FIL is refusing medication and won't agree to go to the doctor. What can we do?
My FIL is 99 and in an AL facility. We placed him there 2 years ago after a bout of severe urinary and prostate issues. With a few doctor and hospital visits, and medication, he recovered well. However, 3 months ago, he refused to take his Avodart and a high blood pressure medication, and the AL nurses let him stop the meds. The past 6 months or so, he has started saying that he will die this year. His overall health for 99 is good, and except for the prostate/urinary issues and some cognitive decline, has no other medical issues. Because of stopping the Avodart, he now is having urinary issues again, but he refuses to go to the doctor to be checked out, and the doctor won't give another prescription for the Avodart without seeing my FIL. My husband is caught in the middle--his dad is refusing care, and yet is complaining about feeling bad, and he keeps saying he wants to die, because he has lived too long. Any thoughts on what course of action we should/can take? My husband is upset and wants to do what is right for his dad, but then his dad won't cooperate. This has been a pattern ever since FIL moved into the AL facility. FIL has been a control freak all his life, and we know that refusing care is one way he can maintain control, but it is hurting his health.
FIL is refusing medication and won't agree to go to the doctor. What can we do?
My FIL is 99 and in an AL facility. We placed him there 2 years ago after a bout of severe urinary and prostate issues. With a few doctor and hospital visits, and medication, he recovered well. However, 3 months ago, he refused to take his Avodart and a high blood pressure medication, and the AL nurses let him stop the meds. The past 6 months or so, he has started saying that he will die this year. His overall health for 99 is good, and except for the prostate/urinary issues and some cognitive decline, has no other medical issues. Because of stopping the Avodart, he now is having urinary issues again, but he refuses to go to the doctor to be checked out, and the doctor won't give another prescription for the Avodart without seeing my FIL. My husband is caught in the middle--his dad is refusing care, and yet is complaining about feeling bad, and he keeps saying he wants to die, because he has lived too long. Any thoughts on what course of action we should/can take? My husband is upset and wants to do what is right for his dad, but then his dad won't cooperate. This has been a pattern ever since FIL moved into the AL facility. FIL has been a control freak all his life, and we know that refusing care is one way he can maintain control, but it is hurting his health.
Honor his requests.
Honor his requests.
Did you try telling him that he will feel more comfortable by taking the medicine? Would it help telling him that Our Father knows what it´s best for us and that He expects us to live accepting the challenges life poses and expecting us to be tolerant? Maybe tell him that we all are responsible for the legacy we leave, and that taking care of himself will be an example of love and fight for life for younger generations?
Did you try telling him that he will feel more comfortable by taking the medicine? Would it help telling him that Our Father knows what it´s best for us and that He expects us to live accepting the challenges life poses and expecting us to be tolerant? Maybe tell him that we all are responsible for the legacy we leave, and that taking care of himself will be an example of love and fight for life for younger generations?
Allow your FIL to retain what little control he feels he has over his life and death. Tell him you want to honor his request to die but assure him you love him and will miss him. If he seems to accept this change, talk about simply helping him become more comfortable by perhaps taking some medication. Find a doctor, perhaps through Hospice who will review his case and may be able to prescribe other meds to make your FIL more relaxed and comfortable. Good luck to you.
Allow your FIL to retain what little control he feels he has over his life and death. Tell him you want to honor his request to die but assure him you love him and will miss him. If he seems to accept this change, talk about simply helping him become more comfortable by perhaps taking some medication. Find a doctor, perhaps through Hospice who will review his case and may be able to prescribe other meds to make your FIL more relaxed and comfortable. Good luck to you.
he's 99, for goodness sake, and lives in a care facility he didn't want to go to. it's very natural that he sees the life he wanted as over, because it is.
by the way, the facility staff didn't "let" him refuse his meds. he has a legal right to do so and they are obliged by law to respect that. that's at least one way he can make a statement about what's going on.
