Even before the pandemic, an older male relative did not like to go to the doctor whether sick or for an annual physical. The last time they went, I had to schedule the appointment and he made me feel guilty for pushing him to go. He has taken me to the doctor on occasion (still drives) and part of the excuse for him not going is "you go too much". I have a few health issues but also am very religious about preventive care like colonoscopies and mammograms.
Now it has been more than three years since he had a physical. He says "don't nag me" but I and other relatives go for annual physicals regularly and try to convince him to go too. He has never had a colonoscopy and is well past 50. It's so frustrating, he's a very intelligent man!
I am not noticing any issues except regular alcohol use (1 or 2 drinks per day, most days) and he gets very little sleep (4 - 5 hours per night). Should I notch it up to individuality or is there a way to convince someone to start seeing a doctor regularly and get preventive care?
Mom: No. If it is cancer I won't do chemo so what good would knowing it do me?
Doc: Explains improvements in cancer care, and again offers the referral to a specialist.
Mom: I have lived a long life. I am going to die of something. If it is cancer, so be it. I don't need to stress every minute of the life I have left thinking of the cancer cells in me.
Doc: Many of my patients feel this way. (Remember that she is a geriatrician.) It is totally your decision. The offer of a referral is always available, if you change your mind.
Doc looks at me. (I haven't said anything so far.)
Doc: Are you OK with this?
Me: It is completely up to Mother. I see her point and I will support her decision. If she changes her mind, I will support that.
I loved that doctor, but she is in high demand and isn't taking new patients now.
You won't change his mind. He already told you that you go too often, so you know what he thinks about annual exams and other regular testing. Let it go.
* Realize you can only do so much.
* Then let go. This may take practice as you likely are used to trying, trying, trying. Or/and feeling you care so much, you don't want to give up. However, this attitude will back-fire on you, depleting your energy and draining you. And, 99.9% likely won't change him. He's in his own little world.
* Everyone, unless diagnosed to have dementia and legally unable legally to make their own decision, can and will. This DOESN'T mean it is a good idea or even safe for a person to do so, it means they can.
* He is likely depressed; an alcoholic or using alcohol to lessen the pain he feels.
* I believe the only behavior you can do is support him where he is and not argue. Do you ask him how he feels?
Explore this?
Don't agree or disagree. Acknowledge what he says. "I understand you feel xxx"
"It must be difficult for you to feel xxx"
Ask open ended questions.
* Be aware to set boundaries on your time. Know it is okay for you to do what you feel is helpful for 20 minutes, 30 minutes, an hour - or whatever and then stop, leave and feel good about yourself for caring and showing concern / love for this person. We can all go in circles if we let that happen. This often is a intense and quick(ly needed) learning curve - to set boundaries, realize you can, to feel good about what you do or change what you do if you don't feel good about it.
I've been doing this work for 6-7 years (direct service) and off-and-on for 15-20 years. Each person and situation is a learning experience.
* While we / I get better at it, we/I are always learning how to manage / handle these difficult / challenging situations with someone aging and/or w dementia.
* I highly recommend you visit Teepa Snow's website. It is invaluable information for everything to do with dementia/elder care and care providers.
Gena / Touch Matters
Welcome back. I have not seen your post for awhile now. It is so nice to see you on the site again.
Anyone refusing to undergo screenings and testings are selfish...they don't think of the possibilities that someone in their family may have to be the caregiver.
Be blunt with him...if you turn out to have colon cancer, I am putting you in a home where they will change your diapers.
Kindness and compassion in this kind of situation is not being helpful but being enabling.
I will pray that your older relative can change and be proactive about his health.
I encourage you to read Dr. Nortin Hadler's book, Rethinking Aging: Growing Old and Living Well in an Overtreated Society. No doubt most people will not accept this, but most screening tests have been over-sold and the benefits do not outweigh the potential risks. This is especially true for those over 65.
When an elderly person has a physical, I can guarantee they will find something. The question is whether this something can be treated successfully, and if the treatment or prescription advantages that person in a meaningful. It is quite possible that a mammogram does not alter the ultimate outcome of the disease, it only tells you earlier that you have cancer. Some cancers are so aggressive, that it doesn't matter when they are detected. I also imagine that every older person has polyps in various places in their bodies - colon, stomach, uterus. There are risks for colonoscopies, and they only detect cancers on one side of the colon. There are also risks from mammograms from repeated exposure to radiation and from the anxiety from false positives and the stress and pain of further tests.
As we age, all our number go up - blood sugar, blood pressure, weight, etc. For various reasons, the medical profession has decided that old folks should have the same "normal" numbers as younger folks, even though the risks to the elderly from medications for lowering these numbers are worse for them than the higher numbers (unless these numbers are way up on the upper end of the curve).
Everyone over the age of 70 has various ailments. Probably almost all elderly women harbor some breast cancer cells just as almost all elderly men harbor prostate cancer cells. That doesn't mean these are going to cause their deaths.
Personally, if I live to be in my eighties, I hope to see a medical professional only if I am having symptoms that I cannot cope with on my own. I expect aches and pains, and some limitations. That is a natural part of aging. Of course, if I break a bone, or have a bad cut, I will have it treated, but I will avoid screenings and tests like the plague.
"I am caring for someone, living at home with alzheimer's / dementia, arthritis, mobility problems, sleep disorder, urinary tract infection, and vision problems."
Is this the older male relative? If so, is he living alone? This is a bigger concern than not going for health screenings. From the statement about sleep habits, he lives with someone, otherwise how would anyone know he only sleeps 4-5 hours? If no one lives with him, what's the plan? How does anyone know he has dementia?
