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Mom has been refusing meds off n on for awhile now. Nursing home called to inform, that she refused over 6 days during the holidays. My father could not get her to take them either. At recent family meeting w/NH, we are informed that she has refused blood sugar tests since Dec. 9, 2013.Disappointed that we were not informed of this sooner. She is between M.D. 's currently, but have one onboard now, but won't see her until rounds early February. We are told NH cannot force any meds/procedures against her will. That we need a court order to do so w/guardianship. Isn't POA, MPOA the same as guardianship? I know she can be coerced into taking meds etc.. but I live an hour away. No one wants to move her to another NH, as Dad is closest now, but less than helpful. Wrote the new M.D, a letter to inform of situation. Current temp M.D. and Psyc. doc. says wait n see, but not sure if they are of aware of the history here. She takes pills for diabetes, and is not a severe case, but non the less, needs her meds. & blood tests. Psyc has her on anti-depressants for moodiness. Concerned with effects for on/off this medication as well. What to do?

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So sorry you are in this tough situation. Only things I can think of off the top of my head are putting the meds in something she likes to eat (ice cream, pudding, shakes) or asking if there is a particular staff member at the NH whom your mom gets along really well with and seeing if that staff person can talk her into taking the meds. If you could at least get her back on the anti-depressants, maybe she would feel happier and start taking the others--not taking the blood tests for diabetes is pretty urgent, in my opinion. I'm surprised you can't get the new M.D. to see her sooner. Best wishes!
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Thank you stevensmom. There is one nurse that she works well with, which happened to be the one gone over the holidays. I was able to coerce her last Weds., will have to wait for updates I guess. The NH said it is illegal for them to put meds in her food. I suppose my Dad could try that, if they allow it.
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My mom was just put in Hospice day before yesterday. She also had been refusing meds and she refused to eat. In the last 3 days she has started eating a bit. Most foods taste bad because of the thrush infection in her mouth/tongue, but she refuses the medication for that too. Hence most things taste bad to her. She loves her tomato soup and ice cream. She indicated that she wanted some pain medication after the packed her wound on her backside (MRSA they cultured), so they gave her the med crushed in applesauce and she ate most of it. They told me not to worry about the MRSA as long as the wound is covered and it is and it is by her bottom. The said just to wash our hands and we would be fine. I think I covered a bunch of things here. I came to Michigan from California to see her and find out how bad everything really are. Before this Hospice she was in a NH for a couple of years. I just need emotional support now. Maybe being in Hospice has different criteria? She also has a GAL and that is another sore subject with me. Thanx.
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((((((hugs)))))) Wisconsin POA, MPOA is not the same as guardianship. If the person is not capable of making decisions for themselves the court can appoint a guardian to make those decisions. The POA is appointed by the person when they are competent to assist that person in the stated ways. I think it is fair to say that guardianship gives more power. It is a distressing situation. My mother who is pretty well physically but mentally ill will not take the antipsychotic meds that help her. You cannot force them to take meds. I have read on here that in some cases meds are put into food but not sure how legal that is. Is you mother competent? If you think you could get guardianship it may be the right route, She certainly is not doing herself any good by refusing treatment. How ill is she? I she getting ready to go? Hope the new doctor has some ideas. Let us know how it unfolds, (((((((hugs)))))

