Irresponsible or loving daughter?

Dear Rosses,

I'm so sorry to hear how your mom is feeling. I know its very difficult. I can totally sympathize and empathize with your struggle. We all want to do what are parents want, but its a struggle as their health declines.

Please try to talk to your mom more and try to find out what she truly wants. I would still consider taking her to a doctor for an evaluation. I think the more information the better. Maybe they can recommend something to make her more comfortable even.

I had the same struggle with my dad. He was a smoker his whole life, never ate well. But he managed to get to 81 without taking a pill. After his stroke he ended up on 10 pills and almost starved to death in 3 months. We cut back on his pills and he seemed to be doing better for awhile. But then he got stubborn and didn't want to take any pills. I let him get away with it instead of arguing with him. He died at 84 of heart failure. It was his life. His choice. I never wanted him to suffer and have no joy. But in hindsight, I still wished I found another way. I want so badly for my dad to still be alive and with me.

Sorry Rosses. I hope you make the right choice for your mom and you. Thinking of you.

Well, she could get hooked on the pain killers, but unfortunately so be it unless you can find Holistic measures and even that isn't going to touch that type of pain.

Rosses, it seems that your mother is not very well. You must consult a doctor quickly since a doctor will be able to prescribe medicines according to her current health condition. As your mother is in severe pain, you can give her pain killers as prescribed by a doctor. However, you must visit the doctor who treated your mother's cancer and explain the problems your mother has been facing. Doctors will likely never disappoint you and you can rely on them for prescribing the needed medications. To assist with her depression, you might want to encourage her to watch a TV series or movie, listen to music, or even play a board game with her like Snake and Ladder. This will help give her some relief to her medical issues and get her happy days back soon.

Try not to allow the stress of the situation cause you to doubt yourself.
God knows your heart.

Thanks..from my heart, to all of you for responding. Having someone that actually can relate give ideas and advice is priceless, and all of you did that for me! It's amazing how people we don't know in person can care and worry enough to help and offer support, that's why this website is a blessing! I'm trying to find ways to deal with the situation, researching what's available here, if nothing else I'll consider getting help for myself (seeing a psychiatrist, exercising, meditating, etc) so I can think about this with some clarity and more energy. The conclusion I get to and I think we all get to the same conclusion is that the situation won't change, WE have to change. Not easy at all, terribly hard actually, yet necessary. Thanks so much again and God bless!!

Read Being Mortal: Medicine and What Matters in the End
by Atul Gawande. It gives 5 questions to help guide you through these difficult times. As far as depression goes, answering these questions may help, but I am struggling with: when is it fine to be unhappy with life's circumstances, and it not be considered depression and just realizing physical suffering is not pleasant, and unending. As ContraryMary put it life is not enjoyable and there is no chance that joy can not again be obtained. I have 3 octogenarians and 1 95y/o with very different health issues and the most significant thing for each of them is to feel someone is truly listening to them.

I am a 73 yr old US citizen. Believe me when I tell you the BEST thing you can do for your mother is to listen to what she has to say. I have been on dialysis for the last eight years. A kidney transplant is out of the question at this stage of my life. I also have other health problems that make it difficult for me to dress just to go three times a week to the clinic for dialysis. There isn't a day that goes by that I wish I could die. I hurt so much sometimes. I am also lonely ...missing my husband who died two years ago on my Birthday.
My three children, two sons and a daughter constantly fight about who needs to take off of work to take me to appointments....often times in my presence.
So I am tired of it all. I saw a doctor the other day and discussed stopping my dialysis and what happens when one does. He agreed with me that it is strictly my choice...if I chose to do so. And that I could be kept comfortable till the end. Do I really want to leave my precious little grand and great grand children? No. But life is not too enjoyable anymore. I don't get to see them very often. Some times I can hardly walk and I keep having falls.
When I tell you to listen to your mom, I mean let her express her feelings. Tell her you understand how she feels, that you love her and you realize she's not enjoying life because of her discomfort. Tell her you want her to enjoy her last days as much as possible. Also try to do things she enjoys as often as possible. She will probably enjoy it very much. My love to both of you.

Maybe look for a different type of healing for her and more importantly you. I am in the same boat to some degree with a very difficult mother and have just been through a horrible medical situation with my dad and he died 2 months later.

Functional medicine that look at cause. A tibetan Doctor who will only have to check her urine and feel her pulse to diagnose and give herbs if she would take them. (A Tibetan Doctor will work to the spiritual level of a person)

There are Herbalists and Naturopaths, etc maybe these type of healers your mum maybe more open to as the main stream medical can be extremely severe.

