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

[KrisZ]

Regarding the passwords, I would set up either a keychain if she’s using an Apple product, or some other password manager to help her with it. You can then have access to that password manager and help her out.

It may not be dimentia, she may simply be overwhelmed.

 

[Vil_Riker]

It's a tough situation.

 

[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.

I have to add , that there are some peripheral tumors that can cause cerebral breakdown, and she may not have classic dementia or Alzheimer's.
Discussions with her physician ,if possible, are crucial.

 

[Vil_Riker]

It is very possible that the surgery will do more harm than good, especially if they decide to do chemo. What stage is the cancer?

 

[chemman]

You (or your wife) needs to do two things with respect to your wife's parents. One, as someone already suggested, is to consult with an elder law attorney. Two, get both parents evaluated at a geriatric medical clinic.

The geriatric medical clinic should perform a complete head to toe physical and also conduct a psychiatric evaluation by a psychiatrist specializing in geriatrics. See https://www.nebraskamed.com/geriatrics for more information.

I had my Aunt evaluated several years ago by the geriatric clinic I referenced above when we suspected she had dementia and we found out she had Alzheimer's. I was extremely glad that she was evaluated and diagnosed, and that I was given specific recommendations for her activities of daily living. Also, Medicare and her medicare supplemental insurance paid for the evaluation.

Good Luck!

 

[PandaBear]

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.

I don't think she is "fighting back". She definitely is scared but she trust my wife completely on making the right decision. Father in law may be a bit hard to work with in daily life but he is sharp at his age and he is working with us for the best medical decision for her. They ended a trip early to bring her home for the diagnosis, despite this makes his own medical procedure a bit more complicated (he had to cancel his own dental procedure to come back early).

Maybe brother in law (lives in another state) is right. In this situation it is better to tell mother in law a "white lie" saying it is a small surgery and it won't hurt much, like telling a kid the little flu shot in the arm doesn't hurt. We took away her Asprin and Vitamin E to prep for her surgery, as she tends to forget she needs to stop 5 days prior and she forgot she had a surgery scheduled.

Will find out in the middle of the surgery if it is a cancer for real or not, and that will determine whether it is a small or large incision and whether she will go home that day or not.

 

[PandaBear]

I have to add , that there are some peripheral tumors that can cause cerebral breakdown, and she may not have classic dementia or Alzheimer's.
Discussions with her physician ,if possible, are crucial.

This will be something we will look at in the long run. At the moment removing the "tumor" is the highest priority and Kaiser has been able to schedule a slot for us almost asap (10 days after the initial CT scan after she came back from Taiwan, where her CT and ultrasound discovered the tumor). Kaiser's surgeon said she will do a biopsy during that initial small incision surgery to see what it is, would only takes 20 mins.

 

[Yourhomiematt]

Having gone down this road with my grandmother, unfortunately my mother knew it was in store for her. She had a detailed living will made up before she was stricken by it

 

[BMWTurboDzl]

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.

That makes sense yet I also think it's a little selfish if one is at least not cognizant of the impact ones decisions may have on family. For example should a retired parent spend like a drunken sailor under the assumption that his/her children will pay for housing/care when the money runs out?

 

[4WD]

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

My Dad solved the driving problem for us. Rode with him for what we assumed was his last license - I had not been in the car with him for a long time - he turned the wrong way into traffic but we survived - after, he said ”drive me home” …

 

[twouvakind]

See an elder law practice, one stop shopping.

<$3,000 in Myrtle Beach (Grand Strand Law Group), money well spent as my Mom is 87.

 

[Aredeeem]

Not an appropriate topic for this forum. So many of us need a shoulder to cry on. It’s a credit to this forum that folks are comfortable with sharing their feelings on it. I don’t envy the moderators hesitation as they hold their fingers over the lock key.

 

[Astro14]

That makes sense yet I also think it's a little selfish if one is at least not cognizant of the impact ones decisions may have on family. For example should a retired parent spend like a drunken sailor under the assumption that his/her children will pay for housing/care when the money runs out?