Karen - (((((((((((((hugs))))))))))))) to you too Have you talked to hospice and/or her doctor to get an idea of what to expect. It is too bad she is refusing the thrush meds as they would make her more comfortable. Sounds like you are in a difficult situation.
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Try crushing the pills and mixing with something sweet - like jelly. That's the technique I use with Mom. It's mostly successful.
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When elderly people living in NH refuse meds and food it might be because they prefer to check out. Why force them to hang on to a life devoid of joy? They should decide when enough is enough. My 101 year old mom continues to take her 5 meds every day, in the mean time her two caregivers and I are slowly expiring.
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(((((shala)))) my mother is 101 too, and still lives in independent living with home care 4 x a day. Sometimes I wonder if she will outlive me. She takes her other meds, just not the antipsychotic that would make her and everyone else's life so much easier. I agree with letting people go when they are ready. Mother wishes to die but she s too darn healthy physically.
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My mom though she refuses her meds, she answers that she wants to live when asked and she says she wants to go home (that is the NH where she has lived for at least 2 years). She has not said she wants to go be with my dad and brother (who both have passed on). The doctor recommended Hospice because of her kidneys fluctuating, her MRSA infection, and she to be debrillated a couple of times for her erratic heart beat, but now in Hospice she won't and that could be the end, but I don't know. Every evening I go home to my cousin's to wait for a phone call and none come. The waiting is the most stressful besides knowing my dear mom is going to leave me very soon.
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My wife has been bedridden for almost 4 years with dementia. There are moments when she refuses to be cooperative. At those times I simply change the subject. Two minutes later she has forgotten the problem and then I try again, repeating the procedure as necessary. So far that technique has worked. If necessary I would prioritize the medicines. Some are much more important than others.
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I would definitely speak with the home and tell them to put her meds in applesauce or Ice cream as the others have said. It is not against the law. I see
It done everyday at mynMom's assisted living and even in hospitals. Some pills can't be crushed for whatever reason but the ones that can should and put in whatever she really likes to eat. The one problem is that the nurse or someone needs to watch while she eats to make sure she eats everything.
Good luck. I know so many people who are having this same problem and so far the only thing that works is putting it in food.
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Um. If a legally competent adult refuses medication, it most definitely is against the law to administer that medication covertly. The law protects us all from people sneaking drugs into us without our knowledge or consent.

Sorry for the inconvenience, but if you want to go that route it is most important either to have your parent certified incompetent and action the MPOA or to obtain guardianship.
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There is a fine line between crushing meds and putting them in food to make it easier for some one to swallow them and hiding them in food so the patient is fooled. When some one refuses to eat, drink, take meds and have been considered appropriate for hospice there is little point in worrying about routine medication if the patient refuses. Meds for pain and anxiety should of course be continued.
A word about MRSA. The advice you received about this was far too casual. everybody entering that room should be doing so using infection control measures. This means wearing a gown, gloves and booties over your shoes. This is a very serious condition to be exposed to and make no mistake you are exposed as everything in that room is contaminated. your future health could be jeapodized if you become a carrier of MRSA. When you come to visit bring with you some form of protective clothing like a lab coat which does not have to be white, rubber gloves and either covers for your shoes or a pair of washable sneakers and some hand sanitizer. Leave your purse in the car and put any valuables in your pocket. Put this stuff on before you enter the room maybe in a restroom or the car. Do not touch anything in the facility without using hand sanitizer and do not remove anything from the room. When you are ready to leave remove your lab coat gloves and booties and place in a sealed plastic bag. If you plan to dispose of this gear place it in the trash in the patient's room. Use your hand sanitizer liberally. do not touch your face on your way out. use the hand sanitizer again before taking anything out of your pocket or touching your car keys. have a plastic bag ready in the car to drop the bottle in and seal it. If you are taking your protective gear home immediately wash it on the hottest setting with bleach. You can also request that you be provided with the necessary equipment by the facility and dispose of it before leaving the room.
I realize this sounds very paranoid but it is essential for your own protection. I would also not use a restroom or eat or drink anything in that facility. MRSA is probably everywhere and proper guidelines are not being followed. All the staff could be carrying it.
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I crush my mom's pills and put them in applesauce and she takes them. Every time I do this , I tell her what a great sport she is. Somehow that seems to work. As she is taking them, I talk to her about something really good coming up after she takes the pills such as eating a muffin (her favorite thing).

