How do we deal with my mother who refuses to seek medical attention?

A fellow caregiver asked...

How do we deal with my mother who refuses to seek medical attention? My mother lives alone, is fiercely independent and has fallen 5 times in the past 6 months. She agreed to see her doctor for only 2 of those falls. She distrusts doctors and believes they will put her in a nursing home, no matter how much we reassure her that she is the "decider" and can't be forced to follow a doctor's recommendations. Mom's doctor is a wonderful woman and mom likes her -- she just won't seek her advice on anything "medical." Mom shows me her bruises but turns down my offers to take her to the doctor. So much of your information includes working with parents' doctors ...what do you advise when the senior chooses NOT to receive health care or medical attention...and is still mentally capable enough to make that decision for herself?

Expert Answer

Maria Basso Lipani writes a popular website on geriatric care topics, where she puts her expertise as a Licensed Clinical Social Worker to good use answering care planning questions. Maria is a graduate of Columbia University School of Social Work and is licensed in California and New York.

If your mother refuses to seek medical attention after she falls, perhaps she would be willing to talk about how to reduce her risk of falling. It’s been my experience that fiercely independent seniors are easily engaged in talks about preventative measures because prevention is in perfect allignment with their ultimate plan…to need as little assistance as possible for as long as possible.

That said, have a conversation with your mother about each of her falls. Ask her what she thinks caused each one and make note of whether the reason is always the same or if there are mutiple contributing factors.  This is what her doctor would do and because you won't be limited by time, you'll do it better.  Depending on the possible answers (see below) perhaps she would be willing to take the corresponding actions.

a) Poor eyesight – an appointment with the eye doctor to determine potential changes in eyesight and the need for glasses, etc.

b) Poor lighting in the home – add lighting as necessary (including night lights) to ensure that pathways are well lit.

c) Feeling of physical weakness – appointment with a physical therapist to learn exercises that can strengthen muscles and improve balance; an appointment with a nutritionist to ensure that diet is enough to sustain muscle strength, etc.

d) Pain in feet – an appointment with the podiatrist to address problems; a trip to the shoe store to purchase shoes that are supportive (ideally flat and rubber-soled)

e) Tripping over items in a cluttered living space – Removing clutter and removing throw rugs (or making sure they are taped down) to reduce to risk of tripping (a good pair of shoes would help here too)

f) Running for the phone– purchasing a cordless phone

g) Dizziness or loss of balance – create a list of medications she is currently taking and indicate which ones (if any) are new. Then ask her if you can contact her doctor specifically to determine if any of the medications could be causing the dizziness and what if any modifications can be made.  No more, no less.