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

You sound like you love your mother very much. My heart goes out to both you and your mother

The headline of your post is your mom is in denial.... What is she in denial about? That she will die if she isn't careful? She probably knows that.

I will be 83 in June, in the last 6 months I have lost a niece who was barely 53, a very good friend and co-worker who was 57, two other good friends in their 70s. All died of illnesses. A couple of years ago from the middle of July to the end of September, that is 6 weeks, I went to 19 funerals. Sometimes more than one a day. When you get our age, you know you can die. Quite often most of your friends already have.

I have multiple problems. I hurt and ache all the time. Yes, I do go to doctors so much that my car knows the way by heart. I keep active and look after my health, but when something serious or bad happens, I might choose not to do anything about it. Please take a minute and think of life from her point of view.

I was talking to my 53 year old daughter, who is a retired fire captain, about how much I loved the cemetery where my 57 year old co-worker is buried. I said I would love to be there but I would be far away from others. Then, we started laughing, I have at least 5 co-workers buried in that cemetery. All were in the wildland fire service. My daughter started teasing me about it. She said as soon as I am in the ground, Vinnie will tell me to get over to check-in, then get to the supply trailer and get my stuff, and the caterer is over in that other part of the cemetery. That those who went ahead of me will already have fire camp set up and I will fit right in. My other daughter thought so too. Think of the Lion King and the Circle-of-Life.

Well, she is 92. I call that "the bonus round." If she has made it this far, I would let her do as she wants as long as it isn't reckless & life threatening. She is most likely dealing with a bit of dementia, forgetfulness, agitation, mood swings, and stubborn behavior when it comes time to go to doctors, being told what to do at her age. I would not try to force her or argue, it will most likely backfire and you don't want to battle with her and end things in frustration.
Just make sure she is comfortable, safe and if she needs meds and does not want to take them, you can get creative on slipping them to her in foods so she doesn't realize, (talk with the doctor about this before doing it, some meds cannot be combined with certain foods, etc.) Diet itself can help avoid certain issues, my husband was diagnosed with Diabetes, he was literally redlining it when they checked his blood and wanted him immediately on meds. He refused and just radically changed his diet and dropped his blood sugar down to normal levels within a couple months. No meds. When he went back to get tested, they were shocked. Now he can bring in little bits of the things he loves on occasion without the levels skyrocketing up again. Best wishes to you and remember, if she has made it this far, she is doing pretty good! My Mom started slipping mentally in her early 70's.

I agree with most of the answers here - I'm a caregiver for my 95 yr old hubby. When at all possible, I do allow him to make his own decisions. I have even asked him if it bothers him that I am keeping him alive. He said he is thankful as he still wants to live. He appreciates that I am in no hurry to become widowed.

However, he is not in chronic pain. That is a biggie that has to be considered. He is also not on a lot of meds: blood pressure, cholesterol, Zoloft, Lasix & Flomax - everything else is basically a chewable vitamin, chewable gas-x. I have to thicken his liquids with Thick-It and I use Ensure Plus to help with nutrition.

What I'm trying to say, it's not all cut & dry. Serious health issues might not be worth a person wanting to remain alive. My biggest problem right now is he sleeps a lot and awakes every couple of hours to void.

But if your mother is on multiple medications and has pain and suffering, then her decision would definitely be different from my DH's. And I would understand. If my Ray was in constant pain, I would be looking to assist him in escaping the pain even though it would mean me letting him go.

You know your mother best - what would you want done if you were in her place? That is a good starting point for all of us. What indeed would we want done to and for ourselves.

Every comment on this thread hit home! My Mom is 83 and although she will take her medication, she refuses any change in them, wants no new ones for anything, and has no problem telling the Doctors that she is old enough to do what she wants and that is how she got to be 83! She has no dementia at all but her body is weakened. She has recently become a fall risk, although she insists it is tripping, her legs are weak, but does not use the walker to help herself, and is quite happy sitting in her comfy chair all of the time. I can only imagine what her new diagnosis of Diabetes will bring. We see that Doctor tomorrow!!