Conversely, I’ve seen kids get upset when their parents go on vacation, because the parents are spending money, and the child thinks that will “reduce my inheritance.”

So, no, parents shouldn’t presume that their kids will pick up the slack if they fail.

But kids shouldn’t view the parents’ money as their own, until after they pass away.

And kids shouldn’t view parents’ decisions as their own, unless the parents really are unfit to make decisions.

As an example, if I choose to blow $100,000 on a cruise around the world, and I’m financially independent, whose business is that besides mine? My money. My decision. Maybe I have always wanted to do it.

Kids should not get a vote in this kind of decision, but many kids think they should. I’m fortunate that my kids don’t feel entitled to my lifetime of savings. They are all independent.

In the OP case, the kids want to make Mom’s decision. But refusing treatment is a reasonable decision for one in possession of their faculties. Every medical provider must obtain patient consent, if the patient is able to grant consent, prior to doing anything. Patients refuse consent all the time.

The real question, then: is mom competent to make decisions?

Because the OP hasn’t made that case, other than to say the decision demonstrated dementia, and to describe circumstantial evidence. But the doctors themselves can help the family determine competency. If they say she’s competent, then it is her call, even if the kids don’t like the decision.

As far as BITOG rules, as long as we’re not giving specific medical, or legal, advice, then I think we’re OK. we are talking about the issue, not telling the @PandaBear what he must, or must not, do.

Other than read Atul Gawande’s book. That’s just a book recommendation.

 

[Thermo1223]

Not an appropriate topic for this forum. So many of us need a shoulder to cry on. It’s a credit to this forum that folks are comfortable with sharing their feelings on it. I don’t envy the moderators hesitation as they hold their fingers over the lock key.

I fail to see this line of reasoning. We're all adults here and can have a reasonable discussion on sensitive personal issues if we choose so. No one forced him to post it and he came here because he obviously trusts our opinion vs. the rest of the online world. This is not about politics or any other highly opinionated issue.

@PandaBear

I went through something similar with my grandmother. I had(Died 2 years back) guardianship along with my cousin. The judge was very histent but we stressed her children do not have her best interest at heart and no knowledge of her issues. My cousin lived very close to where my grandmother was and I was only 45 mins away and better with the financials than my cousin. My Aunt(her daughter) had PoA over her when she started to slip mentally and things went well as she was in a nursing home specifically for memory loss. Once my Aunt got cancer(2014) I knew I was on the short list to take care of her as she did not get along well with her siblings my father included.

In the end it worked out better than I thought but she had very good & very bad days. Luckily mostly good towards the end and she passed peacefully in her sleep one night.

I would advise her that getting PoA isn't a bad thing and will make things way easier in the long run. This goes especially for her not treating the cancer and if her dementia progresses. I would not count on your stepfather to do what's best but that is only my opinion. I know from experience that elders tend to switch off when faced with difficult decisions. You need to be clear minded and resolute.

 

[bbhero]

This will be something we will look at in the long run. At the moment removing the "tumor" is the highest priority and Kaiser has been able to schedule a slot for us almost asap (10 days after the initial CT scan after she came back from Taiwan, where her CT and ultrasound discovered the tumor). Kaiser's surgeon said she will do a biopsy during that initial small incision surgery to see what it is, would only takes 20 mins.

What spasm said is what I was actually alluding to…

I think it is a possibility here…

Let me share with you a similar circumstance… If someone has a urinary tract infection and it is in a early to middle stage on yet present in their blood… they can be “ off” cognitively a bit… Which it gets worse as their blood becomes more infected. Or for some people go from that way of being too… literally snap your fingers and they are unresponsive and make you think they have had a stroke.

I would think like my client the other day… it is on a cellular level possibly… And they may well explain her seemingly acting like she has dementia but… it is possibly something else.

I hope I’m wrong. I mean that sincerely. In my nice lady’s case and in you and your wife’s circumstances too.

If you need anything pb… you can always send me a msg.

 

[SeaJay]

Sadly, you can't convince everyone with dementia as well as those of sound mind. Been there, done that with one of mine of the reasonbly sound mind variety, stubborness runs in the family I suppose.

