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Medication refusal in residential aged care homes: A qualitative exploratory study
Stephanie M Garratt1, Kathleen Tolton2, Lyndal Bugeja3
1School of Nursing and Midwifery, Monash University, Melbourne, VIC, Australia.
Nursing Ethics
|June 1, 2026
Summary
Medication refusal in aged care homes is complex. Aged care workers face challenges balancing patient autonomy with care, highlighting the need to consider residents' decision-making capacity.
Area of Science:
- Gerontology
- Healthcare Ethics
- Qualitative Research
Background:
- Medication administration in Residential Aged Care Homes (RACHs) is managed by staff, not residents.
- Limited qualitative data exists on older adults refusing medication in RACHs.
Purpose of the Study:
- To explore perspectives on medication refusal in RACHs.
- To understand experiences of aged care workers, older adults, and family members regarding medication refusal.
Main Methods:
- Qualitative exploratory study design.
- Semi-structured interviews with aged care workers (n=10), older adults (n=9), and family members (n=7).
- Data analyzed using Braun and Clarke's reflexive thematic analysis.
Main Results:
- Three themes emerged: 'Voices from different corners: medication refusals as more than just saying "no"', 'the tightrope of role obligations - doing good, respecting choice, and avoiding harm', and 'Competent to say yes, but not to say no: the erosion of the right to refuse'.
- Medication refusals present clinical and ethical challenges for aged care workers.
Conclusions:
- Aged care workers employ various strategies to manage medication refusal.
- It is crucial to consider older adults' decisional competence, balancing autonomy with beneficence and best interests.
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