Quite honestly, your only solution here may be prayer. Many or perhaps bordering on most elders don't listen to their doctors' protocol.

Many people who have live very long lives - into their 100's even - attribute their longevity to staying away from Doctors, Microwaves, pharmaceutical drugs and animal flesh and animal byproducts. watch Gerson Natural Therapy - This woman is in her 90's - looks so healthy and young https://www.youtube.com/watch?v=VWBCMGiIyKM

Thank you for all your great answers and suggestions! I do agree that there comes a point when maybe it's best to let nature take its course and to forget about all the procedures that can lead to more stress and anxiety. She has gotten a little better in accepting that she needs these tests, but we haven't gone to the follow up appt. yet, which could result in more stress and anger if its negative. She refuses to go to the geriatric doctor, so I won't force the issue. She says she wants to still feel that she's in control of her life, so I will respect that. Just one more appt. with the cardiologist and then hopefully that will be it for 6 more months.

The old lady is 92, SHE is the one talking about 'Gods will', and frankly, if I were her, I would want to stop taking all those pills to extend a long, wearisome life. I feel that way now at my age (much younger). When they get that old, it is up to caregivers to see they are comfortable, not in pain, not in distress. When my mother was in the nursing home, they started winnowing out many of her pills, as they really weren't even doing her much good any more. Mom eventually died in her sleep, peacefully, from Alzheimers.

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 am 73yrs old. My husband died three years ago ....on my Birthday. I miss him so much. I have been on dialysis eight years. I have some other health problems. I am very tired of going to dialysis three times a week. I talked with several of my doctors and told them if anything else serious come up I would prefer to stop the dialysis. And what will be will be.

In my opinion letting your mother let God take things in his hands is the best thing you can do. Enjoy her however you can at this stage of her life and be happy you had her for so long. My mother died at 69 yrs old

When my mother was in her late 80s, early stage dementia, she was in a transitional care unit for an injury to her arm. Many tests were done there, routinely. I accompanied her when she visited her own wonderful geriatrician when she was discharged. This was the conversation:
Dr: I see that some routine scans revealed something in your pelvic area. I can order further tests to find out exactly what that is.
Ma: I don't want to know what it is. If it is cancer I will not take the treatments, so why do I have to know?
Dr: Many of my patients your age feel that way. I will respect your decision. But it is my duty to tell you that cancer treatments have gotten better, and could save your life.
Ma: I have already lived a good long life. I am going to die of something.
Dr (Speaking to me): How do you feel about your mother's decision?
Me: I feel it is her decision. Her family will stand by her.
Dr (To my mother): I will certainly honor your wishes. I will not order further tests for you. If you think about it and talk with your family about it and change your mind, just let me know. But it is your decision.

At another visit...
Dr: I know that you are annoyed when the nurse asks on each visit if you smoke. I will make a note on your chart not to ask. You've been smoking 78 years and there is no requirement that you stop now. If you ever decide you want to quit, we can help you. But I'll try to see that you are not asked about it again.

And this:
Dr: I'm not going to talk to you about what you should eat. You've lived more than 90 years, so you must be doing something right! Maybe you should tell me how to eat! I am going to suggest, though, that at this age it would be good if you could drink more liquids. It doesn't have to be water ... lemonade, iced tea, hot tea, milk ... any thing you like. Or eat a lot of juicy fruits. I just want to be sure you don't get dehydrated.

I loved this doctor! I'm not sure when I'll switch to a geriatrician, but I sure hope she is taking new patients then.

brdlvr1, listen to all the people who are giving you advice about end of life care. All of them are Rock Stars. I know it hard to lose a parent, but nothing is going to make them young again. Also, think back, were you nagging your mom at lunch? Maybe all she wants to have some quality time with you without you nagging her. What fun is that?

I don't like going to the doctors now at 67 bet I'm going to be a pain if I live to my 90s. I was lucky, Mom never fought me going to the Doctors. But then I didn't tell her to we were leaving. Change is hard for the elderly. She probably had her doctors for years. She doesn't know these people. I agree, look at the tests they are asking for. An EKG should have been done in the office. A stress test, no I wouldn't allow that. Who cares at 90 how much your heart can take. But meds may help. Mom is on mild ones and they have calmed her down after having an UTI. And that is something that should be looked for. Plus potassium and dehydration. All can make people do things they wouldn't normally say or do. My Mom is 89 and they saw something in her neck. Since she can't do dye because of only one kidney the doctor felt we should just let it go. There are just things that aren't worth putting them thru.

