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My 84-year-old father has been diagnosed with six dental abscesses after already losing two teeth, one with a crown, which he hid from my mom under a placemat on the dining room table. His breath smells of the tell-tale pus odor, and two dentists--the regular dentist who took the evaluation x-rays, and the oral surgeon have stressed to him the serious state of his mouth and the need for immediate, life-saving treatment. The infection has advanced to the level where sepsis could occur within, at the outside, three weeks.



Despite both the dentists and myself (I work in laboratory medicine) laying out in gory detail the end-point of not treating his multiple infections, my dad has announced that he won't undergo treatment. Even when I said to him, with tears in my eyes, that he is essentially choosing to commit suicide, he was unmoved. I was unable to reason with him, as he is of the belief that he will be healed by divine intervention.



My mom, my sister, and myself have accepted his decision, since we can't *force* him to receive life-saving treatment, but we are all now filled with sadness that the new year will begin with the messy, septic death of my dad. Any advice on support for our trio would be appreciated.

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OP I am going through something similar. It is painful to know someone is going to die because they won't accept treatment. I would just try and support his decision as hard as it will be.

He thinks god will heal him but maybe tell him sometimes god sends angels in the form of doctors and the creation of medication to do his healing for him. Then ask him why is he rejecting gods help?
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IchibanNeko Dec 30, 2023
I would make that attempt, but as I replied to Odegar23, now that he has stubbornly drawn the line, the conversation is over--any further attempts at discussion will be ignored or likely generate a hostile response.  He's essentially gone into my-way-or-the-highway mode.

I have a hope that maybe once all the neighbors in their large condo complex find out what he's doing, they'll overwhelm him with "You crazy, man!" and he'll change his mind by brunt of sheer numbers plus embarrassment in the neighborhood arena...
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I would say at this point it's just time to shift your thinking and focus on a future without him around.

Are his papers in order? Does Mom know where the bank accounts are? Does she have a copy of his pension papers or anything else she might need once he dies? Has she ensured she's the beneficiary on all their accounts and the house's title is held as joint tenants with rights of survivorship?

Time to get practical and leave him to his choices.
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IchibanNeko Dec 30, 2023
I agree with your point-of-view. As I stated in another reply, it's galling that Mom and I have to wait through the physical cascade failure and all its attendant nastiness, first. Forcing us to suffer watching the inevitable is just not right, especially after all the negativity he injected into our family over the years. Were I physically a cat, my ears would be back, my fur on end, and I'd be lashing my tail.

Fortunately, Mom has been fielding the finances for many years--Dad's pension and SS get deposited to an account with only immediate family female access. I'm pretty sure she has the condo title properly arranged, since she oversaw the mortgage restructuring after Dad pushed them into bankruptcy. She also signed him up with the Neptune Society, so wherever he shuffles off his mortal coil, they'll be there to handle the remains and process them to cremation. So, when all is said and done, Mom is covered for the resulting paperwork, etc.

It just...hurts my heart. He's my dad, yet my feelings mean nothing to him with regard to the pain and suffering he'll experience. My words, my love, all without worth. This is the hard part, right now. When there's no true answer to the question of why...
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If it is any help, a similar situation happened with my neighbor. He had a serious aversion to doctors and spent several weeks with chest pains then died of cardiac arrest. His wife, after a period of grief told me she had to accept his decision. He was a "big boy" who chose how he wanted to live.
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+1 hospice.

Choosing to refuse dental treatment will avoid treatment pain & cost, but will bring other consequences of the most severe nature.

Is there a religionious/faith leader your Dad would like to speak to about his situation & decision? Or for the wider family to speak to?

What a hard situation. Sad indeed.
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IchibanNeko Dec 29, 2023
Thanks for your reply. I don't believe my dad has any faith-based persons in his orbit at the moment. I remember that he was attending a local church prior to the pandemic; then my mom mentioned he'd stopped attending and hadn't resumed.

As for myself, I would describe myself as spiritual, but I don't follow any structured religion. Mom and I reside in Washington State, while my sister is in Oregon. I find myself alternating between sadness and an intense frustration that my dad, typically a logical and rational person (he taught math at a number of levels), is now refusing to receive reasonable medical treatment on the grounds that God will heal him. I'm certain his response to offered hospice would be similar: "I don't need that because God will heal me."

And the irony of the situation is that hospice doesn't even need to be part of the discussion, if he would just follow through with the necessary treatment...
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I don’t have any advice but I am in a somewhat similar situation. My dad has frontotemporal dementia. He does not brush his teeth at all and his diet is very minimal and appalling (he eats one bowl of ice cream per day and little else, including almost no liquids), but he will usually go to doctor appointments, and even (to my surprise) said his tooth hurt about 18 months ago and agreed to go to the dentist to get it pulled. But he does a lot of other disgusting and self-neglect things and my mom refuses to intervene. I think he is likely to die from whatever combination of neglect, disease, and dementia and I do alternate between many negative emotions (frustration, sadness, anger, self doubt) and struggle with what I should do, vs acceptance. Best wishes to you and your mother and sister. The story of his dental abscesses is pretty horrifying. You have my sympathies.
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I'd get hospice on board for dad immediately because I can't understand how he can bear the pain of so many abscesses in his teeth! I had one and the pain was excruciating. Hospice can offer dad comfort care and you and your mom and sister support services from a chaplain and social worker.

