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bolliveb123 Asked September 2019

Mom refusing geriatrician; any tips on how to get her to accept age-appropriate care?

Mom is 81, living alone in the same home she raised my brother and myself. She has some cognitive decline. I want her to see a geriatrician, to get her established in a practice so they can get a baseline on her. She refuses on the grounds that her primary doctor will refer her if he thinks she needs it. She will not see the value in becoming an established patient before something happens and we need to scramble around and perhaps end up with a someone we would not have chosen. I think she is living in fear of what a geriatrician will say regarding her memory. She is also depressed and has been for years but will not admit it or agree to an assessment for that either. She is of the generation where any talk of mental health is shameful. She doesn't believe in mental health treatment, and if you need it, it means you need a straight jacket and rubber room. Any tips on how to get her to accept age-appropriate care?

bolliveb123 Sep 2019
Thanks for the advice. She has a trust, POA, etc. etc. through an elder care lawyer over ten years ago. When she had surgery my brother and I were listed on the HIPAA form, but that was at the hospital and I don't know if it was in perpetuity or just for that occasion.

I have written her PCP two letters describing her situation, but she does not go regularly. She has no real physical health concerns and takes no medicine other than OTC allergy meds and Tylenol. If she gets a sinus infection she goes to urgent care for antibiotics.

Fearful, depressed and inflexible hit the nail on the head. She would have to travel to see a geriatrician as she lives in a very small town. I live in a larger city 1.5 hours away, and I'd of course be willing to drive her to and from. My brother is 7 hours away and working so he is less flexible, although no less willing to help.

Bro and I have brought up the geriatrician issues when everyone is relaxed and it never gets aggressive. She is just so set in her ways that she can't think beyond what she needs right this moment.
Geaton777 Sep 2019
Thank you for the additional info. If your mom is still "reasonable" in other ways, on your next visit you can pull up some of the desperate posts by caregivers on this forum and have her read them. Then you can look her right in the eye and ask, "Is this how you want it to go for yourself AND your children?" If she still gives you an unrealistic answer then you will know with absolute certainty that her "care" will be about doing an end-run around her for probably everything that will help her. When I went through a dumpster-fire with my MIL (too long of a tale to tell here) my own mother (who is 90 and lives next door to me) saw all of it. Then one day my mom made that stupid comment, "If I ever get like that just take me out back and shoot me". The look I shot her finally got through to her. She's never made unrealistic, flippant comments about aging again. Now she regularly visits facilities on her own so that she has participated in the choice if it ever gets to that point.
BarbBrooklyn Sep 2019
How about contacting her doctor about your concerns?

It sounds as though a referral to a geriatric psychiatrist is what is needed most right now. If her PCP recommended that, would she go?

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Geaton777 Sep 2019
Bolliveb123, at 81 I'm not sure you can "get her to accept" anything that she is that fearful of if she hasn't come to peace with it by now. When I had to help my in-denial MIL I offered to accompany her to a doc appt. When she was there I passed the receptionist and the nurse a discreet note stating I was advocating for her and to please do a discreet cognitive test and urinalysis. They were happy to do this. I sat behind her in the appt and if MIL answered a question incorrectly I shook my head with the correct answer. The doc got it. They see it all the time. You could also discreetly ask them for the geriatric referral. If you do get to go to an appt with her also have your mom sign their information release form (HIPAA) so that they have permission to release medical info to you and you can also give them info. This is very important, especially if you are not local to your mom. I know this all feels sneaky but it is for her own good. I can't imagine what would have happened to my MIL had I not done it. Please start with baby steps with your mom...she is in a fearful, depressed and inflexible state. Trying to cram acceptance on her all at once won't be helpful to either of you. In calm moments you will need to bring up little things here and there, like, "Mom, did you know that if you had a medical issue the docs cannot release any info to me because of the HIPAA laws? Even though I'm your family? You should think about signing a release form for me at your next visit." etc.

Hopefully she has her other ducks in a row, like assigning a durable PoA, Medical Directive, DNR, Will, etc. If not please see if she is open to doing this -- it will be extremely important in the times you will need it. Otherwise you'll be powerless to help her. Good luck!

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