My mother will tell me about an ache or pain as if I have the ability to do something about it. I usually ask her some questions in an attempt to appear like I am trying to diagnose (and in some cases, I am) but otherwise, there is noting I can do about them. She always looks at me expectantly like she is waiting for me to fix it.

Last night it was "I hurt right here (pointing to her left lower abdomen)

I asked dull or sharp; Constant or come and go; throbbing; how bad on scale of 1-10?

I then base her need to seek medical treatment solely on the factors of how close it is to bed time and whether or not I have to work in the morning (partially kidding).

A couple of weeks ago, it was a mysterious pain in her chest, just under her breast. I asked her a bunch of questions and determined that it was either angina or a heart attack. Treatment for angina is rest so I put her to bed and figured out that by morning, we would know which one it was. It was not a heart attack.

I don't know what to do about these random pains. They don't seem to be enough to warrant a trip to the ER (minimum 4 hours of our time) but she wants me to do something about them.

Of course, she never has these symptoms or remembers to bring them up when she is actually in front of her doctor.

I try to appear sympathetic but I really don't care.

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Mom2mom, it sounds like she's very ill with that condition and that she's tied your hands so that you can't intervene. That's terrible and unfortunate. Still, you can provide her doctor with information, even if he can't give it to you. You can give him memos, notes of observations and concern. He may still refer her to a psychiatrist.  I'd encourage her to get a diagnosis and prognosis.  That may require complete workups, tests, etc., but it may provide her peace of mind that she's okay.  Or, she may be disappointed. 

For us, it ended up working pretty well, because the doctor told her in my presence that her medical problems were the result of her anxiety and that she needed the medication and psychiatrist. Ever since then, she's been hesitant to call 911 or go to ER. She knows that her doctor will ask what happened and she knows that she will have to provide some answers. She knows that upon examination, they will say that she's fine.

While sympathy is a great thing. From what I have read, for some conditions, it's not helpful, because it just fuels someone's anxiety and OCD over their phantom ailments. That's why I don't get into it with her. It's never enough and actually feeds the anxiety. I show sympathy for her anxiety, but insist that she must take her meds and call her doctor. Constant complaining is not helpful.

I DO TRY to be positive and encourage her when she's being active, reading, going out, eating well, not reporting phantom ailments, etc. I am very supportive of good things. Still.....I can't say that doing that helps.

Mom has medicare and supplemental health insurance. The ambulance bills them first and only sends us the bill if it is denied or only partially paid. I have not received any bills for the last two runs but that does not stop me from telling her that it costs $500 per ride.

I tried to get her to sign a HCPOA and Advanced Medical Directive years ago (when she was more mentally alert) and she refused to even discuss it. First off, she said she said she didn't want me to be the one making the decision because I would surely pull the plug - Hell yeah I would :-)

She would not even discuss the Advanced Directive because, despite all of my convincing otherwise, she thought it was a DNR and she "was not done living yet". She said she wanted us to use all means possible to keep her alive should anything happen.

I tried to explain to her that this was exactly what the form was for - to put those wishes on paper but she was done discussing it.

I do believe that her pain is real. Maybe it was a gas bubble, who knows. But I also know that it is not life threatening and probably diagnosable so what is the point in seeking treatment. You are old. Old people have aches and pains.

Many elderly loved ones have feelings we don't appreciate till we ourselves get to that condition. It is very annoying and frustrating for the caregiver. But for myself a little sympathy goes a long way. If I feel something is serious enough to need attention then I insist on it. Now I can still think rationally so can distinguish between the possibly serious such as a recent fall with sever pain in the elbow - that was broken. Other causes may just be needing a little TLC which can be provided by offering to make me a cup of
tea, put more wood on the fire, fetch the mail, just little things to change the focus.
Some loved ones have simply estranged themselves from their caregivers so will use any means possible to get attention and naturally aches and pains is a good route because we all have them and yes sometimes they are serious and do need attention.
My rule of thumb with the kids when they were small was to wait and see. One of them told me she had broken her arm so I told her to lie on the sofa till we had finished lunch. Well in about five minutes she joined us at the table.
As far as elderly loved ones are concerned i would listen even if this is a daily occurrence and do "something" That earache may be comforted by some warm oil or just a warm cotton pad to hold up to it. The pain in the chest might be helped with some indigestion medicine. Tylenol for the aches and pains or wrap a joint with a bandage or a warm bath or heating pad for that aching back. After that it is on to the white lies and deception I am afraid. Keep a supply of harmless vitamins on hand where your loved one can't see them and produce them when necessary. " Mom why don't you try one of the pills the Dr gave to relax my pulled muscle"
Frequent visitors to the ER tend not to get as much attention as they would like so I would discourage this unless you feel the problem is real. Make it as pleasant as possible. Warm up or cool down the car before trying to bring the person outside. Stop at the ER door and transfer the person to a wheel chair and push inside where it is warm before you park the car. Just don't block the ambulances. When an ambulance is not necessary pretend to call then tell the patient there will be a one hour delay because there has been an accident on State XXX.
In the case of something like a fall when the patient refuses to help themselves and you feel there is nothing wrong and you can't get them up or they are too heavy call the non emergency number and they will usually send a couple of paramedics out to help and give the patient a check over and go from there. Many heavyweights will tell you they are paralysed and can't get up from the toilet when they have been there a long time. You know they walked just fine into the bathroom so it is easy to disbelieve them. this is actually true because they have trapped the nerves behind the upper thighs so they really can't get up. You can try putting the feet up on a stool and massaging the legs till the feeling comes back or just call the EMTs for help.
Each caregiver knows their elder intimately so can decide what they can get away with but a little sympathy does go a long way even if not appreciated.