With the complex relationship you need to have someone you can talk to regularly and the only way out is to go within - meditate (learn a simple breathing exercise, enough to stop your mind whizzing around and get some clarity.)

We want to help so much but if they dont want it then it maybe about us letting go and that is not easy if you have a strong connection and as I you will need help. I am arrogant enough to think that it was better to take care of my parents myself than leave to others etc but maybe I am wrong. All I know now is I am so depleted from it all and I need the healing myself and maybe that is your story as well that you have to see to you first (otherwise we compound the situation by our own energy)

You can google all sorts of meditations if you are not doing it already give it a go. Ideas and thoughts will come through and maybe give you some more insight and another perception of where you are and what options you have and what action to take.

I wish you all the love and hope you get some really good help around you.
With love
Paula

That is spot on correct. You cannot handle it alone. That's why so many here on this topic are saying to get Hospice or VNA (Visiting Nurse Assn) involved.

Hello Rosses. I would recognise You as a Loving Daughter. You are seeing to it that Your Mom's wishes are carried out in full, and it's Your Mom's decision. Your Mom does not want Her Life prolonged to suffer more agony needlessly since She may feel She's Lived a good long fruitful and happy Life up until the cancer.
My Mother was of the same Generation as Your Mom, and that is what She wished " to die in Her own home, in Her own bed.
Since there is no Hospice in Your Area, ask Your Local Hospital would They send a Nurse to assist and relieve Your Moms suffering.

@ACOMNM, I have never heard of that and I find it really hard to fathom how that would be possible, especially in the current environment where abuse of painkillers is a huge issue. All I take is anti-anxiety meds but I can't even get a refill without seeing my doctor every 3 months. Previously when I was taking a different drug that was more controlled (for ADHD), I had to see my prescribing psych *every month* to get a *written prescription* to take to the pharmacy. So while your idea sounds promising, I doubt it would work. It might have been something that could be done 10 years ago, but not now.

Re: the OP's issue with her mom, I totally sympathize. My mom is in her early 80s and doesn't feel well. She's a melanoma survivor, but not interested in seeing a skin doctor to check everything out. She's got cataracts in both eyes, so she can barely see and can't read anymore, and reading used to be her favorite pastime! But she won't get cataract surgery. I take her to her regular GP appointments and lab test appointments, and she sees a headache specialist (she suffers from chronic headaches due to a sinus condition, and that is the one thing she will tolerate specialist visits for!) I've also felt helpless and wondered if I'm doing the right thing by abiding by her wishes. I agree with others who have said you need to take care of yourself, and also see if you can take her to a "pain doctor" (wink wink) who might prescribe her some antidepressant or anti-anxiety meds. (Anxiety and pain can be related.) Wishing you well and I hope you'll come back and check in with us so we know how it's going!

IMO, persons with real clinical depression are not capable of choosing wisely or making good decisions. Treat the depression.

Let your mom know that pan relief is simply that - pain relief. It does not take the place of curative medicines nor does it stray from her obvious wishes. It will however allow her to have some pain relief as her condition progresses and she is able to make the personal decision as to what type of pain relief she prefers. It will also enable her and you to have some more relaxing moments where you can share thoughts and memories beofre the oportunity has passed. Deep breath - her difficult behaviors have a lot of frustration, anger, and loss of control in the mix. Let her vent and let her know you are there. Some times it is the best and most we can do. You will never look back with regrets that way.
Diane

You mention there is no hospice, but can a visiting nurse or doctor come to the house? Perhaps she would accept the visit in the comfort of her own surroundings.
I would certainly talk with the person beforehand to make them fully aware of her wishes.

I, too, have a VERY "difficult" mother. The problem with everyone telling you to "just get pain meds" is that just about every medical professional who can prescribe pain meds is going to insist on finding out what is causing the pain--even if your mother is going to refuse to be treated for the cause of the pain--so they will want blood lab results, scans/images, etc.

One option that might work--with some up-front work from you--is a psychiatrist. Psychiatrists *usually* have no problem "seeing" a patient on the telephone. They often prescribe even Scheduled/"drugs of abuse" (like serious pain meds) from "seeing" the patient on the telephone. My suggestion is to reach out to your friends (or other family, if you are comfortable with that), professionals you know, or your favorite of your mother's doctors and ask for a referral to a psychiatrist.

You could make an initial appointment for you mother but go yourself--take your mom's recent medical records, the names and numbers of a couple of her best doctors (if the psychiatrist wants to confer), and some recent photos [showing you with her] or phone video of your mom [and you--ideally just before you leave, wearing the same clothes].

