TRANSCRIPT

Older Adult Refusing To Go To The Doctor?

Try These 5 Expert Tips

(Podcast #015)

Please forgive typos. Transcripts are created by an automated service.

 

0:00  
Today I'm going to talk about five tips for what to do if your older loved one is refusing to go to the doctor. This is a tough situation because on one hand, you want to respect your older loved one's right to make their own medical decisions, especially if they have capacity to make their own medical decisions. And on the other hand, you're really concerned about them and you don't want whatever is causing the changes to get worse and maybe unable to be corrected. That's really scary. So naturally, you're anxious and you're worried and you want to get through to them and you want them just to say, Okay, let's go to the doctor.

0:44  
I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the Psychology of Aging Podcast to answer some of the most common questions I get about aging: questions about mental health and wellness, changes in the brain like with dementia, relationships and sex, caregiving, and even end of life. Like I say in my therapy groups, no topic is off topic, we just have to have a healthy way of talking about it. So if you're an older adult or caring for one, you're in the right place. Let's get started.

1:24  
This week, I want to talk about a tough situation that arises among older families from time to time. Sometimes family members will approach me and they'll say "my older loved one is refusing to go to the doctor" or "I'm so concerned that my dad is making all sorts of driving errors on the road and I'm so concerned about him, but he's not taking my concerns seriously, and he's refusing to go to the doctor to see what's wrong" or "my wife is declining and I'm worried her breathing has changed. And I'm worried that maybe she has a lung infection and she's refusing to go to the doctor, what do I do?" So today I'm going to talk about five tips for what to do if your older loved one is refusing to go to the doctor. This is such a tough situation because on one hand, you want to respect your older loved ones, right to make their own medical decisions, especially if they have capacity to make their own medical decisions. And on the other hand, you're really concerned about them and you don't want whatever is causing the changes to get worse and maybe unable to be corrected. That's really scary. So naturally, you're anxious and you're worried and you want to get through to them and you want them just to say, Okay, let's go to the doctor. So that's why I wanted to spend some time sharing five tips for what to do if you're older loved one's refusing to go to the doctor and you're super concerned about them.

 

1. Consider changing your approach.

3:05  
So the first tip is to consider changing your approach. If you're really worried about your older loved one, it would be pretty natural to be a little bit demanding or pushy. I mean, I know I've been in that situation where I want somebody to do something and I get a little bit demanding. And I get a little bit pushy. And when we kind of push and demand, what happens is it can have the effect of pushing the person away from what we want rather than pulling them towards it. So consider changing your approach by backing off a little bit and sharing your concerns from another angle. Instead of saying "Dad, you have to go to the doctor. The swelling in your leg has gotten out of hand!" Try having a pleasant conversation, and then sharing, "Hey, dad, I noticed that this swelling in your leg is getting worse. And it concerns me because it could be a sign of something medically wrong. And I think we should check it out." Like that's really going to work, right? So if he stammers and says, "Well, I don't want to put you out. Then you can respond by reassuring him with, "well, I'm really actually happy to do this with you. We can go to the doctor and then go to lunch afterwards, it will be a way for us to spend some time together."

4:32  
Okay, I'm going to stop here for a minute. I get that you're probably not happy about this. Maybe not happy to be the one to take him to the doctor not happy to be the one to spend half of your day going to lunch, and kind of massaging the situation. But in my years of working with older adults and families, I can confidently say that many older adults are afraid of being a burden on their families. And on society. So the more you can use language that reassures your older loved one that they're not a burden on you and your time, the more likely you are to get a positive response from them. So the more that you can tell your older loved one that you'd enjoy the time together, and that it's important to you to be in their life and help at times like this, the easier it's gonna be to get your older loved one out of the house and into the doctor. Okay, this approach works best if it's sincere, so...

