What do people do when their marginally dementia parents / in laws resist necessary medical procedures?

[PandaBear]

Wife's mom is, in our opinion, slightly dementia and diagnosed with a 13cm tumor that is likely ovarian cancer. She was lucky that she can get a surgeon in Kaiser to schedule a surgery within 2 weeks that last 3.5hr if it is benign to about 5hr if it is indeed a cancer (based on biopsy during the surgery). However, she is starting to chicken out and was wondering if she can "wait and see" or take any other medication to reduce / treat it without surgery, as she has never gotten a surgery in life (she's currently 75). We had to convince her that this is really a matter of life and death and there really is no point waiting, and at her age she no longer needs her ovaries, and her mom and sister both had ovarian tumor or cancer so she has a family history of it.

About her borderline "dementia" behaviors: she routinely "cancel" doctors appointment by accidents and lock her medical accounts out by trying the wrong passwords too many times, like locking out 6 times a week.

This got us wondering, what do people in similar situation? How do you work with seniors who fought back on the control? When do you take over their medical plans because they are no longer capable of making decisions?

 

[fisher83]

Is it possible that she is actually of sound mind and just doesn't wish to receive the care? My grandma is 84 and she has pretty much taken the position years ago that at her age she isn't interested in "fixing" anything with her body. She's just going to ride it out until the wheels fall off. She very well may view this much differently than you do given her age.

 

[Leo99]

Sounds like she's not too far gone that you can assume her medical care as guardian but it's a horrible, horrible situation. 13cm is quite large.

 

[Leo99]

Is it possible that she is actually of sound mind and just doesn't wish to receive the care? My grandma is 84 and she has pretty much taken the position years ago that at her age she isn't interested in "fixing" anything with her body. She's just going to ride it out until the wheels fall off. She very well may view this much differently than you do given her age.

My MiL is the same age and says the same thing but she's off to get a mammogram next month.

 

[cptbarkey]

You can very delicately convince her to give medical and/or general power of attorney. Sooner vs later is my advice. My father last few years were stressful with many medical and financial incidents.

 

[twouvakind]

See an elder law practice, one stop shopping.

 

[SammyChevelleTypeS3]

Wife's mom is, in our opinion, slightly dementia and diagnosed with a 13cm tumor that is likely ovarian cancer. She was lucky that she can get a surgeon in Kaiser to schedule a surgery within 2 weeks that last 3.5hr if it is benign to about 5hr if it is indeed a cancer (based on biopsy during the surgery). However, she is starting to chicken out and was wondering if she can "wait and see" or take any other medication to reduce / treat it without surgery, as she has never gotten a surgery in life (she's currently 75). We had to convince her that this is really a matter of life and death and there really is no point waiting, and at her age she no longer needs her ovaries, and her mom and sister both had ovarian tumor or cancer so she has a family history of it.

About her borderline "dementia" behaviors: she routinely "cancel" doctors appointment by accidents and lock her medical accounts out by trying the wrong passwords too many times, like locking out 6 times a week.

This got us wondering, what do people in similar situation? How do you work with seniors who fought back on the control? When do you take over their medical plans because they are no longer capable of making decisions?

Sorry to hear, tough position to be in.

 

[JeffKeryk]

You are entering a new life chapter; caring for an aging parent. The child becomes the parent.
1st, trust in a Doctor is an issue regardless of age, and it is her choice.
2nd, she does not sound that bad mentally.

Sounds like you have tried to talk with her. Perhaps her Doctor can better doscuss the situation?
I cared for my parents for many years. My father was not a nice man, son of poor Ukrainian immagrints, Yale educated and bull headed.
The worst was getting him to stop driving, in his early 90's. Lotsa dents and paint scrapes on his Accord.

Good luck @PandaBear

 

[DemoFly]

My dad heard the C-word and started going into denial. Wanted to wait and see, maybe it's not so bad, etc.

