How can I get care for Mom when she refuses to see a doctor?

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A month ago mom fell and broke some ribs near her spine. I called an ambulance and she was taken to the E.R. She received some x-rays and was sent home with a prescription for 10 pain pills with no refills and was instructed to follow up with her own doctor. The break was minor and there was nothing else they could do for her. Mom has refused to go to her doctor. Today when she stood up to get to the phone, her pants fell down and she tripped over them and fell again and re injured her ribs. She managed to get up and I found her sitting on the sofa with her pants still around her ankles. She refused to be taken back to the E.R. She insists on living alone but is not able to care for herself. I have offered numerous time to have her move in with me so I can help her but she refuses because I have pets that she is allergic to and I will not let her smoke in my home. She has also refused to have anyone else live with her. Other than hog tying her and dragging her to her doctor against her will, is there anything else I can do for her. I thought about making an anonymous call to APS (that way they are the bad guys and not me) but not sure if she would even open the door and let them in. Not sure what else to do.

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If your mother has Original Medicare with a supplement (in other words, she is NOT on a Medicare Advantage plan, aka "Part C") you should be able to find a mobile doctor service that will send a physician to her home. There will be no out of pocket.
I would avoid contacting APS if at all possible. In any event, there is little they can do if she has cognitive capacity.
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When I called APS for advice about two friends of mine for whom I have POA about their driving after revocation, I made sure I was at their condo when the lady came to evaluate their situation. I spoke to her a minute before she came in, then explained to my friends that someone had called APS and she had to evaluate them as part of her job--she was required by law to do this. She did the evaluation and gave me a heads up about how long the wife would last with her fronto-temoral dementia. I was able to get the car keys at that point and move their car to a friend's garage to get ready to sell. Fortunately, they never resisted seeing a doctor. I made the appointments and drove them there and sat in on everything. They were resistant to leaving their condo, but couldn't remember to take their meds, etc, either. I started with a home health service two days a week for 3 hours a day and the lady was marvelous in what she could do with the wife.

When the wife started to wander and was incontinent, I was told they needed 24 hour care and finally was able to convince them to go to a memory care apartment in an assisted living facility for the added care the wife needed. They were inseparable and needed to go together. It worked out really well, but the wife continued to decline and died about 5 months later. The husband is content to stay there and never mentions about going back to their condo. Getting APS involved was key and for each additional step, someone who knew what to do crossed my path with advice. This was all new to me and I still am amazed at the answers and guidance I have received to assist my friends in the best way. They had no children nor close relatives who could do this.
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You can call her doctor yourself and check that the doctor has been informed of the original injury and the requirement for follow up care. You go on to inform them that you have been unable to persuade your mother to make an appointment for that follow up care, and that she has since had further falls.

The doctor's staff won't be able to discuss your mother's care with you without your mother's permission, but you will have reported the situation and placed the ball in their court. Whether or not they act on your information will depend on the quality of their relationship with your mother - so, has she been with this practice long? Has she generally been a good patient?

With luck, they'll take the initiative and contact your mother. But if they tell you they won't, or if nothing happens, you can call APS and report a vulnerable person at risk. They should be able to visit your mother, carry out an assessment of her living conditions, and recommend a plan going forward. I understand you aren't very optimistic about her co-operation, but you don't need to do it secretly and you don't need her permission either. Without looking for an argument, tell her what you're doing and tell her that the whole point of the exercise is to keep her living safely at home. If she still won't let them in, that's her lookout.

Come to that, it's her lookout all round. There will be reasons for her unwillingness to seek or accept help - could be depression, could be fear, could be privacy issues. I'd stop asking her to move in, if I were you. My guess is that being forced to leave her home and give up smoking will be among her greatest fears. So if you want her to accept support, what you need to convince her of is that time marches on and in the end she will be left with two stark choices: let help in, or get carried out.
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As others on this forum has suggested, when she falls again and cannot get up, call 911 and have her taken to the ER again. At that time, explain your concerns to them about your mother's well being, tell them she lives alone and there is NO ONE there (at her home) to properly take care of her. They will want to release her into YOUR care and if that's acceptable to you, have THEM explain this to your mother that she is to go home to YOUR house. If she refuses to live at your house with your rules (no smoking), then tell the social worker/discharge planner that there is no other safe place for her to go back to. Although, if she is severely allergic to your pets, then no, she shouldn't live with you. They will work with you to have her placed. Just know that they will do everything in their power to release her into YOUR custody. Hospitals are notorious in trying to get family members to take their elderly parents home. You must be insistent that there is NO ONE at your Mom's house to take care of her there. If they say she can get home care to come in, that's when you tell them she will not let anyone in. Then they (discharge planner/social worker) have to look for other alternatives.

Is she lucid? Does she have dementia? If not and she is competent and just stubborn, then unfortunately the elderly have the right to stay put in their own homes. It's when something unfortunate happens, like a fall whereby they cannot get up, that's a "wake up" call for them that they need more care than they themselves can manage. It is surely a conundrum to say the least. My Mom refused to have knee replacement surgery 25 years ago when it would have helped her tremendously to have a better quality of life in her twilight years. She didn't want to "go through the pain". So instead she wore out the cartilage in both her knees, shuffle walked for the last 8 years which got progressively worse, refused to do any exercises to strengthen her legs and balance, and ultimately fell and broke her leg. At a frail 86 years old, she received a plate and screws in her femur and will most likely now end her days in long term care in a nursing home. She has mild cognition problems that are progressing into more dementia symptoms.

