My mother has PAD. She has not been back to see a doctor since they recommended she have surgery. She seemed okay for some time, she could still get around and take care of herself well.

But after her husband my stepfather passed away quite suddenly at their home one day her health situation has RAPIDLY changed for the worse.

At this point - not only is she unable to do more than swing her legs off the sidecof the bed or stand up from a chair,
But she has an awful looking sore on her ankle that she tried to hide from me for some time ibsisting her skin was just dry, it was just a scratch - so i finally got a look at her feet withoutthe slippers on and they look very very worrisome!

In the more severe cases of PAD amputations are not unusual!

She is afraid of surgery to help the circulation to her legs but how much more would it terrify her to have to take parts off her in order to stay alive!?

It would humiliate her to have an ambulance called to her home, but she needs to go to the doctor -

Another thing that adds to her resisting a doctor i am sure is something that has caused her to be embarrassed and self conscious for some time - incontinence, which she is rather badly afflicted with i must admit

And she has expressed to me how she has not been able to properly bathe or shower for a long time- takes bird baths because she is afraid that she will fall - and i know that this also adds to her anxiety over potential embarrassment

- i should mention that she has called me on at least three occassions because she has fallen out of her bed or from her chair at night -

My sister and i try to take care of all her needs outside the home - any shoppibg or errands

We check her mail and take out her trash

Housework has now become part of the duties my sister and i have taken on for our mother (again the change in her health has been swift - she was not long ago able to keep up on things in her small clean and orderly single story home - but presently, she can barely get to a standing position from a chair or bed.

Everyday we plan on going to a doctor and agree upon this plan and everyday she finds a reason why we wont.

But like i said her feet are very worrisome! Amputations are not uncommon among sufferers of PAD - she insists its nothing like that - its rolands syndrom (or something like that) or its gout if not just a scratch or dry skin.

I dont want to take away her dignity or insult her or cause her embarrasment or anything of the sort -

But im worried her condition COULD BE life threatening though maybe not life or death right now -

I know she would feel horribly betrayed by me in addition ... And she is my mother who was a damn fine one to me. My childhood was idyllic - as a mother - im not one iota the mother she was to me - she cared for me very well - iys hard for me to think of betraying her trust -

But im thinking i should call an ambulance. She wont go but she is NOT well and getting worse and refuses treatment.

I dont know what to do.

Apologies for the many typos mistakes unusual punctuation and bad grammar - im typing this from my not so smart phone.

Thanks in advance for any insights and withholding judgements.

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You might find that when you and your sister square your shoulders and stand united in front of mom that she will be relieved that she no longer has to make the tough decisions. You will have to mean what you say or she will see through it. You have to let her know that it's not just about her anymore but all of you. That even if she is not concerned that you are concerned and that your feelings also count. If she balks you let her know that you are prepared to call the ambulance. That she is going to the doctor today. Create a sense of urgency within yourselves. When you start having to take care of an amputee you will wonder why in the world you waited so long to take action. Put two pull-ups on her and get it done. If she were going to go to the doctor on her own she would have by now. Come back and let us know how she is doing.
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Jeanne and Carla said the things I was thinking. There are time when we have to become the parent. Your mother is afraid of the surgery, so she is avoiding the doctor. PAD is very painful and she doesn't have to go through all the pain if the surgery works well. You and your sister need to get her to the doctor and not take no as an answer. Just say "You're going. Period." Since she already has an ulcer, things need to go quickly. Does she have pitting edema?

It can be like taking care of kids at time. Kids don't want to go to the doctor. To tell you the truth, I don't, either. But sometimes we have to put on our Depends and just go. I hope that she will go without giving you too much problem. Sometimes you have to be the boss when it comes to elder care.
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I heard what to me were the magic words in your post, Momsmiddlechild: "My sister and I".  If at all possible, you need to reach agreement with your sister and present a united front to your mother. I'd recommend sitting your mother down together with your sister and not agreeing to any course of action that does not include Mom going to the doctor. 

