Dad refusing to take his meds

[claire43]

My dad has been in a care home since Feb 2014. In all this time he has never really settled and always asks to come home, however my mother could never have coped with him due to her health.

He has vascular dementia and it tends to make him paranoid. I've lost count of the number of times his GP has come out to explain what each tablet is for yet he refuses to take them on an almost daily basis. He is convinced they are cheap imitations and that the home is just trying to make money by giving him inferior tablets. The staff are so patient with him and battle this 4 times a day. The result of this is his feet and belly are extremely swollen due to fluid retention, but most worryingly is that his confusion has deteriorated quite rapidly lately mostly due to his refusal to take his mood stabilizers which had managed to even out his behaviour.

Any advice please?

 

[Witzend]

TBH I wouldn't think it's much use the doctor explaining to him, since even if he accepts it at the time he's likely to forget again so quickly, isn't he? It's not usually much use reasoning with someone with dementia. Could the meds be given covertly, in food or drink? Though I think the Dr has to agree and family have to sign some consent form - care home staff aren't allowed to do it otherwise.

 

[Kevinl]

I HATE to make this comparison but if you have to get a child to take medication or have a vaccination that's totally for their own good, without doubt and life saving and it sounds like your Dad's meds are lifesaving so for me nothing is off the agenda; lie, hide them if food or whatever it takes.
I totally understand where the doctor is coming from with the "patient respect" aspect of things and that in normal circumstances is fair enough, in this situation that's all the doctor can do but as someone with a wife with AZ and as a parent of 3 children I feel it's OK to bend the rules/truth in order to achieve certain ends and this sounds like one of them.
K

 

[lin1]

My mum ended up having to have her meds given covertly because she believed they were poison, I also couldn't use their term
Pain killer as mum thought I'd said ,kill her. Which might have caused the problem in the first place.

Some meds come in liquid or syrup form, which provided they taste ok (some taste awful) can be added to food or drink.

The home is likely to need permission to give meds covertly probably from the GP as well as yourself.

Beware about crushing pills as with some it can be life threatening, the medication enters the body all at once rather than over a period of time. if you are thinking of doing this not only check with the GP check with the Pharmacist as well as IMO they know more about medication and its affects than some Doctors.

Sadly I too found their can come a time when explanations prove useless as the person forgets, or becomes very suspicious.
I also with permission of the GP had to stop some of mums meds as even given covertly it was taking most of her food and drink each day to get them into her,and she was getting suspicious, some of these were for her heart, so don't be upset if you find it necessary to discuss doing this with the GP.

I do hope u find a way around this as I know only too well how difficult and worrying it is.

 

[shawshank]

My dad has been in a care home since Feb 2014. In all this time he has never really settled and always asks to come home, however my mother could never have coped with him due to her health.

He has vascular dementia and it tends to make him paranoid. I've lost count of the number of times his GP has come out to explain what each tablet is for yet he refuses to take them on an almost daily basis. He is convinced they are cheap imitations and that the home is just trying to make money by giving him inferior tablets. The staff are so patient with him and battle this 4 times a day. The result of this is his feet and belly are extremely swollen due to fluid retention, but most worryingly is that his confusion has deteriorated quite rapidly lately mostly due to his refusal to take his mood stabilizers which had managed to even out his behaviour.

Any advice please?

Hi Claire - what a difficult situation
Does your dad's paranoia respond to medication? I ask because his reason for refusing to take his tablets sounds like another fairly common example of paranoid thinking - RISPERIDONE/Risperal is usually prescribed for paranoid symptoms and comes as both a liquid/syrup which can be hidden in drinks [and also as an injection] so can more easily be given without consent

I'm guessing that as your dad is taking mood stabilisers that a CPN/psychiatrist is already involved and they will be experts in assessing your dad's capacity to consent [Mental Capacity Act] or whether or not he would need to be 'sectioned' ie detained in hospital under the Mental Health Act in order to give him his medication. Maybe your dad's GP should seek an urgent appointment for your dad before he gets too poorly from not taking his tablets?

 

[claire43]

Thank you all for your helpful suggestions.

We have spoken to the care staff who have built up a lovely relationship with my dad despite him being quite argumentative at times. Unfortunately they would not be able to covertly give him his meds on the unit he is on cos there is no actual nursing element. There is a nursing unit in the same building but my father was initially placed there straight from hospital & he was no where near as bad as the other residents so we had him reassessed and he has been on the current unit for a year. His current behaviour is really bizarre. Hes refusing to eat or drink, partly cos he forgets or he uses it as a protest or he just can't be bothered. We took him chip shop fish n chips this evening and stayed whilst he ate and thankfully he did eat approx a third of it so that was a relieve but it was the first think he'd eaten in 2 days.

When my mother went to see him yesterday he was sat in his underpants and today we were warned by a carer that he'd been refusing to wear clothes all day except for a vest!!! This is so far from what my dad was like - its really upsetting us all cos he so agitated and unsettled.

One of his regular carers has been off for almost a month and when he saw him today he was really shocked at the speed of his decline.

His urine samples are clear, his bloods are fine and the dr has been called out to him several times over last couple of weeks and all his vitals are spot on so we realise hes had another major dip in his dementia probably contributed to by his refusal to take the necessary meds.

It seems like theres nothing more to be done. His paranoia is so absolute there is no hope of talking him round or compromising with regards to his meds.

I knew it was going to get tougher, but he has been stable for over a year now and I suppose we all hoped that would last a while longer.

Feel so helpless