What do you do when your parent refuses to go to the MD for evaluation?

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PattyC - 16 Aug 2007 02:50 GMT

Hi All,

I have been worrying about my Mom for some time, but recently her cognitive
decline seems to have accelerated. We had some family stress (death in the
family), she ended up in the ER with near fainting, came & stayed with me
for a couple weeks.

In any case, that one-on-one time convinced me it's time to start
considering where we are going here. I am an RN and know about a lot of
these types of things. I have worked with people with brain injuries, and
understand at least some of the ways that can demonstrate itself.

Nonetheless, I cannot seem to in any way "handle" my Mom. I scheduled her
for an eval at a geriatric center, starting with an MD appt., then a
Psychiatrist 2 weeks later. I talked to her very good and nice PCP who (at
an appt. today) supported the idea and told my Mom he recommended it.

She outright said she is NOT going; she wants to be independent, etc. (She
seems to be seeing this action as a move toward "putting her in a home.") I
am all for keeping her in the community as long as possible, but also am now
fearing for her safety. She's not incompetent enough to have her declared
incompetent...

My mother can be so depressed & hostile. Actually, she could be so in her
best days. Those qualities seem to be the ones that are enhanced by her
cognitive difficulties. I don't know how to help her if I can't get her to
where help is...

PattyC

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august - 16 Aug 2007 03:51 GMT

> Hi All,
>
[quoted text clipped - 25 lines]
>
> PattyC

The early stages of the disease are in many ways the worst for caregivers to
deal with because this is when denial and suspicion are often at their
highest. Since she is not yet incompetant it can be very difficult to get
her in for an evaluation. Do not mention seeing a psychiatrist. For many
older people the stigma of seeing a shrink means they would never agree to
seeing a psychiatrist even if it was obvious that this was a logical step.
You need to begin learning to fib artfully. "He is an elder care Dr who does
some psychiatry on the side because he does not have enough elder care
patients" - whatever it takes to get her in for an evaluation. Remember you
are not speaking with someone who can make logical decisions or have
balanced discussions. Long discussions about anything serious are not a good
idea in dealing with someone with dementia. Discussion often just raises the
fear level and does not accomplish what needs to be done. Hopefully some of
the others will have better suggestions but in the meantime, order and read
a copy of The 36 Hour Day.
http://www.amazon.com/exec/obidos/ASIN/0446610410/bookstorenow57-20 This
book contains info and strategies from earliest stages to end stage disease.

It's too bad she will not go in for an evaluation. Many types of cognitive
decline may be related to things other than AD and some can be corrected.
Even if she does have AD the time to start drug therapy is during the early
stages when the drugs will do the most good.

welcome to the group nobody wants to join, AW

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Evelyn - 16 Aug 2007 16:40 GMT

> Hi All,
>
[quoted text clipped - 25 lines]
>
> PattyC

Patty, a very reasonable and good argument would be that not all
cognitive problems are caused by alzheimers disease, and some are
actually correctible! Normal Pressure Hydrocephalus NPH is one, and
thyroid problems are another. These can only be ruled out by proper
testing and the time to get that done, is EARLY!

So you need to stress to your mom that a clear diagnosis may even
possibly mean a cure. Chances are that it isn't any of those things,
but having a diagnosis in place is a good idea no matter what the
cause of the illness is.

The alternative is, of course, leaving it alone, and it definitely
will get worse. Sad to say that is the way this illness is.

As August has said, the early stages are by far the worst part. You
have a person who is used to being fully autonomous and in control of
their own life for years, and suddenly being faced with the
possibility of losing control is terrifying, not to mention the fear
of the illness itself. It is difficult to deal with that, and when
the person has been a strong minded or controlling individual all
their life it is even worse.

You are between a rock and a hard place. Either they go for testing
and treatment early on while they still have some cognitive function,
or sadly you wait for some disaster.... like a pot left on the stove
to burn the house down, or taking too many meds or not enough meds, or
getting lost walking only a block from home, or too many other scary
possible scenarios to list. Whenever you hear of an elderly person
gone missing, you can bet there is alzheimers or similar illness
behind it.

I wish you luck and hope all goes well in getting her tested. We are
all here for you and have all been in your shoes at one time or
another.

