup / vitamin solution?
     
  8. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,984
    Suffolk
    OH chewed all tablets, but hit a snag when he had a large slow release capsule to take. Every day I had to tell him to swallow it ( for several years).
     
  9. lin1

    lin1 Registered User

    Jan 14, 2010
    9,320
    Female
    East Kent
    I must add that my mum at the time (post 4) did not have capacity, if she had I would have followed her wishes
     
  10. Slugsta

    Slugsta Registered User

    I guessed as much Lin.
     
  11. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,493
    Female
    Near Southampton
    That didn't bother my husband, he used to chew those as well!

    The thing is that if someone has most mental capacity then logic has gone so how can it be in their best interests to not give tablets because they don't want to take them.
    Isn't that what H&W LPA is all about?
     
  12. 4boding

    4boding Registered User

    Apr 18, 2014
    24
    Thanks for the advice. I had no idea some pills shouldn't be crushed. An internet page I just read says not to crush donezepril, so I guess that kinda settles it? I'll speak to the pharmacist. Thanks.
     
  13. lin1

    lin1 Registered User

    Jan 14, 2010
    9,320
    Female
    East Kent
    #13 lin1, Sep 25, 2015
    Last edited: Sep 25, 2015
    Hi 4Boding
    Some pills need to enter the system slowly , when we crush pills they enter the system quickly and all at once

    As you mentioned Donezepril. I had a look and found this,
    https://www.nice.org.uk/guidance/ta217/chapter/the-technologies
    I was wandering if it may be a good idea to discuss with the prescriber if changing to Rivastigmine patches mentioned in section 3 may be a good idea
     

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