teenager not taking medication - Help

My 14 year old has decided that taking inhalers is a waste of time.

I only cottoned on when I went to get the prescription for her younger brother also asthmatic and her puffer had not been taken (seritide) since we came back from holiday in November.

We have seen the dr a month ago and the dr asked if she was taking her medication and she said yes I am, she was given antibiotics and pred as she had a chest infection.

she didn't take the tablets, only managed a couple of days then didn't bother, (teenage strops are hard enough) so I thought well she should start to feel signs that her asthma is uncontrolled and start to take them, the odd puff was taken here and then. constantly taking her blue puffer, her cough changed got really loud and sounded very deep routed like I have never heard before,this time I decided to take her to the gp again, and I told the gp she was not taking her medication, the gp had a chat with her about the importance of taking her inhalers and tablets.the gp said that she has crackles on her lungs, prescribed more antibiotics and another course of pred, plus reissued her seritde and singular which I have been standing in the kitchen and watching her take them,we have to go back to the dr friday,How can I get it though to her that its serious,she must take this medication, she has been having several asthma attacks, how cross would the hospital be if she got admitted, when all she needs to do is take her preventative medication.

can any one offer advise/help with this>? Has anyone got a similar worry/

23 Replies

  • I can understand your frustrations and worries.. I think its probably a phase most teenagers with health issues go through, they all think they are invincible! I certainly did..

    Im 40 this year and have appalling lungs now. (11% function in small airways, and 25% lung capacity). I use a wheelchair often if I go out and nebulisers regularly, and take 26 tablets a day. When I was a teenager I just had a blue and brown inhaler, and didn't take it. Why? I don't know really, just didn't.. not sure as a teenager you need a reason to rebel lol.

    As an adult now, I would say that I wasn't mature enough at that age to make those decisions myself, I didnt really understand the implications (being told something doesn't necessarily make you internalise it and its not the same as experiencing an asthma attack which makes you end up almost ventilated in ITU - they are just words, and go in one ear and out the other). Im not convinced any child (for thats what she is) has the capacity to weigh up the risks and benefits long term of those kind of decisions.

    Hence, I would not take it on trust that any child of mine was taking their medications - I would stand and watch them, tantrums or not. Tantrums are designed to make you go away and leave the subject - quite an effective way normally! I maybe would give up on the long explanations right now -she's heard it from the GP after all - less discussion just no negotiation on taking them - and watching her do it. You might find that once she realises you mean business that after a few days she just gets on and does it in front of you from then on. But don't be lulled into thinking she will then take responsibility for doing it herself. She's 14. And has better things to be doing ;)

    Lynda (who spent years working with folk who have challenging behaviour, teenagers can fit that category quite well!) ;)

  • Is she likely to pretend to be taking her meds and then not take them. as in will she tell YOU an outright lie? when i was younger (i'm still a teenager) i went through the 'inhalers are a waste of time and effort' thing about once a week. and used to get REALLY angry when my mum made me take them in front of her. whilst this is definitely a better option than her not taking her meds at all what my mum did was set up a system. she sorted all my repeats so knew exactly how fast i was getting through everything. if she deemed i was going through my blue inhaler (of which i was only allowed one - and was fined if i was caught without) too quickly then i had to go an explain to my GP, which I knew was likely to increase all my regular medication. And then there was a chart on the kitchen wall where i ticked every time i took my meds. mum checked it ALL the time so i couldn't forget and think 'oh well' and tick it anyway, she put a cross in every time i missed one and she caught it. If in a week i missed two doses i had a week of doing it in front of her. she also caught on pretty quick that 'doing it in front of her' was much more frustrating for me if my evening dose was taken at 7:30pm as i was much more likely to want to be out, if i wasn't home by then she would just come to me and make me do it there - really embarrassing and i quickly learnt that if doing it myself meant i could avoid that it was much easier.

    its hard as like nurse furby says shes too young to weigh up the pros and cons, but she does have to learn eventually and if you can show her that doing it independently isn't a punishment (as you don't really want to set up that association if you can help it) and hopefully when she feels better she'll realise that actually taking a blue inhaler a zillion times a day is more annoying than preventors twice a day. you can also tell her that you are too worried she'll get ill if she goes out when she's not taking her meds and so she can only go if you can go with her. its a valid argument and will really annoy her (if she's anything like i was) so might be worth a shot

    unfortunately if you cant trust her to tell the truth to you (and you might want to really think properly about whether you can, its complicated at that age - especially if she really really doesn't want to take them) then its probably as nurse furby says just a case of forcing her to do it in front of you. and hopefully she'll learn that its quicker to just do them and not make a fuss.

    good luck, and hopefully she'll feel better for it, even if its harder in the short term

  • And then there was a chart on the kitchen wall where i ticked every time i took my meds. mum checked it ALL the time so i couldn't forget and think 'oh well' and tick it anyway,

    Im being a dimwit probably, but how does the chart help? I would just have ticked it and not taken my inhalers - because unless I was being stood over and watched, how would anyone know? Surely the tick just means you've ticked the chart...?

