People are never to be forced and do have the right to refuse in reasonable circumstances but exactly what does that mean? Those who are alert and oriented can and do refuse medications and/or procedures and it is perfectly fine for them to do so. Make sure they fully understand what it is that they are refusing and then clearly document the facts only. On the other hand, it gets a little "dicey" when we're working with people who live in an "altered mental state" especially when they sometimes appear oriented. Allowing someone who is demented to wear soiled clothes because she refused to be changed would be viewed by the court as elder neglect. Health care workers experienced with dementia know how to get the hard stuff done without too much trouble. Stardust uses a good example.