8. Refusing to take medication
Sometimes, people with dementia refuse to take their prescribed medication. This can be because the medicine is hard to swallow, tastes unpleasant or causes side effects such as nausea. It is important not to assume that the person is just being ‘difficult’.
If this situation arises, you should raise it with the person who prescribed the medication. The prescriber will be able to decide whether or not the person has the capacity to decide for themselves not to take their medication. If the person does not have capacity, then the prescriber will be able to make a decision about what is in their best interests. When making this decision, the prescriber should talk to the person’s relatives and carers, and other professionals involved in the person’s care. If a health and welfare Lasting power of attorney has been set up, it is up to the attorney to make the decision, with the help of the prescriber.
If it is decided that taking the medication is the best option, then this should be done through the least restrictive means available. In some situations, taking the drug in a different form may be easier than swallowing a pill. For example, some dementia and painkiller drugs are available as a patch or an oral solution.
As a last resort, it may be necessary to hide the medication in the person’s food or drink. However, this ‘covert medication’ can affect how the medicine is absorbed, and should only be done with the written approval of the person’s GP, consultant or pharmacist.
Things for carers to think about
- Are there some situations where the person is more comfortable taking the medication, and others less so – eg, in a particular setting or with the help of a particular person?
- Can you tell from the person’s reaction that they dislike the taste, or that the drugs cause unpleasant side effects?
- Does the person have capacity to refuse to take their medication?
- Have you asked the GP about alternative forms of the medication?
- If you are tempted to try hiding medication in food, have you had this approved by a qualified medical professional first?