She's probably extremely afraid, like my dad was. However, maybe it is dementia. If that truly is the case you'll have to call an elder law attorney.

 

[k1xv]

Tell her its either the doctor or the funeral home. Her choice.

You could try a little logical argument. You could say "What if I had your symptoms? Would you want me to see a doctor to take care of it, or would you prefer I do nothing and see what happens?"

 

[bbhero]

I have a couple of thoughts here…

1. Would she be capable/competent of giving power of attorney to your wife ? Is she oriented to person , place, time and circumstance some days to where she could go have that document drawn up and sign it herself ?

2. I wonder…. If she really has “ dementia “… And quite possibly cancer with metastasis to her brain therefore causing dementia like neurological symptoms?

I sincerely and seriously say this… I just met an older lady there other day with that dementia diagnosis. However, this lady had a very noticeable lump on her… I believe it possible in that lady’s case it’s not really dementia… I believe it is possibly something else…


3. If she truly has only the issue she has with no metastasis… Then you can try to reason with her on her good days. Maybe you can get her to settle in and be agreeable to having the surgery.

4. If you are successful in that… The importance of your wife and whoever else who is close to your mother in law… They all must be there right after her surgery… in shifts … THIS is massively important in my opinion to not only ease and help her after surgery… But to make it as least jarring and harmful to her afterwards as well. The hospital staff cannot and will not have the time to truly help her with that.

 

[drtyler]

You could try a little logical argument. You could say "What if I had your symptoms? Would you want me to see a doctor to take care of it, or would you prefer I do nothing and see what happens?"

Son-in-law may not want to hear that answer.

 

[TheLastWord]

This is headed toward lock status. Idiotic comments about a funeral home and amateur "doctors" giving diagnosis.

 

[PandaBear]

Definitely she is in denial of the cancer. At the moment some of the reading (I forgot the name, the baseline is supposedly 30 but her reading is 600) shows it is definitely cancer, but CT scan and ultrasound shows it has not yet metastasis elsewhere.

Regarding to dementia, her sister has it, her dad had it around this age, she is in better condition as she argue with my farther in law all day (they have a mildly troublesome marriage so arguing is a daily thing between them, but that sort of keep her sharp). She has very bad short term memory and would repeat the same question 5 times in an hour, like which day of the week it is, and which grade our children is attending, etc. I would definitely say she is pre-dementia at the moment (she forgot why she need surgery very often), but not severe at all. I guess you can say she is definitely in denial as well.

She felt bloated but no pain, and the doctors told her to sleep side way as the 13cm lump may cutoff blood circulation to her legs. Post surgery father in law will definitely be around to help take care of her, but he himself is 78 years old, and my wife will definitely spend a lot of time visiting and helping. Surgery if small incision, she can go home the same day. If it is a large incision to cut more of the cancer she would likely stay for 3-5 days in the hospital. After that depends on the need she may receive chemo.




Wife just got off a call with her mom, she forgot she is having a surgery this Friday again.

 

[wrcsixeight]

Dementia is cruel.

I'm watching my mom disappear a little more each day.

There is no reason or logic circuits anymore.

Just trying to keep her calm, and happy.

When she has a smidge of lucidity, and realizes just how bad her brain is, Playing some music, and asking my sweet sheepdog to stay by her side, can get her to stop wishing to die.

 

[BMWTurboDzl]

Definitely she is in denial of the cancer. At the moment some of the reading (I forgot the name, the baseline is supposedly 30 but her reading is 600) shows it is definitely cancer, but CT scan and ultrasound shows it has not yet metastasis elsewhere.

Regarding to dementia, her sister has it, her dad had it around this age, she is in better condition as she argue with my farther in law all day (they have a mildly troublesome marriage so arguing is a daily thing between them, but that sort of keep her sharp). She has very bad short term memory and would repeat the same question 5 times in an hour, like which day of the week it is, and which grade our children is attending, etc. I would definitely say she is pre-dementia at the moment (she forgot why she need surgery very often), but not severe at all. I guess you can say she is definitely in denial as well.

