Senior Health: What to Do when the Senior Won't Take His Medication

Seniors refuse medical care, particularly when it comes to taking medicine, for a number of reasons, and the reasons don't really matter. They become important only when they help you figure out how to get your senior loved one to follow medical care.

Much of the refusal centers on a perceived lack of control. No one wants to be told what to do. No one wants to think they've lost all decision making capability, especially when it comes to his own life. Sometimes a senior will refuse necessary care as a means of exercising control of a situation in which he's had little control.

This becomes painfully clear when it comes to medical care. Seniors may refuse medical care, and generally it has nothing to do with not wanting to get well. It gets more complicated when depression takes hold.

Remember when you were a child, and your mom would put out an outfit for you to wear to school. You may have liked the outfit, and yet you pitched a fit and dragged your feet about getting dressed. It's a power struggle that hinges on control. If your mom gave you a choice among a few outfits, you took your time, made a decision, then got dressed. The idea is that although there may be strict parameters, choices are allowed within the parameter.

If a person is to get well, he doesn't have the choice as to whether or not to take a medication, but he has other choices about the medication. Focus on the choices with the senior who is refusing medical care.

Make him part of the process at every turn. Because of failing eyesight or mobility issues, a senior may rely on someone to give an insulin shot and perform the daily insulin readings. However, he can take the testing strips out of the package, gather the supplies and even mark off a daily calendar or chart regarding the testing and medication. Make him part of the process, and you return control to the person.

Discuss options. Somewhere along the line, caregivers and doctors start communicating about the senior, rather than to the senior, regarding his medical care. A senior may depend on a second set of ears when visiting a doctor to keep the information straight. That doesn't mean the senior wants to give up his decision making role. A senior may grasp things more slowly, respond slowly, and doctors, on a schedule, often start talking directly to the caregiver in the room. Even if the senior cannot retain complicated concepts or he cannot respond quickly, the conversation should be directed at him. It's his life. The caregiver is the extra in the room, even if in reality, the caregiver will be the one responsible for the medical care being prescribed by the doctor. Do not cut the senior out of the medical communications.

Work as a team. A parent or older relative may not like a child/relative giving medical care. Old and young alike, you often hear people say that they don't want to be cared for by their children. It's a major fear, so they decline crucial medical care. Become part of the "get well" team, rather than the CEO.

It may be tough for a loved one to take medications offered by you, but not so tough when offered by a caregiver. If your parent is refusing medication, an outside caregiver may have better luck. The goal is to get the person to follow prescribed medical advice, so if someone else can accomplish that, don't fight it.

It's not as humiliating because the outside caregiver is "on the payroll." Again, it's a way of giving the person control of his life. In this case the control comes in paying the person for services, much as he'd pay someone to dust the furniture or mow the lawn. Obviously caregiving is many steps above a maid service, but a person dependent on an outside caregiver can rationalize the personal care because he's paying the person. It takes some of the sting out of it.

A Bitter Pill

The senior may refuse medication and care because the medication or course of medical care may cause additional sickness. He takes a pill, and an hour later he feels sick. Even though the pill is a good, long-term solution, it's tough to take when you know it will make you sick. Moreover, the senior knows that now he "feels" okay, but because he takes a medication, an hour later he'll have to depend on your help when he's feeling sick. Pun intended: It's a tough pill to swallow.

Part of helping your senior loved one continue his necessary, prescribed medical care is helping him look at the long term, rather than the short term. This may just be a matter of sitting quietly while the person tells you his fears and feelings of being out of control.

Listen, don't interrupt. The senior needs to be heard to maintain control of his life choices. When he's done talking, repeat he said so he knows you understood him. Then, try to put things into perspective. Sometimes that means that you acknowledge that it's a horrible thing for him to endure. Your job at that point is to make the person understand that the undesired medical care will allow him to remain part of your family's life in a better way for the long term.

It's not the quite the same as necessary medical care, but the movie Driving Miss Daisy provides a good parallel for this situation. Jessica Tandy didn't want someone to drive her. Each time she accepted additional help, she lost a bit of her freedom, control and self confidence.

Her son meant well. He saw getting her a driver as allowing her to maintain her independence for as long as she could. How you mean it, and how the senior sees it are two different things.

Luckily, the driver, Morgan Freeman, a senior himself, understood how Miss Daisy ticked. He empathized with her feelings of losing control. To that end, he made it a point to be her companion. He made sure she made decisions for herself, down to the smallest thing, and he acted as copilot.

If you want to help your senior loved one to take his needed medication and to follow through with medical procedures that seem degrading and make him feel sick in the short term, you must make him feel that the decisions are his. And they are. No matter how much you love him and want him to feel better, you are only the copilot.