How do I know when to let go when mom refuses to do what the doctor says?

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Mom's health requires that she drink about 60oz of water every day. We try to get most of it in at least 4 hours before bed so getting up in the night is not an issue. She is a quiet woman with an extremely STRONG WILL!!!!!! She will absolutely refuse to drink water, use her cane (after knee replacement surgery she still has need for this to steady herself), and sometimes eating food (has experienced weight loss because of refusing to eat and lack of appetite). She makes comments that make me feel guilty like "am I not supposed to voice my opinion or make decisions for myself anymore?" - makes me feel like I have stripped her of her total independence when I am just trying to keep her healthy and follow Dr. orders. I am tired of the fight - she gives the same comments to my daughter who helps me a couple days of week. This has been getting worse and worse over the last year while she has lived with us. Part of the problem is she is confusing/forgetting information (saying that the Dr. never told her that, etc.) and seems like she doesn't trust me with what I am doing or how I am providing care for her. When my mother was living alone - she would not do what the Dr. said and ended up in the hospital a few times with kidney stones due to dehydration or just being dehydrated and needing to stay a few days in the hospital to be re-hydrated. I need the battles to stop! I am tired of the arguing and the behavior she exhibits matches my 3 yr old grandson. It is so discouraging and frustrating! Is there a point in time when I stop enforcing what the Dr. requires and allow her to control the situation even when I know she is going to end up in the hospital for days at a time on a regular basis? HELP!!!! I just feel like giving up.

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This is really tough, but unless your mother has signed HIPAA forms or through some other means give the doctor permission to release information to you, you probably can't find out what he tells her to do. She obviously feels that you are trying to boss her around when all you are doing is trying to protect her. That happens to people trying to protect their elders from making bad financial decisions, as well. It's just plain hard to get older and be subject to your adult children's opinions.
Does you mom have a trusted friend who can help? Often a third party will be able to get through to an elder, because the family dynamic is removed. Maybe she would take advice from someone her age. Otherwise, I don't know what you can do but to tell her that you'll go along with her wishes and if she gets sicker you'll be there to help her through the consequences. Maybe if you back off - hard as it is - she will eventually come around. Good luck. You aren't alone with this.
Carol
Take written notes for your Mom at all her doctor appointments. At the endof the appointment ask the doctor to be sure you have taken down accurate information and have him or her sign the notes. Give these notes to your Mom to remind her of the doctor's instructions whenever she needs a memory jog, It will take it off you and put it back on the doctor who is making the rules. It has helped with my Mom who has dementia.
I experienced the same thing with my mother, who had early dementia, hard of hearing, bad eyesight, wouldn't eat enough (which eventually killed her) and trouble walking. After falling several times, her doctor ordered the use of a walker or cane. She said the doctor didn't tell her to use one. She was adamant about not using a walker. She would tell stories about the dangers of using a walker/cane (that she made-up to support her opinion of not using one) At first I think she was being stubborn. Later, I think she didn't remember and quite possibly a mix of stubbornness and lack of memory. Never did get her to use a walker or cane. She just got to the point where...she wouldn't do what she didn't want to do...no matter what the doctors ordered or what the family said or how many times she would fall. I think sometimes it became a game of control with her. She was still in charge of her life...and she wouldn't do things to prove it to other people.

Previous comments here have been excellent in giving you ideas in dealing with this difficult issue. I would agree with everything they've said. Try various approaches. Some may work (short term?), some may not. Ultimately, you can't force her to do things she doesn't want...and you have to let it go. You have to resolve within yourself that you have done everything you can...but it has its limits.

Good luck to you and your family.
My heart goes out to you, this is extremely difficult and frustrating. Went through the same thing when my MIL was living here. First of all, if you can, try not to let her make you feel guilty about taking away her independence. Most likely, she has the onset of dementia - I don't think you mentioned if she does.
Before my MIL moved in with us and when she did; her behavior was much like your mother's. Only difference is she was an extrovert. While we do empathize with their feelsings of loss of denpendence, and they think we are taking over their lives - what we really are doing is protecting them and taking care of them the best way we know how. My MIL was getting infection after infection because, due to her nature, she would not take the medication. Her favorite expression was "I pay no attention to the doctors". We soon realized dementia was setting in. Long story, short - she came to live with us. Under my supervision she never developed any infections. She complained relentlessly about taking the medication; but would cooperate after I explained the repercussions of not taking it. And I did embellish what would happen. For some reason, she listened. But the complaining never stopped. Her doctor put her on a low does anti-anxiety medication; which did help. Maybe if you talk to her doctor and explain what is going on - he will have suggestions or at least have understanding ot the situation.

