Why Your Ill Parent Fools the Doctor and What to do About It

Well Ill say none of these suggestions has ever worked for me.If I notify the Dr in advance , he tells Mom what was said, and she gets mad at me, and starts arranging her Dr appts when Im at work and had others take her. Talking to Mom and telling her im concerned,,,, baah !!!!Its called Showtiming for a reason, she has a full audience with the Dr.. and Ive had more than one Dr tell me as long as someone "presents to have cognative ability" then they talk directly to the pt, and assume the pt can relate all needed infor to the caregiver...... sorry this article isnt reality based in Indy

I am a nurse working in a geriatric/family practice office. I also bring my mom to our doctors. I see both sides of the story. Very frustrating! I am mom's primary caregiver. I am verbally abused often by mom, about how "something has to be done" about her shortness of breath, ingrown toenails, swelling in legs, bruising, constipation, weakness, fatigue, eyesight, hearing aides, etc" and how she HAS to see the doctor. Mind you, my mother is of sound mind and very articulate. She is 87 years old with end stage COPD and after years and years of steroids and other medications, she is now suffering the side effects.
She claims, "I've never been so sick before, never like this!" every time. We bring her to the doctor, and she now looks like Zsa Zsa Gabor and it becomes a social visit. Drives me crazy! She never looks sick for the doctor!
On the other hand, as a nurse, I see it all. Yes, I have gotten calls from family members who want me to jump every time they have a question, or a walk-in family member asking to speak with me about the parent that they are not POA for. There is lots of fighting or disagreement between family members over how to proceed with treatments, where ailing parents are going to live, and who is going to handle the finances/medical decisions. What I can tell you, however, is that it is extremely helpful to assign one family member as representative for the parent and family. We appreciate when someone sends or faxes a letter explaining the concerns they have about mom or dad prior to the appointment. We request that the representative attend the appointment with the parent so that we can communicate with the parent and the representative to avoid all the additional phone calls we frequently receive from the other family members. Please bring with you, a CURRENT list of medications and doses of ALL meds and over the counter supplements, etc that the parent is taking. If you don't want to write it down, then bring all the bottles. Please come organized, because although we wish we could spend an hour with you at an appointment, usually the doctor is only allowed 20 minutes on the schedule and that is generous in this day and age. If you think you will need more time, please ask for additional time and we will schedule it that way.

We were very fortunate in my mom's doctor, he was not only a great doctor but he was kind and considerate to the extreme as well. Though he was not my doctor, he treated our conversations with confidence as well. He had a wonderful way of talking to mom, honest and straightforward but with courtesy and consederation. Mom had a little quirk all her life, she had a way of making people think she understood everything that was being said to her, when in actuallity she did not understand at all. If questioned about her view, she would often have a flippant remark that was almost calculated to throw the other person off and make a joke. It was in reality just a COVER to protect her pride. As she got older, this even extended to the people who were trying to help her the most. I did not attend her meetings with her doctor at first, but after observing her in hospital a few times , I started to go to doctor consultations with her. Doctor really thought she was just cute and "feisty", so I wrote him a note and explained this behavior to him, and that he should make her repeat things back to him so that he knew she understood. I asked him to even observe her for pre-dimentia, but his observations were that she was just bored. Long and short of it, old people have pride too, it gets stiffer the older they get (like my knees) and they do not want to let their helplessness show. Of course, my note was added to her file, but he did not really discuss it with her, as far as I know, as a betrayal on my part, just said that I was 'concerned' about some things and had asked for his opinion. It was all ab0ove board, but it was necessary to go outside of the box.

