How to deal with 93-year-old dementia mom who insists on every medical "fix?"
Mom wants every possible medical procedure available, including root canals and knee surgery. She won't take "no" for an answer. If there was such a thing as a brain transplant, she'd want that, too. She absolutely loves going to doctors. Her primary MD treats her as comfort care, which she describes in layman's terms as "alleviating pain and discomfort but not trying to fix everything." As Moms medical POA, I heartily agree.
To my discredit, I ended up taking her to an endodontist at her dentist's recommendation for 2 very expensive root canals, which IMHO given her age could have been pulled with no compromise to quality-of-life. I caved because it was her money. I knew if I didn't she'd bellow to anyone who would listen how I "neglected" her, refused her medical care, etc., but how I appear to others doesn't bother me so much anymore. Honestly? I just wanted her to shut up about it . Enough already.
Now she wants knee replacement surgery, which I refuse to allow, given her age. I've tried to talk her out of it. She gets around okay with a walker and Orthovisc injections. She complains of pain but goes like a racehorse in her walker. She uses a walker because she's a fall risk with stability issues. Her orthopedist said he could do the surgery but didn't recommend it. I keep putting her off but get tired of endless wrangling over it. Talk about persistent! Reasoning with her is useless and even if she did agree with me, she'd forget the next day, thus the endless cycle. Am I stuck with the status quo?
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We went through this with my MIL at about the same age. She insisted that she had to have the surgery, the doctor met with us several times to make sure we the surgery was not our idea. She had the surgery and never walked again, dying at age 99 1/2. Stick to what you know is right, our parents often become "our children".
Sorry, I just returned from taking my FIL to a totally useless follow-up visit with one of his doctors whose milking Medicare for every "follow-up visit" penny. My FIL LOVES getting all the attention from this doctor in particular. And yet FIL also will complain non-stop all the way there and back. My FIL has mild dementia.
I've had 2 teeth pulled rather than undergo root canals, and I manage fine without them. And I'm not even 70 yet.
If your mom is expecting you to coordinate the surgery, just tell her no, because her doctor doesn't think it's necessary, and you won't be a part of it.
For dental visits I wonder if she would be satisfied with a good cleaning, maybe a bit of Nitrous Oxide that would put her in a mood that she may or may not know exactly what was done.
What might work..and this is a bit of therapeutic fibbing here...."conspire" with her doctor to get her is a "drug study" say that since she is co-operative and healthy they want her to try a new drug for her...knee..or head..or whatever body part she wants "fixed"
Give her a bottle of placebo pills, Tic Tac is perfect for this or even the little candy Smarties. She should take 1 pill in the morning, 1 at night or make up some schedule and give her a notebook. Then her task is to record when she takes the pill, how she feels, how her XXX whatever body part we are treating. You can make this a 1 month test, a 2 month test. however long you want.
The catch is during the "drug study" she can not have any other procedures done. After that test schedule is done she can either have to wait a month or two before she can schedule any other procedures. And when you go in to see the doctor about scheduling a procedure the doctor can say how pleased they were with her that they would like her to join another study. This sounds convoluted as I write it out but it might keep her busy for a while. You might even get the facility staff involved in the "drug study" and see if they will play along.
Of if she likes the attention maybe scheduling a weekly hair appointment, a monthly mani-pedi take her to a store once in a while to a make up counter and get her "made up".
So she thinks that things will get better and she will have new knees again for the second time.
She has ALZ and kidney failure combines with CHF. She will never be a candidate for any major surgery again.
Apparently, your MIL has good doctors like my mom does. Makes a difference. I think I would be miffed if my mom’s doctor’s would even hint at her being a candidate for surgery.
I think she would enjoy pampering! I know I do.
We the caregivers need the pampering! Well balanced older people like being pampered but so many don’t. If Can’t Dance’s mom is like mine and a few others, it’s not about positive attention for them. It’s the negativity that they do enjoy!
Conversations among older people in my family always went like this,
Old person #1. Hello
Old person #2. Hello
#1. How are you?
#2. Not so good.
#1. How is Fred? Oh, terrible. He was in the hospital.
#2. George just got out of the hospital.
#1. Fred had a stroke.
#2. George had bypass surgery.
And on and on and on but not in a matter of fact or concerned way, in an unhealthy competitive way. They like to outdo each other. Becomes a hobby to complain! Drives me nuts!
#1. How are you holding up, dear?
#2. Not very well. I didn’t sleep a wink last night.
#1. I haven’t slept in 3 nights.
#2. Sometimes I don’t sleep for a week!
Young person’s conversation.
#1. Do you want half of my candy bar?
#2. Sure, that’s my favorite candy!
#1. Hey, no fair! Your piece is bigger! I’m telling mom!
#2. Go ahead and tell. I don’t care!
#1. Go home. I don’t want to play anymore.
#2. Why don’t we go shoot hoops at the park?
#. 1. Good idea!
#. 2. Bye mom, We are going to shoot hoops at the park before dinner.
Young people, my brother and the neighbor kid fought all the time but they were best friends and always looked forward to things. YOUTH! Isn’t it great?
Old people are bored. Complaining for some, become their competition instead of shooting hoops or another sport that young people do.
My mom says, “Getting old is hell!”
We are in the same boat! My mom is 93 like yours. Think they will make it to 100? Will we be in a mental ward of a hospital by then, a mental hospital or God forbid, will we be dead, they finally did us in!? HaHa, I am being quite a smarty pants today!