She felt bloated but no pain, and the doctors told her to sleep side way as the 13cm lump may cutoff blood circulation to her legs. Post surgery father in law will definitely be around to help take care of her, but he himself is 78 years old, and my wife will definitely spend a lot of time visiting and helping. Surgery if small incision, she can go home the same day. If it is a large incision to cut more of the cancer she would likely stay for 3-5 days in the hospital. After that depends on the need she may receive chemo.




Wife just got off a call with her mom, she forgot she is having a surgery this Friday again.

Cognitive decline is a fact of life and the rate is highly variable. At 75 she obviously doesn't want to have a major operation. I would also ask the MD and do a little research on the effects of anesthesia on patients with dementia. However, your MIL hasn't been formerly diagnosed with dementia. You'd have to talk to a lawyer but assuming you have a medical POA do you really want to drag your MIL into the hospital screaming over a procedure she doesn't want to have?

I wish you and your family the best.

 

[cptbarkey]

This is headed toward lock status. Idiotic comments about a funeral home and amateur "doctors" giving diagnosis.

Its a sensitive topic but I don’t think either topics you mention has been broached, are you commenting on the right thread? So far its civil and we are nowhere in Steven King Misery novel territory.

Many middle aged people have to cope with at least once in their lifetime, the role gets reversed and that alone is stressful. Asking for help / advice on a forum is commendable.

 

[spasm3]

Every situation is different. But I have to say, if I was 75, and had significant dementia, I would not do much to prolong my own life. I would not want the slow decline and constant care that it would eventually require , and the burden for my loved ones.

She maybe wiser than you give her credit for.

 

[PimTac]

At that age even for someone with a clear mind it is a good idea for someone to accompany her to all the doctors visits. A lot of things can go wrong or get misunderstood.

We did this with our mother. She had duplicate medications from different doctors. We told her to choose one doctor. He narrowed the medication list down substantially. We also learned about dietary restrictions and other suggestions.

 

[Astro14]

Wife's mom is, in our opinion, slightly dementia and diagnosed with a 13cm tumor that is likely ovarian cancer. She was lucky that she can get a surgeon in Kaiser to schedule a surgery within 2 weeks that last 3.5hr if it is benign to about 5hr if it is indeed a cancer (based on biopsy during the surgery). However, she is starting to chicken out and was wondering if she can "wait and see" or take any other medication to reduce / treat it without surgery, as she has never gotten a surgery in life (she's currently 75). We had to convince her that this is really a matter of life and death and there really is no point waiting, and at her age she no longer needs her ovaries, and her mom and sister both had ovarian tumor or cancer so she has a family history of it.

About her borderline "dementia" behaviors: she routinely "cancel" doctors appointment by accidents and lock her medical accounts out by trying the wrong passwords too many times, like locking out 6 times a week.

This got us wondering, what do people in similar situation? How do you work with seniors who fought back on the control? When do you take over their medical plans because they are no longer capable of making decisions?

Is she no longer capable?

Is she fighting back on control?

Just because she doesn’t want the surgery, doesn’t make her incompetent, and forgetting your password is about average for most people her age (and younger).

From her perspective - you’re trying to tell her how to live her life, how to choose her health care. That’s incredibly presumptuous and controlling of her child - your wife. Child doesn’t get to declare Mom incompetent so that she can win this argument.

I will be honest, while I will listen to my daughter, who is far more qualified* than your wife to make medical decisions, I will still choose my own path.

Let the mom choose. If she chooses an early death over her fear of surgery, that is her choice. In the meantime, pick up a copy of “Being Mortal” by Atul Gawande and give it a read. Most people, and many doctors, make very expensive, painful decisions near the end of life. Your mother in law may be choosing to avoid that path.

*She is a doctor. A surgeon.