Health & Medicine

When a loved one refuses care

A concerned reader recently contacted me: “My mother has moderate dementia,” she explained. “She has lost all interest in going anywhere or doing anything with Dad. She refuses to see a doctor. And she won’t take any medication.”

The reader went on to say that she and her siblings have tried coaxing, begging and threatening their mother. But nothing has changed her behavior.

This woman’s situation is incredibly common. Many of us have loved ones who are ill or infirm. We want to assist them as best we can. We’re willing to do anything to make them well or to keep them comfortable.

Often our actions run contrary to the wishes of those we’re most trying to help. When my own mother was diagnosed with breast cancer nine years ago I encouraged her to take an aggressive treatment approach. At the very least, I wanted her to get a second opinion from a major cancer center.

Mom had other ideas. She wanted to stay close to home. She selected a more conservative course of action that she felt better suited her needs.

At first her resistance frustrated me; I so wanted her to get better. I begged with her to fight the disease.

But I quickly realized that my fear of losing my mother was interfering with her emotional needs. This was her illness, not mine. She needed a calm and nurturing daughter, not a control freak who constantly pushed her to do things that just weren’t right.

Loved ones refuse treatment for a variety of reasons. Some are based on long-held values. Although my mother-in-law suffered from advanced dementia, her husband refused to hospitalize her because he didn’t want to put her in a “home.”

Other refusals correspond to physical limitations. The reader’s mother is probably confused when she is in new situations so she avoids any changes to her schedule. She may also have problems with her mobility and become fatigued climbing into cars or negotiating curbs.

Ailing loved ones often feel embarrassed by their limitations, so they’re apt to make excuses for their choices.

A man may complain that his once-favorite restaurant now cooks bad food when he’s really having problems hearing conversations taking place around him.

Emotions run high when our loved ones are aged or ill. A son may grapple with guilt because his father complains of loneliness yet refuses to move out of the home he’s lived in for 30 years. A parent might be angry with an adult child who refuses to get help for his alcoholism.

We can even find ourselves involved in long-standing family dramas. A cantankerous man who abandoned his children makes life even more difficult by firing his nurse after hip- replacement surgery.

At these times it’s wise to remember that we can’t dictate what other people do. Even when we can see that their decisions are potentially harmful, we still have to accept their choices.

Of course, all bets are off if loved ones are incompetent and unable to make decisions for themselves. An elderly parent with Alzheimer’s disease isn’t lucid enough to know where she should live.

Family members must step in to ensure that she is cared for and safe.

The same holds true if they pose a threat to the safety of others. The family of a man with advanced macular degeneration may be forced to take the keys to his car, even though he insists that he can see the road.

As a rule, though, we take a back seat to loved ones’ wishes, no matter how much they collide with ours. The trick lies in managing our critical thoughts about what that person is doing. We have to silence our own internal dialogues and replace them with more accepting phrases. Statements such as, “This is what she wants to do.

I don’t need to do any more,” relieve us of undue angst and free us to fully enjoy our loved ones for the time they remain in our lives.

Making the best decision

Having trouble accepting your loved one’s refusal to accept medical care? Then try these ideas:

• Get advice. Talk to your loved one’s medical personnel or others knowledgeable in the field. Arming yourself with adequate information gives you a sense of control while helping you assist in decisions.

• Know when to be silent. Yes, you have your opinions. But your loved one doesn’t need any more stress.

Be pleasant when you are together. And honor what the patient needs.

• Understand your limitations. You didn’t create this situation.

And you’re probably not able to fix it. Do what you can to ease the burden, then acknowledge that you’ve done your best.

• Quiet your inner agitation.

Take lots of deep breaths. Release angry thoughts. Create a soothing mantra you repeat to yourself when your emotional thermometer starts to boil.

• Find enjoyable activities to share with your loved one.

Play cards. Read stories aloud. Listen to music. You’ll create lasting memories that are filled with warmth and respect.

• Know that life ends. Illness, aging and death are parts of life. Accepting them with grace provides a terrific role model for future generations to follow.

Linda Lewis Griffith is a local marriage and family therapist. For information or to contact her visit