Thursday, February 26, 2009

Better Living Through Chemistry...

...or chemical restraint?

Using chemical restraints (giving medication to a resident for the sole purpose of making them easier to handle) is illegal. However, there is a very fine line between treating a resident and using a chemical restraint.

Case in point: Resident A is screaming. I mean SCREAMING. Not because they are in pain, but because they are unhappy about their meal choices and no one is able to go purchase a meal from Sonic for them, including the resident's family members. The hall has about 30 residents on it and every one of them is getting more and more upset as this goes on for more than an hour. Nothing the kitchen can make is good enough and all the cajoling in the world is not making the situation better.


Said resident is due for a routine pain pill. They also have a PRN order for a "relaxing pill". This is a new order from the doctor and the resident has not taken one yet. The "relaxing pill" is given along with the resident's routine meds which include the pain pill. Within thirty minutes, the resident is quiet. When I reach the dining room to finish passing the meds for the five o'clock, the resident is sitting at one of the tables, chatting with the other residents. This is not normal behavior for this resident. Usually, they eat in their room. The resident eats about half their meal, all the while being pleasant. The next thing I hear is singing. "I found my thrill...on blueberry hill..." After supper, instead of going right back to their room, the resident sits in the TV room for about an hour and then politely asks to be taken to their room.


So, was this better living through chemistry or chemical restraint? The resident wasn't given anything that was not prescribed for them, but it was given for the purpose of quieting them down. The other twenty-nine resident's on the hall were certainly thankful for it. All of the nursing staff was grateful as well. This was likely the nicest evening this resident has spent in a long while, so I imagine they were happy as well. As with most things ethical, the line is so fine, it's often nearly invisible.

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