Geriatric Evaluation: Is it an essential tool?


I set up an appointment to get my mother a geriatric evaluation, but she cancelled it the day before she was supposed to go. The evaluation was to take place at a very reputable facility in her town, that has out patients programs, as well as being a nursing home.
She accused me of using this appointment as a way of admitting her into their nursing home, and cancelled her appointment. Talk about histrionics. The truth of the matter is: I can't force her to go, right?

She's 88, lives alone and is fairly independent. She was diagnosed with congestive heart failure three years ago, which she seems to have stabilized through her drug regime. She goes back to the cardiologist 3 times a year.

Her cardiologist has put her on a no-salt diet, which she totally disregards. Her legs are quite swollen, which restricts her mobility.

I've noticed that she doesn't seem to have facial recognition.
Her doctors say she doesn't have dementia; she pays all of her own bills, shops for herself, and gets to most of her doctor appointments independently. However, I do take her to all her specialist appointments.

Should I force the issue with the evaluation? By nature she is not a co-operative person, has always been suspicious of everyone in her family's motivations. And generally refuses help from anyone, as she says it makes her look weak.

Thanks for any thoughts.

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Thanks for the tip on filial law, KathyO - will look into it.
- Rugs

I just had this sort of discussion with an eldercare attorney. She said a person has a right to make decisions for themselves, even if they're bad ones. That's fine, I guess, if no one else has to clean up the mess afterwards. Also, I just found out about the filial law in effect in 30 states, where the child may be liable for the parents expenses when he/she runs out of $$. (Google it!) If they decide to spend all their money, we are left holding the bag if Medicaid won't kick in for some reason? I sympathize with your plight, as I'm in the same position. I have to resort to subtle manipulation to steer him in the right direction. I hate it it - it seems so devious, but that's what I'm left with. I tried talking to his GP about a competancy test, but he he doesn't seem to want to be involved. He said I needed to make an appointment with a geriatric neurologist or psychiatrist. The lawyer said, no, that's not true. Even I can fill out this assessment form with the help of his CNAs, and get the doctor to sign it. Then off to court we go. That of course will infuriate my father and make him even more toxic and paranoid than he already is, which I dread. So, I'm back to manipulation. So, Ruggles, I have to learn to accept this, too. But we also need to protect ourselves, so be aware of the filial law in your state.

Thanks to you both for the good advice.
My mother doesn't want my help; she doesn't want to do anything that would help improve her quality of life, and she is not interested/capable of yielding to bring peace of mind to her caregivers.
I have to learn to accept this.

I wish they would give these types of tests a different name. Where I live they call it a "long-term care" assessment. My mother went ballistic when I suggested she have one because she, too thought I was going to put her into a facility. These tests have nothing to do with putting seniors into homes. They are a complete review of the person's "functional ability, physical health, cognition and mental health, and socioenvironmental" condition. They are done to see how an elder manages his or her daily living functions.

The importance of these tests is to have a starting point to track that person's abilities and in subsequent assessments will help flag any deterioration. This is, in my opinion, the most important thing to have completed.

In my mother's case, I finally convinced her that what they do in this assessment is to evaluate all of her abilities, which are amazing for someone in her condition. I then told her that this assessment is meant to identify the supports she may need to help her stay in her home as long as possible. She seemed to accept this and the assessment was done, and in fact identified a couple of supports that has helped her maintain her independence longer were put in place. That was three years ago and those supports have helped her continue to live in her own home.

And how, exactly, would you "force" the issue? You not only can't make her go to the nursing home, as you said, can't make her do anything at all. You can only lay the groundwork, and be ready for when her needs are so severe that the issue is "forced" by a starker reality. Painful, isn't it!

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