However, even with health POAs (assumption is no POAs at all), we can't force someone to do what they refuse, EVEN when dementia is definitely in the picture. POAs don't give us that capability. Guardianship may give more power over someone, but even then generally the courts will want to allow some autonomy and decision making. Even the staff at my mother's MC facility told me they can't force residents to do/take anything they are refusing. They can only coax and try to get the person to make the decision. About all we can do is encourage it, suggest it and ASK if they'd like to go. If the answer is no, it's no. Just don't harp on him, telling him he MUST go or NEEDS to go. Keep it open as an offer only.
"I and other relatives go for annual physicals regularly..."
This is fine for you and the others, but you are not likely to convince him to go just because you all go. He is only going to go if HE feels it necessary, which currently he doesn't.
"He has never had a colonoscopy and is well past 50."
Me too (aka past 50 and never had one! I did finally do the "poop in a box" test, but that's it! It was more to get the docs off my back than out of any concern.) A nice incentive was getting paid TWICE to do it (insurance plan AND the company)! Unless there's a concern or family history, let that go. IF his insurance offers gift cards for getting screening done, you could let him know and it *might* be an incentive, but I wouldn't hold my breath!
"I am not noticing any issues except regular alcohol use (1 or 2 drinks per day, most days) and he gets very little sleep (4 - 5 hours per night)."
You've noted no issues. 1-2 drinks/day isn't really a big deal (unless the drinks are a gallon at a time!) Sleep routines vary between individuals. He also may be napping during the day, which would tend to cut down how much he might sleep at night. Has anyone observed daytime nap habits?
"Should I notch it up to individuality or is there a way to convince someone to start seeing a doctor regularly and get preventive care?"
Yes, so long as he's capable and not showing signs of any discomfort/difficulty, let it go.
No, there really isn't a way to convince someone to do what they don't want to do.
Medicare and/or insurance/advantage plans may encourage regular routine checks and testing, but it's up to the person. No one can really force another person to do what they refuse. If he gets notices from Medicare or his insurance, you can try suggesting it saying Medicare requires it, at least once in a while, but he can still refuse. His choice unfortunately.
Not every one sees the need to go get a Physical every year and plenty don't go to see a Dr until they feel bad.
Actually, I'm 69 and I have never had a Colonoscopy and I don't intend too.
Mout everyone has pollops anyway and usually are not cancerous and even if they were, if your old, You would die of something else before the cancer pollops anyway.
Also, most Seniors are on way too many Rx's prescribed by Dr's and each time they prescrib something. Thete are side effects and you have to take something else for that, on and on a ficious cycle.
I say have nice visits with your Senior and stop bothering him about going to the Dr. It's his Life and he should live it however he wants.
You have already voiced your opinion too many times and he knows how you think.
He even drives, so if he wants to go to a Dr he will.
His Life, His Decision.
Every else says, leave him alone. That's great advice until it falls on YOU to caregive him after an illness. That's what I had to do. Watch a train wreck until the inevitable happens, when you KNOW if they just would have done some preventative care, their illness may not have been as serious or never happened at all! It's frustrating to say the least.
As my parents aged, I would always jump when the phone rang at 11 pm because I knew one of them had to go to the ER. My father didn't want to know anything. If he didn't feel good, he'd wait until he could stand it (which was, of course, on a weekend after 9 pm, when the primary care provider was closed) and then a trip to the ER with my Mom and brother in tow for 18 hours. It was maddening. My father was depressed and not a positive individual. He told my MIL that he would not see Christmas. He celebrated his 80th birthday a week before Thanksgiving in the ER. He died of a heart attack a week later. My mother and brother was shocked when he passed. No goodbyes, gone. Was I? No, I could see the writing on the wall. He did not want to live anymore. The strange thing -- if he would have taken care of himself (even got some therapy for his depression), I'll bet he would have lived another 10 years. I feel sad that he just didn't care about himself.
He has his reasons whatever they are, and these are his choices to make.
An apple a day keeps the Doctor away.
You're an apple, he's an ain't broke. It's ok to differ.
There are Youtube videos that cover various physical exams that you might suggest to him, that may allay his fears going to the doctor.
Even though he is a male, he may feel more at ease with a male doctor (many are nice and understanding as well, and will probably use humour to put an anxious patient at ease)
Try to reason with him that these check-ups - usually covered by insurance - are helpful to "catch problems early." Maybe he will value not having permanent pain or problems from cancer:
colon - colon removal and wearing a colostomy bag
prostate - painful metastases to bone or brain
gi tract - since he drinks and is at risk of cancer from mouth to colon
which can be treated with good results when caught early.
On a personal note, my husband insisted on a PSA blood level when doctors were seeing patients again during this COVID pandemic. We discovered he has prostate cancer that is aggressive - and he doesn't have any symptoms. Luckily, he is getting it treated before it metastasized and DID cause symptoms. We expect him to have a good recovery and not need chemo or radiation.
Feel free to share our story with him.
The thing is, if this is someone who thinks YOU will be their caregiver down the road, get off that train.
When I met my husband (we were both 50) he hadn't been to a doctor in years. Sent him to my doc. He had high blood pressure and bronchitis.
Fast forward 2 years. Had a "crick in his neck". Doc sent him to cardiologist (his dad died at 40 from unspecified heart issue). Cardio discovered 5.8 cm aneurysm and leaky aortic valve.
Had surgery. Is alive and well.
All because he had a "regular" doc who knew him and his history.
But hey, it's up to him. Some folks who rather drop dead at 55.