 

[PandaBear]

That makes sense yet I also think it's a little selfish if one is at least not cognizant of the impact ones decisions may have on family. For example should a retired parent spend like a drunken sailor under the assumption that his/her children will pay for housing/care when the money runs out?

This is a hard to answer question. Typically people assume that seniors with no financial mean of self support are put on an allowance plan so they don't spend like a drunken sailor. However as my father in law has shown in the past, our offer to buy them a used Hyundai Elantra turns into his wish for us to finance a lease for a fully loaded Camry XLE for 3 years, and got upset when we say no.

 

[BMWTurboDzl]

This is a hard to answer question. Typically people assume that seniors with no financial mean of self support are put on an allowance plan so they don't spend like a drunken sailor. However as my father in law has shown in the past, our offer to buy them a used Hyundai Elantra turns into his wish for us to finance a lease for a fully loaded Camry XLE for 3 years, and got upset when we say no.

It's a challenge because you can't just put an elderly parent on an allowance plan.

 

[Astro14]

This is a hard to answer question. Typically people assume that seniors with no financial mean of self support are put on an allowance plan so they don't spend like a drunken sailor. However as my father in law has shown in the past, our offer to buy them a used Hyundai Elantra turns into his wish for us to finance a lease for a fully loaded Camry XLE for 3 years, and got upset when we say no.

Then your situation is complicated by their financial reliance on you.

If they’re not able to support themselves, and you are supporting them financially, then, yes, you do get a say in their financial decisions.

An allowance, if you like. And they have a responsibility, to you, to be reasonable with their spending.

There is a lot to unpack here - about who has control - who is making decisions.

Because they rely on you for financial support, is your wife used to telling them what they can and cannot do? An inverse parent-child relationship?

Because the nature of that relationship would, of course, shape how she approaches medical decisions. She is already used to telling Mom what to do, so, of course, she wants to tell Mom what to do in this case.

I do not envy this situation. Very difficult circumstances.

 

[BMWTurboDzl]

Conversely, I’ve seen kids get upset when their parents go on vacation, because the parents are spending money, and the child thinks that will “reduce my inheritance.”

So, no, parents shouldn’t presume that their kids will pick up the slack if they fail.

But kids shouldn’t view the parents’ money as their own, until after they pass away.

And kids shouldn’t view parents’ decisions as their own, unless the parents really are unfit to make decisions.

As an example, if I choose to blow $100,000 on a cruise around the world, and I’m financially independent, whose business is that besides mine? My money. My decision. Maybe I have always wanted to do it.

Kids should not get a vote in this kind of decision, but many kids think they should. I’m fortunate that my kids don’t feel entitled to my lifetime of savings. They are all independent.

In the OP case, the kids want to make Mom’s decision. But refusing treatment is a reasonable decision for one in possession of their faculties. Every medical provider must obtain patient consent, if the patient is able to grant consent, prior to doing anything. Patients refuse consent all the time.

The real question, then: is mom competent to make decisions?

Because the OP hasn’t made that case, other than to say the decision demonstrated dementia, and to describe circumstantial evidence. But the doctors themselves can help the family determine competency. If they say she’s competent, then it is her call, even if the kids don’t like the decision.

As far as BITOG rules, as long as we’re not giving specific medical, or legal, advice, then I think we’re OK. we are talking about the issue, not telling the @PandaBear what he must, or must not, do.

Other than read Atul Gawande’s book. That’s just a book recommendation.

There's definitely a balancing act on the part of the adult children but regardless of what elderly parents "Feel" with regards to their own financial status is, as they get older their "feelings" may not jive with reality. An elderly parent who's experiencing the slow mental decline may not be aware of how bad things really are and they simply choose to ignore it. I've noticed this weird thing with baby-boomers through discussion with my mother where they want to spend all they can before they pass. That's fine, but they better have an incredibly good idea of "when" that time is arriving. Not all adult children can afford to place their parent(s) in assisted living for $9k/month.