Anyway, my mom’s doctor says no to any surgeries at age 93 and I wholeheartedly agree! It’s not a financial issue but a safety issue, a 93 year old woman with Parkinson’s has no business getting surgery.
My mom has the bone on bone thing too. It is painful and I wish they didn’t hurt. My mom knows better than to even consider surgeries. But they do LOVE telling the doctor all of their complaints which I get. Here’s the thing though. My mom gets the answers how to treat, says yes to the doctor about advice but on the way home in car, says to me that she isn’t going to follow doctor’s advice. I say, “Mom, then why did you ask about it, if you don’t want the answer?” It’s a vicious cycle. They are bored. All her friends are dead. Most of the family is dead. My brothers don’t visit. She just has me. Too much togetherness! Sad. She won’t go to the senior center. I even told her that I wanted to go and have lunch there. She still won’t go but truly amazing how they can hop in the car or in my mom’s case, struggle to get in the car to visit the doctor only to ignore the doctor’s advice!
He did have heart problems that he was hospitalized for a few times. The cardiologist was in his room explaining something minor. Grandfather says “So what you’re saying is I could drop dead any minute?”. Doctor said that is true for anyone. Every time he was hospitalized and told he’d be fine but stay a few days for observation/tests, he’d want out of there. Like there was no reason to stay if he wasn’t at death’s doorstep.
One time he was being discharged and was given prescriptions to fill. We wanted to get that done at the hospital too before leaving. Grandpa says “No, we can come back tomorrow and get them.”
Needless to say we stuck to the original plan.
The root canals: correct decision. You weighed up the risks and benefits, you also gave due weight to the decision your mother would have made on her own account were she able to. One might privately think there wasn't a heck of a lot to gain from it at this point... But, people spend a lot of money on pointless things, do they not? Why not your mother, if there was no major drawback to set against it?
With the knee surgery, the risks are far more significant, and your mother's specialist is not recommending it, and the benefits to be gained are far from certain given that your mother's mobility is pretty good. If she were unable to move because of the pain or the joint were wrecked in a fall it might be different; but as it is your mother is scooting about the place and you can't be nearly sure enough that the surgery would improve matters for her - on the contrary, and that's why her surgeon isn't in favour.
Reasoning is useless; and besides it's exactly because your mother can't do her own reasoning that you have taken it over on her behalf. All I can suggest is that you get a bit creative with the wrangling, if only to give yourself some light relief. E.g., um... the surgeon is waiting for more results. The prosthetics factory has burned down/is being sued/can't get the parts. The insurer is processing the application. A new bionic knee joint is about to get FDA approval (do they do prosthetics?) so let's hold off awhile...
My mom came from the Hollywood glamour era. The women in the 40’s dressed beautifully!!! She still dresses up just to sit home!
Gotta say, my mom is vain, yes even at age 93! Several years back she wore make up before surgery! The doctor made her go wash her face.
She is fanatical about her weight and would freak out if she gained weight. She likes wearing a size small. I don’t get it. At her age I would eat all the ice cream I wanted! Haha
Weird disorder, huh? I know of a mother who had it by proxy. She lost custody of her child. The father raised that child. She had to give custody to the father because her mother said if she didn’t give up custody she would take her to court and fight for custody as a grandparent.
I had to end the friendship years and years ago when I saw how she treated her child. I told her I couldn’t watch her abuse her child and it had to stop or I would contact authorities. I was relieved when the grandmother threatened her and the father gained custody.
She had the disorder for herself too. Attempted suicide, institutionalized many times. Loves the attention. Abuses the drugs. Horrible. It is a disturbing mental illness. She always went to the doctor for imaginary conditions.
Thanks for your response. Mom's orthopedist ordered visiting PT for Mom at Memory care. Three times a week a technician came out to help her learn how to use her walker more efficiently. She forgot everything she was taught and continues to hunch over it, but boy can she get around in that thing!
Never met a surgery she didn't like/want.
She's had over 60 surgeries of some kind in her life (89) and is still on the lookout for something she hasn't had done yet, but might need.
It's a mental condition, I don't know what it's called. At age 86 her orthopedic doc said "NO MORE" and shut her file and refuses to even see her. She's 89 now and looks 100.
She has a permanent catheter (I shudder to even think of living with that!) after about 6-7 surgeries to "lift" her bladder failed. 4 back surgeries. Both knees replaced, one hip, wants the other one done, but can't get a doc to do it....stomach and throat surgeries, shoulders, elbows, appendectomy (her appendix was FINE), and the funniest one--she has not had her gallbladder out, but I had mine out 23 years ago and she has "borrowed" my story about it and tells people this is what happened to her.
So weird.
She adored the attention after each surgery, Just wallowed in it. A lot happened after I left home and I never even knew she'd had them done, I was not that invested in her day to day.
She did receive PT after ALL surgeries that would have messed with her walking or moving. She'd do fine until the PT was done and then she never so much as did one exercise again.
She complains of being "tied" to her walker. but brother can see her in her apartment from his yard and he says he sees her bopping around w/ o the walked all the time. So--impossible to judge what she really NEEDS vs what she wants.
I’ve had physical therapy. It’s hard, it hurts. I pushed myself because it did help me and I figured out it did not make me feel any better to complain each session. I would have driven my therapist nuts.
My doc, after a horrible accident ordered aggressive PT three times a week for three hours at the time. I learned to suck it up and get it over with. Sure, I have some permanent damage but I am so lucky to have the majority of my range of motion back. Was temporarily paralyzed after the accident.