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My mother in law was recently diagnosed with COPD and prescribed oxygen 24/7, nebulizer 3x/daily (and she has hypertension). She just returned from dr. who told her she now has lingular atelectasis (partial collapse). Still, she told me she will never wear oxygen 24/7. A couple of us went together and bought her a portable Inogen for ease and convenience. However, if she's not going to use her oxygen as prescribed to actually help her, I'm not sure what I can do for her. I want to respect her and be kind, but really don't understand her irrationality. She even knows that when she is not on oxygen, her mind is not as clear and she does not function as well. She doesn't like feeling like that BUT refuses to help it.
Any suggestions are appreciated.

You can remind
You can inform
You can beg, plead,
You can not force.
You can not make a personal decision for her.
You might want to sit down and have her fill out a POLST (or whatever it is called in your State). One of the questions is do you want to be intubated.....
Ask her when she does not have enough oxygen and does not respond and you have to call 911 what does she want the hospital medical staff to do....
Maybe if she realizes what can happen if she is without oxygen for an extended period of time she might change her mind. (It might scare her but if the heart stops and they do CPR ribs will be broken, sternum most likely will be broken, recovery is slow and painful)
But if she is fully aware there is not much you can do.
Even if she were diagnosed with dementia and you could make all her medical care decisions for her keeping oxygen on is still a problem. (One of the reasons Memory Care facilities rarely take a patient/resident that has any "tubes" Oxygen, feeding, IV's catheters, "ostomy's" they tend to pull at them and eventually pull them out.)

Personal opinion here...I have had oxygen several times for minor surgery and I hated it. I hated the feeling, I hated the cold dry air that seemed to make my nose so dry it hurt. I fully understand why she does not want to use it!
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Reply to Grandma1954
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Thank you AlvaDeer. I am an RT who worked 40 years in a hospital with COPDers. It is obvious that she does not feel she is suffering from lack of oxygen which may be why she takes it off. Ethically even a doctor cannot force her. Speak to her that she can choose the revolving door of hospitalization where it will become more frequent and she will get weaker. Does she want hospice to make her more comfortable? You can call her bluff on this but you can ask her if she wants you to leave her and not check up on her so that she can die alone at home.
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Reply to MACinCT
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If this is actually dangerous, and mother is adamant, could you get an initial appointment with hospice? That would help her to look at the risks, the upside and the downside of this particular intervention. If she still refuses, and the result is deadly or disabling, you will have the reassurance that she knew what she was doing and what she was risking. You don’t need to go ahead and apply for hospice, but they are the experts in talking through this type of issue.
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Reply to MargaretMcKen
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It is uncomfortable to have oxygen on constantly. I have been hospitalized for asthma and had oxygen on the entire hospital stay. I wore it but it is bothersome.

My brother removed his oxygen in hospice. The nurse let him keep it off which I understand. My mother kept hers on but she would pull at it occasionally.

I don’t know what else you can do to entice her to wear it. You can’t force her.

Best of luck to you regarding this situation.
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Reply to NeedHelpWithMom
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My 70-yr old employee has COPD, diagnosed several years ago. It is a mental and emotional adjustment for certain. She has the Inogen (or small, portable) O2 and a way to recharge it from her car (back-up would be important if your MIL lives in a severe storm state where power outages are possible. She goes to PT to learn breathing techniques, which help her. But you can't have this adjustment for your MIL...she has to come to terms with it at her own pace. How old is she? Is it possible she has mild dementia? Maybe this would explain some of her reticence.
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Reply to Geaton777
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There is quite honestly nothing you can do if gentle persuasion doesn't work. She will decide when and if she needs it hopefully, but this is a common problem. Constant O2 flow is very uncomfortable, very drying to the nasal membranes.Many choose to do the best they can without using it all the time. You understand what this diagnosis mean, and she will have to live the remainder to her on her own terms in so far as she is able. The loss of control and power and constant talking about the O2 won't help a whole lot.
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Reply to AlvaDeer
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Try it yourself and see how happy you'd be. Her irrationality might make more sense when you've experienced the downside. (Obviously you don't turn *up* the oxygen in your case!)

Get her a finger tip oximeter if she doesn't already have one. This was the only way I could get one gentleman to take brief breaks during his morning personal routine instead of attempting to charge through the whole process at full speed - no good my saying "I think you should stop," the only way to convince him was to stick the thing on his finger and say "oh dear, 87, let's just pause it there for a moment and get the O2 on."

How much noise does the Inogen make? Another client kept her generator outside in the hall and had extra long tubing for it.

Check (I'm sure you have anyway, but just in case) that the skin over her ears and around her nostrils isn't getting sore.

Any other potential discomfort issues?
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Reply to Countrymouse
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