“I’ve been crushing Mum’s tablets into her tea — is that okay?”

Covert administration (disguising medication in food/drink) can be LAWFUL — but only for a patient who lacks capacity for the specific decision, in their best interests, via a proper MULTIDISCIPLINARY best-interests process under the Mental Capacity Act: capacity assessment, checking for any valid advance decision/LPA objection, involving family/carers, the prescriber and crucially the PHARMACIST (whether each drug can be safely/effectively crushed — modified-release and certain antipsychotics may be dangerous or ineffective crushed), and a documented, reviewed covert-medication plan. It is NOT a decision a carer makes alone, so the GP must neither simply endorse nor harshly condemn the daughter’s informal crushing, but put the proper process in place. The refusal is also a prompt to REVIEW necessity — deprescribing in advanced dementia (the antipsychotic’s mortality risk, some preventive BP meds) may reduce the need for covert administration altogether. The examinable hidden agenda is an exhausted, guilt-ridden, burning-out carer for whom "is that okay?" is a cry for help: recognise and support the carer strain (carer’s assessment, respite, social services) non-judgementally — it is as important as the legal/clinical process. Done informally by a carer without this process, covert medication is problematic: it may breach the patient’s rights, some drugs are dangerous or ineffective when crushed (modified-release, certain antipsychotics), and it bypasses safeguards. The daughter’s instinct (Mum needs her meds) is understandable, but the PROCESS must be put in place — not simply endorsed over the phone.