    Lynda :)

  • Soph - wow, your mum is good.

    I wasn't diagnosed as asthmatic as a teen, but I do remember how incredibly important it was to me to be able to do things on my own when I knew I was responsible enough to do them. Fair's fair if I messed up (like your mother going to you with your friends - ouch!), but the times adults just assumed I was irresponsible and never gave me a chance to prove myself would really upset me.

    Teens aren't children. Teenage is a weird sometimes zone - needing to be adult when one can, but needing help when one can't. Seems like your mum understood that.

  • yeah - trust is a big deal, and it does depend in part on why shes not taking meds. the chart reduces forgetfulness, but it is also important that repeats are managed by someone else. you cant tick everyday and not have the amount of drug in the inhaler go down unless you are really willing to make the effort to spray out meds and not take them. like i said, its important that if you do this you can trust the teenager. i wouldnt lie to my mum, i might not take my meds, and i might not mention that i have stopped but for me personally i wouldnt lie. its really tricky. also you run the risk of getting caught i guess, that one time someone watches (and if its in a prominent place such as kitchen/living room where people are likely to be around in the morning or evening then you are gonna find it hard to find a time nooone is looking) isnt worth the hassle of not being able to sort it out yourself!

  • I'm a teenager (for a few more moths anyway :P) and I'm really bad at using my inhalers. I think I get into a pattern of taking the and then feeling ok and so start to think I don't really need them, that I've been over-diagnosed and to prove I don't need them, I don't take them. I know I shouldn't but at the same time I don't want them, if that makes sense. My parents don't believe in asthma so I've had to force myself to remember them and to take them. I found it helped putting it next to my toothbrush, so I that have to move it out of the way to get to my toothbrush. After picking it up there's no point in me not taking it. Likewise, I keep a diary of the exercise I do (something before I did before I was diagnosed) and use this to show myself that if I don't use my preventer for a few days, I go from 45 mins of continuous cardio to 10, then if I miss it for a week I can manage just 5 mins. It works to remind me of how much of an impact it can have and kind of makes me think that taking my inhaler is far less hassle than being cooped up inside all day and having to use the lift all of the time.

    I think that being a teenager is difficult. You kind of want to be left alone and allowed to grow up but don't understand why people, especially parents, won't let you. I guess you don't realise how much you don't know. Is there anyway you could give your daughter the impression that taking inhalers without being forced is a really grown up, independent thing to do? Or maybe remind her of how bad she can get?

  • I think that being a teenager is difficult. You kind of want to be left alone and allowed to grow up but don't understand why people, especially parents, won't let you. I guess you don't realise how much you don't know. Is there anyway you could give your daughter the impression that taking inhalers without being forced is a really grown up, independent thing to do? Or maybe remind her of how bad she can get?

    Nice to get feedback from teens, I remember being one and not taking my inhalers LOL but it was a while ago sadly! Rachel I think you hit the nail on the head - yes teens feel like they are grown up and want to be grown up/treated more like an adult, but the reality is there is a lot they dont know, - and psychologically and developmentally they are not adults. At 14 you are still a child, albeit an older one. Of course children need to be involved in their care and decision making, but understanding both the short and long time effects of not taking medication is not easy at that age. You dont give a hoot about 20 years time then!

    Most of you wont have heard of the capacity act, which is used for adults, but there are criteria you have to satisfy in order to be making a 'capacitated' decision. It is for use with adults over the age of 18.

    1 Understand the information relevant to that decision, including understanding the likely consequences of making, or not making the


    2 Retain that information.

    3 Use or weigh that information as part of the process of making the decision.

    4 Communicate their decision (whether by talking, using sign language or any other means).

    Its useful when considering the decisions of teens who we think can make them independently - because if they were making decisions about medication as an adult, and we were concerned they were making bad decisions, this is what would be looked at. If they could do all that, and were still making a bad decision thats fine - its their choice. But I would question whether a 14 year old could understand all the information and (future long term as well as short term) consequences, retain it all, and weigh it all up..

    Who said being a parent was easy ;)


  • Lynda, since you mentioned capacity I was thinking about Gillick competence which is for under-16s specifically (but you prob know all about this). A 14-year-old could be declared 'Gillick competent' ie able to make decisions about her own medical treatment, if it was decided they were mature enough. I don't know if mumof3's daughter might find this knowledge something of a spur, as I read somewhere that people are more likely to 'live up' to what you show you think of them - so perhaps if, (despite evidence to the contrary in her case), you suggest to your daughter that people her age can be deemed responsible enough to take charge of their own medical care, she might feel more inclined to try to be like this on the basis of wanting to be more adult? I was always desperate to show I could be 'adult' at that age, even if I wasn't.