since he's clearly uncomfortable and unhappy, i'd urge bringing hospice in for him ASAP. at his very advanced age and in his health, they're bound to accept him. then they will work to bring him the ease, comfort and emotional acknowledgement that he really needs. when that begins to happens, he will probably be able to let go and die peacefully.
clearly the family have done the best they can, and that's great. but he needs care from people not connected with the enforced move from home.
not my business, by why on earth didn't they bring care into his home rather than force him into a place he didn't want to be? don't people realize what it means to have your whole life taken away while you're still living?
he's 99, for goodness sake, and lives in a care facility he didn't want to go to. it's very natural that he sees the life he wanted as over, because it is.
by the way, the facility staff didn't "let" him refuse his meds. he has a legal right to do so and they are obliged by law to respect that. that's at least one way he can make a statement about what's going on.
since he's clearly uncomfortable and unhappy, i'd urge bringing hospice in for him ASAP. at his very advanced age and in his health, they're bound to accept him. then they will work to bring him the ease, comfort and emotional acknowledgement that he really needs. when that begins to happens, he will probably be able to let go and die peacefully.
clearly the family have done the best they can, and that's great. but he needs care from people not connected with the enforced move from home.
not my business, by why on earth didn't they bring care into his home rather than force him into a place he didn't want to be? don't people realize what it means to have your whole life taken away while you're still living?
Speaking as a RN, working in long term care. My advice is even though the situation is ripping your guts out. Respect your elder's wishes. Part of the dying process, is saying, "I'm tired, and I do not want to fight death any longer." Remember all men die, it is the living between birth and death that counts.
Speaking as a RN, working in long term care. My advice is even though the situation is ripping your guts out. Respect your elder's wishes. Part of the dying process, is saying, "I'm tired, and I do not want to fight death any longer." Remember all men die, it is the living between birth and death that counts.
Tell him you understand his wishes and that you will honor them, even though it is painful for you. Ask him how he wants to spend the time he has left and where he would like to spend it. Ask him what he would still like to do, where he might like to go, what he might like to see one more time. Ask him if he is willing to take some medication in order to be more comfortable while he does whatever he would still like to experience. Ask him what is one thing he wishes he had done in his life that he has not yet done. Try to find out what he wants with these last months of his life, how he really wishes he might spend them. Help him make it happen. Move him home with you if that is what he wants. Surround him with caring and love in these last months. Make this time one which your family can share together and say and do the things you wish you could do. Talk to him, listen to what he has to say. Ask him about his life. Ask him what he wishes you might learn from his experiences.It is a time you will never regret having spent.
Tell him you understand his wishes and that you will honor them, even though it is painful for you. Ask him how he wants to spend the time he has left and where he would like to spend it. Ask him what he would still like to do, where he might like to go, what he might like to see one more time. Ask him if he is willing to take some medication in order to be more comfortable while he does whatever he would still like to experience. Ask him what is one thing he wishes he had done in his life that he has not yet done. Try to find out what he wants with these last months of his life, how he really wishes he might spend them. Help him make it happen. Move him home with you if that is what he wants. Surround him with caring and love in these last months. Make this time one which your family can share together and say and do the things you wish you could do. Talk to him, listen to what he has to say. Ask him about his life. Ask him what he wishes you might learn from his experiences.It is a time you will never regret having spent.
My husband and I have recently been faced with this same situation with his mother who is 93. Up until two months ago she was totally independent with her own apartment but after a fall that fractured her wrist she has been going down hill since then. She was recently hospitalized for a urinary track infection and all she talked about was wanting to die. After the nurses found out about her continuous request and demand to die, a team of Pellative Care Nurses were called in. In case you aren't familiar with that term it is the step before Hospic care. With the MIL,my husband and myself we met with the Pellative Care team and spent several hours discussing all her choices. At the end she still wanted to die and refused any medicine, tests or treatments of any kind. These nurses did a "MOST" form on her in which each thing she requested was discussed to make sure she understood what she wanted done and knew what was going to happen with her request and then it was all written in detail, signed, witnessed and notarized to be put in her permanent medical records along with a DNR form. She was living about 80 miles away so we had her brought to the city we live in and she is now in a nursing home here. She still has not changed her mind (and that is getting worse with each passing day)so we have had to accept her decision. It is a very hard thing to do but it is her life and not ours so what can you do but honor her wishes. Good luck and believe me I know what you're going through.The only request I have made is to God and asked him not to let her suffer.
