Curious to know what others have observed can be done in AL. Of course I'll ask the doctor these questions in detail also.
If a resident is prescribed a psychiatric medicine but is refusing it, can AL force it? How would they do that? If the resident is completely refusing, can they sneak medicines in such as by hiding it in foods?
I told them that if they still dont agree with me and keep telling him that, then they have to do ALL of the organization, hiring and firing of caregivers etc and run the whole show. They then agreed that managing things at home is infeasible, unsafe and unwise and that me and my brother should lead the approach.
She had a stroke. The geriatric as psychiatrist in her acute rehab asked me (as her health care proxy) if I would okay starting an AD which was part of their post stroke protocol.
By the time she found out she was on an AD, she felt so much better, she agreed to continue it.
Just one data point
She calmed down and was able to sleep at night. Like Barb’s mom, she became at ease with taking meds.
The doctor wanted my father to take meds when he became very anxious when going through bladder cancer treatments. He wouldn’t take them.
A lot of older people have misconceptions about meds. They have it in their heads that they are only for ‘crazy’ people. Younger people are better educated about meds and are more willing to take them.
Paranoia is often part of dementia. My 95-yr old Mom is now having random "pockets" of it, usually about me trying to steal her money or put her in a home. She is on the lowest dose of Lexapro for depression/mood, but I'm not sure if there's anything that works on paranoia.
I agree that the staff probably won't be able/willing to hide meds in his food. FYI not all meds can be broken or crushed as this disables the time-release component in the medicine. Also, most are inconceivably bitter and no food hides that awful taste.
Please don't exert yourself trying to reason with someone with paranoia. Trust me, it doesn't work. Redirect the conversation. If you need to talk to your Dad about important things, try doing it in the morning to avoid his fatigue and possible sundowning. My Mom gets "worse" as the day goes on, but not every day -- for now.
You have now asked a question about which there are reams of lawsuit testimony and law books full of judgements.
Just go in and google "Can psychiatric meds be forced on incompetent patient".
You will be reading for the next millennia.
Yes, this is a question to discuss with your Dad's attorney, most importantly because YOU will figure in the decision as the POA.
I will only tell you that this IS done, but most often only when the patient is a serious danger to self and others. It is in a no-man's land legally.
Dad still will not accept the honest answer from me and my brother (co-POAs) that he just has to be in assisted living from now on. We decided to make it an honest answer now, not give false hope. His geriatrician recently also told him he must stay in AL.
So now, he has been telling visiting family members and others by phone that, the reason he thinks that us sons are not letting him leave assisted living is to save money so that we have more inheritance . ( the doctors have said he needs 24/7 coverage, in theory we could do that at home with a live in, but the money would not last long then, but doable for a while ). In truth, the main reason to not go home is safety and logistics, NOT financial. . He is difficult to get along with , and would fire caregivers at home left and right. If he was more easy to get along with, I would have been fine with a trial at home to begin with! I have tried to explain this out to family and my dad. The family understand. They agree now that he should not go home, given his medical issues and dementia. However, some have been giving a sort of false hope, saying "well maybe there is a way to go home if you get better". Now my dad has this hope of a plan. How to handle this whole thing?
On asking the AL to have their staff sneak psychiatric medications by hiding them in his food, I would caution you on how you discuss this with the AL. This is AL that he is in, not a SNF skilled nursing care facility, or even a MC, both where care is done as per physician orders with input from his POA or Guardian. AL lets the resident be self directed…. if he refuses to go to activities, or eat in the dining room, or take his medications, or bathe, they cannot force him. They can ask if he wants to or make suggestions that he does, but that’s about it if he flat out refuses.
Personally I’d be more concerned if the AL knows he’s RX’d for psych / behavioral meds and he’s refusing them that the AL will tell you that dad needs a higher level of care. He’s been there like 6 months, right? He’s tried to leave the AL. Didn’t he complain about his AL apt and moved into another unit? He’s very antisocial, won’t listen, wants to argue, etc. You’ve had private pay aides to help & companion in addition to whatever services this AL provides but it still isn’t enough, correct? Not taking his prescription meds will be the tipping point for this place imo.
You could use this to provide an opportunity for him to move to a different level of care, maybe MC or an SNF. His RXs will be given. He’ll be pissed but it sounds like he’s always that anyways. My take is that he’s been bitterly unhappy for 30 + years when your mom divorced him and moved to England. It’s quite sad. I know your nature is to try to fix things to make him happy but sometimes you have to recognize that you can’t.
AL can not hide or force a person to take medications.
If medications are necessary and have to be administered that would be done in more of a medical setting for example a Psych facility for meds for a psychiatric condition or even a Skilled Nursing facility would have more ability to give meds.
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