I'm so sorry to hear of your dad's decision and pray for a quick and painless passing for him. I hope he's open to hospice, too.
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IchibanNeko Dec 29, 2023
That's the mind-boggling aspect to this: Dad hasn't made a peep about pain, and the two teeth he lost early on in the infection process, he never said a word about to Mom, even going so far as to hide them under a placemat.

As I replied to Beatty, I'm certain he'd refuse hospice with the same illogical response that he doesn't need it, that God will heal him. And the irony of the situation is that hospice doesn't even need to be part of the discussion, if he would just follow through with the necessary treatment...

If someone had told me, even a year ago, that my rational, mathematics professor father would take such an irrational, unreasonable course of action, I would have told them they were full of çaça... The situation seems surreal at best.
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I might guess your dad has anxiety related to the dentist. Maybe see if he would agree to a sedative pill or IV sedation? Tell him lots of people dread dental work, and that’s why they have sedation dentistry
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IchibanNeko Dec 30, 2023
If Dad has anxiety, he refuses to communicate that to anyone. And now that he has stubbornly drawn the line, the conversation is over--any further attempts at discussion will be ignored or likely generate a hostile response. He has been like this for many years, with almost schizoid behavior worsening over time.
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You do not give much info on your dad.
If dad has dementia he can no longer make important decisions for himself . (this is different than asking him if he wants a ham sandwich or soup for lunch)
The person that is POA is the one that makes decisions like this for him.
If he has not been diagnosed with dementia and this is a "new" thing, or change in his personality I would get his to his primary for a urine test. UTI can often result in personality changes and poor decision making. A stroke can also effect decision making abilities.
On the other hand if dad is cognizant and he has a lot of other medical issues he may be just "done" and if that is the case this is his choice that he is making and your next step would be to consult with the Hospice of your choice and let them manage his medical care now.
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IchibanNeko Dec 30, 2023
Yes, mea culpa on the lack of details. Dad suffered an ischemic stroke in 2002, caused by a red blood cell clump (not a clot) that passed through a cardiac PFO and blocked a cerebral artery. He suffered severe balance impairment and experienced some short- and long-term memory loss, but nothing more debilitating than that. Mom cared for him through his long recovery, wearing herself thin in the process.

A few years later, with Dad fully recovered, they sold the house my sister and I grew up in, and moved into their current condo. They had a nice nest egg from the house sale and Mom's inheritance from her mom's passing. That's when Dad's behavior turned bizarre, and he spent all that money (over $200K) on propping up a church member's store of African imports. In the middle of this situation, my sister overheard said church member discussing with his "partner" how much money they'd be able to get from our dad. Turns out the "church member" was a practiced scam artist, and he used the religious angle to con my dad but good. When my sister, my mom, and myself tried to explain what was going on to Dad, he first asked why we were "bearing false witness" against the church member. When we persisted, adamant that we were telling the truth, Dad became hostile, and refused to listen. When Mom stated that 50% of the money was legally hers, and Dad had taken it without any discussion, he responded that *he* was the head of the household and all financial resources were *his* to do with as he pleased. Mom ended up having to file joint bankruptcy, and it was a long road till they were financially clear once more. It took a court official browbeating Dad with legal chapter and verse before the gravity of the situation got through to him.

The present situation is more of the same willful obtuseness, only it's not just money on the line this time, it's what remains of his life. He's fairly healthy for his age, and could enjoy a number of years more with proper medical treatment of his dental infections. Dementia is the unanswered question in this equation, because every time Mom attempted to schedule him for the requisite medical evaluation in the past, he pulled similar passive-aggressive crap and either canceled the appointment behind her back, or simply refused to go. After a decade of trying, I think my mom is now redirecting her energy toward preserving herself.

As long as he has not been officially diagnosed with dementia, he is in control of his medical care. The oral surgeon's office told Mom that they must abide by his wishes. And as I originally posted, from his side of things, the conversation is over. Trying to browbeat him with the inevitability of a nasty hospitalization then death at this point will result in either being ignored with this smug little smirk, or a hostile response that could escalate to physical violence. So Mom and I have withdrawn from the situation to prevent further problems; that doesn't lessen our own sadness and helpless frustration, however.

Regarding hospice, pursuing that is up to my mom, since she has her own support group outside of immediate family. And no one can truly predict how his infections will advance at this time. There may come a point where he reaches screaming agony before finally allowing himself to be hospitalized. Or he may develop Ludwig's Angina and his trachea becomes occluded, ending in suffocation. (Mom signed him up for the Neptune Society, so no matter where he expires, his remains will be taken care of.)

Who knows? Maybe once all the neighbors in their large condo complex find out what he's doing, they'll overwhelm him with "You crazy, man!" and he'll change his mind by brunt of sheer numbers plus embarrassment in the neighborhood arena... Life is strange and constantly in flux.
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Have you considered taking yourself and mom on an extended holiday for a couple of weeks?

Look, your dad sounds mentally ill. Neither you nor mom can do anything about that. And it appears that she's had difficulty maintaining boundaries to prevent him from damaging her financially for a long time.

Right now, it's time to divorce mom and yourself from this madness. Get out of there.
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lealonnie1 Dec 30, 2023
No kidding.
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He is living his life on his own terms. I know this sounds harsh but leave him to it.

If he is no longer of sound mind, why prolong his misery anyway? He’s not going to get better.
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