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Phoebe242 Asked February 2022

Are there options for getting high blood pressure prescriptions refilled for a stubborn 87-yr-old when she refuses to go to her doctor or get labs?

My 87 year old mother has never liked going to the doctor and would cancel her appts numerous times before finally going. Her doctor of more than 35 years joined a new practice and they now require blood work to continue to be seen and get prescription refills. She refuses to have blood work and does
not want to go to the doctor now, I assume out of fear that they may find something wrong. She is going to be out of high blood pressure med refills soon and I sense her plan is to just stop taking her pills which I know will lead to a health event of some kind. Are there any options for getting her care that would allow her to get her meds refilled? The suggestion of telling her you’re going somewhere else and showing up at the doctor will not work because I can guarantee she will NOT get out of the car. Any ideas are appreciated.

Sighopinion Feb 2022
She is 87 years let her do what she wants. As a society we really need to stop with this mindset of prolonging life. If she does not want to see a doctor or take her meds so be it.

Explain to her what will happen, if that is not possible try to understand what their wishes would be if they were on life support and wait it out.
kahill1918 Feb 2022
I am sighing too. It seems that dying is not to be permitted.
Grandma1954 Feb 2022
Some doctors will make house calls and blood draws can be done that way as well as a physical.
Does you mom have any other physical conditions that are of concern?
If not maybe have a conversation that goes like this....
Mom, I have a POLST (a form like a DNR but more detailed, can called by different names in some states) I need you to fill it out so that I know what you want me to do in case something happens. Since you won't go to the doctor I need to know what you want if I have to call the paramedics one day.
You can go through all the possibilities of what can happen if BP goes uncontrolled but at 87 I am sure that she figures none of that will matter. The thing to impress on her is IF she has a stroke and survives she will probably not recover fully.

Bottom line is...if your mom is cognizant she can make her own decisions and if this is the choice she wants to make then that is her decision.

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Taarna Feb 2022
Call her doctor. Explain that she doesn't want to do labs or go to see the doctor. The doctor can schedule a tele-visit (be there for the appointment online or via telephone).

Create a log of her blood pressure readings. Ideally, you should check her blood pressure at least 3 times during the day - first thing in the morning upon her waking up, sometime in the middle of the day, and before bedtime. Try to get a week's worth of readings before the doctor's appointment. If mom won't see the doctor in person, get those readings to the doctor before or at the tele-appointment. Buy an automatic blood pressure cuff. I am an RN and I have one that works on the wrist so that you don't need all the different sizes of BP cuffs.

If she still needs bloodwork, take her to a lab and ask them to use a butterfly set and mini-tubes. Some of my older patients tend to do better when I use a butterfly set-up and use a syringe instead of the vacutainers. (Feel free to print this out and take to the lab so they can read what I wrote.) The doctor can also prescribe numbing medication to put on her elbow creases and back of her hands 1 hour before she gets lab work drawn so she won't feel the pain,
GAinPA Feb 2022
Thank you for the info you provided. Many people hop on the boat “you CANNOT make them do what they don’t want to do” without examining the options.
TChamp Feb 2022
If you mother is legally competent, she has the right to refuse treatment and accept the consequences. You can't force her unless she is legally incompetent and you are her guardian. Even in such case, you can't make her swallow her medicines,

BarbBrooklyn Feb 2022
Have you spoken to her doctor about this? Perhaps s/he can set up a telemed visit with a nurse practitioner.

Or assure her, as can you, that nothing will be treated that she doesn't want treated.

Have you asked her why she doesn't want to go?

tjstyme Feb 2022
I have a mobile Phlebotomist. I get orders in writing from Dr. It costs 80.00 and then she takes blood work to lab everything else just as if u did at drs office. This person knows what needles to use for my mom who takes a pediatric needle which most offices don't carry.
Its a little costly but worth it in so many ways. Good luck.

Erikka Feb 2022
Do you both have enough information to make an informed decision?

Did you ask if this is her way of dying? Did you tell her you’re not ready but you understand? And if she wants to die, are her affairs in order? Does she understand the physical and possibly mental repercussions of a heart related health event? Or how long it could last? Or what care she might need and how to pay for it?

Have you asked yourself what kind of life you want to live at 87 or 90 years old? And at what point you’ve spent enough time on Disney Earth, ridden enough rides, seen enough sights, had enough highs that exhilarate, persevered enough storms; but you’re tired, it’s not much fun and you’re ready to go home?

NYCmama Feb 2022
My Dad did the exact same thing with his doctor appointments - and actually, it does become burdensome to get the elderly to doctor appointments. His doctor understood and arranged for his blood to be drawn at home every three months. Ask if this is a service that can be provided for your Mom - it is not unheard of and is covered by Medicare.
BurntCaregiver Feb 2022
I know how that is. I was caregiver to an elderly woman who was totally invalid from LBD and bedbound. Her doctor would not refill her prescriptions that she'd been on for years unless she came in for an office visit. Her insurance covered home draws for her bloodwork to get done. That wasn't the issue with her doctor.
She had to be transported by ambulance to the doctor's office. He really didn't even examine her. The medical assistant took her blood pressure and he listened to her heart. Both could have been done at home by a visiting nurse. They're only insistent like this to run the bill up. No other reason.
MaryKathleen Feb 2022
Remind her, if she has a stroke, because of her high blood pressure, she MIGHT NOT DIE. She might just be paralyzed and live out her days in a skilled nursing facility with tubes coming in and out of her body. That scares the begeezes out of me.

If she has paperwork that states she doesn't want certain measures taken. Be sure you know where the copy is. And as hard as it is for you, you might have to let it happen. How high is her BP?

My husband had a low BP incident the other day. I called 911 and the medics wanted him to go to the hospital in an ambulance and be checked out. He wouldn't go, he happily signed the release slip. It is his life and I have to respect his decisions. He was mad at me because I called 911. I just let him know he had the rest of his life to get over his mad and I will do it again if I feel the need.

Dosmo13 Feb 2022
From all the responses, yours and others, I'm not clear as to why she won't go to the doctor.
Is it the blood draw she objects to? As already mentioned, this can be made less painful. But it's never pleasant, esp. if frequent.

The medication? Some blood pressure meds, can make one feel lightheaded or dizzy (which, incidentally, increases chances of a fall). If this is the case, the doctor may adjust the dose, try a different medication or stop medication entirely.

If she is like many 87 year-olds, she would tell you, in all seriousness, that she would rather DIE than go into a "nursing home". This seems to be the greatest fear of people her age.

Virtually nothing will guarantee she stays out of a nursing home. And, as she well knows, there are many possible fatal outcomes at her age. She should be urged to at least discuss her preferences with you and her physician so that you can all be on the same page.
It may not be "stubbornness" on her part, but simply a sense of resignation, a willingness to face what is inevitable. Some elders simply grow weary of being analysed, treated, scanned, medicated, and subjected to various therapies. She might just consider your company the therapy of choice.
Legally, unless declared incompetent, it is her right to choose.

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