Mom won’t go to the doctor

TaraAggie97

Hello to you all.  I am wondering how to convince my mom to go to the doctor.  She began showing obvious symptoms in May and has really gone downhill since then.  She has seen a PCP but refuses to go to the neurologist .  My dad encourages her to go to a neurologist (as suggested by the PCP), but she continues to adamantly refuse.  What are our options in getting her there? She has recently become quite agitated over little things and is making my dad’s life really hard with her constant demands and frustration.  She was a strong-willed person before this, but this is getting really tough to deal with.  Thanks for the help!

M1

Welcome Tara. You may have to fib to get her there, people frequently say things like "this is required by your insurance" or similar. But I suspect you and your dad need to think about what your goals are-do you want him/her to rule out treatable problems? Hopefully her pcp has already done that. Do you want him/her to tell her she has dementia? Likely pointless, she'll deny and won't remember. Do you want him her to prescribe medication?  If so, what for: for memory, for agitation and other behaviors, for sleep? If you have these things clear in your own mind before you go, you'll come closer to getting what you want out of it. Good luck-

Mint

Welcome Tara,  seems like most people can eventually find something that works to get their LO care.  Others may come along with more suggestions.  Personally I have never been able to get my mom to be medically compliant.  Even when the shoe dropped, she had a stroke, she refused to go when squad came, a week later I got her to go to hospital but was totally noncompliant there also.  The only good thing is that there is documentation out there that I tried.  Have just had to detach.

This is very hard for all involved.  It gets very tiring for you and your dad.  If possible try to provide your dad with some time where he can get away.  Living with this, in the same house is tough 24x7.  I know, I’ve been there.

windyshores

I am not sure what the point is, of going to a neurologist.  And if she gest worse, these things may get easier, paradoxically.  Unless you have a specific reason for the neuro appointment, I don't think it is worth having the conflict over it.

If you really need a diagnosis you could also have her evaluated at home. Hospices do dementia tests, and perhaps telehealth with a neuro or geriatric psychiatrist would be possible.

MrsAnnabelLee

There are many reasons why it is important to see a neurologist and have a proper diagnosis on file. If your mom is dealing with dementia, there are several forms. Different types of dementia have different treatment plans and different medications available. If she is dealing with agitation, your neurologist can prescribe some medications that are helpful. The neurologist's office will perform routine cognitive assessments to monitor her progression and help when the time comes to make decisions about things like driving. In a more severe scenario, if you or your father need to seek a guardianship for your mother's wellbeing in the future, a diagnosis will be required. 

Some illnesses can look like dementia when they really are not. Ruling these out is important because some of these diseases are reversible with proper treatment. 

Often, there can be relational issues that pop up around this disease. When the PWD is able to put on a good show and seem like everything is ok around certain relatives or coworkers or friends, and people begin to question why you are acting like something is wrong when everything seems ok. Having this diagnosis on file from a neurologist is helpful in these situations as well. This is obviously not the primary reason to take her, but I felt it worth mentioning.

As for getting her there, your job isn't to convince, it's to transport. "Required by insurance" or "oh your check up is today, let's go! Where should we eat afterward?" Get her there, be willing to risk her anger.

SonShine Lady

Hi TaraAggie,

We had the same issue with my mother who was 85 when this all began.  Refusing to see a Dr. seems to be fairly common with dementia.  Trying to "fib" or "trick" my mother into going wouldn't have worked because she'd become a recluse and didn't want to go anywhere and my 87 year old step-father ran all the errands and did the grocery shopping (wouldn't let me do it.) We were frustrated to the max for the two years Mother was home, going downhill rapidly, and refusing help.  Both my step-father and I asked our respective doctors what we could do to get her to a Dr. and both of us were told it was a matter of "patient rights" and if she was able to refuse there was little we could do.  Mother is very intelligent and articulate, is not physically impaired, and can sound convincing to those who don't know her.  She even had the police officer convinced (story below).  I asked her Dr.'s office manager what to do when she was obviously in need of care and was told to call 911 if there was a medical emergency.  Step-father refused to do that and Mother would have refused when they arrived.  In our case, Mother didn't get the help she needed despite our best efforts until the situation was out of our hands and had turned dire. 

One early symptom of Mother's memory loss was forgetting to take her thyroid medication, which she had always taken scrupulously, resulting in extreme fatigue, being in bed most of the time, not eating, and losing weight rapidly, all the while saying either nothing was wrong with her or "Can't you leave me alone to be sick in peace?"  Finally got her to see her heart specialist who prescribed her thyroid meds after her family PCP retired years ago and who she really liked and trusted.  Mother would not allow me to go into the examining room with her but I did tell the office manager all the symptoms of dementia Mother was displaying and our concerns.  My step-father encouraged my mother to ask the Dr. for a referral to his neurologist.

Mother came out of the appointment smiling, with a new script for the thyroid meds, and said the Dr. told her "You look pretty good to me."  My mother had seen this Dr. for many years so a drop of over 10 lbs and her wig on sideways didn't alert him to something wrong???  Later she told my step-father that when she told the Dr. her husband wanted her to see a neurologist his response was, "Are they (apparently referring to me (only child) and step-father (her husband) trying to put you in a nursing home?"  We were livid but there was no way we could legally prove he said that. 

Next she wouldn't go to get her blood drawn so my step-father found a phlebotomist who came to the house.  The continued resistance to returning to the Dr. for her follow-up appointment continued for months until my mother was so frail  (she is 5'7", normal weight 140, lowest weight during this ordeal was 106!!) and ill that she asked to go to my Dr.  After that she did go to the neurologist and was prescribed Aricept.  We lost at least six months of diagnosis/treatment with her refusal to see a Dr. and another few when she wouldn't return for the follow-up but were relived she responded so well to the medication and was "herself" again....until she began refusing to take the medication because "we were trying to put her in a nursing home."  No amount of telling her we were trying to do the opposite swayed her and she went downhill again.  She became very aggressive (formerly the type that tried to please everyone), delusional, and paranoid.  This went on for approximately nine months then hallucinations set in.  The final straw was when she slipped out of the house (had never done that before), and was found sitting in the middle of the neighborhood road by a police officer.  Mother told him she had to leave because her husband and daughter were having an affair.  For two years she had been accusing my step-father of having an affair with a house cleaner, and two of  Mother's sisters-in-law in another state that she hadn't seen in many years - accusing me was a gut punch.)  She was Baker Acted to the hospital as required by law in our state and finally did have to be placed in memory care since she had become a danger to herself.  Now that she's back on her meds and eating regularly she's "herself" again and has gained most of her weight back.  Had she been compliant with her meds, she likely could have stayed at home for probably another year or so.  She is now 87.  Thankfully we can visit her due to our state being more open than some. 

Every person is different so perhaps some of the advice by others will work for your mother. Just wanted to let you know you aren't alone in this dilemma. 

Abuela

My mom went to the neurologist once.  She stopped cooperating with him in the middle of the appointment and walked out.  She was non compliant with the meds he prescribed and he refused to continue the meds .... which to be honest did not really help.  So I would say... it's not a big deal if she does not go.   Some PCPs will not prescribe memory drugs, some will.  Her NJ doc gave them to her for years before she moved here.  The doc here would no longer do it.  He insisted that we had to go to a Neuro even though mom had been on the drugs for years.   So if you are looking for her to get drugs for her memory... good luck.  Otherwise... move on to other battles.  The Neuro cannot cure her and a dx will not change anything.   Any placement in memory care requires an assessment by their own medical team before she can enter... so Neuro is superfluous.    Don't knock yourself out or put her though it.