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Parkinson’s Disease Community
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Dealing with meds
by Mjthewritermom, Nov 29, 2008 05:12PM
What are some of the ways you (any one who would like to answer this question) deal with giving meds to your loved one when they don't want to take them?
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I'd have to know what disability you are talking about. If the disability is treatment refractory schizophrenia my advice is look for better treatment and I can give specific information. The person should be recovered enough from their medication to understand why they need it. If the disability like my cousin's is a developmental disability that is of a severe nature that would impair cognition that's another issue but with developmental disabilities anti-psychotics cannot treat them but are used for "behavioral management" something I disapprove of and some psychiatrists would agree. If a person has a developmental disability and a psychiatric disability as well and needs medication a counselor or social worker can help explain to them why they need it and remind them to take it every day. They do that in supported and supportive housing and supported housing is a good option for a person with a psychiatric disability who cannot live on their own regardless.
So I can summarize but I'd have to know specifics as to what the disability is and what kind of medication it is. If its psychiatric medication the whole point is for the person to be rational enough to know why they needed medication. I went off medication once in 1993 and I ended up in the psychiatric hospital but my pychiatrist explained why I needed it and the experience itself shook me up enough not to do that again. But I also learned about what it was for, what it treated, what the side effects were, the long term effects and what recovery meant. And as I was learning about treatment I advocated to get on better medications and I ended up calling for a referral for a psychopharmocologist and advocated further when nothing worked to get on the experimental antipsychotic I am on now glycine, which is a glutamate antagonist in Phase II FDA study a new form of antipsychotic that will not cause tardive dyskinesia or diabetes. Which is the only reason I post here in the Parkinsons's Community because my tardive dyskinesia is a full blown Parkinsonian condition that has made me homebound. I wish I had full disclosure about the severity of it before.
So to answer your question in how I always put it I believe in "partnering on recovery", "compliance" as a reason leads to "defiance". Educate the person on exactly why they need the medication and how it helps them.
Thanks for ideas, etc.
It would be good to know what medication it is. And what kind of place you are working at? If its a hospital then my guess is there are difficulties with the person not understanding their medication and its well run but some nursing homes use anti-psychotics like Haldol in elderly people to "calm them down" and that's not an appropriate usage and many psychiatrists would agree with this statement. And I do network with and sometimes attend a Parkinson's support group so I know about this disability. And some of the medications I mentioned might help if they haven't been tried depending on what's going on.
I was struggling with whether I would mix it in with applesauce/pudding and not tell the person it was med time. My understanding of it when I went through training is in regards to patient rights (bill of rights). However when individuals have alzheimers/dementia.....they are not thinking clearly. I try to be compassionate and gentle each day I work and to do an excellent job in how I care for each resident.
Sincerely,
:-)
Just understand that increasingly even psychiatrists are concerned with the use of antipsychotics in the elderly because of the severe side effects. You don't have to discuss it further. But you could look it up. And thankfully from what you describe you don't work in a place that misuses them for behavior management which can be abusive in some nursing homes. But if you ever saw this anywhere you could speak to someone from an outside agency about it.
But regardless, its good to know what are the increasing availability of treatment options and Zofran for psychosis from Parkinsons' is one and Namenda for dementia from Alzheimer's or any condition is becoming a standard. And as treatments improve and more importantly as people's standards changed so did the idea of living in the community. So for some people who are in hospitals they are there because of the severity of their disability. But for many people in nursing homes, some younger people with physical disabilities, living in the community with a home attendant is a possibility. Look up the "Community Choice Act" which will be passed next year which will allow more people to move into the community with Medicaid funding. And I'm sure you work with the people well and are kind and there's certainly no need to detail further especially because of those regulations. But this information I gave you is all worth understanding if it ever would apply.
:-)
I am off to work within 1/2 hr. I am the early bird (up at 4 a.m.)
Have a great day (I get to travel through the snow........)