 

2. Try to see where your loved one is coming from.

4:32  
Okay, number two: Try to see where your older loved one is coming from. So if changing your approach doesn't work, and your older loved one is still refusing, try asking gentle and loving questions to see where they're coming from. Like, "tell me what's going on that's making you not want to go to the doctor" and hear them out. Your older Loved One might say things like: "my doctor doesn't listen to me" or "I don't agree with what my doctor says much of the time".... "All they're going to do is give me medicine. I'm already taking too many medications" "They're too young," or "they just don't understand me." Or "the doctor tells me 'well, of course you're in pain, you're old'". So if your older loved one is saying any of these things, this could be their way of telling you that there's some cultural barriers or missteps happening with their doctor. And often these are due to ageism. So ageism is discrimination based on age and in the medical field and in the mental health field this often shows up as "Of course, you have that problem, you're old. What do you expect?" So as you can imagine, this approach is not helpful to older adults, and is actually quite hurtful, instead. If your older loved one is telling you these things, it might be a sign that they need a doctor who understands older adults. And if this is the case, then I'd encourage you to offer to help your older loved one find a new doctor, a doctor who specializes in older adults. These doctors are called geriatricians. In my show notes all have a little guide on how to find a geriatrician.

 

3. Ask if your loved one would be willing to go with another family member or a friend.

7:27  
The third approach that you could take if you're an older loved one is refusing to go to the doctor and you're super concerned about them is to ask your older loved one if they'd be willing to go with another family member or friend. If your older loved one doesn't want to go with you to the doctor, which I was talking about in tip one, and doesn't want to find a new doctor, which I was just talking about tip number two, then ask if they'd be willing to go with another family member or friend to the doctor. If your older loved one agrees to this, then don't stop there. Ask them to name the person that they're willing to go with and then ask if they'd be willing to call that person now and see if they can help. If you're around, you could call that person together. If you do this, let your older loved one speak first and then ask if you can share your thoughts, rather than imposing your thoughts. It can sting a little bit if your older loved one isn't willing to go to the doctor with you but is willing to go with somebody else. Sometimes it might take a few people to share their concerns before your older loved one takes a medical problems seriously. And sometimes it can help for someone closer to your older loved one's age, to share their own experience and encourage your older loved one to go to the doctor. Sometimes it might take a few people to share their concerns before your older loved one takes whatever's happening for them seriously. Sometimes it can help for someone closer to your older loved one's own age, to share their experiences and what their process was like at the doctor. Sometimes that will help your older loved one to go. Whatever the case may be. The important piece to hold on to here is that your older loved one is gonna go to the doctor. So take this as an opportunity to expand your older loved one's care network. This could actually be a win win. You might not have to help with everything after all.

 

4. Ask another family member or friend to reach out to your loved one

9:32  
Moving on to number four, ask another family member or friend to reach out to your older loved one. So at this point, if you've tried all the other steps and your older loved one is still refusing and you're still concerned about something major going on in their body or their mind or their mental health. Try asking another family member friend to reach out to your older loved one and express concern about the medical problem or the mental health problem or the cognitive problem, and their encouragement for your older loved one to go to the doctor, and then also ask if they'd be willing to offer to help your older loved one to go to the doctor. If your older loved one's living in an assisted living community, there might be on-site nurses who can check in on them. You might call the front office and see if there's a nurse on site who'd be willing to pay your older loved one a visit and talk with your older loved one about going to the doctor. Sometimes a third party can be really helpful. So oftentimes families will show up in my office and they'll say and maybe my, my patient is the older adult in question. And a family member might say, you know, I'm really concerned about my loved one. And I'll ask the loved one questions and kind of try to figure out is this a mental health concern? might this be a medical concern? And the family member will say I've tried to get them to come to the doctor,  but they keep refusing. And then after I spend some time with the older adult and do a little bit of assessment, and figure out actually this might be medical, it doesn't seem like mental health concerns. And if I suggested the older adult might be more likely to go, because they have a third party a more objective opinion, or perspective, or recommendation. So if you're like, I'm going back to the senior care community example, if your older loved one lives in a senior care community and there's a nurse on site, asking the nurse to go and see your loved one can help to give a third party perspective. Okay, this might get a little costly though I don't think those nurse visits are really free all the time, if at all, and so just be mindful of that as well.

 

5. Take a break and give your loved one some space.

And then fifth tip for helping your older loved one to go to the doctor when they are not willing to go is to actually take a break and give your older loved one some space. If you've tried all of these strategies and your older loved one is still not willing to go to the doctor, you might have to take a break and give them some space. After all, most older adults are capable of making their own decisions about medical care, and can decide when and how they wish to go to the doctor. This may be one of the hardest things to do is to sit back and watch your older loved ones struggle. It's really really hard to be powerless and have no control over the actions and decisions of somebody that you love who you see is suffering. Especially when from the outside it looks like there's a really simple solution. Just go to the doctor.