So my Mom made her decisions and now, unfortunately, her decisions have resulted in major caregiving results for me. I have had to completely take over her financial affairs, getting her Medicaid eligible, hire an elder law attorney, getting mountains of paperwork handled, deal with the rehab/nursing home problems (less than stellar care from CNAs), deal with my other siblings who have their own challenges and one who is completely disinterested, my own health situation, and reassure my Mom's constant questions and worries about "never getting out of there" and wanting to "go home" (which will now never happen).

So, you see, your Mom is allowed to make her decisions. Will they ultimately affect you? Of course, especially if you want to stay involved in her care. Will calling APS help? Perhaps, but nothing will happen right away unless she is living in total filth and her environment is a health hazard.

Do you have siblings that can talk to your Mom with you and present a "united front"? Perhaps she'll "listen" to them. I find that in most cases, it comes down to one child in the family that takes on the majority of care for ailing/aging parents. Other siblings are perfectly contented to let one do all the caregiving. This is what causes many caregivers to burn out and die an early death themselves, sometimes BEFORE the aging parent. It's so sad when siblings cannot come together (including mine) and share the load, so to speak.

So the answer to your question, "Other than hog tying her and dragging her to her doctor against her will, is there anything else I can do for her?", the short answer is no, not until she has another fall and requires a trip to the ER (then see the first paragraph above).

It is so hard to care for our aging parents when they insist they can do it themselves. It's a matter of wanting to keep their independence. Think about it. We all want that -- to live and age gracefully in place in our own homes, die peacefully, thinking that we just won't wake up some day. Unfortunately, doing that takes fairly good health early on, making smart decisions in our middle age, and pre-planning for our golden years. Most of our parents (who were born in the Depression era) have not thought of that and frankly, most don't want to think or talk about it. So we, as children, are now scrambling to do the best we can for them, trying to do what's in their best interests, and for that we get push back from our aging/paranoid parents who now have dementia and think we're all trying to put them "in a nursing home". Yeesh.

Countrymouse said it best, "what you need to convince her of is that time marches on and in the end she will be left with two stark choices: let help in, or get carried out." It's hard to detach and accept that she is making poor decisions, but they are her decisions and she will have to accept the consequences.

Please come back and let us know how you're doing. We care.
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I find our local area on aging to be a wonderful support. In my area they always send in very kind and compassionate people who are a great support, but the situation often has to be dire if the person shows capacity. When environment is below what I find acceptable without being dangerous and they have capcity The Area on Aging usually leaves people in the home. I think a the Area on Aging is a good place to start but be aware that they might not move at the pace you might expect or get you the results you want. They can certainly direct and support you and they do it well, it's just not usually a simple one time step in most situations. In my experience situations like this are usually a process that is taken step by step. With a few steps forward and a step back over and over again. Most often you have to nudge an elderly person along the way, breaking down denial with great compassion and empathy and love partnering with them to help them feel in control. My experience is that once you get them into an assisted living situation and give them time to adjust. They are happy and tend to thrive. I recommend trying your local area on aging, they are a good place to start. They break down some denial and will help your Mom recognize for a short time that things can't stay the same, but it usually does not get the results you want on the first try. If the area on aging doesn't get her to address the issues, try hiring a Geriatric Care Manager who will come to her house and assess her capacity, the environment and gather her medical information and help you come up with a plan. Once a geriatric care manager develops a relationship of trust, they can usually help facilitate a move.
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With rare exceptions, hospitals and medical clinics are depressing places. I understand your mom not wanting to go to them. Maybe she would consider going to a naturopathic practitioner, such as an acupuncturist or chiropractor. Not only are their settings often more welcoming, but they also encourage wellness, rather than sickness maintenance.
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I'm so sorry to hear this, Sherridene. I'm sorry it was such a hard passing. I hope you'll take some comfort from having done everything the right way, and being there for her when she was ready to let you. My condolences to you and your family.
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I sure don't have answers, but will be following this post. I keep making appointments for my dad and he keeps cancelling them.
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If your mother would rather live in pain rather than go to a doctor, I'd let her. Tell her you won't force her, but you won't be the nurse either. Does she have money to pay for home care? They usually will send a nurse to the home during the admittance process. It is around $20 an hour and they can help bathe, clean or do errands. A few hours of this can make a big difference.
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My mother would cancel appointments, too, and then ask me to reschedule them. I finally got her to go... and she loved the doctor. Many of the geriatric specialists will be excellent and "know" how to deal with your mother once you get her there. I don't have all the answers, but I understand what you are going through. Sometimes it would take me all morning to coax my mother into an appointment of sorts...

Suggestions:
Can you make the appointment around lunch time and tell her you are taking her out to eat after the doctor's apppointment and go to her favorite restaurant?
Do you have a sibling that your mother listens to? (I have one brother who my mother would usually listen to more than the others... and I would just call him to try to talk her into things... It worked 75% of the time. I would also call my sister and my mother would often listen to her, too.

I would keep trying and hopefully one of the times, she will go.

Good Luck!
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