There are many reasons why an older adult would refuse medical treatment but there are things the caregiver can do to help get them to the doctor. Talking about what fears they are having, discussing possible outcomes if they get treatment and if they do not and of course, making sure that they are comfortable with their doctor(s).
The three most important factors that a family caregiver (and the adult children) must consider are…
- Is their elderly parent cognitively competent?
- If yes, then as a competent adult they DO have the right to refuse medical treatment.
- If not, then a primary caregiver can take over the decision making for their healthcare needs.
The Patient Self-Determination Act (PSDA) is a federal law, and compliance is mandatory. It is the purpose of this act to ensure that a patient’s right to self-determination in health care decisions be communicated and protected.
National Library of Medicine
One of the most common reasons older people would refuse medical treatment is the fear of what will happen. They may be afraid of the pain, of being in the hospital or even of dying or not dying.
It is important to talk about these fears with them. It may be helpful to have a medical professional such as their primary care physician, nurse and/or social worker with you to help explain all the possible options and outcomes.
If they are afraid of dying, it is important to discuss the possible outcomes if they do not get treatment. For example, if they have a heart condition, you can explain that without treatment, they may have a heart attack and die. However, with treatment, their chances of surviving are much higher.
Of course, if they feel that they are ready to die, there may be nothing that you can do to change their mind. In this case, it is important to respect their wishes and provide them with as much support as possible. (As long as they show no cognitive decline).
A dementia patient may refuse medical treatment because they no longer understand the purpose of it. So again, this would be when it’s okay for the caregiver to step in to make decisions.
You may feel that you are dealing with a very stubborn parent. But in the end, as difficult as it may be, it is important to respect their own decisions, even if you do not agree with it.
They are the ones who have to live with the consequences, not you. Of course, this is only true if they are cognitively intact.
I will be repeating this throughout this article because in my experience, I have found that this seems to be the most difficult issue for family caregivers.
Tips On How To Help An Elderly Parent Accept Medical Treatment
If you have an elderly parent who is refusing treatment for their medical problem, try to understand their reasons. It may be that they are afraid of the side effects of the treatment or that they do not want to be a burden to the family.
This fear often manifests itself in refusal to visit doctors or get treatments. What should you do if your parent refuses medical care?
The first step is to try to understand the reasons behind your parent’s decision. It could be that they have a fear of hospitals, a mistrust of doctors, or simply a desire to avoid any kind of treatment.
This national study found that nearly one fourth of older adults in the United States reported avoiding needed medical care in 2008. Likelihood of avoidance was higher among those with worse health status, severe psychological distress, lower health self-efficacy, lower confidence in obtaining health information, lower trust in doctors, less patient-centered communication, lower health care quality, and those who were current smokers. An analysis of qualitative reasons reported by older adults for avoiding medical care corroborated quantitative results.
Southern Gerontological Society
There are a number of other reasons why an elderly parent may refuse medical treatment.
- In some cases, the parent may be concerned about the side effects of the treatment or the cost of the treatment.
- In other cases, they may not believe that the treatment will be effective for their health issues.
- They do not want themselves and their health problem to be a burden on their family or friends.
- They are afraid of hospitals or doctors.
- They may not believe that their medical conditions are serious enough to warrant medical intervention.
- They may be afraid of the next steps after medical intervention such as rehabilitation.
- They do not want to go through the hassle or expense of treatments.
- They feel they will have a poor quality of life and are ready to die and see refusing treatment as hastening the process.
- They believe that death is a natural part of life and that medical intervention is unnatural.
- They have a religious or spiritual belief that opposes medical treatment.
If the situation is urgent, you may want to consult with a counselor or therapist to help you and your parent.
If they are refusing treatment for a specific condition, you could try to get more information about the condition and the available treatments. Sometimes, simply understanding the risks and benefits of treatment can help someone make a decision.
You could also look for alternative treatments that might be more palatable to your parent, such as acupuncture or herbal remedies.
It can be difficult to watch a loved one suffer, but ultimately, the decision about whether or not to seek treatment is up to the individual. The best thing you can do is provide support and understanding, and respect your parent’s wishes.
What is in your elderly parent’s best interests should always be the guiding force in any decision made about their medical care.
Can An Elderly Person Refuse Medical Treatment?
