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What To Do When Elderly Parent Refuses Needed Care

Dr. Regina Koepp is a board certified clinical psychologist, clinical geropsychologist, and founder and CEO of the Center for Mental Health & Aging: the “go to” place for mental health and aging. Dr. Koepp is a sought after speaker on the topics of mental health and aging, caregiving, ageism, resilience, intimacy in the context of life altering Illness, and dementia and sexual expression. Dr. Koepp is on a mission to ensure mental health and belonging for older adults, because every person at every age is worthy of healing, transformation, and love. Learn more about Dr. Regina Koepp here.

Regina Koepp, PsyD, ABPP

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You care about your aging parent so much and for some reason, they’re just not listening to you and your pleas for them to go to the doctor. You try and you try, but nothing you say is convincing your parent that whatever is going on in their mind or body is worth checking out. So, here are expert tips for what to do when elderly parents refuse needed care.

Try to see where your aging parent is coming from.

If changing your approach doesn’t work and your parent is still refusing, ask gentle and loving questions to see where they’re coming from. Like, “Tell me what’s going on that makes you not want to go to the doctor.” Then hear them out.

Your parent might say things like: “my doctor doesn’t listen to me”… “I don’t agree with what my doctor says”… “all they’re gonna do is give me medicine; I’m already on too many medications”… “They’re too young”… “They don’t understand me”… “the doctor tells me ‘well of course you’re in pain, you’re old”

If your parent is saying any of these things, this could be their way of telling you that there are some cultural barriers or missteps happening with their doctor -like some ageism.

Ageism is discrimination based on age, and in the medical field this often shows up as: “of course you have THAT problem, you’re old, what do you expect?”

As you can imagine, this approach is NOT helpful and is actually hurtful toward older adults. This may be a sign that your parent needs a doctor who understands older adults. If this is the case, I’d encourage you to offer to help your parent find a new doctor- one that specializes with older adults  – called a Geriatrician.

Work with a Geriatrician

A Geriatrician is a Primary Care Provider who specializes with older adults and is skilled in helping older adults to address complex medical and mental health concerns more common with aging, like dementia.

Here are some tips for finding a Geriatrician:

  • HealthinAging.org, created by the American Geriatrics Society’s Health in Aging Foundation, provides up-to-date information and advice on health and aging. Their Find A Geriatrics Health Professional referral tool allows you to plug in your zip code and find geriatric specialists near you.
  • Major Medical Centers and Universities – If your older loved one lives near a major medical center or medical university, go online (or google them) to see if they offer geriatric primary care services, a geriatric medical clinic, geriatricians, geriatric medicine, etc.
  • Area Agency on Aging. Call your local Area Agency on Aging and see if they have any recommendations for geriatric medicine specialists. Simply plug in your zip code and call the agency nearest your oldest loved one.

Consider changing your approach.

If you’re really worried about your aging parent, it’s common to have the tendency to be demanding or a little bit pushy. Perhaps back off a bit and share 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 then sharing, “dad, I notice that the 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.”

If he stammers and says “I don’t want to put you out”, respond by reassuring him with, “I’m happy to do this with you, we can go to the doctor and then go to lunch. It’ll be a way for us to spend time together.”

Many older adults are afraid of being a burden on their family and society. The more you can tell your parent 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’ll be to get your parent out of the house and into the doctor.

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

If your parent doesn’t want to go with you to the doctor (Tip 1) and doesn’t want to find a new doctor (Tip 2), ask if they’d be willing to go with another family member, or friend, to the doctor. If your parent agrees to this, don’t stop there. Ask them to name the person they’re willing to go with. Then, ask if they’d be willing to call that person now and see if they can help. If you’re around, call that person together. Let your parent speak first, then ask if you can share your thoughts.

It can sting a little bit, if your parent ISN’T willing to go with you, but IS willing to go with somebody else. Sometimes it might take a few people to share their concerns before your parent takes a medical or mental health problem seriously. For some people, it can help for someone closer to your parent’s own age shares their own experience and encourages them.

Whatever the case may be, the important piece to hold onto here, is that your parent IS willing to go to the doctor. Take this as an opportunity to expand your parent’s care network. This could actually be a win-win.

Ask another family member or friend to reach out to your parent.

Still refusing? Try asking another family member or friend to reach out to your parent to express concern about the medical problem, encourage them to go to the doctor, and ask if they’d offer to take your parent to the doctor. If your parent is living in a senior community, there may be on-site nurses who can check in on them. If this is the case, consider calling the front office to see if there is a nurse on site there who’d be willing to pay your parent a visit. Note: there may be a fee for this type of service.

 

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Email or fax your parent’s medical provider

Your parent’s medical provider may not be able to give you information directly, but you can give the medical provider information about your concerns. Email or fax is best as this information more often makes it to the physician and in the older adult’s medical record. If this is not possible, try calling and sharing your concerns with a nurse. When you do share your concerns, give objective examples of the signs and symptoms you’ve been noticing. If the signs are related to memory or mental health, give examples of how these symptoms are different from 5 years ago.

Take a break and give your parent some space.

If the situation is not an emergency and If you’ve tried all of these strategies above and your parent is still not willing to go, you may 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 – to sit back and watch your parent struggle. It’s really difficult to be powerless and have no control over the actions of somebody you love who is suffering. Especially when, from the outside, it looks like there’s a very simple solution- just go to the doctor!

Continue communicating and engaging with your loved one

If you do take a step back and give your parent some space, don’t throw up your hands and ignore them. Even if you’re frustrated continue to call, visit, and stay engaged. The better the relationship, the more likely your parent will be to listen to your concerns down the road.

In some extreme cases, if your aging parent is very sick and refusing to go to the doctor, it might be necessary to call 911 or take them to the ER. If you do call 911 and the ambulance drivers say that they can’t take your parent to the ER because they’re refusing, you might find yourself in a real bind. If you’re worried about your parent’s safety or severe self-neglect, you may consider calling Adult Protective Services (APS) in the county where your parent lives to get a third party / case manager involved. They’ll go out to the home and assess the situation.

Situations like these are really tough, it’s important that in the midst of all this chaos that you find some time to care for yourself.

Get professional help

If you and your loved one are not communicating well about changes that you’re noticing in your older loved one and you’re concerned that these changes may be related to a major medical or mental health change, working with a professional can help to clarify what is causing these changes. Are these changes normal with aging? Related to a treatable medical condition? Signs of a dementia disorder? A mental health condition? Only a professional can help to identify what is causing these changes and how to plan for next steps. The best first place to start is with an ER if this is an emergency, or secondarily with a primary care provider. It’s best to rule out any medical causes of changes in your loved one before moving on to mental health care.

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