    I was definitely a stubborn nightmare as a teenager though so as an adult (though not a parent) I can understand both sides - but I'm also thinking carrot might be better than stick as any suggestion that I was being immature, even if true, made me even more stubborn! I would actually have been more willing to do something in secret, if I didn't feel someone was standing over me making me do it, though I get that you want to be sure she is in fact doing it - maybe monitoring as suggested so you can keep an eye without her feeling like you're right there?

    I didn't have this particular issue because at that age my asthma was so mild I didn't need any preventers. I will say though that I hated seeing doctors and one of the things I most loathed about it was having my mother there in the room as I've always been quite private, and it made me really sulky and hard to deal with. I don't know if perhaps, although I can understand you want to know what the GP says and perhaps reinforce it, you could again use the 'carrot' and offer to let her go in the GP's room by herself - again with the implication that you're treating her as more of an adult and perhaps get her to feel she needs to live up to this? It seems like the GP is prepared to give a lecture if needed, but maybe she'll be more inclined to listen to it and take it on board without her mother there, if she's anything like me, and this might be a way for her to compromise ie take them properly but without 'losing face' by being 'seen to give in'.

    I have no idea if this is helpful; I've never been a parent but just remembering being a stroppy teenager.

  • Lynda, since you mentioned capacity I was thinking about Gillick competence which is for under-16s specifically (but you prob know all about this). A 14-year-old could be declared 'Gillick competent' ie able to make decisions about her own medical treatment, if it was decided they were mature enough.

    Yup, Gillick does relate to under 16's - just thought the capacity info may be helpful, as it defines what being competent/having capacity to make a decision actually means practically :)

  • sorry but I wouldn`t let her see the GP alone as she is already giving trouble taking her meds - you need to know what the GP says to her

    maybe she will need to get so ill as to need hospital treatment to make her realise the seriousness of her asthma, I know when my cough changes to a `bark` that it is serious

    If only there was a `teenager help pill`

    good luck

  • sorry but I wouldn`t let her see the GP alone as she is already giving trouble taking her meds - you need to know what the GP says to her

    good luck

    I couldnt agree more with you. There is a lot of discussion about treating a 14 yr old like a mature person and trust, but surely the most important thing here is ensuring that a 14 year old child takes her medication which is in her best interests to avoid both long and short term harm. Children and teens need boundaries - and they need parents, not parents who are trying to be their friends and not upset them. When they ARE adults and look back, they are generally grateful for those boundaries because they understand the need for them as an adult..


  • Lynda, I see your point and I'm not a parent myself. I just thought that despite her not being that mature yet re medication etc, treating her as though she were *might* possibly have the desired effect ie getting her to take her medication and be a bit more sensible about it all off her own bat, given her parents can't be everywhere.

    Not everyone is the same, but I think I'd have been more inclined to do it properly with this approach - but the OP does know her child best so hopefully will know if she might respond to this or whether stick is going to work better short term. Of course, if there's a school trip or anything like that coming up there's always the 'well, I don't know if you'll be well enough to go unless you take your inhalers' approach? Or is her younger brother on preventers too? Does he take them properly? Wondering if there's the 'he's younger than you and he can do it' shame option.

  • After reading these responses, thinking about my own experience working with teens (having taught, tutotored, advised youth groups, and been aunty to teens), I have a few more thoughts.

    Have you had a sit down with her and asked her why she isn't taking medications she knows she needs? I mean beyond ""waste of time"" , i.e. what is it taking time from that is important to her?

    Teens, for all of their rebellion and moods, are fairly rational creatures, if one makes an effort to get inside of their world view. I am sure she has reasons and if you and she have the kind of relationship where you can sit and just listen, it might be a good idea to ask her. If you don't (sometimes mother-daughter relationships can be fraught) is there someone - her father, an aunt, a family friend, a grandmother who would be willing to chat with her?

    The fact that your child is not complying actually is a sign of her increasing maturity - as a child she merely did things because ""mom said"" - now she realizes that she needs her own reasons and motivations and mom (however wise) is not enough.

    Although you can provide structure along the lines of Soph's mother (and perhaps should if you think it would help), blind pressuring her without finding out the underlying reasons she isn't taking them is not going to solve the problem and will likely wear both of you out (ah the strops). Especially at this point in her life, the biggest favor you can give her is to help her be wise when she insists on doing it her own way - which she will. For example,

    * she may be having trouble organizing her morning routine and given the choice of missing the bus/demerit/detention and taking medicine - she'd prefer avoiding school trouble. If so, the solution isn't standing over her to take the medicine, but helping her come up with a system that works for her. Even adults have problems with juggling busy lives and medication regimes as can be seen from some previous posts in the general forum.

