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Medical Forum / Diseases and Disorders / Alzheimer's / July 2006refusal to seek treatment
Just a newbie, poking around for some advice. Please help if you can. I am very concerned about my mother. She will be 70 this year. Last fall we began to be concerned about memory loss. This winter we lost my Dad suddenly. Now my mother is alone, although I live a few miles away and my brother's are out of state. Her friends are reporting frequent forgetfulness. She cannot comprehend simple math problems, and struggles to communicate effectively. She will repeat questions/stories within the same conversation. Despite all of this, she is completely unwilling to be medically evaluated. Her mother suffered from Alzheimers (TIAs) and passed away 6 years ago. My mother passed her doctor's cursory "memory quiz", and although my father and I have spoken to him several times in the last year, he is totally unhelpful in persuading my mother to seek treatment. Her friends have been unable to persuade her to go to the doctor either. They are calling me with "reports" of her recent forgetfulness. How am I supposed to handle this? If I call Adult Protective Services I will be opening Pandora's Box, but how do I convince an unwilling person to seek medical treatment for a disease they don't believe they have? Any advice would be appreciated. Please don't simply tell me to take her to the doctor. This would require actual physical force, something I'm not ready to do unless I have no other options. I need a practical way to convince her that she needs to seek treatment. Thank you, Kate > Just a newbie, poking around for some advice. Please help if you can. > [quoted text clipped - 18 lines] > to do unless I have no other options. I need a practical way to convince > her that she needs to seek treatment. Thank you, Kate Dear Kate, You are in the worst of dilemmas, and most all of us have been there at one point. I recall very vividly fearing what we might hear every time the phone rang when my mother in law was still living alone. We didn't know if she'd overdose on her medications accidentally, thinking she'd already taken them, or forget a pot on the stove and burn the house down, or get lost walking to the corner store. Before she would get evaluated and properly diagnosed, we feared the only thing that would get the situation to the forefront would be a disaster of some kind. The most important thing for you to realize is that just now, at this stage of the game, it is essential that you find a way to get a proper full gerontological workup done. There are illnesses that look exactly like alzheimers, that are not, and that are REVERSIBLE! You may have seen the commercial on TV where the man speaks about how impaired he was, but it turned out to be NPH (normal pressure hydrocephalus) and that now he is normal again. That is just one example of a reversible situation, and there are others. Also, if she DOES have alzheimers, you will be needing certain legal documents in order to care for her properly. Not to mention the fact that there are some excellent newer medications now that can slow the progression of the illness, and other medications to control the depression that so often accompanies it. You really need to get an appointment with her doctor and make a list of all the deficits that are being reported to you. You can tell him that this is getting worse and that you are getting more and more concerned about it. Then see if he realizes that there really is a problem. If he still fails to act towards helping you get a proper diagnosis, you might suggest that if anything bad happens, you will not fail to implicate him for ignoring a situation he has been made fully aware of. This would be especially true in the case of some of those reversible other causes.... Maybe you wouldn't actually sue him, but if he realized that you are serious about pursuing this, he might be more inclined to press for more testing. After all this is your mother! If all else fails, you can always wait and do nothing, as it will surely get worse, but in the meantime you don't know what sort of dangerous situations could occur. I already mentioned some of what we saw with my mother in law. She got worse rather quickly, in fact within a year it was way worse, and the few friends who had been in denial were actually calling us to come get her and do something about it, which we eventually did. Adult protective services is always an option, but as a last resort, because as you say, it might be seen in a bad light. In the meantime I would stay as close as you can, call often, tell her you love her and are worried about her and that you are there for her if she needs you. Enlist the help of your brothers too if you possibly can. Do all possible to inspire her confidence in you. Don't push too hard, she will just dig her heels in and the urge to resist your wishes will become automatic. Do little things for her in any way you can. Staying close and loving to her will only serve you both well. You might also consider that she could be fearing that what happened to her mother is happening to her, and attempting to deny it in any way she can. Add to this the fact she lost her husband very recently. It could be that she is just depressed, just as it could really be the start of alzheimers. At this point she still has some small amount of reasoning ability left. My mother in law did too, when we first realized something was wrong. But later on even that was gone. I wish I had some magic suggestion to help you get through this challenge effectively. The sad thing is that I don't. But if it is any comfort to you, we have all been through it, and wish you good luck in dealing with it. Keep abreast of the replies here, and feel free to ask more questions. There are a lot of really good people who post here, and it is an incredible resource.  SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') Its a tough one, and as E says below most of us have been here. I think Es suggestion about going to the doctor is a good one, perhaps prefaced with a letter so its in writing. Point out that he has so far refused to offer any treatment and you'll hold him liable for any harm that may come to her. Failing that you really dont have a whole heap of choices. You can wait for her to get worse (but even then she may still refuse treatment, my father certainly would have) or you could call in APS. No good choices there but with this disease thats often the way, you just make the best choice you can even if its a really crappy one. One other _strong_ suggestion, can you persuade her to sign legal and medical Powers Of Attorney now, before she is (eventually?) declared incompetent? This might be a real help later on. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com > >> Just a newbie, poking around for some advice. Please help if you can. [quoted text clipped - 94 lines] > questions. There are a lot of really good people who post here, and it is > an incredible resource. Kate, Is it possible that you could convince your mother that she needs to be evaluated for a different medical condition? If her mother had TIAs, perhaps she could be convinced that she needs to have a checkup with a neurologist who can insure that her blood flow is okay and that she gets any medication she needs to prevent it happening to her. You could tell her that you plan to get a checkup for yourself too. It's a long shot, but maybe it could help. As far as the specific doctor is concerned, maybe a doctor other than the one she's using would be a better idea. A neurologist would be much better equipped to evaluate her than would a general practitioner. If your mother has health insurance, you could call the insurer and ask what needs to be done to find a neurologist. They will very likely require a referral from the family doctor. If so, the next step might be to call him on the phone and see if he will give you a referral without requiring an examination of his own. Very often they won't, but if you list all the symptoms and press him, sometimes they'll give in. As Evelyn and Tumbleweed have said, this is all very hard. We've all been there. Most of us have been in situations that went well beyond the point where we knew intervention was required but we weren't able to find any way to intervene. You are right to be concerned about all this, but don't let it consume you. There is only so much that each of us can do. You are doing the right things. You need to continue to do the right things. But you also need to recognize that the situation is not really under your control. Bad things happen to most of us when we get old. Our children are not able to prevent most of them. Best of luck. Alan Thank you for the very empathetic and helpful responses. I know this group has alot of collective wisdom to share, and I'm so glad I found it! Regarding her primary care physician - I spoke to him on the phone and it was a very nasty conversation. He basically became very defensive and explained that it was my mother's choice whether or not she sought treatment. He said his only other option was to have her committed against her will. Naturally this was not appealing. He agreed to have an appointment with her the next day after our conversation. My pan was to go and pick her up at home and take her to the doctor's. But apparently, they called that morning with an appointment reminder. My only guess is that she figured she had forgotten, and went to the appointment on her own. The doctor told me how the appointment went. He said she passed the memory test (remember these three things) with flying colors. He referred her to the neurologist and scheduled a CAT scan. On the day of the CAT scan she refused to go when I called to ask if she wanted me there as company. On the day of the neurologist appointment, my brother was visiting from New York. He attempted to talk her into going, but was unsuccessful. This was in April, and any discussion of her health has since ceased. Her forgetfulness has increased, and recent problems with simple calculations and logical reasoning have recently surfaced. I am afraid to discuss with her attorney the problems I suspect because things may be taken out of our control completely. She has an estate trustee handling my father's estate. If he knows that her decision-making ability is at risk, can he file papers to declare her incompetent? I guess I'm just at a loss as to what to do next. Her friends are all waiting for the family to do something, and