You think your parent is showing signs of dementia. They live alone, rarely answer the phone or doorbell, the house smells like urine, and they’re wearing the same filthy clothes every time you see them. Obviously, you’re concerned and think they should be evaluated by a doctor. The problem is that your loved one flat out refuses to attend any doctor’s appointments. What can well-meaning family members do in a situation like this?
Dr. Robert Stall, a practicing geriatrician based in Buffalo, New York, with more than 20 years of experience, says the first step is to try to understand what is behind an elderly loved one’s refusal to go to the doctor. There are countless reasons why seniors avoid physicians, even despite showing symptoms of potentially serious conditions. Fear, denial, thriftiness, distrust, embarrassment and discomfort are common reasons that cause older individuals to dig their heels in when it’s time for an annual physical or to check out a new or worsening problem.
Alzheimer’s disease and other forms of dementia can complicate matters further by making it difficult or even impossible to reason with a senior and drive home the importance of monitoring their health. Some older individuals even cease going to their primary care physician (PCP), whom they previously trusted and had a good doctor-patient relationship with. So, it comes as no surprise that bringing a new doctor, such as a specialist, into the mix could cause issues.
“Elders usually develop a level of trust and respect when they’ve been going to the same doctor for a long time,” explains Dr. Stall. “Adding a new person into the equation could bring on feelings of vulnerability, distrust and fear of the unknown.” Dealing with these feelings can be difficult, but there are strategies caregivers can use to work through these concerns and ensure their loved ones receive the medical care they need.
Enlist a Third Party’s Help
In cases where a senior ignores or refutes all your pleas for them to see a doctor, it’s time to bring in reinforcements. If your loved one is still comfortable with seeing their primary care physician, Dr. Stall suggests enlisting their help. Have the doctor explain why he or she needs to make an appointment with a specialist. If your loved one no longer has a PCP or has sworn off doctors altogether, then find someone else whom they respect to spearhead this conversation.
A close friend, family member, religious leader, elder law attorney, geriatric care manager or other esteemed individual may be able to convince them to finally make and keep at least one doctor’s appointment. These people will likely use the same argument and talking points that you posed to your loved one, but oftentimes seniors listen better to equals or authority figures who are not related to them.
“Don’t take it personally,” Stall advises. “It’s easier to ignore the suggestions of our loved ones—that’s how family dynamics often work.” In an elder’s mind, the opinion of a doctor or similarly aged friend who is more removed from the personal situation carries more weight than that of a family member who knows the elder well and cares for them deeply.
Avoid Implying Long-Term Commitments
If you’re trying to introduce a new physician to the care team or simply get a loved one back into the routine of going to doctor’s appointments more regularly, try to compromise with them. Don’t frame this agreement as a long-term commitment. Instead, urge them to go just this one time, just to meet the new physician or get a general check-up. If your loved one doesn’t like the new doc, then you’re simply back at square one and ready to try again. Giving the senior the option to rule on whether to continue with these appointments helps them feel more in control of the situation and less afraid of losing what is familiar to them.
Find a Quality Doctor
Seeing a new doctor is always a gamble. Each one has different approaches to health care, a different bedside manner and a different way that they run their practice. Conduct plenty of research on potential physicians and try to ask other doctors and people you trust for recommendations before deciding. Getting a loved one to the appointment is a real struggle, but a bad experience with a physician can ruin your chances for setting future appointments with any medical professionals.
If possible, try to find a local physician who has plenty of experience working with older individuals, such as a geriatrician. They tend to have a better grasp on age-related health issues, medication problems in seniors and how medical changes can directly affect mood, independent functioning, and quality of life. Geriatricians are also used to handling difficult patients, whereas a family doctor may not fully understand or be able to speak to a senior’s unique concerns. Your loved one is likely to feel more comfortable with a doctor who understands their perspective and goals for the future.
Competence Plays a Role
If a senior is still capable of making informed decisions about their medical care and finances, then there is little you can do to convince them to be proactive about their health. However, if there are other red flags present that point to cognitive decline (like Alzheimer’s or other dementia), and your loved one still refuses to seek an evaluation, then it may be time to take a more serious approach. While it may be an unpleasant notion, filing a report with adult protective services (APS) or seeking guardianship may be the only way to help a senior finally get the care and attention they need.