My husband and I have recently been faced with this same situation with his mother who is 93. Up until two months ago she was totally independent with her own apartment but after a fall that fractured her wrist she has been going down hill since then. She was recently hospitalized for a urinary track infection and all she talked about was wanting to die. After the nurses found out about her continuous request and demand to die, a team of Pellative Care Nurses were called in. In case you aren't familiar with that term it is the step before Hospic care. With the MIL,my husband and myself we met with the Pellative Care team and spent several hours discussing all her choices. At the end she still wanted to die and refused any medicine, tests or treatments of any kind. These nurses did a "MOST" form on her in which each thing she requested was discussed to make sure she understood what she wanted done and knew what was going to happen with her request and then it was all written in detail, signed, witnessed and notarized to be put in her permanent medical records along with a DNR form. She was living about 80 miles away so we had her brought to the city we live in and she is now in a nursing home here. She still has not changed her mind (and that is getting worse with each passing day)so we have had to accept her decision. It is a very hard thing to do but it is her life and not ours so what can you do but honor her wishes. Good luck and believe me I know what you're going through.The only request I have made is to God and asked him not to let her suffer.
wow all of the stories that I have just read from above my comment really touch me. I am 25 years old my dad was only 52 years old when he passed away in January. I think that you should Ask him how he wants to spend the time he has left and where he would like to spend it. I would never want to be in a nursing home. I worked at one and it is so sad there family members place their family there to get the care they need but then how often to they come back to visit. To the family of the 99 year old man, and the 93 year old woman, Let them do what they want. he is 99 years old he has probably lived and seen more then we can even read about in a book. You have to realize that you have had so many wonderful years together maybe he is just done now. I must admit how I envy you guys who have your parents still. My dad was my best friend in the world. I spent everyday with him I knew he had chf but I didn't know how bad it was until after he was gone and I became his P.R. and got his medical records. I'm only 25 and my infant will never get to know my dad and I bet your family members are great grandparents maybe even great great grandparents be happy that you got to spend this much time with them and grant there wishes don't try to make them do something they don't want to do, because that will just make however much time is left miserable. Enjoy the time you have and if they are in pain ask the doctor to give them pain medication and let them go however they choose. Natalie
wow all of the stories that I have just read from above my comment really touch me. I am 25 years old my dad was only 52 years old when he passed away in January. I think that you should Ask him how he wants to spend the time he has left and where he would like to spend it. I would never want to be in a nursing home. I worked at one and it is so sad there family members place their family there to get the care they need but then how often to they come back to visit. To the family of the 99 year old man, and the 93 year old woman, Let them do what they want. he is 99 years old he has probably lived and seen more then we can even read about in a book. You have to realize that you have had so many wonderful years together maybe he is just done now. I must admit how I envy you guys who have your parents still. My dad was my best friend in the world. I spent everyday with him I knew he had chf but I didn't know how bad it was until after he was gone and I became his P.R. and got his medical records. I'm only 25 and my infant will never get to know my dad and I bet your family members are great grandparents maybe even great great grandparents be happy that you got to spend this much time with them and grant there wishes don't try to make them do something they don't want to do, because that will just make however much time is left miserable. Enjoy the time you have and if they are in pain ask the doctor to give them pain medication and let them go however they choose. Natalie
Thanks for all your responses. My FIL lived 6 hours away from us, and had no support system where he was. My husband and I are the only family he has. His neighbors found him wandering in the yard in his underwear, in pain. They took him to the hospital, then called my DH. The drs. said he absolutely could NOT return home, so we chose to move him to assisted living close to where we live, so he could have support and companionship. It's easy to comment that he should have been allowed to remain at home with help, but that was not an option. Distance, cost, and home conditions dictated a move across state so we could physically be there for my FIL. His house was a mess, and it took 2 years to clean it up so it could be sold. We had to sell it to help pay for FIL's care.
