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Elder refusals to visit the doctor

by Isabel Fawcett

A chronically ill loved one is adamant that he, or she, is not going to the doctor. Other than becoming stressed, how do caregivers handle such a challenge?

This time, the words came with no prior warning and entirely out-of-the-blue. "I am not going to any of those doctors anymore," my mother said as she slowly made her way back to bed after an early morning trip to the bathroom. Though half-asleep, that much she knew and proclaimed.

My intuitive reply came from an old inside family joke: "We're going if it kills us," I said from the comfort of another room. Our inside joke has never failed to yield laughter upon timely delivery. Sure enough, though still sleepy, she laughed. She repeated herself in a feeble attempt to put me on notice. "You think I'm kidding? I'm not going to one of those doctors anymore. No."

Repetition on my part, more laughter from both of us, and, back to bed she went. I tucked her blanket around her and said good night. She quickly opened her eyes and asked, "Wait! Isn't it morning?" I replied, "Yes, morning, as in it's still time to sleep, so good night." More laughter from both of us as she drifted off to sleep.

Mercifully, she has no doctors' appointments for several weeks. Between now and then, there is no harm in her declaration of independence from doctors. To the contrary, her declaration makes perfect sense to me based on chronic medical conditions. It is not uncommon for chronically ill children who are in and out of the hospital to express the same sentiment on occasion.

The sentiment is best acknowledged and the derivative humor enjoyed. Seriously, who really wants to go to the doctor other than perhaps a hypochondriac?

Elders Refusing Medical Appointments

There are a number triggers to "not going to the doctor" sentiments. Chronic pain, stress, physical and/or mental exhaustion and uncertainty are on the short list

Pain. It is likely that her early morning comment came from chronic joint stiffness. Such symptoms are worse upon awakening, standing and on cool mornings. Her statement shows that she occasionally gets ahead of herself. For some individuals, chronic physical symptoms are a continuous reminder of being under a doctor's care, or needing to be. Right at that moment, she simply wanted to be free of her mobility impairments and chronic physical discomfort without having to go to any doctor anytime. Nice wish. No harm.

Cognitive Smoke Screens and Mirrors. The refusal to go to appointments also arises based on a doctor's surname. Word associations loom large when it comes to doctors surnames--who knew? "The doctor's surname sounds like." "Would you go to a doctor with a name that sounds like that?"

I wonder why I never thought of that as the caregiver?

How silly of me for trying to identify top-notch medical practitioners by area of specialization. In the future, I'll also consider possible word associations doctors' surnames.

Sometimes she asks: "How come I can't go to your doctor?"

This twist is merely another evasive technique, though I wonder whether my life might just be easier. If only my doctor accepted Medicare patients.

Simple Caregiver Techniques

In addition to keeping a sense of humor, the following approaches have proven successful in my role of diffusing refusals to go to the doctor.

Understand a need for space. Depending on the nature of the appointment, Mom's prevailing symptoms at the time, and office scheduling practices, occasionally I demonstrate understanding and support of her need for space. Usually no more than twice annually, I ask her whether she would like to have me try to re-schedule her appointment to the first available.

First available may mean 2-3 weeks plus. While I this strategy sparingly, it offers her the respite and space she needs. The technique has an added perk of deferring to a mature adult's judgment and creates a much-needed elder win.

Out of sight, out of mind. Avoid discussing upcoming medical appointments well in advance of the scheduled date if your loved one's tendency is to worry or obsesses about medical visits. I only mention appointments when Mom is no more than 2 days away from the appointment.

Use Rewards. After a doctor's appointment, breakfast at IHOP can be a real treat and serves as an incentive for future appointments. It is a positive memory to discuss the last time you enjoyed breakfast before or after a doctor's appointment. It further becomes a nice focal point whenever you finally mention an upcoming appointment.

Barring medical emergencies, refusal to go to the doctor is best handled creatively. What works one time may not work in other circumstances. Keep thinking and trying. It doesn't hurt to keep your fingers crossed.