Are these drugs available as liquids? For example, drugs like Pepcid sometimes comes as an effervescent tablet that dissolves in water or juice.

Can you break the pills in half?

Have you tried giving them their meds in something like yogurt or applesauce (many people can swallow their pills whole if you put them in a small bit of soft food).

And are you sure your patients aren't playing games with you?

Well my first pt had a long history of mental illness. 83, overcoming tardive dyskenesia from too much Haldol, and on the medical floor for UTI/dehydration. She had to take all meds crushed in applesauce. I'm sure she's had a lot of practice refusing meds in her life (I don't mean that to be mean, but it's probably true), and she probably took advantage of that with me.
My 2nd pt was young woman who had a 45 minute long grand-mal seizure the day before. She spoke no English (she spoke Ukraine/Russian?) and of course no interpreter available. She did not understand how to use a phone for the national interpreting service, as she had a severe mental handicap.

I guess my the issue here is this: I will be encountering patients with mental illness throughout my career. What is the best way to handle giving medications to people who either don't understand what is going on, or who know just enough to take advantage of a situation? Any advice would be great. Thanks for listening.

Well, the first issue is: Are they under court-ordered meds? If it's court ordered, they have to take it and they know it. Most psych facilities will have a policy for dealing with that issue.

The second issue is to find out why they won't take their meds. You problem-solve based on the reason they refuse.

The 83 year old is much like any geriatric patient, and you will have to try different things to get her to take her meds, especially if she has dementia in addition to her psych issues. One of my current clients will respond to things like candy. "Do you want some peppermint candy?" and she always does, so she will take her meds for me then.

A younger person may be playing games with you, but this should be addressed in the care plan, so check with your interdisciplinary team for suggestions.

People with a long history of mentall illness are used to taking meds, and know the scoop. When they start refusing, it may be a sign that something else is going on (for example, a schizophrenic might be hearing more voices), so you need to ask why they don't want their meds.

Thank you for taking the time to help me out. It's always nice to get advice from someone who has experience!