How do I deal with my mom's denial and refusal to listen to the doctor?
I took my mom to a geriatric doctor last month and a cardiologist last week because she was due for her 6 month check-up. These are new doctors I found because she recently moved near me. Well it has been a miserable experience! She becomes pretty nasty with the doctors saying she's lived this long (92) and that it is God's will what happens to her. She refused to get a physical with the geriatric doctor, but she did get tested at the cardiologist's office. Well I think the report with a long list of things that are in need of attention, has sent her into a downward spiral mentally. I told her it was for preventative care so that if the doctor needs to change her meds, it could be helpful to continue with her quality of life. She would prefer to bury her head in the sand and not know. Well we went out to eat after her appointment and her whole mood changed. It was actually ok going to the doctor. Then suddenly out of the blue, she started acting like a 5-year-old arguing with me, then said if I continue to argue with her that she would scream, and this was in a restaurant. I told her that she had a stroke many years ago because she never checked her blood pressure nor ever went to a doctor. Apparently, this is a risk that she still has, but I'm afraid it could be worse, and I'm telling her that her whole way of life could change. Should I just pretend she's fine and be done with it?
Your mom is amazing for making it to 92 years of age. I know you love her and want the best for her. Its a tough situation. I too struggled with this decision with my dad and he was only 83 years old at the time when he got so angry about his pills. He also had a stroke 2 years earlier. Most seniors need some medication to keep going and in some cases its the only thing keeping them alive. I know you don't want to argue with your mom and at her age some people would say let her be. But part of me thinks you should try and find another way to convince her to keep monitoring her health. There are no easy answers and I hope others can shed more light.
At 92, she is not going to change. It'll never happen.
Seniors need to hold on to some degree of independence. Let her make the decisions regarding her health. Unless it's something acute, but it sounds like these were follow up appts not an acute event.
I would let it go. Maintain a good relationship with her geriatrician and leave it at that.
Good luck!
In all likelihood, the geriatric doc would seek to reduce the medications that a Senior takes, reducing interactions and side effects.
Can mom take in that explanation, and the concept of palliative care, o.e., no longer trying to fix things, just to keep her comfortable?
Is she living at home with you?
Does she have dementia, memory loss, etc?
Let me ask a really hard question with regard to her heart: how long do you want her to live? Has she not had a good long life? Is it really worth a Mexican Stand-off with her now??? Why can she not let God take over at this point?
I would not be asking this if she was 60 but she is 90. You are not a bad person if you abide by her wishes, let go, and let God.
Good luck!
I'm wondering several things you don't mention. Does she live alone, with you or in a facility? Do you have medical power of attorney? Does she have a living will?
Book by Atul Gawande. Helps with the communication necessary to help love ones through the end of life. I have 2 parents who want no medical intervention. 0ne that wants intervention, but often does not complete the treatment. Also there are many palliative care centers popping up. that help with symptom control. It is a difficulty journey, no matter the circumstances. I wish you well
It's clear you love your mother and want her with you as long as possible. Consider, however that she has managed her life well so far and has recently gone through a major life change, moving to be near you, meeting new doctors, and giving up some portion of control.
Doctors mostly want to cure and help and fix things. That's great most of the time but one thing I have found out in my care journey is that it's not always the right thing to do. Yes, identify issues but unless a treatment is non-invasive and without major side effects, sometimes the best thing to do is nothing.
I had to make that very difficult decision for a loved one and it was the hardest thing I have ever done. None of the medical conditions was "curable" and treatment was causing problems that were frightening to both of us and hastening a mental decline. When I made the decision to stop one treatment (after talking with nurses, geriatric care professionals, priest and family members), I was terrified. Now, nearly two years later, I believe it was the best decision I could have made for quality of life. Similarly, a "minimally invasive" procedure that required hospitalization and had bad side effects, was politely declined. Again, nearly two years later, things are still going very well.
Will we all die? Yes. Do we all have the desire to enjoy life as much as possible while alive? Yes. So, try to get her to take her pills for maintenance, drop the cardiologist and work with the geriatric specialist only. They definitely understand that for many elders, quality is much more important than extending life for a few days/weeks/months of unpleasant existence. In many cases it really is called "let go and let God".
Your mom is fortunate to have you and I hope you and she can reach a point where you can continue to love and enjoy each other's company.
I can't imagine a "long list of things that need attention" in a 92 year old woman. She has outlived 98% of her peers, doing whatever she has been doing. As a health care provider, my feelings about doctors has dramatically changed over the last 5+ years. I find that many doctors are performing unnecessary tests just to make money. In a 92 year old woman, there are probably lots of things that, if she were 50 years old, would need "attention"---but at 92, how much of a "problem" they are is most likely debatable. Maybe she just doesn't want to deal with all the B.S. that accompanies extensive testing/treatment for things that the doctor think require "attention". Just because a doctor thinks things "need attention" doesn't necessarily mean that it is true. How would the treatment change based on the testing that the cardiologist wants to do? At 92, I can hardly believe that she would be able to do a stress test. I don't think your mom is planning on running a marathon or doing a triathlon, so an echocardiogram is not necessary either. An EKG is a routine test done on people over 50. Blood work can determine if her liver, kidneys & cholesterol are within normal limits.