My own mother is in a facility and will refuse medication. I've been told that you can'f "force" a patient to take medication. Also, last time she was hospitalized she refused blood work - ahhhh, so difficult to deal with.
Here's the thing about your Mom's withdrawal of "trust," -- or at least how I read it. It isn't personal to YOU. YOU are the person telling her what to do, and therefore the symbol of a lack of independence to I've without meds, live without reminders, live without physical limits. She is withdrawing trust from the world, and you are the symbol of the world, for her. Don't take it personally.

Second, it's not going to help her "trust" you more to back away. Lack of hydration, especially, will only make her less rational.

many of us get to the point where we just have to power through. Just as our kids didn't want the naps and the medicine and the curfews, our parents don't want the equivalent. An since they once DID have charge of their lives, it's harder for them to hear that there are "rules" that apply to their current situation. Whatever you did to not take to personally when your daughter told you you were the worst mother ever, or that she didn't like you anymore, etc. -- that's what you have to do now.

It's a change in perspective: I am taking care of her and she doesn't have to like it. Her "trust in me" is not at issue here; the things that make her mistrust the world are never going to get easier. She is pushing at boundaries, same as any three year old. Or thirteen year old. Or 23 year old, for that matter. The boundaries exist now in ways and places she didn't see coming and doesn't like. You can't change that. All you can do is show her where the boundary is, with love.

Good luck to you!
Thank you for your comments - further information....

I take mom to all her Dr. appointments and have released information at all of them. I have taken care of her finances and medications for over 10 years and the Dr.'s and banks are all familiar with our caregiving situation and me. It feels like she is losing "trust" in my caregiving - is that because I insist on her following Dr.'s orders that she is refusing to follow or forgets that is what they said, even though I am in the room with her and know what has taken place (she really truly believes one thing even when it is not true)? Mom refuses to keep in touch with friends and always has - she is an true introvert. She prefers to live a life "removed" from most people other than family and has been that way most of her life. The problem with that is that my daughter and I are the only ones who live close that are willing to provide care for her. My sister has the "care from afar" attitude even though she is only 30 minutes away. My backing off just seems like giving up on her :( How can I earn back her "trust" and help her to see that I am looking out for her health in the best way possible? Does eventually come around mean that I have to let her get sick again and be hospitalized? She doesn't even remember the last time she was hospitalized just because she was dehydrated :( If I back off - what will my siblings say? Will I be accused of not providing proper care for mom? Legal ramifications of that would be? I am very concerned!!!!
Sometimes the negative traits in a person become magnified with dementia. My dad never drank water until he came to live with us. One of my tricks is to give him a full glass of water when he takes his medication. When my dad sees his doctors he always says "I'm doing just great". If she's always been an introvert, she's not going to change. She's not doing these things to irritate you, it's the dementia talking. Perhaps now would be a good time to get POA. Take her to you sister's for day care! I know how hard this is. Good luck to you all!
I know what you mean about Mom not following instructions. My Mom needs oxygen and she hates it. She fights with the aide everytime they try to put it in her nose. If she doesn't get it she behaves terribly. Last week she told the aide not to come near her or touch her and that she hated her. I was there at the time and felt so bad, I told her that the aide was there to help her and not to talk that way. She can't dress herself as she has a bad arm. She is legally blind, hard of hearing,unstable with her walking and has dementia. It is tough.
I care for my Dad and step mom.....he is a jewel but she thinks that she should be waited on constantly (Princess syndrome?) To my knowledge she does NOT have dementia but she is stubborn and has compulsive issues. She drinks and takes her pills to the point she falls and gets hurt. Last week a broken arm, 41 staples in her scalp & 3 stitches in her eyebrow....not to mention all the bruising! The doc has talked to her, .Dad has had no luck with it, another daughter has also no luck, she got mad when I told her she was an alcoholic, and checked the boxes on the doc office intake form for anxiety, depression and alcohol, but she does take meds for the 1st 2 and certainly has issues with the drink. It really scares me that she mixes her pain & sleep meds with drink...whatever is her compulsion this month is complete and total. I have consulted with her doc..I am on the HIPPA list...now I am trying to get a joint appt to speak with her about it all explaining in detail what can happen by mixing them and if she falls again and breaks a hip she will go to a nursing home. I don't think she cares and that breaks my heart as Daddy loves her and wants her here with him. Any ideas? she is a control freak too, which doesn't help!
There comes a time when there is nothing else you can do to help them-try backing off and see how it goes-she might like the attention she get when in the hospital-maybe she has to be placed in a NH where nurses will be taking care of her-a lot of elders will fight you tooth and nail just because they can-my mother made an issue of not wanting to eat at meals so I said take what you want instead of reminding her she is losing weight-realizing that you can not help them might give you some relief-you can only do what you are able to do.

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