we are paralyzed by this powerful woman's refusal to seek any kind of help.She has already begun to automatically refuse my suggestions. I am the "bad daughter" who wants to interfere. But I am the only one here everyday. I just feel so helpless. I miss my dad so much. Without him our family has lost its anchor. And I fear my mother is caught in a whirpool. How long till she gets to the middle and is pulled down forever? Kate > Thank you for the very empathetic and helpful responses. I know this > group has alot of collective wisdom to share, and I'm so glad I found it! [quoted text clipped - 36 lines] > > Kate This is pretty much standard, an dits likley things will get worse before they get better. (think 'better' in a relative way, not actually better. But this stage of Az can be the hardest to deal with. So, you seemingly have to choose from 3 crap choices; 1)do nothing 2)call APS 3)talk to the attorney. [You say you are afraid to call the attorney because "things may be taken out of your hands". Forgive me for being blunt but it doesnt sound like they are in your hands in any way shape or form.] In any event dont get trapped into thinking there is a good choice somewhere that you have missed, sounds like there isnt. Whilst you wait, it would certainly come in useful for 2&3 if you can document every single call from a neighbour or friend, what the reported behaviour was and so on. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com > In any event dont get trapped into thinking there is a good choice somewhere > that you have missed, sounds like there isnt. Whilst you wait, it would > certainly come in useful for 2&3 if you can document every single call from > a neighbour or friend, what the reported behaviour was and so on. in addition, a good written record could be used to either remind the doc that his failure to take action could make him liable for any injury resulting from that failure, or to get adult protective services involved. like he said, events are already out of your hands, so talking to the trust attorney first would be a wise thing to do. it's very possible your father was aware that she was having problems and made some provision for it. at the very least, she/he might know who has the durable powers of attorney for her business affairs and health matters. it's a pity your parents weren't candid with you about these matters. in my family we have been so, and everyone knows what everyone else wants --- and we have all executed POAs and living wills to ensure that it happens. Old people live like old people.....and accept what happens to them.....But I refuse to do It ,I try to keep my mind working as much as I can and Write everything down.....Like important phone calls from people that want to drill on our land or Lay pipelines.... what ever they want.....My husband expects it from me and I try to keep up.....instead of just give up....I am in my 6th year of alzheimers.... Old people live like old people.....and accept what happens to them.....But I refuse to do It ,I try to keep my mind working as much as I can and Write everything down.....Like important phone calls from people that want to drill on our land or Lay pipelines.... what ever they want.....My husband expects it from me and I try to keep up.....instead of just give up....I am in my 6th year of alzheimers.... ------------------------------------------------------------------------------ Easter Stephens Dear Easter, Good for you! I am sure it is a good thing to try and stay as active an on top of things as is possible. I also hope you have good and loving family members around you who can help if it gets to be too much. -- Best Regards, Evelyn (to reply to me personally, remove 'sox') Again - many thanks for the advice. I have already made one change in my behavior towards my mother, and I think it's the influence of this calm group! Yesterday when she began yelling at me about interfering (was trying to fix the phones that got killed by lightning on Sunday), I calmly told her not to yell at me, that it was inappropriate. To my ever so appropriate mother that was like a slap in the face. And it shut her right up so I could finish getting the phones back together again. Then, her housekeeper told me that my mother has yet to pay the citation for her "fender bender" a few weeks ago. I smiled, and looked at the housekeeper, and said "We will all stop covering for her. So please don't remind her anymore." Maybe I'm wrong to do this, but I think she has to fail in order to see how far she's gone. So if it costs her driving license, maybe she will finally come to realize. And would it be so horrible if she lost her license anyway? No more U-turns from the right hand lane!!! Will check in later Kate > Maybe I'm wrong to do this, but I think she has to > fail in order to see how far she's gone. So if it costs her driving > license, maybe she will finally come to realize. And would it be so > horrible if she lost her license anyway? No more U-turns from the right > hand lane!!! you need to alert state authorities and if the doctor gave an ALZ diagnosis in writing, to send them a copy! she should NOT be driving, period. please, for the sake of everyone else on the road, get her license taken away! if you can, get someone else to be