It is not uncommon for elderly parents to refuse medical treatment, even when it is life-saving.
It’s a good idea to remember that, even if an elderly parent refuses medical treatment, they still have the right to receive pain medication and other palliative measures. In these instances, hospice may be an option. Families should not make the decision to withhold treatment from an elderly parent without first consulting with a medical professional.
It is unethical to physically force or coerce someone into treatment against their will if they are of sound mind and are mentally capable of making an informed decision.
verywellhealth.com
It is important to remember that each situation is unique and what works in one case may not work in another.
The Different Types of Refusal
There are different types of refusals that you may recognize your parent displaying.
The first is passive refusal, in which the parent simply does not comply with medical recommendations. For example, a parent may agree to a doctor’s appointment but then fail to show up. Or, a parent may start a course of treatment but then stop taking the prescribed medication .
The second type of refusal is active refusal. This occurs when the parent openly refuses to comply with medical recommendations. For example, a parent may refuse to go to the doctor for a scheduled appointment or refuse to take medication as prescribed.
These can be very frustrating situations for family members. In some cases, it may be possible to convince the parent to change their mind. However, in other cases, it may be necessary to respect the parent’s wishes and accept their decision.
What To Do When A Loved One Refuses Medical Treatment?
In addition to the tips that we mentioned above, there are some other things that family and loved ones can do.
- Avoid arguing – The best way to start is to remain calm. It can be tempting to try to convince the parent or loved one to see things your way. However, this is usually not productive and can further damage the relationship.
- Focus on listening – It’s important to understand why the parent or loved one is refusing treatment. Often, they may have valid concerns that should be addressed.
- Offer support – Sometimes, all a parent or loved one needs is some emotional support. Let them know that you’re there for them and will help in any way you can.
- Encourage them to consider alternatives – If the parent or loved one is adamant about not pursuing treatment, there may be other care options to consider. For example, if they’re refusing chemotherapy, homeopathic treatments may be an option. If they refuse therapy, perhaps they would say yes to home care services.
- Get a second opinion – If the parent or loved one is still unwilling to pursue treatment, it may be helpful to get a second opinion from another doctor.
- Home health care – can be a great option for elderly parents who refuse medical treatment.
- Contact hospice – if their medical condition justifies hospice, contact them for help and support.
Express your concerns and explain how you feel about their decision. It is important to be honest but respectful.
If your loved one is competent and still refuses treatment, there is unfortunately not much you can do. You may need to accept their decision and focus on providing them with the best possible support.
What Determines If Your Elderly Parent Is Competent?
Cognitive impairment is quite common amongst elderly people and must be considered, tested and treated before any decisions about medical treatment are made.
This is especially important if your parent is refusing life-sustaining treatment, as they may not have the mental capacity to make this decision.
There are a few different ways to test for cognitive impairment:
The Montreal Cognitive Assessment (MoCA) is a short and widely used test that can screen for different types of cognitive impairment, including Alzheimer’s disease.
The Short Test of Mental Status (STMS) is another brief test that can be used to assess global cognitive function.
If your parent scores poorly on either of these tests, it may be indicative of a more serious cognitive impairment that needs to be addressed.
There are a few things that will be taken into account when determining if your elderly parent is competent. This includes their:
- Ability to show that they have sufficient information about their condition.
- Ability to communicate their choice.
- Ability to understand the treatment options.
- Ability to understand the risks and benefits of each option.
- Ability to make a decision based on their knowledge of their condition about their care.
- Ability to make their decision without undue influence from others.
These aspects of informed consent can be applied to refusals in order to best mitigate the conflict between the care provider’s duty to treat and to respect patient autonomy.
Journal of Emergency Medical Services
What If My Elderly Parent Is Not Competent?
If your loved one is unable to do any of these things, a doctor can test your elderly parent to determine if they are truly incompetent. It may be that they are in the early stages of dementia or Alzheimer’s disease.
If the primary family caregiver does not yet have power of attorney then it’s recommended to speak to an elder law attorney to begin the process of obtaining one.
An Advanced Directive aka Medical Power of Attorney can be used in this situation. This document gives you the authority to make decisions about your loved one’s medical care if they are unable to do so themselves.
There are other power of attorney forms that you may want to consider.