We can't even say the word hospice around my FIL, because he throws fits. Five years ago, my FIL was providing care for my MIL, who had lung cancer, but he was unable to care for her. We called in hospice, who removed her from the home and put her in a hospice facility because my FIL refused to give her oxygen and medication. FIL was a phone call away from being picked up by the police for elder abuse when hospice stepped in. She died less than 2 weeks later. Even though we know how great hospice is, and we believe wholeheartedly in their work, my FIL will have nothing to do with them. We will try to honor his requests NOT to call in hospice, even though we know what good options they could provide.
We continue to tell him he is loved, and DH tries to explain the importance of his medications to maintaining his health. We try to give him control over what we can, understanding his need to make decisions. We have just found out that the assisted living facility soon will have a doctor who comes in to do patient assessments, so we don't have to transport my FIL to a doctor. The doctor can see him on site, and may be able to work with my FIL to make him as happy and comfortable as possible. Except for urinary issues, he is not ill, and does not look or act 99.
Thanks for all your responses. My FIL lived 6 hours away from us, and had no support system where he was. My husband and I are the only family he has. His neighbors found him wandering in the yard in his underwear, in pain. They took him to the hospital, then called my DH. The drs. said he absolutely could NOT return home, so we chose to move him to assisted living close to where we live, so he could have support and companionship. It's easy to comment that he should have been allowed to remain at home with help, but that was not an option. Distance, cost, and home conditions dictated a move across state so we could physically be there for my FIL. His house was a mess, and it took 2 years to clean it up so it could be sold. We had to sell it to help pay for FIL's care.
We can't even say the word hospice around my FIL, because he throws fits. Five years ago, my FIL was providing care for my MIL, who had lung cancer, but he was unable to care for her. We called in hospice, who removed her from the home and put her in a hospice facility because my FIL refused to give her oxygen and medication. FIL was a phone call away from being picked up by the police for elder abuse when hospice stepped in. She died less than 2 weeks later. Even though we know how great hospice is, and we believe wholeheartedly in their work, my FIL will have nothing to do with them. We will try to honor his requests NOT to call in hospice, even though we know what good options they could provide.
We continue to tell him he is loved, and DH tries to explain the importance of his medications to maintaining his health. We try to give him control over what we can, understanding his need to make decisions. We have just found out that the assisted living facility soon will have a doctor who comes in to do patient assessments, so we don't have to transport my FIL to a doctor. The doctor can see him on site, and may be able to work with my FIL to make him as happy and comfortable as possible. Except for urinary issues, he is not ill, and does not look or act 99.
Dealing with some of the same issues, as my Dad is adamant about not going back to the hospital for any treatment, but then asks why he is so short of breath & fatigued - his CHF has moved to end-stage. "Doing what is right" is what your FIL wants - its his life. In our family we remind one another of that - we are here to assist, support and care, but we are not parents to direct. Hard to do when you know what they are doing will hasten the end; has forced us all to examine quality as versus quanity of life. Is the facility your FIL is in appropriate for him, in that are the other residents he spends time with at the same coginative level he is? If possible bring him closer to you. Frequent short visits are much better, and provide a sense of consistency and security.
Dealing with some of the same issues, as my Dad is adamant about not going back to the hospital for any treatment, but then asks why he is so short of breath & fatigued - his CHF has moved to end-stage. "Doing what is right" is what your FIL wants - its his life. In our family we remind one another of that - we are here to assist, support and care, but we are not parents to direct. Hard to do when you know what they are doing will hasten the end; has forced us all to examine quality as versus quanity of life. Is the facility your FIL is in appropriate for him, in that are the other residents he spends time with at the same coginative level he is? If possible bring him closer to you. Frequent short visits are much better, and provide a sense of consistency and security.
Are there any physicians willing to see him at the facility? Would he be willing to consider palliative care? Some places have that program in place for people who maybe aren't ready for Hospice but still need the type of assistance/care Hospice provides.