    * she may be struggling with how it looks to her friends. Peer relationships are very important at this age. Her failure to take the medicine she needs may be part of a larger issue of balancing her need to take care of herself with pressures from friends. If this is an issue for her - as it is for nearly all teens - she might need your support and help in learning how to put herself first.

    * or maybe it is something else entirely? - there is really no way for us here to know or guess, because she's not here to say and only she knows her reasons.

    You might find this article useful ( fampra.oxfordjournals.org/c... ) - it is a study that interviewed teens to find out why they don't take thier medicine. You can also google ""adolescence compliance asthma"" and find many other similar articles. This is a very common problem and a great deal has been written on it.

  • Read this post with interest. My 15 yr old son is not very good with taking Seretide but mostly remembers to take his pills (Singulair, Nuelin, antihistamines and vitamins, and steroids/antibiotics when he needs them). He uses a pill box - one with days and compartments for morning and evening meds - and this has worked very well. He's had it for about 7yrs, in the beginning I used to put the pills out for him to take, but he now does it all himself. I always check the box and sometimes I have to remind him, but he has learnt the hard way - ie if he forgets the Nuelin he gets wheezy after a few hours. Also, I think he got into a routine from fairly young, so it's not a hassle now.

    Sorry, this is not much help, but just thought I would share what we've done.

  • Angie Im 39 and I use a pill box LOL ;) I was getting so pissed off with faffing around with boxes of tablets four times a day, it was really winding me up! (I take over 20) - now I sort it at the beginning of the week and it um, enhances my compliance..! I find the four inhalers and peak flows equally as annoying, but needs must eh, my lungs are too crap for non compliance now.. I was quite good at it as a teenager! I didn't really learn the hard way either, but I think because my lungs were always crap regardless, I didnt see the point.

    I think another issue around inhalers, isn't just the taking them, but ensuring good technique. The amount of folk I have seen with decent inhaler technique is few and far between.. its a wonder it even gets into the lungs!

    Lynda :)

  • Thanks Lynda - glad my son is not the only one with a pill box!! Agree with you too about the importance of good inhaler technique. :)

  • Talking about good inhaler technique, it was only last month whilst in hospital that my consultant wanted to see how I took my inhalers, turns out that I was using my Bricanyl Turbohaler (reliever) incorrectly, they showed me where I was going wrong, no wonder I was using it sometimes up to 20 or 30 times before bringing in my home nebs, now the maximum I usually go to in worst case situation is 12 times before bringing in my home nebs.

  • i have a pill box, im only 18, i dont really like it but it saves me soooo much time on a morning, and i know there would be days where id be too alseep to care enough to wake up and sort it all out, or id get them mixed up! (can so imagine me taking 8 of something that wasnt my pred by accident when im not awake!) my inhaler technique gets checked all the time, but i cant manage at all with turbohalers unless im really well! its good that theyve worked it out asthmagirl, hopefully itll make you feel a load better, and it'll help them get a better idea of what stage of an attack you're in if you ever need hosp! had it not been checked in a while?

  • Hi everyone

    There's negative connotations concerning inhalers and meds to teens. Also busy lives cause for us to forget to take it. If a glass of aloe juice in the morning would be more easily implimented then I can definately help. Being natural it either helps or it doesnt. My sister had terrible asthma and was on serious steroids at 1! She is 24 now & hasn't used an inhaler in over a decade. Here is my number if anyone is looking for a hopeful alternative to their asthma meds/ assistancetheir asthma.

    <phone number removed by moderator as per terms and conditions agreed to on signing up>, Talyena

  • hi and thank you for all your replies, I have been able to take away a lot of positive help and tips from them.

    I just wanted to point out that I don't in fact let my daughter go into the surgery by herself, I always go with her, I do think that standing and watching her take her medication is annoying for her but in the long run will be worth while, she has generally started to improve the last few days, one thing I have noticed is that she breaths really heavy. I am going to mention this to the gp when we return.

    the iphone app is going to be really helpful I think, I am going to suggest this to her today, I never new there was such a thing what a great idea.

    thank you again for all your support. I am going to put another post on separately about my little boy poor little man not been a good few nights..

  • Glad things are improving for your daughter but sorry to hear tjat your son is struggling at the mo. I hope things continue to improve for you all.

    Take care

    Rose xx

  • your child should consume regularly for asthma medicine.. asthma is chronic that's why for a mom should take care their children

    There are many material to know ashma deeper. may be one of this web can help

  • I am a product designer looking to create a product to help remind and encourage teenagers to use their preventer inhalers to hopefully reduce the overall long term effects. It would be brilliant if you could take 2 minutes to fill out a market research questionnaire so the product really is catered to you and your child's needs.

    <details removed by moderator: as per forum terms and conditions agreed to on signing up, please do post asking for any research without Asthma UK approval first>

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