…oftentimes once-competent elders don’t think as rationally as they used to, and they can begin making unwise decisions. When you know in your heart that the time has come to step up and ensure your loved one gets the care they need, think creatively about how to make it happen. Look into house calls, telemedicine, or use therapeutic fibs to get them into the doctor’s office. There’s no shame in guaranteeing your mom or dad gets proper medical treatment.
Agingcare.com
The care of elderly parents is not easy, in fact it may be the most difficult task you will ever do, especially when it comes to end of life issues.
So, I encourage you to seek out a support group, a counselor, any form of respite care so that you can be as healthy (mentally and physically) as possible so that you can make the best decisions for yourself and your aging parent.
How To Talk To Your Parent About Their Decision
It can be difficult to talk to your parent about their decision to refuse medical treatment. You may feel like you are disagreeing with them or that you are not respecting their wishes. Just make sure to be honest and respectful when discussing this topic.
Here are some tips for how to talk to your parent about their decision:
- Acknowledge their feelings and respect their decision.
- Ask why they have made this decision.
- Talk to them about the legal paperwork that needs to get in order in case their condition worsens.
- Find out what their concerns are about treatment.
- Share your own concerns and explain why you think treatment is important.
- Offer to help them research their options and get more information about treatment.
- Help them to make a plan for what to do if their health deteriorates.
- Keep the lines of communication open and continue to talk about their decision
Offer to help them research their options and get more information about treatment. Help them to make a plan for what to do if their health deteriorates. Keep the lines of communication open and continue to talk about their decision.
If your parent is refusing treatment for a life-threatening condition, get professional help from a social worker or geriatric care manager.
You may need to seek a court order to ensure they receive the care they need. Speak to a doctor and/or an elder law attorney about your options.
The Role Of Family And Friends In Convincing Elderly Parents To Seek Medical Treatment
Sometimes, a third party outside of the family can be very helpful. Other individuals such as family and friends may be able to help convince your aging parent to seek medical treatment.
It can be difficult for one person to get the message across, but if multiple people are involved, it may be more effective.
Family and friends can provide emotional support and help explain the risks of not receiving treatment in a way that is respectful of your parent’s wishes.
Again, it’s important to remember that everyone has their own point of view and that should be respected.
The Legal Implications Of Refusing Medical Treatment As An Elderly Person
Your elderly parent has the right to refuse medical treatment, even if that means forgoing life-saving measures. However, there are some exceptions to this rule.
A patient’s right to the refusal of care is founded upon one of the basic ethical principles of medicine, autonomy. This principle states that every person has the right to make informed decisions about their healthcare and that healthcare professionals should not impose their own beliefs or decisions upon their patients.
National Library of Medicine
For example, if your parent is not of sound mind, they may not be able to make decisions about their own medical care. In this case, you may need to seek a guardianship or conservatorship.
It’s also important to understand that refusing medical treatment can have legal implications. For example, if your parent refuses treatment for a life-threatening condition, they could be considered incompetent and may lose the ability to make decisions about their own care.
What Are The Options If My Elderly Parent Refuses Medical Treatment?
If your elderly parent refuses medical treatment, you have a few options. You can try to convince them to change their mind by explaining the risks involved in not getting treatment.
If they are still unwilling to get treatment, you can ask their doctor for more information about the condition and the risks involved. You can also look into getting a second opinion from another doctor.
You can also consider getting a court order if your parent is not competent to make decisions about their own medical care. This is a last resort option, and you should speak to an attorney before taking this step.
Ultimately, you want to do what is best for your parent, even if that means making tough medical decisions. If you are concerned about their welfare, be sure to talk to their doctor and get as much information as possible.
With the right information, you can make the best decision for your parent’s health and well-being.
Final Thoughts
So, I know that I repeated several times about the importance of respecting your parent’s wishes but as I said earlier, this issue is most likely the most difficult for family members to accept.
When your aging parent refuse to go the doctor or receive medical treatment, you are left feeling like a caregiver who has lost control.
Remember that it’s important for everyone in a relationship with their parents – including yourself – to maintain integrity by offering support and care while also respecting free agency choices even if they don’t seem ideal or make sense at first glance.
If you’re feeling overwhelmed by the situation, it’s important to remember that you can always reach out to care managers for help.
