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

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A frequent problem expressed among adult children is that their parents aren't truthful with their doctors. While the parent may complain at home of pain, exhibit memory problems and accuse family of theft when he or she can't locate a commonly used item, the moment the parent faces their doctor a change occurs. Like an actor on stage, the person sitting in front of the doctor becomes animated and charming.

My mom was a supreme example. She fell in her apartment—often more than once a week. She had memory problems. She was taken advantage of by telemarketers. She had digestive issues. However, when I took her to her doctor, what I called her "hostess personality" took over. While she may have complained of pain in the car during our drive, the minute she had a chance to tell her doctor how terrible she felt she was perkiness personified.

I'm not alone. A friend of mine took her mother to the doctor because she suspected her mom was in the early stages of Alzheimer's. My friend sat dumbfounded as her mom charmed the socks off the doctor and seemed as sharp as she was ten years ago. The mother denied any health issues, especially those associated with memory. The doctor, too busy to run tests on someone who seemed "so good for her age," signed off of some prescriptions and sent them off. My friend felt like banging her head against the wall.

Why do they do it?

One reason our elders put on such a show for the doctor is fear. They don't want to hear a bad diagnosis for many reasons, one being the possible loss of independence. So, they put on their company manners. They tell the doctor whatever seems best in order to get out of there "free."

Denial is a natural and useful human tool. It often helps us get through things until we can emotionally handle an issue. In the case of the elder, if he or she can get home from a doctor visit with a fairly clean slate, they've dodged a bullet. It's a challenge to be sure, but they marshal all of their energy for that one appointment and it's often enough to convince a doctor or other professional who doesn't see the elder daily.

Tips to help the doctor see the truth

  1. Talk with your parent ahead of time, explaining how doctors these days respect and appreciate an educated patient. Doctors want to know symptoms and they value the patient's opinion. Our elders grew up in an age where the doctor was next to God. Generally the patient and doctor didn't interact much then. The doctor just took over. Reminding your parent that these days they have some power in the interaction with their doctor may encourage him or her to be more truthful.
  2. Remind your parent that you are on their side. You want their safety and health to be the first consideration. If your dynamic with your parent isn't the best, try to improve it. This isn't always possible, as they may suspect everyone. All you can do is try.
  3. Try to talk to the doctor ahead of time. Alert him or her to your parent's Academy-award-worthy acting abilities. Discuss the symptoms and problem behaviors you observe at home. Few doctors will talk directly with you without an appointment. So make an appointment or talk to a nurse.
  4. Another option for communicating with the doctor is to write a letter ahead of the appointment noting your concerns. This way, the doctor is prepared with the facts as you see them. He or she can bring up issues in a tactful way, or suggest a specialist without fingering you as the bad guy.
  5. Attach to your general letter a diary that you've kept over a week or two, indicating times and dates of your parent's behaviors or health issues that concern you. Again, you will get information to the doctor without embarrassing your parent in front of the doctor.
  6. Bring with you a list and if possible the containers of every prescription, over-the-counter medication, herb and vitamin your parents uses. This can help the doctor look for problems with drug interactions or over-medication. It can also open up a dialog where the doctor can catch your parent off guard and ask some questions that can lead to a more truthful interaction.
  7. During the visit, make sure the doctor interacts with your parent. Medical people are busy, and some will look over the notes and then speak directly to you, the caregiver, since it's faster and often more direct. Yet, you are there to give support to your parent and give information to the doctor. You are also there to take notes and be part of the care plan. However, your parent deserves the dignity of being treated as an adult patient, no matter how childish his or her behavior may sometimes be.

Carol Bradley Bursack

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Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen, "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.

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39 Comments

oldcodger2 .... you have said the other things that are on my mind. We are definitely put between a rock and a hard place, damaging our own health, well-being and relationships in the process. And why is it we are good enough to deal with all the unpleasantness, but not good enough to be trusted in our efforts to make things better and safer??? And when things hit rock bottom ... it's quite true we could be seen as being neglectful, even though we've had no legal authority or obligation to oversee our parents
and their issues. I agree with others that we do have to respect our elders' right to make their own decisions and live their lives as they choose. However, if they are a sinking ship, and we have done all we can to avert the situation, they should not expect us to go down with them .... and neither should anyone else. I only pray that if I am lucky enough to grow old, that I will have faith in the two beautiful children my spouse and I have raised, with our values, to do right by me .... and that I will never, ever put them through the pain and agony that that my father is causing me.
My MIL is the same way. Forgets what day it is, forgets her meds, complains of aches and pains constantly - NEVER has a good day. The sun NEVER shines - EVER - for her.

Yet, if someone stops by to see her or calls her - she is chipper as a little birdie in Spring! No complaints! All is well in her world. Same with Doctor visits. She complains of this or that until NOT taking her to the doctor would basically be neglect on our part and then when she gets to the doctor - she tells him she is 'doing pretty good for an old lady' as she puts it.

The Doctor jokes with her and she jokes with him. They laugh and have a pretty good time. I have to remind her about why she is there.

Even though we know why they do it (for attention or be prove their independence) - it does not lessen the frustration. We get to hear them harangue about how awful they feel all the time. (I then feel guilty because I get so exasperated. I know she doesn't feel great or even close to good - ever).

But, everyone else gets to see the 'sweet little old lady.' Her other kids think we are making it all up - they can't see anything wrong with mom. We does her hair for them, puts on make up, dresser nicer, walks straighter. If they call or visit (rare occasions) she looks and sounds like a completely different person. She tells them, I'M FINE - YOU DON'T NEED TO WORRY ABOUT ME.

No, THEY don't have to worry about mom - WE do it for them :0(

As for that lovely question "Do you feel safe at home" - that is legally required if an older person or child is taken to the ER. (she had to go last year due to sciatica). I wonder what would happen if an elderly parent happened to be 'mad' at you at the time and decided to say 'YES' just for the heck of it? In this day and age, a person is guilty until proven innocent.
Yes this is a problem for me too. I am caregiver firmly 90 year old husband. He is still handsome and charming and dresses to the nines when he goes to see the doctor. He makes polite chitchat and really goes the extra mike. At home he wallows in self pitt, wearing an old bathrobe and moaning and groaning and asking questions that indicate he is mentally somewhere else. I was beginning to think he was "exaggerating" his problems at home. I see that he is to some degree acting both at home and in the doctors office. I guess that is normal andI have to make allowances. It was helpful to read everybody's comments on this.