My Mom has had two wonderful doctors. The first one said he didn't like "to bother the elderly". He was in full agreement that only absolutely necessary tests should be performed and that the elderly should be allowed to live out their life as they see fit. Current doctor actually cancelled tests from a specialist explaining that the doctor ordered them because he should but she was cancelling because she can. My Mom is 91 and has some issues but still living fairly well. Also when we visit she doesn't take BP or other things that work my Mom up, just sits and visits. She also only bills half a regular visit. This way of thinking works well for my Mom as she has dementia and just wants to sit and talk about the past anyway. She won't take any medications so there is no point in fighting about it. I have POA and do everything but just trying to hang in there as she is coming to the end of her life and I just want it to be peaceful.

I agree with your Mom she's made it 92 years without doctors and their pill pushing. Stop nagging her for what You think is right and leave it up to God who is always in control.
It's not easy but it's the right thing to do.

If she says it's god's will that she lived that long, then tell her that is probably god's will that she went to drs [ & maybe the move was part also] - also it's god's way of saying when it's your time then it's your time to die but that god planned those drs to have that education to soften and ease her remaining years because she earned it

In other words turn it back on her - say god came to you in a dream or came when you were praying whatever it takes - even say it might be god's way of testing her to see how compliant she is to god's wishes

You can't lose anything for trying this route - also bring it up when she refuses pills - she now can go back from her earlier stance of not agreeing by saying it is 'the lord's will I follow the drs' [you can only hope] without loosing face

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.

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.

My mom, who is in her 90s, would also get very agitated when it's was time to see her doctor. She'd fight and argue with me and deny anything was wrong with her while the doctor was present. Yet, once the visit was over and all her vitals and reports were deemed fine medically, she was a happy camper! It's then I realized she was acting out due to great fear of the unknown by little things like a Urine analysis or blood test. and the realization she was dependent and no longer in control. After that I'd soothe her by fears holding her hand and giving her positive affirmations about her health and pray with her as we waited for the doctor. If the doctor said she needed a medication to help with whatever was her ailment we would thank the Lord that there was a med for that! I always saw my mom was the strongest woman I had ever known and so to see her fear was new to me but it also brought us closer. I then became the "parent" and like you deal with a child, willful or not, there's a always a way to work with their moods and diminishing capacity for their good. I agree with others here who have said that your mom, like mine, has had a long life and so pick your battles wisely. These days with my mom now close to 92 with dementia and wheel chair bound, I always seek to make her happy and content with lots of verbal affirmations of my love for her and my commitment to her as she ages. I want her to know and feel she is not alone and loved.

Although I'll admit I can't know the full context of the conversation, it strikes me as rather insulting and just a bit irresponsible for a doctor to tell a patient what happens to her is "God's will" as if she is no longer quite worthy of conscientious medical attention.

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.

Read the book Being Mortal: Medicine and What Matters in the End, Reviews
Book by Atul Gawande. Helps with the communication necessary to help love ones through the end of life. I have 2 parents who want no medical intervention. 0ne that wants intervention, but often does not complete the treatment. Also there are many palliative care centers popping up. that help with symptom control. It is a difficulty journey, no matter the circumstances. I wish you well

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.

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?

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.

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!

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? 

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!

Dear brdlvr,

Your mom is amazing for making it to 92 years of age. I know you love her and want the best for her. Its a tough situation. I too struggled with this decision with my dad and he was only 83 years old at the time when he got so angry about his pills. He also had a stroke 2 years earlier. Most seniors need some medication to keep going and in some cases its the only thing keeping them alive. I know you don't want to argue with your mom and at her age some people would say let her be. But part of me thinks you should try and find another way to convince her to keep monitoring her health. There are no easy answers and I hope others can shed more light.