Unless she has Medicaid medical, she likely has some out of pocket costs for ambulances and ER's. Can she afford it? If she's able to comprehend, I'd take out the bills and explain how he's out of hand.

If you tend to stay with her all night in the ER, as most places that's what happens, then, I might start refusing to do that. Just let her go and pick her up when she released. Sound cold, but, I came to do this.

I think it was someone on this site who referred to this as thick file syndrome. It's never really easy and the things that you can do, may not really help. Sorry, but that's just been my experience. The most help that I have seen was getting my loved one to a Psychiatrist. It was one that her Primary referred her to and the Primary had already diagnosed her Anxiety and prescribed meds for it.

Still, it's very difficult to get people who have psychologically induced ailments to accept the truth. They just can't accept it. Their brain fights them on it. The only med they may refuse to take is the one that they need the most.

Are you her HCPOA? If so, I'd work on getting the Primary on board with what you are seeing. No doubt, her file reflects this. That way when she has an ailment, tell her to call her Primary. Discourage her from doctor shopping.

Try to keep in mind that often with these conditions, the patient really does feel the pain, aches, sickness, etc. Their brain just causes it to happen for some unexplained reasons. Maybe, therapy would help.

I do feel for you. It's very stressful and such a shame, because she might be living a much more comfortable life, if these phantom ailments could be addressed. All we can do, is all we can do. Try not to let it pull you down.

ff, we are almost the exact same distance between 3 emergency rooms/hospitals - each about 25-30 minutes away and one stand alone ER about 15-20 minutes away. There are no other convenient urgent care places near us.

Part of the problem is that she doesn't want to walk out in the cold and get in the car so if she says she needs treatment, she wants an ambulance. If I deny her, she will suddenly become to weak to walk and make it to the door. The 911 center and paramedics literally know me by name (they do... but, that is because I am their Training Coordinator :-)) so I really hate calling. I try not to "play up" her symptoms so I don't have to call.

Mom2Mom, my mother is sick every day all day long. There is something wrong all the time. She hurts here or there. She has a bump on her skin. She thinks she's getting another UTI. There's a feeling inside that has to be cancer. When she says these things she looks at me like I'm supposed to fix it. Of course, I can't, because I know there's nothing really wrong beyond her being self-obsessed and a worry wart. She is actually rather healthy for a 90-year old with diabetes, dementia, and spinal stenosis -- if you can be healthy with those things.

I can come across as very uncaring when I don't pay a lot of attention to the complaints. The problem is that if I did, I would be completely crazy by now... or should I say even crazier? I listen to most of complaints now like they are just her way of communicating.

I recently learned that she had been calling my cousin who is a doctor. He told her that she shouldn't call him, but talk to her own doctor. He has also learned that there is nothing wrong that can be fixed. I do wish there was a magic pill that would make people 40 again and their bodies would feel better. The trouble is that living a long life often comes with feeling bad toward the end of it, and there is nothing we can do but sympathize when the complaints seem unfounded.

BTW, many chest pains come from the intestines and esophagus. A spasm in the esophagus can feel like a heart attack. Spasms of the intercostal muscles can also feel like a heart attack. Both have quick onset, but can normally be abated by swallowing for the first and stretching the arms out for the second.

It could be she is just looking for a little attention and sympathy... I can't remember, does your mom have any dementia?
When my mom complains I try to do or say something to mollify her: "yes, mom, we already had your tylenol, I hope it kicks in soon" or I'll rub a little voltaren on her knees. Of course she will ask again in 5 minutes....

Instead of going to the ER if you feel Mom's pain needs immediate care, do you have any urgent care type places in your area. They are all walk-in. The wait time isn't bad, and if the doctors feel your Mom needs a higher level of care, they will call 911.

I've been to the urgent care more times than my own primary doctor. One time I had pain in my chest, so rushed over there, turned out it was a pulled muscle due to me trying to clear out my parent's house.

I feel your pain. I've lived with a similar situation. I'm not sure what is causing your mom's aches and pains, but, I'll share what I discovered. (I'd write down all complaints and take notes to her doctor, so they can examine.)

Apparently, multiple aches and pains, none of which are ever diagnosed as an actual medical issue, can come from any number of sources, such as depression, anxiety, conversion disorder, etc. My loved one's doctor eventually, diagnosed her with anxiety disorder and prescribed meds. When she takes them, she has less aches and pains. When she doesn't, her symptoms are out of control.

One day, as she was complaining of ear pain for the 40th time, she said, there is no need to see another doctor, because they will just tell me that there is nothing wrong with my ears. It's true. She's seen 2 primaries and 3 ENT's and they see no problem with her ears. She also got a clean report on her bladder, which had claimed was prolapsed for 20 years. Not so. It's fine. The list goes on and on. She's actually pretty healthy, but can't accept it.

What I do is ignore the complaints and tell her that she should take her prescribed medication and call her doctor. I don't play the game. Now, if the LO is incompetent and can't take care of themselves, I wouldn't take this approach. It's up to you to decide if it's an emergency situation.

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