the bad person that does it, but make sure it gets happens. > you need to alert state authorities and if the doctor gave an ALZ > diagnosis in writing, to send them a copy! she should NOT be > driving, period. please, for the sake of everyone else on the > road, get her license taken away! if you can, get someone else > to be the bad person that does it, but make sure it gets happens. umm...maybe you missed my first post, but I have been completely unable to get my mother to see a neurologist - much less get any kind of diagnosis. And I don't think that calling the cops on her is going to improve our relationship in any way. I am hoping that by neglecting to take care of things, she will in effect cause the revoking of her license all by herself. Without a diagnosis I cannot take the steps you demand I take. So please do not imply that the health and safety of everyone on the road depends on me. Your advice came across as finger-wagging, at least that's how I interpret it. It was not very helpful. Kate > I am hoping that by neglecting to take care of things, she will in effect > cause the revoking of her license all by herself. yeh, maybe she'll run someone over all by herself and then get her licence revoked, that'll work. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com Geeze Louise, Kate is Not Responsible for this if she does..... Elderly adults who have not been diagnosed with dementia have legal rights. They do what they want to do. Any person with a brain drives defensively, because there are some of these people on the road, and some young drunks, and old drunks, and epileptics who are not taking their medication and unlicensed drivers and a RAFT of other dangerous sorts. People who are prone to heart disease and stroke, folks who forgot their glasses at home....... SignatureLes yeh, maybe she'll run someone over all by herself and then get her licence revoked, that'll work. SignatureTumbleweed Nice. Very nice. Would you prefer I put my mother in handcuffs and drag her by the hair to the doctor's office to get a diagnosis. Then I can call the state police and the DMV and the Division of Highways and the ASPCA. Then, well, why don't I lock her in a room by herself so it's impossible that she could hurt anyone else. Because if I do all of that, I'll be taking responsibility, right? I shouldn't worry about how this will all affect my mother, because it's everyone else out there that matters, right? After the wisdom of your previous posts, I was surprised that you should lay this on me. Very hurtful response - not appreciated. >> I am hoping that by neglecting to take care of things, she will in effect >> cause the revoking of her license all by herself. > > yeh, maybe she'll run someone over all by herself and then get her licence > revoked, that'll work. > Nice. > Very nice. [quoted text clipped - 10 lines] > lay this on me. > Very hurtful response - not appreciated. Dear Kate. Tumbleweed and Dennis mean well and they both know I love them, but they can come across too strongly at times. We do all know what you are going through. I certainly know! My father just renewed his license BY MAIL..... AUTOMATICALLY at 93!!!! Yeah it sux! He claims he doesn't drive anymore, that he just wants the license for whatever... but he also still owns a car, and keeps the insurance up etc. Legally he can get into his car and drive wherever he wants. Scary isn't it? I can't even get the man to speak to me on the phone, much less to tell him what to do. He has no diagnosis in place either. I don't have POA on him, nor does my brother. My sister who does have POA is consumed with her own problems and is not for "rocking the boat" in any way. After all, he is still in sufficiently legal sound mind to change his will........no matter what his vascular tests show. Come to think of it, I think I know what your mother is afraid of. If she gets a diagnosis, it is a label of some kind and she is afraid that she will lose control of her life. So what does she do? She resists with all she's got, not to get to the doctor or let anyone pin that label on her. Very nice. For you and for her and for everyone she meets on the road. We aren't always in control of our loved ones, no matter even if we see disaster looming. Just hang in there and do the best you can. There just aren't always easy or doable solutions for parents who are nearing the end of their independent days and who are hanging on for dear life....... and heaven help the child who tries to interfere with that. One poster here that I know of personally, can tell you what happened when she tried to read her stubborn and willful father the riot act about several issues..... (that is if she is still reading). He drew back and completely alienated from her. She was dead right, but now she has no input, and she was deeply concerned and tried hard to do the right thing. To the person I have in mind, if you are still reading here, it might be time to chime in. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') Hi, Evelyn -- Glad someone remembers me -- even for infamous acts! I do check in once in a while and see what's up with everyone, but I have little to contribute. In the last 10 months, I have had a grand total of four phone conversations and two letters from my parents, one to tell me I no longer had POA and one to tell me they were moving. My situation is a little different from Kate's -- both my parents are alive and the problem is not my mother with dementia but my dad who has other serious health issues but insists he can take care of my mom, keep up the house, and hold down a job at the age of 70. For the last year, I had repeated conversations with him about how Mom needed more care due to her dementia and diabetes that was what they call fragile -- her blood sugar was quite erratic and hard to control. He was irritated with me, but made some of the changes I suggested. Then he had a serious health scare (his heart stopped and he totalled his car, crash restarted heart, pacemaker implanted that day, pacemaker later infected, second 7-day hospital stay to remove it and replace it ) which meant I had to move in with Mom and discovered just how bad things still were despite his claims to the contrary. After he recovered, I told him I thought he needed to move someplace where he could get help with meals, cleaning, and extra help for Mom. He basically threw me out of the house -- though he then moved somewhere he could get a bit more help, though not as much as I thought he needed. Since then we have had little contact. He has totalled another car, he had my mother execute another POA to take me out of the picture and changed his so that I must function in concert with my brother, with whom he has little contact as well. She has had a cancer scare which fortunately came to nothing, and he has had prostate surgery (but nothing was wrong with his prostate, he assures me.) Mom does not drive and is no danger to herself or others. She tries very hard -- like Easter, whose posts I love reading -- to keep herself as functioning and well as possible. My dad is an idiot, but he is mentally competent. He has the right to make all the bad decisions he wants (including the one he just made to move back out of the retirement community they moved to, claiming Mom was disoriented because their apartment was so small. I suspect she is disoriented, period, and the move will make her only more so.) I have lots of people keeping an eye on him, from his banker to the people in his church, and they let me know how things are going. (I have also put in some words with people in high places, but would rather not go into that on a public forum.) When he wants my help, he can ask for it, but I refuse to take any more of the abuse he heaped on me growing up. Mom has also made her choice to side with him. It hurts. Deeply. But I don't regret what I did and would do it again tomorrow. I spoke the truth in the most loving way I could. I must also respect the fact that they are adult human beings with the right to choose. Dad has made poorly reasoned choices throughout his life, and Mom has always sided with him, no matter what. He is her world -- who am I to take that away from her? There are worse things than having someone mad at you. I found I had to speak my mind -- normally something my father respects but not from his daughter or son. <G> Now -- Kate has a different situation. If only one of my parents were alive, I would feel the need to take a more proactive role. But what it comes down to, Kate, is doing what is right for you and your situation. Am I sure I did the right thing? Of course not. I second-guess myself constantly, but I would do that no matter what I had done. At least I am at peace with myself, and my stress-related illnesses have had a miraculous <G> remission. Did the opinions I heard here help me? Yes. Tumbleweed and Dennis helped me find a spine, Evelyn helped reassure me when the worst happened, and many others chimed in with good thoughts and cyber hugs and back pats. I needed all of them. Listen to all the advice you get, mull it over, then go with your heart and your gut. Peace, Songbird Songbird, so glad you posted. Sorry things aren't any better, but glad that you have accepted it all (as much as possible) and your illnesses are in remission. That is very good news. Still wishing you the best. Gwen > Hi, Evelyn -- Glad someone remembers me -- even for infamous acts! > [quoted text clipped - 71 lines] > > Peace, Songbird Dear Songbird, I am so glad you replied and gave us an update. We miss you around here! :-) SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') > Hi, Evelyn -- Glad someone remembers me -- even for infamous acts! > [quoted text clipped - 71 lines] > > Peace, Songbird Evelyn, I have wondered about her also. Gwen >> Nice. >> Very nice. [quoted text clipped - 54 lines] > To the person I have in mind, if you are still reading here, it might be > time to chime in. Imagine yourself having the following conversation with the parent of the person your mother just killed in a traffic 'accident'. "yes, I knew she was unsafe to drive but I didnt report her because I thought it would upset her." Now who is being hurtful? Handcuffs aren't needed, just a letter to the DMV. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com > Nice. > Very nice. [quoted text clipped - 16 lines] >> yeh, maybe she'll run someone over all by herself and then get her >> licence revoked, that'll work. > Imagine yourself having the following conversation with the parent of the > person your mother just killed in a traffic 'accident'. [quoted text clipped - 5 lines] > > Handcuffs aren't needed, just a letter to the DMV. I have written and deleted several replies to this post. I came here to find out how to get my mother to go to the doctor. You would have me circumvent the medical profession entirely, and be all mighty judge of my mother's abilities. I am not afraid to "upset" my mother. I've done it all my life. The DMV is not going to revoke my mother's driving priveleges on the word of her concerned daughter. They will require a medical diagnosis of some sort. So if you could please stop making me responsible for the safety of everyone on the road, I would appreciate it. I need advice on how to get an unwilling person to see a neurologist. Anything useful on that front? Or are you just good at assigning responsibility? Hey Kate, if you do what you say in this post to an undiagnosed elderly woman, what you will get is arrested for elder abuse. The ASPCA. Good one. You have to take what you read online with a grain of salt. SignatureLesanne > Nice. > Very nice. [quoted text clipped - 16 lines] >> yeh, maybe she'll run someone over all by herself and then get her >> licence revoked, that'll work. Don't fret Lesanne. No elder abuse here. Just extreme sarcasm. It just really ticked me off that I came here for help and all of a sudden I'm this horrible person who is putting lives at risk. But you are right, and the grain of salt is always present. Thanks Kate > Hey Kate, if you do what you say in this post to an undiagnosed elderly > woman, what you will get is arrested for elder abuse. The ASPCA. [quoted text clipped - 20 lines] >>> yeh, maybe she'll run someone over all by herself and then get her >>> licence revoked, that'll work. Hi Kate......I went thru some of the same things only my mother has the dementia and my brother had the denial. I've posted before what I did and I will give you the short version. My mother had a Florida driver's license and I knew she shouldn't be driving. I went online to the Florida BMV in 2001 and reported her. This can be done anonymously. A doctors statement that she was capable of driving would have been all she needed and actually my brother found one that would do it for the price of an office call. He wanted my mother to go to the doctors office to get it. Of course she couldn't remember to do it and Mom license was suspended when she didn't show for the drivers test at the bureau of motor vehicles in Florida. If you can't bring yourself to do it then get a friend to do it and you can plead innocence. Maybe then she will go to the doctor to prove she can drive. Just a thought. BTW my brother finally realized that mom shouldn't be driving when he tried to help her pass a drivers test in Indiana.....June > Don't fret Lesanne. > No elder abuse here. [quoted text clipped - 28 lines] >>>> yeh, maybe she'll run someone over all by herself and then get her >>>> licence revoked, that'll work. Find her a webtv...and let her find a life if you can call it that...I found out 6 years ago that I have Alzheimers....My DIL got me my webtv and I have met so many nice people on here I really think it is keeping me almost or close to sane.....I still take care of my self and spend a lot of time alone but have met so many nice people On Webtv..... That's a wonderful idea. She has been wanting a computer, but has never used one before. WebTV would be easier for her to use. I hereby pledge that before the end of July she will be up and running. The only issue is she might forget how to use it.....would simple written instructions help? kate Find her a webtv...and let her find a life if you can call it that...I found out 6 years ago that I have Alzheimers....My DIL got me my webtv and I have met so many nice people on here I really think it is keeping me almost or close to sane.....I still take care of my self and spend a lot of time alone but have met so many nice people On Webtv..... Easter Stephens > That's a wonderful idea. She has been wanting a computer, but has never > used one before. WebTV would be easier for her to use. I hereby pledge > that before the end of July she will be up and running. The only issue is > she might forget how to use it.....would simple written instructions help? unlikely if she keeps forgetting, all you can do is try. Might help for a while, but sooner or later she'll forget there are instructions. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com > The only issue is > she might forget how to use it.....would simple written instructions help? nope. new things are the hardest to learn. my mother bought a mac "to write a book" but could never figure out where she had saved stuff, and never quite got it about using a mouse, either. > Find her a webtv...and let her find a life if you can call it that...I > found out 6 years ago that I have Alzheimers....My DIL got me my webtv [quoted text clipped - 3 lines] > >> Easter Stephens what drugs have you been prescribed? To be using a webTV or similar technology after 6 years with Az is pretty remarkable. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com I'm Taking Aricept and nemenda twice aday...May have got that one spelled wrong... |
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