Explain the situation. Call your mom (make sure she knows you're going to call) and put her on speakerphone and introduce her. Let the psychiatrist do some Q and A. (The psychiatrist has to be sure that you aren't there drug-seeking for yourself. Volunteer to step outside so they can speak privately.)

If your mother has a problem with psychiatrists (like mine would!), just tell mom the psychiatrist is a "pain doctor" (and don't forget to tell the psychiatrist what you told mom and why). You may need a signed health care proxy where you are, I do not know. If nothing else, have mom write (or at least sign--video the signing on your phone if you can) a simple one-page document that says something like:

"I am [name] and I am [age]. I know, want, and have agreed for my daughter, [your name on ID], to see you today [date], [Dr. Name], to discuss my medical condition, problems, and desires. My daughter is my primary caregiver and is the person who best knows my medical conditions and my wishes not to have additional medical procedures. To assist her, I have provided her with my medical records for your review."

"I refused to go with her to see you today, because as she knows, my wish is to stay at home and have no further medical appointments or hospital stays. My wish for the outcome of her visit with you is that you will agree to "see" me by phone, and that you will prescribe me medication(s) that will relieve my constant pain, which on a scale of 1-10, is a constant [#], and has been so for [# of weeks/months]. I look forward to your call today and I hope you can help me. Thank you.
[Mom's signature and printed name]
[Mom's phone number and address] "

That's the best advice I have if you cannot find someone who will do a home visit, or cannot find a palliative care clinic. My advice assumes that you have already called you favorite of your mom's doctors to ask for a Rx for pain meds for her without success. Oh, and be sure to know her height and weight.

Hi, I would like to suggest something that is a little out of the ordinary. My Mom is 92 and has very little health issues. She still drives but only to the Senior Center and back every week day. She still lives in her own house too. However, a couple of years ago I spent the weekend with my sister-inlaw whose now 100 year old Mom lives with her. We took her Mom with us to get pedicures. I had never done anything like that before and saw how much her Mom enjoyed getting her feet and hands done. Afterwards we went out to lunch. It was a kind of girls day out that she does with her Mom about once a month.

I started doing this with my Mom on one of our shopping trips. I take my Mom shopping on the weekends. One weekend I asked her if she would like to get a pedicure or manicure or both. She opted for both since I wanted to get both. She loved it. We then went out to eat and then shopped for groceries.

This developed into getting a massage once a month and facial or pedicure/manicure. Sometimes if the money allows it we opt for twice a month massages. My Mom also likes to get her hair done. So I now set up appointments every weekend for her to get her hair done. On other weekends we get the massages or pedicures and manicures.

My Mom's doctor is amazed by how healthy my Mom is because the massages keep her circulation healthy, it helps with Mom's mental state and keeps her from getting depressed. My Mom looks forward to my coming by to take her shopping as she never knows for certain if we are getting massages or her hair done. She kind of likes not knowing until I pick her up. She will say, what are we doing this weekend and just smiles.

I recently took my mom to a geriatric Doctor so that she would have a primary care doctor to oversee her whole condition. I just moved her near me a couple of months ago. She's on about 12 medications for her heart and high cholesterol. The whole appt. got me so stressed out because of her defiant personality that I ended up with chest pains the rest of the day, not heart related, but stress related. She was refusing every test the doctor was recommending and calcium for her bones. She kept saying she had cardiologist before and that's all she needs. Her ankles are swollen which tells me the medications may not be enough. I am going to set up an appt. with a cardiologist, which she will see, but just saying I empathize with you. I know how stressful it can be when as a daughter you want to do all you can to help, but your mom refuses as you see her condition worsening. I guess as others have commented, it's her choice, and I've told her if she ends up in the hospital or assisted care, then she can't say I didn't warn her.

Loving daughter.

I know this doesn't answer the global issue, but someone once mentioned there are creams that can be infused with narcotic pain killers that are applied topically or even pain patches. At least those would bypass stomach irritation? I'm sure you've probably checked, but would she let a provider come to her at home (house call)?

To help your mom along, you could say something like "it's okay if you want to go; I'll be fine" so she doesn't hang on thinking she has all these responsibilities. I would look into seeing if there is a doctor in your area who would make a house call. If so, that doctor could provide pain management.

I took my mother to have her port removed because she has been in remission from her cancer for 8 yrs, she's 84. I was told she could not be treated anyway if it came back because of her other health problems, heart failure, kidney failure, ect. One of her doctors was very kind and helpful to ME and he told me to cut out most of her doctors that they were just keeping the money wheel turning and we all are dying the minute we are born!!! I cut out half her doctors.