12:56  
All right, you might be really frustrated and angry. But don't shut your older loved one out if they're making a decision not to go. Don't shut them out. Aging and becoming sick can be really scary things for older adults, many older adults, especially when they're sick wonder, Is this going to be the illness that takes me out? Are they going to find cancer? A lot of my friends are dying, am I going to be next and they might find something bad and then what? So don't shut them out. Sometimes people just need a little space and grace to come around. If you do take a step back and give your older loved one some space. Don't ignore them. Continue to call and visit and stay engaged. The better your relationship, the more likely your older loved one is to listen to you down the road. See how that works?

 

Learn more about delirium

13:53  
Let me just say there's an important side note here. Here's an important consideration that we have to talk about if we're talking about older adults refusing to go to the doctor, and you're noticing really concerning medical changes or mental health changes. So if your older loved one is really sick, and they're hallucinating, like hearing or seeing things that other people don't hear or see, or have strange beliefs like that they're marrying somebody, your older loved ones 95. And they just got married to somebody and had triplets. And truly believe that, those are bizarre thoughts. And if those thoughts and those experiences are happening out of the blue, and that's coupled with mood changes and sleep changes, it might be necessary to get your older loved one, immediate medical attention. So those are signs of delirium. I'll link to a show that I did on delirium where I interviewed my friend Dr. Lisa Frank, who's a psychiatrist and specializes in older adults. In that episode, we talk about delirium and what you need to know about delirium. But that's a serious medical condition that needs immediate medical attention. And so please get educated about that, so you'll know how to help your older loved one if you're noticing these acute changes. If you are noticing these acute changes, you may need to call 911. Or take your older loved one to the ER. If you do call 911, and the ambulance driver says that they can't take your older loved one to the ER because your older loved one's refusing. That's going to be really tough on you, and you're going to be in a bind and it also puts your older loved one at risk as well, especially if they have delirium. So if you're really worried about your older loved one safety or severe self neglect, you can consider calling Adult Protective Services in the county where you're older loved one lives to get a third party involved. They'll go out to the home and assess the situation. That is not as immediate as going to the ER. And the people who go out to the home are case managers, they're not medical providers. If you're noticing those acute changes, you need to find a way to get your older loved one to the ER for an evaluation. situations like these are so tough. And I really my heart goes out to you. I've been in the role of really demanding that a family member take the older loved one to the ER because they're delirious and need immediate medical attention. And I hate that because the older adult can sometimes understand that these decisions are being made against their will. Later on, if it's true delirium, oftentimes the person doesn't even remember what's happened because their brain is so impaired from a medical problem. So that's the saving grace of this, but please learn more about delirium. It's a very serious situation it can happen Instantly in older adult bodies, and it's really important to know just to kind of help you make a decision about what your next steps are. And so like I said, I'll link to that episode on delirium. I have a blog article on delirium, and so you can read all about it. And it will help you make a decision about what your next steps are. If this seems to be like a serious medical problem, or one that you could give some space and grace around.

15:59  
I want you to know that you're not alone. And I'm here to help. My hope with this podcast is that it helps to walk you through some of the most complicated situations with your older loved ones. Because I want older adults to live their best lives, and I want you to live your best life too. I like to say that I want you to have peace of mind knowing that you are doing everything you can to help your older loved one live their best life, without giving up your own life in the process.

 

Learn more about memory loss warning signs


18:03  
I also want to share that sometimes refusing to go to the doctor can be because of early signs of memory loss. So what I'd like you to do is learn more about memory loss by downloading my memory loss guide. The memory loss guide, we'll share 10 must know memory loss warning signs. We'll share what to do if you're if you're noticing signs of memory loss and the benefits of evaluation. So head on over to the show notes and download the memory loss guide. Join me next week and I'm actually going to dive deeper into 10 memory loss warning signs.

 

Wrapping Up



18:44  
So if you liked this episode, be sure to subscribe and leave a review. subscriptions and reviews help people to find this show. And here's why this is so important. Older adults and caregivers are often left out of the conversation when it comes to mental health and wellness. So do your part to include them by subscribing and leaving a review. As always, the information shared in this episode is for educational purposes only, and should not take the place of licensed medical or mental health care. I'll see you next week. Same time, same place. Lots of love to you and your family. Bye for now.

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