My dad passed away in March of 2011. Prior to that, I went to visit him and he claimed he accidently banged his head on the sink. He claimed he washed his hands and accidently leaned on the sink, lost his grip and banged his head when he tried to catch his balance. He had a huge black eye that was shocking! A few weeks later, my sister took him to his doctors for a checkup and the doctor told my sister he had bruises all over and he had to have fallen. Of course, he was on coumadin ( a drug I firmly believe is pushed on most seniors and is not necessary), which made the situation worse. He maintained his story and denied falling. As a woman pursuing a masters in gerontology, and having experience taking care of my mother, father and great aunt, and a 94 year old friend, I have discovered the key issue is their fear of losing independence. If an elderly individual complains, falls, or shows any form of incompetence in showing they cannot live alone anymore, they will find ways to cover anything that could have any professional take that independence away. While an adult "child" will scold a parent, or show concerns, a professional (i.e., doctor, nurse, social worker, lawyer) seems to have more authority to stir things up and permanently change their lifestyle. The one thing I have learned in the numerous courses I have taken is that seniors want to age in place. As soon as you take them out of their environment, they go down-hill. The 94 year old person I have worked with for 26 years now has aids 24 hours a day. She complains she has lost control of her home environment, is frustrated things are not put away where they belong, and complains she feels like a guest in her own home. I have conversations with her and try to make light of the situation, incorporate laughter, and basically tell her: "what are the alternatives?" I remind her that if she needs assistance, at least she can remain in her home. She calms down - until our next conversation. It is very frightening to lose control and lose the right to making one's own decisions. Change is difficult, and granting seniors that right to be a part of those decisions is crucial. It allows them to hold on their dignity. Adult children can find ways to introduce concerns to doctors in ways that will address the issue, but still allow their parent(s) to maintain control. We, children, want our parents to be safe; however, scolding them isn't the way. We need to devise ways to make the parent think it is their idea. Those with dementia obviously are individuals who need special handling, but for those who have their faculties, allowing them to maintaincontrol is key.

Wow,,, thank you for the insite. I hadnt thought of it in the way you put it. that mom still has her pride and would be afraid of losing her independence... Wahtching her get older faster is scary enouph, but to think shes worried about the things I take for granted... I love this site !!! Ive learned so much already, a humble thank you.....

I even think it goes a little deeper than just misplaced pride. Without going into detail I have already once sort of "faced" my own mortality, and am now doing it again (imminent valve replacement surgery), so I found and still find a lot of empathy with what my mom was facing, which was sure death, if not soon, at least not too far in the future. She had, after all, outlived everyone in her family AND my father and older brother and sister, so she has seen a lot of death and must have felt very, very alone, in spite of me being there (sometimes she did not treat me very well because of the fear, as a matter of fact). So, what are we dealing with when we look after an older person - pride, some denial, fear, dispair. Imagine how you would feel if you went to the doctor and he/she told you there was nothing more he could do for you, and by inference, death is the next step. Sure, I would lose my temper at mom occasionally and do some shouting and I often would have to tell her to back off to protect my own space, but in general, it was a matter of being kind. To do otherwise would have been like kicking a puppy. And yes, I worked my tail off. (Of course each case is individual and some parents I have read about here are either in dimentia or outright mean, you have to make your own assessment of the problem in the end.)

Thanks so much....the description in the article is my mom personified. She is a little doll, and everyone loves her to pieces. But when she is coy with her doctors or doesn't report the same complaints she makes to me, I step in. I will say "mom, remember you told me about that sharp pain you keep feeling in your left side?" I am VERY specific...she gets annoyed, but that's OK. At least her doctors know all of her complaints. She also gets really PO'd when the docs start talking to me instead of her....and I will tell the doctor: "you need to be talking to HER." Doesn't matter to me if the doctor is in a hurry, they will treat her with dignity as long as I am around.

Now on the other hand, my FIL is just the opposite. He waits until I take him to a doctors appointment and then tells them all of his aches, pains, issues, and problems that he has never mentioned to anyone in the family. Sometimes his doctors look at me like I am abusing him and it is humiliating and hurtful. The worst instance was when he told a pulmonary doctor that he wasn't using his nebulizer (even though he had told me he was), then told the doctor that "no one ever showed me how to use it so I didn't know how." The doctor gave me a look that would have withered a guilty person, but since my conscience was clear, not me. I immediately informed the doctor that , even though FIL doesn't live with me, I WAS there when the nebulizer was delivered, the tech did indeed show him how to use it, and that this was the first time I had heard he wasn't using it as prescribed. My FIL went into a fit of rage, but I'm also used to that...it is absolutely normal behavior for him. Then in a couple of days, he'll call me like nothing happened and ask me to take him to another appointment.