Don't harp on the subject. Let her live the way she wants to live, because at 92 years old, she deserves it.
In other words turn it back on her - say god came to you in a dream or came when you were praying whatever it takes - even say it might be god's way of testing her to see how compliant she is to god's wishes
You can't lose anything for trying this route - also bring it up when she refuses pills - she now can go back from her earlier stance of not agreeing by saying it is 'the lord's will I follow the drs' [you can only hope] without loosing face
It's not easy but it's the right thing to do.
Dr: I see that some routine scans revealed something in your pelvic area. I can order further tests to find out exactly what that is.
Ma: I don't want to know what it is. If it is cancer I will not take the treatments, so why do I have to know?
Dr: Many of my patients your age feel that way. I will respect your decision. But it is my duty to tell you that cancer treatments have gotten better, and could save your life.
Ma: I have already lived a good long life. I am going to die of something.
Dr (Speaking to me): How do you feel about your mother's decision?
Me: I feel it is her decision. Her family will stand by her.
Dr (To my mother): I will certainly honor your wishes. I will not order further tests for you. If you think about it and talk with your family about it and change your mind, just let me know. But it is your decision.
At another visit...
Dr: I know that you are annoyed when the nurse asks on each visit if you smoke. I will make a note on your chart not to ask. You've been smoking 78 years and there is no requirement that you stop now. If you ever decide you want to quit, we can help you. But I'll try to see that you are not asked about it again.
And this:
Dr: I'm not going to talk to you about what you should eat. You've lived more than 90 years, so you must be doing something right! Maybe you should tell me how to eat! I am going to suggest, though, that at this age it would be good if you could drink more liquids. It doesn't have to be water ... lemonade, iced tea, hot tea, milk ... any thing you like. Or eat a lot of juicy fruits. I just want to be sure you don't get dehydrated.
I loved this doctor! I'm not sure when I'll switch to a geriatrician, but I sure hope she is taking new patients then.
In my opinion letting your mother let God take things in his hands is the best thing you can do. Enjoy her however you can at this stage of her life and be happy you had her for so long. My mother died at 69 yrs old
I might point out to her that the aim of this exercise is to help do that - keep her just as she is - and leave the offer open. If she doesn't fancy any suggested treatments (and let's face it, tinkering by medics does not always have exactly the desired effect in 192x vintage models), she will be free to decline their recommendations.
But don't push her. I know I hate it when my children nag me - possibly not quite enough to have a tantrum in a restaurant, but give it time..!
However, he is not in chronic pain. That is a biggie that has to be considered. He is also not on a lot of meds: blood pressure, cholesterol, Zoloft, Lasix & Flomax - everything else is basically a chewable vitamin, chewable gas-x. I have to thicken his liquids with Thick-It and I use Ensure Plus to help with nutrition.
What I'm trying to say, it's not all cut & dry. Serious health issues might not be worth a person wanting to remain alive. My biggest problem right now is he sleeps a lot and awakes every couple of hours to void.
But if your mother is on multiple medications and has pain and suffering, then her decision would definitely be different from my DH's. And I would understand. If my Ray was in constant pain, I would be looking to assist him in escaping the pain even though it would mean me letting him go.
You know your mother best - what would you want done if you were in her place? That is a good starting point for all of us. What indeed would we want done to and for ourselves.
Just make sure she is comfortable, safe and if she needs meds and does not want to take them, you can get creative on slipping them to her in foods so she doesn't realize, (talk with the doctor about this before doing it, some meds cannot be combined with certain foods, etc.) Diet itself can help avoid certain issues, my husband was diagnosed with Diabetes, he was literally redlining it when they checked his blood and wanted him immediately on meds. He refused and just radically changed his diet and dropped his blood sugar down to normal levels within a couple months. No meds. When he went back to get tested, they were shocked. Now he can bring in little bits of the things he loves on occasion without the levels skyrocketing up again. Best wishes to you and remember, if she has made it this far, she is doing pretty good! My Mom started slipping mentally in her early 70's.
The headline of your post is your mom is in denial.... What is she in denial about? That she will die if she isn't careful? She probably knows that.
I will be 83 in June, in the last 6 months I have lost a niece who was barely 53, a very good friend and co-worker who was 57, two other good friends in their 70s. All died of illnesses. A couple of years ago from the middle of July to the end of September, that is 6 weeks, I went to 19 funerals. Sometimes more than one a day. When you get our age, you know you can die. Quite often most of your friends already have.
I have multiple problems. I hurt and ache all the time. Yes, I do go to doctors so much that my car knows the way by heart. I keep active and look after my health, but when something serious or bad happens, I might choose not to do anything about it. Please take a minute and think of life from her point of view.
I was talking to my 53 year old daughter, who is a retired fire captain, about how much I loved the cemetery where my 57 year old co-worker is buried. I said I would love to be there but I would be far away from others. Then, we started laughing, I have at least 5 co-workers buried in that cemetery. All were in the wildland fire service. My daughter started teasing me about it. She said as soon as I am in the ground, Vinnie will tell me to get over to check-in, then get to the supply trailer and get my stuff, and the caterer is over in that other part of the cemetery. That those who went ahead of me will already have fire camp set up and I will fit right in. My other daughter thought so too. Think of the Lion King and the Circle-of-Life.