I was at my mother's house this past Monday and she was refusing to go to the ER (despite her doctor's advice to me on the phone), so I texted my sister and called her over there as backup. My mother can never resist pressure from the full committee of adult daughters. Twenty minutes later, Mom and I were in the car on the way to the ER.

I agree with the advice given by others above as well. I know this can be a very difficult issue - Good Luck!!!
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Poor Mom! She's lost her life partner, she is embarrassed because she is incontinent, she can't bathe often, she can't get around well, has to rely on her daughters for basic housework, and her daughters want her to go see a doctor! Can't she just be left in peace?!

Well, no. As much as we can all sympathize with her, we want to see her taken care of. Losing her dignity isn't anything to losing her leg!

Can one of you be there while mom showers a couple times per week? Get her a shower bench and if it is in a tub, a chair that helps her transfer in. She shouldn't have to be embarrassed about not being clean.

Does she have well-fitting incontinence briefs? Help her pack an attractive tote bag with extra briefs and a spare pair of pants, and clean-up products. It may help her to realize that even if the worst happens and she has an accident while she is out, she can at least clean up. Has she seen a doctor about this condition?

Help to minimize her distress about going out. Then be sympathetic but firm. Make an appointment and take her to the doctor. Can she go by car? A medical taxi? Would she need an ambulance? Make arrangements. Help her bathe the night before. Don't accept her excuses that day.

I went to pick my mom up for a medical appointment and was distressed to see her still in pajamas. "I'm just too tired to go today," she said. I told her she could be tired in the car and in the doctor's office. I got her clothes and helped her dress. She may not have felt my treatment was very dignified, but, by golly, she got to the doctor appointment!

This is going to be uncomfortable for you. But you are NOT betraying your mother. On the contrary you are acting in her best interests. It is sooo hard to see our loved ones neglecting themselves. I wish you every success in getting her to the doctor.
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Momsmiddle, first off, I endorse all that CM said.

Second, I want you to go back and look at all times you say "I'm sure that" and phrases like that. Yes, your mom is having a hard time with aging and its attendant indignities. Don't compound that by allowing your own fears about what your mom is feeling to cloud the issue.

You KNOW that she's got a serious medical condition and that she almost certainly needs a more supportive environment than living alone, at least temporarily.

Fear of the unknown is not uncommon. Promise your mother that you'll face the unknown together (not that you'll always allow her to remain in her home) but that you'll make the best decisions for her health together.

It also sounds as though she's depressed. Talk to her doctor about that too.

In terms of the actual appointment, I would send the doctor a list of your concerns and make an appointment. Don't tell mom about it, just take her, after taking her out to lunch, say.
Helpful Answer (3)

This is just a thought to help you shed those inhibitions that are holding you back:

If she were you as a little child, and you were her mother back then, what would she have done if you were suddenly anxious and appearing to try to hide something serious from her?

Isn't it part of respecting her qualities as a mother to imitate them?

Meanwhile. If you know your mother's GP well enough to talk to, you could call him and ask him to telephone your mother and tell her he would like to see her. This might help to fix a date that she would be less casual about calling off, perhaps. If you don't think that would get anywhere, can you engineer a home visit, unannounced if necessary?

When it came to "down below" issues - skin integrity first, and then later continence care - the person who swept away all embarrassment was our District Nurse. There's something about a brisk, old-fashioned, down-to-earth, no-nonsense manner that just doesn't leave room for blushes. Anyone like that on the scene?

With the loss of your stepfather, added to very natural worries about the PAD and all its implications, it sounds as though your mother is trying to give up, is losing hope. Somebody posted yesterday about a person with dementia - but the message is the same - "isn't giving you a hard time. They're having a hard time." I wish I'd read that thought years ago!

But it's not too late to get her through this hard time, and if she can be persuaded to agree to treatment it could be genuinely transformative. Best of luck, I really hope you find a way.
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