I'll take my mom's behavior ANY DAY...much easier to deal with a coy, super mannered, and maybe even flirtatious senior than one who tries to make you look like a bad person in front of their doctors.

That little thing always at the same time amused and irritated me - often when I took mom somewhere (we usually used a wheelchair as her legs were the first thing to go), the receptionist would direct their questions to me rather than to mom, asumming, I guess, that if she were in a chair that she also was not in her right mind..... In spite of the understanding thing I mentioned, she still had a pretty sharp mind, right up until the last couple weeks,(when I think she actually just gave up) she would sort her own pills into her daily boxes and write her own checks, etc. I tried very hard to keep quiet during consultations but like you, I had to jump in occasionally to clarify or elaborate. I also was a little nervous about mom's black and blue spots, apprehensive that someone might think I gave them to her. Indeed, a few years ago whenever she would go in for, maybe a first examination, they would ask her a question like, "Do you ever feel threatened at home?" A leading question, and irritatingly funny as I was in the room when they asked! But mom would get black and blue spots even from the IV needles or somtimes when they just took blood, sometimes from seemingly nothing at all. She must have rubbed her eye one night in her sleep and woke up with a huge black eye! I was very apprehensive about that! But, in the end everyone commented on what good care I took of her (though I say it who shouldn't...)

PS - I would say that if your FIL gets mad becasue you clarify things for his doctor, he will just have to get mad, it you have taken on the responsability of his medical care then that is your first duty, If your doctor is as good as my mom's he will not only stick up for you but make your FIL understand that it is for his own good and he must cooperate with dignity if he wants respect.

All these responses sound familiar, as I have dealt with my mother who broke her femur bone from a fall, and then the hardware broke in her leg 6 months later and broke her femur bone again! She had 2 surgeries, 2 hospital stays and 2 rehab stays. I have 5 sisters and a brother (with 2 sisters as nurses). I worked 3 jobs and used to visit my mother 5 days a week after work from 3-8 PM M-F. I also went to doctor appointments. It seemed she saved up all her frustrations for me. When discussing issues with my siblings, no one seemed to have the same experiences. While I took it personally at the time, I look back and realize that she must have felt comfortable enough with me to express her frustrations. Who knew being a human punching bag would actually be a compliment?! I also know about the frustrating doctor's visits. I have recently been taking my great aunt to doctors' appointments and she would sit there and say to the doctors that she has no one and she is all alone in this world. I, too, was sitting there. A cardiologist did seem very surprised when my great aunt introduced me as her great niece. She stated she had never seen a niece take initiative and interest in bringing an aunt to doctors' appointments. It did make me feel appreciated. Well, as far as excessive bruising, usually blood thinners or asprin will cause bruising, or various difficiencies. Of couse, the doctors all want to point a finger without looking at a person's list of scripts! I have also lost my temper with my mother, father and great aunt. I'm not proud, but I will acknowledge that I am human. I try to focus on situations that I can control that might initiate that trigger point. For example, if I am extremely tired or hungry, this will add to my frustration levels. Therefore, in order to take back the control, I try to get enough sleep and try to make sure I have eaten if I am going to deal with the aging population. I recently took my mother out to breakfast and I was quite snippy. The first thing I mentioned before we got into conversations was that I had only gotten 4 hours of sleep and I was a bit cranky. At least I brought this to my mother's attention so that when I got a bit testy, she was aware that I hadn't gotten much sleep the night before and my frustration was not directed toward her. We were able to focus on casual conversation and we didn't get into any conversation that would have aggravated either of us. We wound up enjoying ourselves, and instead of venturing out to do errands together, I dropped her off at her apartment, and I went home to rest. I guess the key is to fully become aware of our short-comings and limitations, and focus on our stengths.