Some elders have always been wary of doctors, hospitals and medications, while others become more distrustful over the years. It makes sense that an aging loved one might refuse to go to doctor’s appointments. After all, by avoiding them, a senior can dodge any new diagnoses and information about the status of their existing health conditions. Growing older is scary for a multitude of reasons and often that fear manifests as a refusal to participate in annual physicals, diagnostic testing, preventative health care and even receive emergency medical treatments.
While the “ignorance is bliss” approach to aging is somewhat understandable, it also happens to be a major source of frustration and anxiety for family caregivers. Our job is to ensure our care recipients’ health and safety, but we can’t do that without a clear picture of their current physical and mental health.
The Right to Refuse Medical Treatment
The truth is that a person who is of sound mind has the right to refuse medical treatment. If a senior is competent and capable of informed decision-making, they can manage their own health in any way they choose, so long as they do not pose an immediate threat to their community. This means that family caregivers cannot force their loved ones to seek out or receive medical treatments, even if doing so would improve their health and quality of life. Seniors who have their faculties can make even poor decisions about their own medical care.
Getting a Dementia Patient to Go to the Doctor
Managing medical care for a senior who is mentally ill or incompetent is a far more complex matter. Unfortunately, decision-making capacity is not black and white. Rather, it exists on a spectrum. When a senior has Alzheimer’s disease or another form of dementia, determining their ability to make decisions about their health becomes even more complicated because their mental status can fluctuate from day to day and even hour to hour.
One of the most common reasons why dementia patients refuse to go to the doctor is perceived denial of their changes in cognitive function. Denial can play a part to some extent, but the disease itself is often to blame. The damage that has occurred to a dementia patient’s brain can actually prevent them from recognizing their deficits. The formal medical term for this lack of self-awareness is called anosognosia. When a senior is incapable of acknowledging their illness, it poses serious problems for a family caregiver who is desperate to have them evaluated. The pressure is on because an early diagnosis of dementia is crucial for prompt treatment and planning for the future.
A valid medical power of attorney (POA) document is critical for managing a dementia patient’s health care. However, many seniors never complete a POA or opt for one that requires their certified incapacitation before the legal document goes into effect (a springing POA). Of course, the challenge is that a medical evaluation to confirm a senior’s competency is typically required to activate a springing POA or seek guardianship.
Yes, a valid POA document for health care or a guardianship will give a designated caregiver the legal ability to control a loved one’s medical care, but this power does not make it any easier to convince a resistant elder to go to the doctor or physically get them to a medical facility. This is where some finesse and a great deal of patience come into play.
If your care recipient has a primary care physician (PCP) whom they trust and you’re just trying to get them to warm up to the idea of a seeing new specialist like a neurologist, contact their PCP for some back-up. Ask the doctor to rave about this new physician and how much he or she has helped their patients over the years. Sometimes this approach can work if another trusted professional, friend or even religious leader can put in a good word for a potential new doctor as well.
Another tactic is to use a little white lie to get a senior to the doctor’s office. Set up an appointment and then get your loved one out of the house on the day of under the premise of doing an activity they enjoy, such as shopping or eating lunch at their favorite restaurant. Take your loved one out as planned and do not mention the appointment. On the way home, pretend you have an errand and casually drive by the new doctor’s office. Say something like, “Oh, here’s where that Dr. Smith’s office is! Let’s go in and put your name on the waiting list while we’re here, since it is going to be such a long time before we can get an appointment.” Casually go in, sign in and then say, “Oh my gosh, the doctor has a cancellation and can see us right now! What luck we are having!”
Just be sure to give the receptionist fair warning about your ploy and how reluctant your loved one is to visit the office so nothing goes awry. Staff at doctor’s offices frequently encounter elders who don’t want to be there. If you discuss the issue with the office staff or a nurse beforehand, they may have some additional ideas for minimizing your loved one’s anxieties and reducing time spent waiting for the doctor before the appointment.
Finding the Right Doctor
Changing to a new doctor is often stressful, but for an elder who is set in their ways, seeing an unfamiliar physician can be extremely unsettling. Choosing the right physician can make all the difference when it comes to managing the many issues that arise with age. It is preferable to find one with interest and experience in treating older adults, such as a geriatric doctor (geriatrician). The bottom line is that you want a physician who has a heart for seniors, is well-versed in their unique conditions and symptoms, and communicates well with their patients (and caregivers). It may take some research and trial and error, but when you find the right fit, it’ll be well worth it.
Caregivers can find Geriatrics Healthcare Professionals in their area by using the search tool on the American Geriatrics Society website.
Making Tough Care Decisions
If you have an aging parent who won’t go see a doctor of any kind, period, you have to realize that, when you were a child and you were ill, your parent would have done everything in their power to make you better. If you recall, it didn’t matter how much you kicked and yelled. If you needed to see a doctor, get your shots or take some medicine, they made it happen.
Yes, as adults, we’ve earned the right to make our own decisions, but oftentimes once-competent elders don’t think as rationally as they used to, and they can begin making unwise decisions. When you know in your heart that the time has come to step up and ensure your loved one gets the care they need, you must think creatively about how to make it happen. Look into house calls, ask the physician to talk to your parent on the phone to help them feel more comfortable, or use some fibs to get them into the doctor’s office. There’s no shame in guaranteeing your mom or dad gets proper medical treatment.