Now, I went thru a time with her when she refused to eat, so I know how trying and upsetting it can be when a parent won't eat or take their medication. I tried everything to get her to eat and spent a fortune buying all kinds of food that ended up being wasted since she kept refusing. Finally, her doctor prescribed a pill called Mirtazapine which has not only helped her depression but has given her a huge appetite as well. You should talk to her doctor about what you can do for her. Maybe she is on the wrong medication for her moods and if you switch, she will do better. This all ties in to why she won't take her medication, I'm sure. Best of luck to you!!
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Veronica, I missed the MRSA bit - where's that, please?
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My mom who is still in her own home called 911 and had the ambulance pick her up (yesterday) and take her to ER because as she puts it: she "was feeling a little under the weather." She checked out fine (physically) but doing this gave me and my husband more "evidence" that she indeed needs our guardianship...which we can get on on emergency basis in 72 hours if needed, according to the hospital social worker. If your mom is refusing meds, you probably should be her guardian. Look into the process. Someone in your area can tell you what you need to do. It's really not hard. Let us know how it goes!
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My Mom has been in hospice since last Monday. She had stopped eating and was hiding her meds most of the time. It was gut wrenching and soul destroying to watch this behavior or to try and not change it. Since she has been in hospice it has been so much better. They make her comfortable, but she makes the decisions about what she wants, and they have helped me to understand that she should have the right to make decisions for herself. I've read a lot about it and talked to a really nice Rabbi at the hospice and he said that sometimes this is a person's body's way of saying it has had enough. That she is probably tired and ready to go, that she just needs me to be. Don't get me wrong, I will never be ready, but I do understand now it is not about refusal or giving up, it is about making a choice to move on. Mom is now taking her meds with ice cream or applesauce or pudding most of the time, I think mostly for me. She is still not really eating because she is not hungry and doesn't want it, and that's ok. It should be her choice. The hospice cannot and will not make her take her meds or eat. It is against the law to do so. I could go the route of getting guardianship, but these things are not what she wants. I asked her if she understood that she would not get better and that it was a matter of time given the current status, and she said that she did. I asked her if she knew she would never get to come home like this, and she said she did. I asked her if she was right with God and ready to go and she said she was. I believe this is true and she has a good life and is ready to leave this one. This is not easy and never will be, but I want to honor her in death as I have honored her in life. It is her choice. Maybe it would help to talk to your Mom about these things to find out if she understands them. I know it helped me. Maybe it would also help to find hospice care for your Mom. They are experts and their job is to make the person and their family as comfortable as possible and to help everyone understand what is going on. They have been such a blessing for my family and I. I hope these thoughts will help you, I do truly know how hard all of this is. I have never given up hope for my Mom I want her to get better if she is meant to and wants to, but I have been able to get some understanding and acceptance.
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Sometimes their instincts are correct. Check it all out on the Internet to make sure she even needs each medication. Last night we finally got a list of our Mom's medications and learned she is taking 28 medications! Some are for issues she no longer has. Others are duplicates. We are very glad we listened to her complaints and refusals. Doctors seem to solve everything by writing yet another prescription. The family member with the POA didn't check and also placed her one hour and 15 minutes from us. Still, we found talking to her in person had a better chance of getting her to comply. We are changing the POA.
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Why force her to take the meds if she doesn't want to take them. Why prolong a life that has no quality. I have to admit sometimes I want to stop giving my Mom her meds to hasten her demise. She is miserable in her current condition and has no quality in her life.
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Under the new federal guidelines one cannot be forced to take meds, unless they are deemed a danger to themselves or others. If the diabetes is mild and she is able maintain her blood sugars by diet alone, Dec. 3 is a long time to go without a diabetic crisis which would have put her probably in the hospital. So follow up with the new doctor and make sure the psychiatrist knows about the diabetes. There are M.D.'s as well, so they can make an adjustment. Has anyone asked her why she is refusing medications?
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As for guardianship, it really depends on whether someone is being properly cared for. If the meds are not a matter of life/death, perhaps it's not such a big deal if the person refuses to take them. On the other hand, if there is a pattern of refusing the care she absolutely needs, like eating enough AND the life expectancy is pretty good, the refusal to do what is good for her becomes an ethical one - she may be suffering from dementia and is basically relying on loved ones to make sure she is keeping herself as healthy as possible. When dementia becomes significant, guardianship is necessary.
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Where can I find a copy of the federal guidelines on medications?
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Sherry that was a wonderful post. So hard for you but so honest and caring. the only thing I would ask is if you have told her it is OK to go and although the family will miss her they will take car of each other.
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Wisconsin - I have the same problem - ask the doctor to give the NH a crush order for the meds then everyone is covered. Granted you don't know how much they get - but if they can put it in a food she likes or pudding that May hide the taste - it could help.
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Good advice about getting meds down to the 'vital few'. The doctor can place a 'discontinue' order for those meds that are no longer necessary to take. Not sure why the NH is telling you it's illegal to put meds in her food unless the law is different in the state where your Mom lives. In California, it is legal to do this, but, only if the doctor OK's what's called a "crush order" and then this can only be done on some medications. Those that will upset the stomach are typically enteric coated so the dissolving process is delayed until the med gets into the intestine. These types of drugs cannot be crushed. Your pharmacist is the best person to advise you about which meds can/cannot be crushed, but, your Mom's doctor has to give the order to the NH.
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CM MRSA is Methicillin resistant Staphylococcus Aureus. it is resistant to certain antibiotics and may cause skin and other infections. it is spread by contact with the infected person, things they have touched or used. It is most common in institutions and other crowded conditions. many people carry the infection and are unaware so it is very important to follow good hygiene practices such as frequent hand washing with soap which does not have to be antibacterial and if not possible in a public place use hand sanitizer and avoid touching the face. Be particularly careful around people with compromised immune systems, the elderly and young children. keep all open skin wound clean and covered and consult a Dr is it shows signs of infection or there is a fever. Take the full course of any antibiotics that are prescribed. It is becoming more common in the community and may be found on such things as magazines in waiting rooms or the library and shared sports equipment.
No one needs to be paranoid about this just be aware and assume it is on everything you may touch and wash your hands
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A technique that I see staff use regularly with my Dad and others in his memory care unit....when they say they don't need or don't want their meds....try just 'forgetting' about meds then, and go away, and come back in a couple minutes and start a conversation about something your Mom CAN discuss....life as a little girl in her house...or a trip she remembers enjoying...almost anything that will get her remembering and talking about something. THEN, while she is sharing and talking, just hand her the pills and a drink without much commenting to interrupt her...and see if she doesn't just go along with taking them, because her mind is focused on something else. If it seems as though she is going to focus on the pills, just ask her another question about what she was remembering and discussing...and don't comment any longer than to say, " It's time to take these pills" or something similar. Sometimes, you have to walk away and come back a couple times even. It's called diversion and with dementia, it works really well to calm agitation, disperse anger....all sorts of things because by the time you come back again, or get them focused on something else, they have totally forgotten what had them upset.
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Sherry, what I liked is the way you presented the facts to your mother. You let her know what will happen if she chooses not to take her medication. That is informed consent/