If hospice or palliative care is not available, you could research various modes of pain relief, other than pills. Or you could wait until an emergency, and attempt to get the doctor to prescribe a med regime that is followed up with phone calls, only.

My dad reached that point, except he was planning to do to his next doctor's appointment and tell him - he was still on his "cancer" meds - that he was going to quit, only problem he had his doctor's mixed up and didn't really have an appointment with who he thought he did and looking back, not sure I really realized it at the time - mistake # how many? - anyway, before the appointment he did have he did wind up with an emergency situation that resulted in him winding up in the hospital, which could happen with your mom, if, I suppose, if you allow it at that point; maybe we should research those laws; I know someone who didn't even do that with their dad at that point because he'd said earlier he didn't want it

"She has a very difficult personality, yet and because of that I know I am the only person that can take care of her." The 2nd half of that statement is a perception -- not a fact. Mom is an emotional vampire. And her mind games are overcomplicating something that is already sad and difficult -- for both of you.

Your mother does not acknowledge where she ends and where you begin (and she's always been that way, right?). You need to work double-time at healthy boundaries. Is it fair? No. Is it just as important as mom's medical issues? Yes.

Whatever path you choose, remember that after mom is gone, there will still be YOU. I urge you to find a way to be there for mom that allows you to retain your own life, your own relationships and your own ability to earn an income.

Rosses -- I am 85 year old woman in fair health who has instructed my children to contact hospice if I reach a point where I would be eligible for their services. If hospice isn't available her country, ask a church if something similar exists there.

rosses, I totally understand the way you set up this question. You can force her to do a little something, the question is what. When my mother says 'I want to die,' I tell her unfortunately she doesn't get to choose that, only what state she's in if her body still won't give up. Your mom is choosing misery NOT death, and if you agree you may find a way to gently point that out here and there. No one rightly chooses that, so you may find a way to get her connected to a care service anyway, and be ready for a fight and her not talking to you for a few days. How about searching for articles or youtube videos on 'people stubbornly rejecting pain relief' (I'd bet money they're out there) and read or show them to her. You know, words from other people vs. the silly daughter (I'm one, too). And get going on the 'second' item, care and coaching for you! I feel the SAME way, I take on too much of how my mother feels and you want to stay on top of that. Pulling for you!!

Bless your Mother sounds like she has been through a lot. Maybe you could talk to Hospice and they could come to the house and check your Mother out. Hospice could then contact her doctor and go from there to see what can be done to help your Mother. Your Mother is a lucky lady to have a daughter like you. Good luck to all of you..

Thank you all for taking the time to write. It's a very difficult situation..as all of our individual situations are, I know all who visit here are or have gone through a lot. My mom is kind of right in that she prefers to endure the pain rather than taking pills that will cause worst harm to her stomach. Yet, I know at some point the situation will get out of hand, mine and her hands. Someone told me a while ago that my mom's situation was way beyond being something that I could handle alone. Like I mentioned, aside from being sick she has a very difficult personality, yet and because of that I know I am the only person that can take care of her. Thank you church mouse for researching Nicaragua's resources. The thing is doctors want to see her in person, and she just doesn't want to be seen. It's because really it's non stop for her, if not the pain that she always has in her entire body, it's her teeth, her eyes, ears, hand..etc..you name it. Something is always failing, so we act only when she has no choice, so when not an emergency per se, she just doesn't want doctors.
When the moment comes, and I know somehow it will, we will have no choice but to seek medical help. Will continue researching palliative care options, although outside the US medical assistance of that type is not easily found. Thanks again for giving me feedback. I just hope I remain strong.

Rosses, you are suffering a lot having to watch your mother feel so bad. What you might try is to ask her to go to the doctor for you. Tell her that it would make you feel better to know why she was having pain and feeling so bad. Assure her that she doesn't have to do anything she doesn't want to, but maybe the doctor will know what's causing the discomfort and how to make it better. If you mother knows she is doing it for you, maybe she will do it.

If you google "palliative care in Nicaragua" you'll see a site called "Rewired and Retired" which has a whole section on pain control and many of the legal and ethical issues that might come up.

On the question of your responsibility to "push" medical intervention or not, if your mother is of sound mind then she is responsible for her own decisions. That doesn't mean you can't urge her to seek professional advice, and you can reassure her that no doctor in any country is going to force onerous, heroic treatments on her against her will - that really would be unethical in any language. But there will be a good deal they can do to make her much more comfortable. I hope you find a sympathetic practitioner very soon.