How do I deal with my mom's denial and refusal to listen to the doctor?

This is sad because your mom could really benefit from the right meds for her moods swings, anxiety, etc.

Is she living at home with you?

Does she have dementia, memory loss, etc?

Let me ask a really hard question with regard to her heart: how long do you want her to live? Has she not had a good long life? Is it really worth a Mexican Stand-off with her now??? Why can she not let God take over at this point?

I would not be asking this if she was 60 but she is 90. You are not a bad person if you abide by her wishes, let go, and let God.

Good luck!

I am sure the cardiologist recommended a boatload of "preventative" testing they feel she needs so they can manage any "change" that arises with your mom. Take a look at the list. At her age I would take her for the easiest diagnostic testing- an EKG, an echocardiogram. But if that list includes a stress test where they put your 92 y/o mother on a treadmill, well I don't know if I would proceed either.
At 92, she is not going to change. It'll never happen.
Seniors need to hold on to some degree of independence. Let her make the decisions regarding her health. Unless it's something acute, but it sounds like these were follow up appts not an acute event.
I would let it go. Maintain a good relationship with her geriatrician and leave it at that.
Good luck!

It's really hard to balance what they think is best (which is to ignore everything and let nature take its course, most of the time), and what we think is best. It's like walking a tightrope. My mom, although she's only 83, would rather not be alive, so she wants to ignore all health issues. The problem is that any of her particular health issues (fall risk, bad foot care, weakness from no activity) will not actually kill her, just make her that much harder to take care of, and will make her life even more miserable and painful than it already is. I honestly think she's trying to die faster by neglecting herself, but it doesn't work that way, and it just puts a burden on everyone else, and will increase her suffering. It's just hard to get her to see it that way. I'm not sure I've found a balance between respecting her wishes, and forcing her to accept the minimum care to keep her as comfortable and happy (?) as she's able to be, and that truly I'm ethically and legally obligated to provide. I realize that was absolutely zero advice, but I really empathize with your situation.

Dear Brdlvr,

It's clear you love your mother and want her with you as long as possible. Consider, however that she has managed her life well so far and has recently gone through a major life change, moving to be near you, meeting new doctors, and giving up some portion of control.

Doctors mostly want to cure and help and fix things. That's great most of the time but one thing I have found out in my care journey is that it's not always the right thing to do. Yes, identify issues but unless a treatment is non-invasive and without major side effects, sometimes the best thing to do is nothing.

I had to make that very difficult decision for a loved one and it was the hardest thing I have ever done. None of the medical conditions was "curable" and treatment was causing problems that were frightening to both of us and hastening a mental decline. When I made the decision to stop one treatment (after talking with nurses, geriatric care professionals, priest and family members), I was terrified. Now, nearly two years later, I believe it was the best decision I could have made for quality of life. Similarly, a "minimally invasive" procedure that required hospitalization and had bad side effects, was politely declined. Again, nearly two years later, things are still going very well.

Will we all die? Yes. Do we all have the desire to enjoy life as much as possible while alive? Yes. So, try to get her to take her pills for maintenance, drop the cardiologist and work with the geriatric specialist only. They definitely understand that for many elders, quality is much more important than extending life for a few days/weeks/months of unpleasant existence. In many cases it really is called "let go and let God".

Your mom is fortunate to have you and I hope you and she can reach a point where you can continue to love and enjoy each other's company.

It's a shame that your mom chose to cooperate with cardio and not with geriatrics.

In all likelihood, the  geriatric doc would seek to reduce the medications that a Senior takes, reducing interactions and side effects.

Can mom take in that explanation, and the concept of palliative care, o.e., no longer trying to fix things, just to keep her comfortable? 

Right now, I intend to quit taking all "preventive" medications, such as blood pressure and cholesterol lowering drugs, when I am 85. That may not be enough to cause my death before I become demented and/or immobile, which to me is much worse than death. Meds to reduce pain or induce sleep, that's all I want.

She is 92 years old. The vast majority of people do not live that long. If she is able to go to the doctor, and then go out to lunch/dinner, God bless her. Maybe you were nagging her in the restaurant, where she just wanted to sit, relax and eat after the doctor's appointment & she had to threaten that she would scream to get you to stop.

I can't imagine a "long list of things that need attention" in a 92 year old woman. She has outlived 98% of her peers, doing whatever she has been doing. As a health care provider, my feelings about doctors has dramatically changed over the last 5+ years. I find that many doctors are performing unnecessary tests just to make money. In a 92 year old woman, there are probably lots of things that, if she were 50 years old, would need "attention"---but at 92, how much of a "problem" they are is most likely debatable. Maybe she just doesn't want to deal with all the B.S. that accompanies extensive testing/treatment for things that the doctor think require "attention". Just because a doctor thinks things "need attention" doesn't necessarily mean that it is true. How would the treatment change based on the testing that the cardiologist wants to do? At 92, I can hardly believe that she would be able to do a stress test. I don't think your mom is planning on running a marathon or doing a triathlon, so an echocardiogram is not necessary either. An EKG is a routine test done on people over 50. Blood work can determine if her liver, kidneys & cholesterol are within normal limits.

Don't harp on the subject. Let her live the way she wants to live, because at 92 years old, she deserves it.

Jacobsonbob, I think it was the OP's mother saying that she has got to 92 and the rest of it is up to God. And to be honest, she has a point. This lady is 92. She is basically fit and well and certainly up to a good argument and telling interfering doctors where to get off. May God bless her and keep her, just as she is.

I might point out to her that the aim of this exercise is to help do that - keep her just as she is - and leave the offer open. If she doesn't fancy any suggested treatments (and let's face it, tinkering by medics does not always have exactly the desired effect in 192x vintage models), she will be free to decline their recommendations.

But don't push her. I know I hate it when my children nag me - possibly not quite enough to have a tantrum in a restaurant, but give it time..!

I have the same issues with my mother. It's only recently that I've been able to convince her to let me go in to the doctor/dentist/specialists, etc. with her. She is 90 and is in denial and then tries to manipulate what the doctors say and prescribe. Now that I'm fully aware of what's going on, I just do my best to get her right in to the doctor when an issue arises and follow up with each of their recommendations. I believe some dementia and elderly anxiety is causing this lack of judgement on my mother's part, but try my best to reason with her before, during, and after each doctor appointment. It's a struggle because she has never been an easy person to deal with, but it is what it is. Sometimes I have to be firm with her, other times she is cooperative. I keep reminding her that I'm on her side with her best interest in mind. When need be, I have met privately with her doctors so they understand what I'm dealing with. I also consult a senior social worker for ideas, and use resources such as aging care to help. That has truly helped both the doctors and me deal with a difficult person and situation but make it more safe and healthy for my mother as she lives out her life. I wish you the best.

Elderly can be pretty suspicious about medication and doctors. I would guess although you don't mention it, that she could have some dementia...perhaps vascular type since she's had stroke history. Her behavior isn't normal. Has she always been this way or is this new? Did her geriatrician giver her any cognitive evaluations? I hope you will let us know her mental status. She does act like she has some anxiety. Sadly a lot of elderly are depressed and are tired of living and just want to go. I don't know if this is your mom or not. But if you can't get her to cooperate then you are fighting a losing battle.
I'm wondering several things you don't mention. Does she live alone, with you or in a facility? Do you have medical power of attorney? Does she have a living will?