• All threads and posts regarding Coronavirus COVID-19 can now be found in our new area specifically for Coronavirus COVID-19 discussion.

    You can directly access this area >here<.

A grey area over medication

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:
 

marionq

Registered User
Apr 24, 2013
6,099
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.
 

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
 

lin1

Registered User
Jan 14, 2010
9,319
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.
 

Witzend

Registered User
Aug 29, 2007
4,291
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.
 

Slugsta

Registered User
Aug 25, 2015
2,761
South coast of England
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.
 

looviloo

Registered User
May 3, 2015
463
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?
 

Spamar

Registered User
Oct 5, 2013
7,214
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).
 

lin1

Registered User
Jan 14, 2010
9,319
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
 

Saffie

Registered User
Mar 26, 2011
22,510
Near Southampton
OH chewed all tablets, but hit a snag when he had a large slow release capsule to take.
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?
 

4boding

Registered User
Apr 18, 2014
24
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.
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.
 

lin1

Registered User
Jan 14, 2010
9,319
East Kent
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
 
Last edited: