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Even before the pandemic, an older male relative did not like to go to the doctor whether sick or for an annual physical. The last time they went, I had to schedule the appointment and he made me feel guilty for pushing him to go. He has taken me to the doctor on occasion (still drives) and part of the excuse for him not going is "you go too much". I have a few health issues but also am very religious about preventive care like colonoscopies and mammograms.
Now it has been more than three years since he had a physical. He says "don't nag me" but I and other relatives go for annual physicals regularly and try to convince him to go too. He has never had a colonoscopy and is well past 50. It's so frustrating, he's a very intelligent man!
I am not noticing any issues except regular alcohol use (1 or 2 drinks per day, most days) and he gets very little sleep (4 - 5 hours per night). Should I notch it up to individuality or is there a way to convince someone to start seeing a doctor regularly and get preventive care?

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My mother was in a TCU for a broken arm and they did several tests She was in her late 80s at the time. When she got back to her regular doctor (a geriatrician) the doctor told her one of the scans at the TCU shows "something" in her pelvic area. Would she like the doctor to make an appointment with a specialist to find out what it is?

Mom: No. If it is cancer I won't do chemo so what good would knowing it do me?
Doc: Explains improvements in cancer care, and again offers the referral to a specialist.
Mom: I have lived a long life. I am going to die of something. If it is cancer, so be it. I don't need to stress every minute of the life I have left thinking of the cancer cells in me.
Doc: Many of my patients feel this way. (Remember that she is a geriatrician.) It is totally your decision. The offer of a referral is always available, if you change your mind.
Doc looks at me. (I haven't said anything so far.)
Doc: Are you OK with this?
Me: It is completely up to Mother. I see her point and I will support her decision. If she changes her mind, I will support that.

I loved that doctor, but she is in high demand and isn't taking new patients now.
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Some people are proactive with healthcare and some are reactive. Men tend to fall in the reactive area. A colonoscopy could catch and stop cancer if caught early, but many wait until they have serious issues and cannot fix the problems with OTC meds - they will require more intense care, surgeries, etc. Because of what has to be done for the test, the will avoid it. A dr told me one time that if a man lives long enough, he will get prostate cancer - not sure if that's true or not, but it would sure encourage me to get examined. That's me. I'm proactive.

You won't change his mind. He already told you that you go too often, so you know what he thinks about annual exams and other regular testing. Let it go.
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He did not 'make you' feel guilty. This is how you decided or automatically felt. Another person may not feel guilty; they could have felt good about their decision to support a person to get medical care. You can change your response / feelings with awareness and desire. This may be your MO - become aware of alternative feelings you might / could have.
* Realize you can only do so much.
* Then let go. This may take practice as you likely are used to trying, trying, trying. Or/and feeling you care so much, you don't want to give up. However, this attitude will back-fire on you, depleting your energy and draining you. And, 99.9% likely won't change him. He's in his own little world.
* Everyone, unless diagnosed to have dementia and legally unable legally to make their own decision, can and will. This DOESN'T mean it is a good idea or even safe for a person to do so, it means they can.
* He is likely depressed; an alcoholic or using alcohol to lessen the pain he feels.
* I believe the only behavior you can do is support him where he is and not argue. Do you ask him how he feels?
Explore this?
Don't agree or disagree. Acknowledge what he says. "I understand you feel xxx"
"It must be difficult for you to feel xxx"
Ask open ended questions.
* Be aware to set boundaries on your time. Know it is okay for you to do what you feel is helpful for 20 minutes, 30 minutes, an hour - or whatever and then stop, leave and feel good about yourself for caring and showing concern / love for this person. We can all go in circles if we let that happen. This often is a intense and quick(ly needed) learning curve - to set boundaries, realize you can, to feel good about what you do or change what you do if you don't feel good about it.
I've been doing this work for 6-7 years (direct service) and off-and-on for 15-20 years. Each person and situation is a learning experience.
* While we / I get better at it, we/I are always learning how to manage / handle these difficult / challenging situations with someone aging and/or w dementia.
* I highly recommend you visit Teepa Snow's website. It is invaluable information for everything to do with dementia/elder care and care providers.
Gena / Touch Matters
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Hi MaryKathleen,
Welcome back. I have not seen your post for awhile now. It is so nice to see you on the site again.
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My mothers GYN specialist continued to recommend her getting her annual mamograms but I spoke with radiologist and he said no need to put her through such a procedure any longer. She would cry standing up with the machine compressing her breasts. I felt so sad and decided no more. She was about 80 years old.
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Someone well past 50 isn't old and sounds perfectly capable of making his own decisions. Short of scheduling his appointment yourself and hoping he will go, you have to give up on this dilemma. You can lead a horse to water, but you can't make him drink.
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He may be afraid to learn he has something.

Anyone refusing to undergo screenings and testings are selfish...they don't think of the possibilities that someone in their family may have to be the caregiver.

Be blunt with him...if you turn out to have colon cancer, I am putting you in a home where they will change your diapers.

Kindness and compassion in this kind of situation is not being helpful but being enabling.
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I agree. And to be honest, being ‘very religious about ... colonoscopies and mammograms’ doesn’t sound like anything recommended in the New Testament!
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My late mother, who lived to the age of 94, stated "your dad is not a 'doctor person.' " My dad died of massive cardiac arrest at age 50. An uncle was urged to have a colonoscopy as he had a family history of colon cancer. He passed away from colon cancer as he didn't want to get a colonoscopy.
I will pray that your older relative can change and be proactive about his health.
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I think it would be easier for both of you if you just let him be. I know you worry and that is hard, but it is his choice.
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Annual physicals are pretty useless no matter what your age. The government task force on health stopped recommending them, but people thought this was some sort of call for rationing, so they backed off.

I encourage you to read Dr. Nortin Hadler's book, Rethinking Aging: Growing Old and Living Well in an Overtreated Society. No doubt most people will not accept this, but most screening tests have been over-sold and the benefits do not outweigh the potential risks. This is especially true for those over 65.

When an elderly person has a physical, I can guarantee they will find something. The question is whether this something can be treated successfully, and if the treatment or prescription advantages that person in a meaningful. It is quite possible that a mammogram does not alter the ultimate outcome of the disease, it only tells you earlier that you have cancer. Some cancers are so aggressive, that it doesn't matter when they are detected. I also imagine that every older person has polyps in various places in their bodies - colon, stomach, uterus. There are risks for colonoscopies, and they only detect cancers on one side of the colon. There are also risks from mammograms from repeated exposure to radiation and from the anxiety from false positives and the stress and pain of further tests.

As we age, all our number go up - blood sugar, blood pressure, weight, etc. For various reasons, the medical profession has decided that old folks should have the same "normal" numbers as younger folks, even though the risks to the elderly from medications for lowering these numbers are worse for them than the higher numbers (unless these numbers are way up on the upper end of the curve).

Everyone over the age of 70 has various ailments. Probably almost all elderly women harbor some breast cancer cells just as almost all elderly men harbor prostate cancer cells. That doesn't mean these are going to cause their deaths.

Personally, if I live to be in my eighties, I hope to see a medical professional only if I am having symptoms that I cannot cope with on my own. I expect aches and pains, and some limitations. That is a natural part of aging. Of course, if I break a bone, or have a bad cut, I will have it treated, but I will avoid screenings and tests like the plague.
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Sunnydayze Jul 2021
You made some very interesting points. My dad was overly prescribed medications. It’s interesting that the pharmacy did not even pickup on the same Rx prescribed by two different doctors. Also, my dad’s primary and specialists worked for the same healthcare system with electronic charts. My dad took all medications with him to all appointments and ER. Years later, a nurse went through his medication bag and noticed the duplicate! Anyway, thank you for your post!
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Your profile states:
"I am caring for someone, living at home with alzheimer's / dementia, arthritis, mobility problems, sleep disorder, urinary tract infection, and vision problems."

Is this the older male relative? If so, is he living alone? This is a bigger concern than not going for health screenings. From the statement about sleep habits, he lives with someone, otherwise how would anyone know he only sleeps 4-5 hours? If no one lives with him, what's the plan? How does anyone know he has dementia?

However, even with health POAs (assumption is no POAs at all), we can't force someone to do what they refuse, EVEN when dementia is definitely in the picture. POAs don't give us that capability. Guardianship may give more power over someone, but even then generally the courts will want to allow some autonomy and decision making. Even the staff at my mother's MC facility told me they can't force residents to do/take anything they are refusing. They can only coax and try to get the person to make the decision. About all we can do is encourage it, suggest it and ASK if they'd like to go. If the answer is no, it's no. Just don't harp on him, telling him he MUST go or NEEDS to go. Keep it open as an offer only.

"I and other relatives go for annual physicals regularly..."

This is fine for you and the others, but you are not likely to convince him to go just because you all go. He is only going to go if HE feels it necessary, which currently he doesn't.

"He has never had a colonoscopy and is well past 50."

Me too (aka past 50 and never had one! I did finally do the "poop in a box" test, but that's it! It was more to get the docs off my back than out of any concern.) A nice incentive was getting paid TWICE to do it (insurance plan AND the company)! Unless there's a concern or family history, let that go. IF his insurance offers gift cards for getting screening done, you could let him know and it *might* be an incentive, but I wouldn't hold my breath!

"I am not noticing any issues except regular alcohol use (1 or 2 drinks per day, most days) and he gets very little sleep (4 - 5 hours per night)."

You've noted no issues. 1-2 drinks/day isn't really a big deal (unless the drinks are a gallon at a time!) Sleep routines vary between individuals. He also may be napping during the day, which would tend to cut down how much he might sleep at night. Has anyone observed daytime nap habits?

"Should I notch it up to individuality or is there a way to convince someone to start seeing a doctor regularly and get preventive care?"

Yes, so long as he's capable and not showing signs of any discomfort/difficulty, let it go.

No, there really isn't a way to convince someone to do what they don't want to do.

Medicare and/or insurance/advantage plans may encourage regular routine checks and testing, but it's up to the person. No one can really force another person to do what they refuse. If he gets notices from Medicare or his insurance, you can try suggesting it saying Medicare requires it, at least once in a while, but he can still refuse. His choice unfortunately.
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Respect his personal decisions. "Don't nag me."
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Notch up.
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He has by choice a life long history of preferring NOT to go the same as you prefer TO go. Would you like someone on your case telling you NOT to GO? Leave him alone. We all like our own autonomy and how is it that you know so much about his sleeping and drinking habits? So he's never had a colonoscopy...he's alive to say so isn't he? We all make choices and take risks, and as you said, he's very intelligent so he is aware of that risk. I'd find something better to do with your time,
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He has his mind and You should leave him alone.
Not every one sees the need to go get a Physical every year and plenty don't go to see a Dr until they feel bad.
Actually, I'm 69 and I have never had a Colonoscopy and I don't intend too.
Mout everyone has pollops anyway and usually are not cancerous and even if they were, if your old, You would die of something else before the cancer pollops anyway.
Also, most Seniors are on way too many Rx's prescribed by Dr's and each time they prescrib something. Thete are side effects and you have to take something else for that, on and on a ficious cycle.

I say have nice visits with your Senior and stop bothering him about going to the Dr. It's his Life and he should live it however he wants.

You have already voiced your opinion too many times and he knows how you think.
He even drives, so if he wants to go to a Dr he will.

His Life, His Decision.
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My parents were pretty much like that. They waited until sh** hit the fan, THEN went to the ER to find out what's wrong. Did they have a Primary Care doctor? Of course. Did they go for annual physicals? No. My parents (now deceased) and my 70-yr old brother (living) were/is of the thought that if I don't go to the doctor, I'm okay. Ugh. Never mind that it was an 18-24 hour affair in the ER to find out what was wrong when they didn't feel good. The ER always told them to "follow up" with your primary care provider. Did they? No. If they were prescribed antibiotics for a 10-day course, they would take them for 3 or 4 days until they felt better and then stopped. Bottom line is, you can't force someone to take care of themselves.

Every else says, leave him alone. That's great advice until it falls on YOU to caregive him after an illness. That's what I had to do. Watch a train wreck until the inevitable happens, when you KNOW if they just would have done some preventative care, their illness may not have been as serious or never happened at all! It's frustrating to say the least.

As my parents aged, I would always jump when the phone rang at 11 pm because I knew one of them had to go to the ER. My father didn't want to know anything. If he didn't feel good, he'd wait until he could stand it (which was, of course, on a weekend after 9 pm, when the primary care provider was closed) and then a trip to the ER with my Mom and brother in tow for 18 hours. It was maddening. My father was depressed and not a positive individual. He told my MIL that he would not see Christmas. He celebrated his 80th birthday a week before Thanksgiving in the ER. He died of a heart attack a week later. My mother and brother was shocked when he passed. No goodbyes, gone. Was I? No, I could see the writing on the wall. He did not want to live anymore. The strange thing -- if he would have taken care of himself (even got some therapy for his depression), I'll bet he would have lived another 10 years. I feel sad that he just didn't care about himself.
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my brother is 74 and hadn't been to a doctor in over 20 years until the other year when he got a small rash on his leg, went to doctor, got stuff, and only goes when somethings is really wrong. I am vigilant on certain things in going to doctor, but why force someone to go when they don't want to. He will go when something is wrong or when he wants to. Some people as they get older do not sleep as many hours as a younger person. I wake up myself 2 or 3 times a night to use bathroom (we got to bed at 11) and by 6 I am tossing/turning and finally get up at 7, some days i get up at 6......why toss/turn. You keep doing your thing and let him do his thing.
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If you have said your piece with him and he is capable of making his own decisions leave it alone for now.
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Medical doctors are not the magic men and women we often think they are. With few exceptions, they treat the symptoms without looking at the root cause of disease. It is best to be your own health advocate and do your research, and decide what health protocol is best for you. We need to think outside the boxes that Big Pharma and Big Food try to put us in.
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rhsolucky it sounds as if you are very young by the comment you have an older relative. Yes he might be older but at age 50 he is not old. I thought you were talking about someone in their mid 70s-90 year olds. Most men don't like going to Dr's. It has been proven most women take better care of themselves then men. If you don't see any real health issues going on I would not worry.
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Leave him alone. I don't know what you think of as "elder" but we are totally capable of making our own choices on our health. I refuse my annual check ups, I don't need and MOT like a car, I know if I feel healthy and to be honest something will kill me one day, and I don't want to take medication on the off chance it may do some good. So leave me alone and don't treat me like an idiot. Its very nice of you to care, but I have made my choice, I am compos mentis to do so, and who wants to live to be old, incapable and have reduced mental capacity. OK - we are not talking about me, but I don't read anything in your post that suggests the relative you are talking about needs your assistance or is incapable of making all the decisions mentioned above.
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He may have suffered an embarrassing or abusive healthcare encounter in the past that he doesn't want to talk about, at least with you, and now chooses avoidance as the path of least resistance. Childhood and teenage traumas endure in ways adults may not understand.

He has his reasons whatever they are, and these are his choices to make.
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Old people can be horribly stubborn - I see two possible ways of handling this as I doubt anything else is going to work - why? Who knows. First I would set up an appointment and tell him he is going and no if's, and's or but's....you will take him, period - he goes. (This reminds me years ago when my husband was dying - did not know yet it was pancreatic cancer - and no one could figure out what was wrong. I told him I was taking him to the University of PA hospital but he refused to go after I told him I had taken the day off and made the appointment. So I said to think about it until the next day. Next day I asked him again and got a no. So I told him he had TWO CHOICES. (1) he goes with me peacefully and I will treat him to lunch - no, not going. (2) same question but I added "I have hired two men to accompany you when I take you. Now I have to feed them and pay them both for their time." So which option do you choose. HE WENT WITH ME! He had pancreatic cancer and died six months later. ) The point is you FORCE THIS MAN TO GO or option two is to walk away and let him lie in the bed he makes for himself. There is NO OTHER SOLUTION.
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MJ1929 Jul 2021
He has nothing wrong with him. Why should he be forced to go anywhere? That's absurd.
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Why are you so consumed with whether or not this relative goes to the Dr. or not? It seems a bit odd to me. He's a grown ass man, and can do what he wants, if wants and when he wants, so yes, you should leave him alone.
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jemfleming Jul 2021
Not odd at all to care and be concerned about a person who means something to you…. But in the end it is THEIR choice - no one else’s. Just worrisome to the poster since they have feelings for this person and since most of us have heard about or know someone who waited too long such that no medical intervention was helpful or possible.
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If it ain't broke, don't fix it.

An apple a day keeps the Doctor away.

You're an apple, he's an ain't broke. It's ok to differ.
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Some men are concerned that if the doc does any exam involving the rectum and anus it will make them gay.

There are Youtube videos that cover various physical exams that you might suggest to him, that may allay his fears going to the doctor.

Even though he is a male, he may feel more at ease with a male doctor (many are nice and understanding as well, and will probably use humour to put an anxious patient at ease)
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NeedHelpWithMom Jul 2021
Oh gosh! Gay? This is sad that a man would believe such a thing in this day and age.
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If he is mentally competent, he is considered responsible for his decisions and the consequences. Many older men and women are used to thinking you only need the doctor when you aren't feeling well. He probably doesn't realize the annual check-ups "catch" medical problems in the early stages - before he has problematic symptoms. Since he feels fine, he doesn't think he needs a doctor.

Try to reason with him that these check-ups - usually covered by insurance - are helpful to "catch problems early." Maybe he will value not having permanent pain or problems from cancer:
colon - colon removal and wearing a colostomy bag
prostate - painful metastases to bone or brain
gi tract - since he drinks and is at risk of cancer from mouth to colon
which can be treated with good results when caught early.

On a personal note, my husband insisted on a PSA blood level when doctors were seeing patients again during this COVID pandemic. We discovered he has prostate cancer that is aggressive - and he doesn't have any symptoms. Luckily, he is getting it treated before it metastasized and DID cause symptoms. We expect him to have a good recovery and not need chemo or radiation.

Feel free to share our story with him.
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MaryKathleen Jul 2021
Personally, I have never had a doctor that did much for preventative medicine. I only had tests when I brought up the problem. I take that back, the colonoscopy was suggested by the doctor.
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We can only care about other folk's medical care as much as they are willing to care about it.

The thing is, if this is someone who thinks YOU will be their caregiver down the road, get off that train.

When I met my husband (we were both 50) he hadn't been to a doctor in years. Sent him to my doc. He had high blood pressure and bronchitis.

Fast forward 2 years. Had a "crick in his neck". Doc sent him to cardiologist (his dad died at 40 from unspecified heart issue). Cardio discovered 5.8 cm aneurysm and leaky aortic valve.

Had surgery. Is alive and well.

All because he had a "regular" doc who knew him and his history.

But hey, it's up to him. Some folks who rather drop dead at 55.
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It is your relatives decision and you need to respect it. My brother refused to get a colonoscopy developed colon cancer and died. I would hound him over and over and finally I gave up and respected his decision. He did say to me before he died he wished he listened to me .It can be very frustrating but it is his life to do as he pleases.
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