Best Regards,
Evelyn

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Boydette - 20 Aug 2007 04:43 GMT

Patty

I could sooooo relate to your dilemna...I went thru the same thing with
my mom

I can only say that for three years I beat my head up against a
bureacratic wall that refused to do anything because she had not been
diagnosed with any kind of illness...the symptoms to me were quite
apparent but when interviewed or questioned(since they didnt know my
mom) she could be quite convincing that she was ok and was very much in
denial and with the last shred of her sanity stated.... NO ONE was gonna
run her life!!!

The advice me and my sister got was to get a lawyer and bla bla bla...
but my mom was bound and determined to be independent and we didnt have
the funds or the energy to pursue a case I was sure we would lose
anyway.... not to scare you but if you read my other post you will see
it did not turn out well...sometimes the answer seems to be there is no
answer

Sad part is I have no substantial advice to give you since like I said I
hit dead ends every where I went....I dont know how old you and your mom
are but I am a in a firm belief that my mom came from the old school and
she just refused to let anyone else know her business or control her
life....and the bottom line is its all about money...so if you have the
funds and are able to pursue it maybe you can get some kind of legal
help...its the only solution we were ever offered and yet sad to say I
still dont think it would have made any difference..come hell or high
water she was calling the shots even in her demented state...our laws in
the US really stink when it comes to taking charge of an adult

sorry I cant be more encouraging...I just know what you are going thru
and if nothing else I hope it helps to know you are not alone...stick to
your guns with your mom...I took alot of abuse physical and mental and
verbal...and it was so hard for me to reverse the roles but after awhile
I had to treat her like an unruly child...ie "If you are gonna
yell/curse/scream at and hit me I am gonna leave/hang up"....then she
would become quite complacent...for about five minutes...it is a
horrible chain of events and I pity anyone who has to go thru this..HUGS

Boydette

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sweetpickleNO@SPAMknology.net - 20 Aug 2007 12:10 GMT

Boydette, it is good to hear from you but I'm sorry the news wasn't better.
You and your sister really did have a hard time with your parents and I know
her death was not an easy time for you. Please don't beat yourself up over
it though. Each person just has to do the best they can with what they know
and are able to do at any particular time. You know you tried, but you
needed cooperation from your mom and didn't ever get it. No guilt allowed.
Do you have anyone besides your sister to help look after you if you need
it? Please take as good care of yourself as possible, and now that you're
back stay with us and keep us posted on how you and your dad are doing.
Gwen

> Patty
>
[quoted text clipped - 37 lines]
>
> Boydette

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Boydette - 26 Aug 2007 20:29 GMT

THANKS GWEN...you are such a sweety pie...and to answer your question I
am NOT all that bad yet but my hubby takes pretty good care of me (as I
do him..hehehe)...my kids and my sister are not that close
(geographically) and I dont really have many friends since I dumped all
my "drinking buddies"

Also from what my doc told me I might be able to halt the progression
even though I cant reverse it...so I take some stuff besides my psych
meds and thyroid (I have no gland)I have been taking calcium for one
cause I was borderline for osteo...dont know if yall remember but I
broke my leg a couple times...since taking the calcium I have had a bone
density test and I am in good condition there....I also take a
multivitamin for women over 50 and estroven which is the herb black
cohosh and it has several other things in it to help with post
menopausal symptoms and I think the B vitamins help with mental health
I also take fish oil which again I am sure that aids in the brain area

most of my troubles is as usual the short term memory loss...it really
scared me when I started doing stuff to my kids and others by repeating
myself or telling them stuff I already told them...or I would call them
and say I have to tell them something and then they would say MOM we had
a long discussion about this...OMG I got so scared and I decided then
and there I was going to do everything in my power to halt this terrible
disease

I have made a regimen for myself to do word puzzles number puzzles and
trivia.... and I read alot and if I find myself reading the same line
over and over them I force myself to finish the page and then see what I
can recall...this is the worst part cause I have been such an avid
reader and my sister has always had a problem reading with
comprehension...she says now I know how it feels but I think its worse
cause I loved it so and now I feel so frustrated

I am trying to do everything I can so my loved ones dont have to go
through that living hell that I went thru with BOTH my parents...and I
have a better relationship with my kids cause I have put them FIRST
instead of demanding they worry about MY problems...they have their own
lives to live...I also have forgiven them for not really being there
when my mom was sick and then died cause my mom was just NOT a nice
person or a good grandma ...I loved her cause she was my mom and I tried
to focus on good things...there were some happy times after all...too
bad my kids didnt see too much of that side of her...anyway end
rant...LOL

Thanks for letting me get a few things off my chest

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