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'Refusing' medication

Discussion in 'ARCHIVE FORUM: Support discussions' started by alix, Jun 30, 2004.

  1. alix

    alix Registered User

    Jun 23, 2004
    8
    London
    My grandfather has late-stage Alzheimer’s and was recently admitted to hospital. We (my mother, sister and myself) have been visiting him regularly – mostly twice daily.

    After about a week, the nurses told us he had been ‘refusing’ his medication. We were quite taken aback as we had been checking his drug chart and it had looked like everything was OK. We asked some questions and found out that he had not had any medication for several days.

    We were quite upset and angry that this had not been communicated to us, and we offered to try to administer it. We didn’t have any trouble getting him to take it and now we do it most days.

    Since then there have been other occasions where I’ve been told that he has ‘refused’ help – I went to see him yesterday and he was slumped sideways in his chair with one hand trailing on the floor, and the arm of the chair digging into his side. I moved him and propped him up with a pillow, but the nurse told me she had just tried and he had ‘refused’ to be touched.

    I’m just really worried by the idea that he is ‘refusing’ things – and that the nurses feel that it’s OK to just leave him, even if he is clearly uncomfortable, or it means that he is not getting any treatment!

    I don’t mean that I want things to be forced on him – I don’t – but I do think it’s the carers responsibility to take a view on some things that have consequences that he is not really able to grasp.

    Has anyone else had a similar experience? How have other people dealt with this?
    Sorry for the epic post, but I’d really appreciate any views…

    Thanks,
    Alix
     
  2. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    If the hospital is a general one, then, like other people, nurses do not all have the knowledge of dementia and how to care for people with it. It is possible they could take the slightest confusion to be refusal.

    Also, they may not realise the degree of confusion, so may try to pull the person upright without explaining what is going on.

    Can he still recognise you? If so, it is quite possible he is genuinely refusing things as he does not know the people trying to help.

    I'd go in at a time when medication is due and observe how they handle it. That would give you some additional information, and that is a lot of what it is all about - observation, and responding accordingly. Also observe how they deal with him when you are with him. Don't be afraid to advise the 'professionals' as in this case your knowledge is probably greater, and is certainly greater about your grandfather and what he likes.

    Another thing is that they may simply not have the time to help someone who is in a confused state.

    I guess I'm saying that before you get angry, learn more about the problem. Then you can save your missiles to use should they really not be caring as well for him as they should be expected to.

    Best wishes
     
  3. alix

    alix Registered User

    Jun 23, 2004
    8
    London
    Thanks for your wise words, Bruce.

    He is being discharged today, so I won't be able to get a chance to see what was really going on, I'm afraid. However, it is good advice for the future. Thank you.

    You asked if he still recognised me. The honest answer is I'm not sure. He certainly hasn't really known that I'm his grand-daughter, or referred to me by name, for some years. But I do think that at some level he recognises us. And yes, he does seem to be 'better behaved' for us - though not always by any means!

    As you say, I think some of the problem is that not many of the staff are very aware of dementia. We spoke to as many of the staff about it as we could, but this does get very frustrating - on a geriatric ward you expect a better level of knowledge.
    In the end we printed out some of the AS factsheets and added them to his file - not sure they would be read, but at least it felt like we were doing something to address the issue.
     
  4. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Well done, glad he is being discharged. This is an ongoing campaign getting awareness into the wards for our loved ones. I did the same things with my mum. There is so little time allowed to do things on a ward and as we are all aware who have a family member/friend with this illness, "no" often isn't "no" it's a reaction to something they are unsure of. A little coaxing can work wonders,and of course they can't be rushed, this will definately lead to refusals or challenging behaviour. We just have to keep plugging it that they are confused and need extra time and care to respond.
    Love, She. XX
     

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