As live-in carers, we will often have to oversee our clients taking their medication. Sometimes we will need to help administer meds, particularly if a client cannot do this.
Most of the time our clients will take their medication, maybe not willingly, but they do take it. Unfortunately, every so often you may be at a placement where a client refuses to take their medication.
This can be a very worrying situation because medication is prescribed for a reason. Not taking it at the specified time may have detrimental effects on your client’s well-being.
What can I do?
There are different things to consider when your client adamantly refuses to take their medication, but the first and most important thing is to speak to the doctor.
The doctor (and only the doctor) will decide if the medication is absolutely essential, or whether it can be stopped. This should never be your decision because you are not qualified to make it. Never be tempted to stop any medication without the doctor’s permission, preferably in writing.
You must be sure you document this change because in doing so, you are covering yourself. You should report it to your agency or the family/next-of-kin.
It is also important here that if the family/next-of-kin agree that you stop administering medication, that you do not follow that advice without first talking to the doctor. Again, family are not qualified to make that decision.
When you document and report it to your agency, they will back you up in the decision to talk to the doctor.
Two things may happen at this point:
1. An alternative way to administer
The doctor may arrange for an alternative way to administer the medication. He may change the prescription to a liquid form instead of tablet. This should be easier for any client than swallowing tablets.
Although you will have been taught at training that we do not cut tablets in half, there may be a reason for doing this if the medication is essential and the doctor agrees to it.
The doctor may also agree – if the medication is essential – that you can crush the tablet and add to a food such as yogurt or soup.
If this is the case, then you must be sure that your client eats all the food you have added the medication to. It will be better to serve small amounts with all the crushed tablet in so that you can be sure your client eats the entire amount.
It is important that this is put in writing, again, you need to be sure to cover yourself.
2. Stop the medication altogether
Sometimes, particularly towards end of life situations a doctor may agree to halt medication altogether. This is often the case where a patient has difficulty swallowing and there is a risk of choking.
In cases like this the doctor may change to a liquid form, or if there is no further benefit for taking the medication, agree to stop altogether.
If the doctor agrees to stop the medication you must be sure to have this in writing. This is not a decision for you or family/next-of-kin to make.
In conclusion
The decision to stop administering any medication or change the way you administer it because your client refuses is not something you should take lightly. You should never make it yourself, neither should you agree to doing this because family want it.
Whatever you do, you must document it, report it, and only take advice from the doctor about what to do.
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