My 87 year old mother has never liked going to the doctor and would cancel her appts numerous times before finally going. Her doctor of more than 35 years joined a new practice and they now require blood work to continue to be seen and get prescription refills. She refuses to have blood work and does
not want to go to the doctor now, I assume out of fear that they may find something wrong. She is going to be out of high blood pressure med refills soon and I sense her plan is to just stop taking her pills which I know will lead to a health event of some kind. Are there any options for getting her care that would allow her to get her meds refilled? The suggestion of telling her you’re going somewhere else and showing up at the doctor will not work because I can guarantee she will NOT get out of the car. Any ideas are appreciated.
Explain to her what will happen, if that is not possible try to understand what their wishes would be if they were on life support and wait it out.
Does you mom have any other physical conditions that are of concern?
If not maybe have a conversation that goes like this....
Mom, I have a POLST (a form like a DNR but more detailed, can called by different names in some states) I need you to fill it out so that I know what you want me to do in case something happens. Since you won't go to the doctor I need to know what you want if I have to call the paramedics one day.
You can go through all the possibilities of what can happen if BP goes uncontrolled but at 87 I am sure that she figures none of that will matter. The thing to impress on her is IF she has a stroke and survives she will probably not recover fully.
Bottom line is...if your mom is cognizant she can make her own decisions and if this is the choice she wants to make then that is her decision.
Create a log of her blood pressure readings. Ideally, you should check her blood pressure at least 3 times during the day - first thing in the morning upon her waking up, sometime in the middle of the day, and before bedtime. Try to get a week's worth of readings before the doctor's appointment. If mom won't see the doctor in person, get those readings to the doctor before or at the tele-appointment. Buy an automatic blood pressure cuff. I am an RN and I have one that works on the wrist so that you don't need all the different sizes of BP cuffs.
If she still needs bloodwork, take her to a lab and ask them to use a butterfly set and mini-tubes. Some of my older patients tend to do better when I use a butterfly set-up and use a syringe instead of the vacutainers. (Feel free to print this out and take to the lab so they can read what I wrote.) The doctor can also prescribe numbing medication to put on her elbow creases and back of her hands 1 hour before she gets lab work drawn so she won't feel the pain,
Or assure her, as can you, that nothing will be treated that she doesn't want treated.
Have you asked her why she doesn't want to go?
Its a little costly but worth it in so many ways. Good luck.
Did you ask if this is her way of dying? Did you tell her you’re not ready but you understand? And if she wants to die, are her affairs in order? Does she understand the physical and possibly mental repercussions of a heart related health event? Or how long it could last? Or what care she might need and how to pay for it?
Have you asked yourself what kind of life you want to live at 87 or 90 years old? And at what point you’ve spent enough time on Disney Earth, ridden enough rides, seen enough sights, had enough highs that exhilarate, persevered enough storms; but you’re tired, it’s not much fun and you’re ready to go home?
She had to be transported by ambulance to the doctor's office. He really didn't even examine her. The medical assistant took her blood pressure and he listened to her heart. Both could have been done at home by a visiting nurse. They're only insistent like this to run the bill up. No other reason.
If she has paperwork that states she doesn't want certain measures taken. Be sure you know where the copy is. And as hard as it is for you, you might have to let it happen. How high is her BP?
My husband had a low BP incident the other day. I called 911 and the medics wanted him to go to the hospital in an ambulance and be checked out. He wouldn't go, he happily signed the release slip. It is his life and I have to respect his decisions. He was mad at me because I called 911. I just let him know he had the rest of his life to get over his mad and I will do it again if I feel the need.
Is it the blood draw she objects to? As already mentioned, this can be made less painful. But it's never pleasant, esp. if frequent.
The medication? Some blood pressure meds, can make one feel lightheaded or dizzy (which, incidentally, increases chances of a fall). If this is the case, the doctor may adjust the dose, try a different medication or stop medication entirely.
If she is like many 87 year-olds, she would tell you, in all seriousness, that she would rather DIE than go into a "nursing home". This seems to be the greatest fear of people her age.
Virtually nothing will guarantee she stays out of a nursing home. And, as she well knows, there are many possible fatal outcomes at her age. She should be urged to at least discuss her preferences with you and her physician so that you can all be on the same page.
It may not be "stubbornness" on her part, but simply a sense of resignation, a willingness to face what is inevitable. Some elders simply grow weary of being analysed, treated, scanned, medicated, and subjected to various therapies. She might just consider your company the therapy of choice.
Legally, unless declared incompetent, it is her right to choose.
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