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?

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?

I think the question is: Even if you got her into the clinic would she allow anyone to draw her blood or take her BP? Is she voluntarily taking the remaining meds? If so have you asked her why she bothers taking those if she's going to run out anyway?

You can't argue using reason or logic with a phobia (if that's what it is but she would have had this prior to being 87) or, she more likely has the beginnings of dementia and the cognitive confusion and diminishing ability to use reason and logic is making her appear stubborn or phobic.

You can purchase a BP cuff to see if she'll even let you do it yourself at home just to see if she'd even comply with any other testing. Because if her doctor can certify her as "home bound" then Medicare may cover an in-home visit. What she probably really needs is a cognitive exam and test for a UTI.

https://www.medicare.gov/coverage/home-health-services

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.

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,

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.

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.

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,

If your mother is resisting care it is time to talk to her exactly what the consequences are for each of her decisions. Preparing the detailed documents DNR, POLST, etc. is an eye opening experience.

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?

Phoebe, do you have any feedback about what your mom's line of reasoning is?

I think your 87 year old mother thinks she is being ripped off, and do you know I'm not sure she doesn't have a point. What blood work, and how often? Does her doctor agree that these investigations are necessary?

A relationship of 35 years is not to be tossed aside lightly by either party. If I were you I'd call that doctor personally, explain the problem, and ask for help with it. Perhaps s/he can speak to your mother and get her agreement.

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.

If her doctor's office is insisting on bloodwork and an office visit, they will not refill her prescriptions. What will end up happening is the doctor will drop your mother as a patient. Then another will have to be found.
Stop trying to humor your mother and work around the asinine stubbornness so many of our elderly population have.
Tell her exactly this:

Your doctor now insists on bloodwork getting done to keep your medications refilled. I do not run his office or the American medical industry so don't complain about it to me because there's nothing I can do about it. Here's what happens if you stop taking your blood pressure pills. You will have a stroke. If you don't die from it, you'll spend the rest of your natural life in a nursing home because you will need professional care that I cannot provide for you. Getting bloodwork done and seeing your doctor really doesn't seem all that bad now does it? You've lived a long life of 87 years. Do you really want to die of stubbornness? It's your choice if you want to.

I'm pretty sure if you tell your mother in exactly these terms she won't give you a hard time about going to see her doctor and getting a bloodtest. Good luck.

That is a tough one. I do hope you can convince her. My dad had very high blood pressure for many years and finally was put on BP meds. He took them for awhile but he was with Kaiser and when his doctor retired he was assigned a new one and so he was reticent to go and just stopped taking his meds. He ended up with vascular dementia later on and I believe the untreated blood pressure had a lot to do with it. Can you reason with her about the possible effects of letting her blood pressure go untreated? I’d start by talking to her doctor yourself and telling them the situation. They may have some suggestions or perhaps make an exception in your moms case. I think these days they have to do that kind of thing to cover themselves since people are sue happy.

One great thing about this Covid business is the tele-medicine appointments! See if you can do that and she may comply that way! My Daddy refused to go to doctors too! I could not force him, he was 6feet 2 inches and I just had to tell him "well guess your not gonna get your medicine then" mmmm... how instantly his mind changed!
Hugs for you!

I'd try to get a "Vacation Refill" for 30 days on her current meds when they're almost due. That would bide you some time, at least. Perhaps another month. Gives you time to find another practitioner.

Most of the Doctors around where we live have started requesting blood tests/prescription refills every 3 months. I truly think it's about greed. More visits = more money. It's very hard on the patients, esp people who take off work & lose money to see the Doctor, and the elderly who hate going. Even every 4 months would be easier for patients.

Might be time to change Doctors. We changed Doctors for a similar reason - difficulty getting to the Doctor, because we had to pay a private ambulance/stretcher each time.

Found one that would send out a Nurse Practitioner to the house for visits, and they were able to advise of a Lab that also made house calls. (Side Note: My Mom is bed-bound, paralyzed.) They're also less picky about the timing, for established patients the visits are as-needed, or every 4-6 months. Works well for her. In fact, I'd say it works perfect for her.

I had to do all of the research myself. The Area Agency on Aging didn't have any recommendations, her insurance was clueless. I just got on the Internet and started searching and calling.

I recommend the NextDoor website for asking others in your area for recommendations on practitioners that do home visits in the area.

Does your mother even check her blood pressure daily or has she just been taking the pills without knowing what her BP actually is?

At 87, prolonging life shouldn't be the goal. If she has a stroke because her BP is through the roof then explain to her that that is a real possibility. If that's a risk she's willing to take, then she should follow through, get herself a living will that clearly states she's DNR (do not resuscitate), she only wants palliative/comfort care, and to allow for natural death.

Obviously, you will not trick her into doing anything she doesn't want to do and so, at this point, I would focus on making sure her wishes for end of life are spelled out clearly. Enjoy whatever time you have left together.

First of all I would explain to her that she has to have blood tests to get RX refills and tell her she will get a stroke and what will happen if she gets a stroke - DO NOT HOLD BACK ON THE UGLY DETAILS. Then tell her you will NOT be able to help her and she will end up in a nursing home. She will be on your own - you are FINISHED AND WILL NOT HELP HER. And if she refuses to go, then get another doctor who will work with you. Also possibly look into a home health nurse who would come to the house and do the blood work for her. If all else fails, wash your hands of it and let her be - she is stubborn and stupid and if she makes her bed, let her lie in it. I am sorry but I have no compassion for old people who are stubborn, selfish and just plain stupid.

My son never showed up to any appointment I made for him (since he'e become an adult); it is time to let Mom be the captain of her own ship. Dr Phil always says, "When you choose the behavior, you choose the consequence." Let go and Let God.

Phoebe's update:

"Not trying to force my mother to prolong her life for my benefit so please stop judging. If she wanted to die, I would certainly let her. But she has given me no indication that that is the case. My mother is part of a generation/mindset that felt doctors and hospitals only meant they would start digging around to find a reason to put you in a nursing home. Doesn’t want the bloodwork because she’s afraid of what it might show. Afraid she might have to go into the hospital. (Yes she knows not going to the doctor may cause this anyway) Put yourself in her shoes, show some compassion, and understand the fear of this aging population."

So, Phoebe, what is mom's reason for not going to the doctor? Have you asked her and gotten an answer?

Does your mom understand that she can say "no" to further investigations? My mom was shocked to learn that she could say "no" to a bone biopsy and spinal tap after a few abnormal cells were seen in a test!

Our parents grew up in a culture in which to say "no" to a physician was to be labelled difficult and tossed away, blacklisted as a patient.

We eventually got mom to see that it was no longer the case, but she did a lot of weeping before we got there.

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.

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.

Phoebe242: While a patient may be able to get a one time pass from having an in office visit, e.g. 'patient is ill and cannot schedule an in office visit,' eventually they must be seen by their physician. Unless your mother has a home blood pressure cuff and monitors her reading routinely, she won't know if her physician has to adjust her medication.

You can buy them direct from India. They won't be covered by insurance but they will be inexpensive. You don't need a prescription. Most pharmaceuticals in the US are manufactured in India.

How bad is her blood pressure?

We found Mom no longer needs prescription blood pressure meds simply by giving her magnesium.

400 mg of magnesium dropped her blood pressure about 15 points

Magnesium citrate--if tends towards constipation
Magnesium glycinate--if loose stools

My 83 year old father is just as stubborn about doctor visits. He’s the same way when the doctor schedules a home health nurse to check vitals & draw blood. He refuses their help when they call to confirm the visit. It’s his choice, so to maintain my health and sanity, I let it go & let God. He’s lived a long and full life so I let him be.

I hope you find peace I have with this approach.