If none of these are options, then really the only thing you can do is respect his wishes. Its not an easy thing to do. But it can be the most loving.
Are there any physicians willing to see him at the facility? Would he be willing to consider palliative care? Some places have that program in place for people who maybe aren't ready for Hospice but still need the type of assistance/care Hospice provides.
If none of these are options, then really the only thing you can do is respect his wishes. Its not an easy thing to do. But it can be the most loving.
Thanks to everyone for your comments and concern. My FIL committed suicide this morning. He was found by the AL staff when he didn't appear for breakfast. We did everything for him that we could, and provided quality care and support for him. We can't feel guilty, because we loved him and he knew it. We don't understand it or agree with it, but we allowed him his freedom of choice. As usual, he didn't consider the impact of his actions, and how it would affect my DH, but that was his usual pattern and way of doing things, so he was consistent to the end.
Thanks to everyone for your comments and concern. My FIL committed suicide this morning. He was found by the AL staff when he didn't appear for breakfast. We did everything for him that we could, and provided quality care and support for him. We can't feel guilty, because we loved him and he knew it. We don't understand it or agree with it, but we allowed him his freedom of choice. As usual, he didn't consider the impact of his actions, and how it would affect my DH, but that was his usual pattern and way of doing things, so he was consistent to the end.
Your conscience is clear. He obviously was ready to go. I work in LTC and people know when they are ready and have had 'enough'. Loss of indepence, loss of control. They stop taking meds, eating & drinking, and withdraw. Nothing would have changed this sad outcome. My condolences to you and your family.
Your conscience is clear. He obviously was ready to go. I work in LTC and people know when they are ready and have had 'enough'. Loss of indepence, loss of control. They stop taking meds, eating & drinking, and withdraw. Nothing would have changed this sad outcome. My condolences to you and your family.
My thanks to each person who responded quite some time ago, to my concerns about my son. He continues to wish he was "gone" but no longer says he wants to die and now takes his meds and continues to eat well. He is 58 years old and has had a good life until 1999 when his older brother died of a heart attack and in 2001 his wonderful sister was killed on 9/11. About that time his health began to fail and he had an unsuccessful liver transplant in 2006. 8 mos later he was clearly dying when a pristine liver was given to him. It was completely successful and has remained so throughout his most recent ordeals, including a massive brain aneurysm followed by complete paralysis.
3 years have passed and today he can speak clearly and can move his limbs and his body except for his right arm and hand. He was doing physical therapy and could walk with a cane and drive his car. A year and a half ago he had another small stroke and refused to go to the hospital and refused any more PT. At that point Hospice came into help until he clearly became too healthy for Hospice. I have tried every suggestion many folks have made, we hired a psychologist for about a year, but my son said no more to that approach. Any other thoughts or suggestions would be appreciated.
My thanks to each person who responded quite some time ago, to my concerns about my son. He continues to wish he was "gone" but no longer says he wants to die and now takes his meds and continues to eat well. He is 58 years old and has had a good life until 1999 when his older brother died of a heart attack and in 2001 his wonderful sister was killed on 9/11. About that time his health began to fail and he had an unsuccessful liver transplant in 2006. 8 mos later he was clearly dying when a pristine liver was given to him. It was completely successful and has remained so throughout his most recent ordeals, including a massive brain aneurysm followed by complete paralysis.
3 years have passed and today he can speak clearly and can move his limbs and his body except for his right arm and hand. He was doing physical therapy and could walk with a cane and drive his car. A year and a half ago he had another small stroke and refused to go to the hospital and refused any more PT. At that point Hospice came into help until he clearly became too healthy for Hospice. I have tried every suggestion many folks have made, we hired a psychologist for about a year, but my son said no more to that approach. Any other thoughts or suggestions would be appreciated.
AMEN!
AMEN!
I like your combination of love and respect. It might rekindle an interest that he once had to be asked in such a way.
I like your combination of love and respect. It might rekindle an interest that he once had to be asked in such a way.