Now you know that she has the facts, so as hard as it is, you can accept that she knows what she's doing. God bless you.
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Has anyone considered the fact that when someone doesn't want to take a certain medication is because they hate the side-effects from that medication?

All medications have fillers, and depending on the fillers being used one could be hypersensitive to just one filler in the pill, which could cause a variety of different side-effects.

I know first hand how that can be with one pill that I need to take daily, and finding a manufacturer who uses fillers I can tolerate. I refuse to take the pill if it is made by two other manufactures, I rather take the health risk.
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So much in medicine is hidden behind the curtain.

The hospital's official charges are in no way what the insurance company pays. On generic medication, the main ingredient may be bioequivalent, but as FreqFlyer says, sometimes the differences are all too noticeable to some of us. I loved Effexor, but it was expensive. The first generic I tried gave me weird symptoms that were really nothing, but which led me to spend an expensive night in the ER. (Plus Effexor causes weight gain.) So generic prozac at $3.89 a month it is.
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My mother who is 76 with depression also refuses to take meds.but me and my two nurses children tell her that please take your vitamins (her meds) to make you healthy and be more healthy because we need this to be heathy. We conditioned her that this is not a medicine but a vitamin...so she takes it. Meaning our password is vitamins not medicine. For if she hears medicine she won't ..but if we say vitamins ..she would.
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