Worried my Mum is really ill and don't know what to do

[CesareBorgiasUnicornMask]

My Mum is nearly 60, diabetic, very heavy smoker, takes no care of herself at all and is also fairly depressed since my Dad left eight years ago.

Basically I'm now worried she's seriously ill. Her voice has been getting hoarser and hoarser for the last two months, she's barely eating (says she has no appetite but basically cba - she'll eat if we're out or someone else cooks), and she's constantly exhausted and forgetting everything.

The trouble is, she refuses to go to the doctor. She's terrified of medical stuff and has said on the past she'd rather just die of something like cancer than be told she has it. Ditto alzheimers, which both her mum and grandma had - she doesn't want to know if she's getting it ever. I'm a medical student, so aware I'm probably in the position of seeing awful sinister illnesses round every corner, but I do think there's enough to be a bit worried about.

If I say anything to her though she'll flip out, accuse me of trying to scare her/ trying to 'kill her with fear'/ pushing my 'agenda' (she thinks and has said in the past I want to medicalise everything - when I idly wondered to her if my DS might have a milk allergy as he had constant rashes.) and after all that hassle she still won't go to the GP.

But I have to say something, don't I?

[thesandwich]

Hi- it sounds tough. Is there anyone she will listen to? A friend/ relative ? In some ways she is responsible herself- careful what you take on- you cannot fix her if she doesn't want help. Good luck

[Fettuccinecarbonara]

No I don't think you do actually.

It's her life, her choices, her boundaries.

It must be terrible watching her and thinking the worst, but if that keeps her happier then surely that's best?

She sounds like she's refuse treatment if there were anything wrong anyway. All a diagnosis, or hint of one, would do is affect her mental health as well as her physical health.

I think you have to sadly respect her wishes and back away. Whilst trying to care for her as best she'll let you.

for you though. I can't imagine how difficult it must be for you.

[MuttonDressedAsMutton]

Sorry for this difficult situation - must be a real worry for you. When you say you 'have to say something' - well - I kind of understand but I don't think it will achieve anything more than getting her all wound up again. It sounds to me as though she knows perfectly well what she's doing to herself and maybe has a bit of a doctor phobia (is there a proper term for that? I don't know it!) - anyway - I don't think you saying anything is going to help. Are there any other relatives perhaps closer in age but less close relationship wise that might have a word with her?

[Tarrarra]

I think she would get on well with my mum who is also diabetic and living alone suffering with cold after years of heavy smoking. It is really hard to watch someone you love take so little care of themselves. Trouble is you can't force her to seek a medical opinion. Try getting her sorted with online shopping for ready meals so she is eating better, maybe buy her an electronic cigarette so she can give it a try? And make suggestions about general fitness or take her for short walks? It took us years to get mum to face up to her situation but she had now been smoke free for over a year. It may be that she is depressed living alone so the best thing you can do is provide company and tread gently. We started with stories of "so and so at work has given up smoking using an ecig/patches, and went to a hypnotherapist". At a particularly bad time we asked the GP to phone her and ask her to come in for a check up. Can you contact her doctor and express your concerns? Good luck x

[Out2pasture]

you may want to alert her family dr. hopefully she has one. self neglect although not uncommon can be due to a variety of reasons. and even though you can understand where she is coming from (in Canada) family could be held legally responsible. the dr. can then have the community health nurses check on her regularly (at least that is what they do here).

[loveyoutothemoon]

I agree, make her GP aware. You don't want to be held responsible for neglect.

[CesareBorgiasUnicornMask]

Font think she has a GP atm. She hasn't reregistered since moving in August. She says she will when she runs out of diabetes medication but she only takes it intermittently so has a huge stockpile, so god knows when that will be. She's actually highly intelligent, but manages an insane sort of doublethink when it comes to her own health. Eg she only drinks instant coffee - 15+ cups per day - but that has nothing to do with her poor sleep, apparently, as it 'doesnt affect her'. I'm so frustrated with her tbh - feel desperately sorry for her but also very angry.

[Bluetrews25]

The food/not eating / fatigue/ forgetfulness thing sounds like depression.
The hoarse voice thing is a bit worrying, and worthy of investigation.
But, with the best will in the world, you can't force her.
She has the right to refuse treatment at any stage, which is what she is doing right now.
Any patient with capacity has the right to make a decision even if it is the 'wrong' one, and as a medic you will have to accept that.
Harsh, but true, so sorry.

[George2014]

The hoarse voice could be caused by excessive caffeine and smoking effects - could just require some vocal hygiene advice to improve things...but it could also be a sign of something more serious. She would need to see an ENT doctor who would put a camera up her nose and into her throat to visualise her vocal folds and see what's going on. That info alone would probably terrify her. My mum is similar, currently she would rather classify herself as deaf, not hear ds, not participate in conversations rather than go to the nurse to have her ears syringed. It seems ridiculous and if you talk to her she'll say 'I know, I'll go when I have more time' and she's said it for a year and obviously won't go. I also think she will suddenly be riddled with some awful disease because she will ignore it for so long. But ultimately she has capacity to decide her own fate and all we can do is encourage her that it's ok to be scared and do some hand holding!

[mayhew]

I have a brother like this. My mother and I watch him deteriorate each year. Heavy smoker with emphysema, undiagnosed probable rheumatoid condition, emaciated, heavy drinker who has had seizures. She has resigned herself to probably outliving him. As a mother, it's hard.

She gives him a good meal once a week and leaves him to his disfunctional ways. Because he's an intelligent adult, there is nothing we can say that he hasn't heard before. He's very stubborn and will just engage in argument and denial.

As a medical student, you will have studied the law on consent. A competent adult can refuse any medical intervention even if that decision is irrational to their health care professional.

You can be there for your mother but you can't force her to do things she doesn't want to do. However sensible those things would be.

[CesareBorgiasUnicornMask]

I know I can't force her. I really do. Which would sort of be ok if she'd just ignore the subject entirely, but instead she constantly asks me for reassurance, which I obviously can't give her because I don't know enough and also think her symptoms are worrying. So eg when she gets diabetic ulcers in her leg she'll ask me to look, and then say 'could it just be a boil do you think?' And if I say it's an ulcer and she should see GP, or at least a pharmacist, I get yelled at. And if I refuse to look, I get yelled at/'some doctor you'll make' comments. So the hoarse voice has been going on now for a few months, and every time it's 'do you think it's anything to worry about? What should I do?' And if I give the 'wrong' answer - which is anything other than 'no - it's definitely nothing' - I get screamed at and then two days later it's like the conversation never happened and she starts again.
At my wits end with it.

[Potatoface2]

She sounds to me like she could have a thyroid problem...but to get treatment etc she needs to see a doctor....its a difficult call

[mayhew]

When she looks to you for reassurance that all will be fine (in the face of all evidence) have some stock replies:

"I'm not an expert on x but I would recommend you see your GP"
"It could be several things but to get a diagnosis you need to see a specialist"
"I'll go with you to the appointment if you want some support"

And then change the subject.

For a lot of anxious people, talking about a problem is far preferable to doing anything about it. It's as though she is "giving" you the problem, then can blame you if it's not resolved. To the point of madness. You get upset and frustrated that she won't take sensible advice. She gets angry that you cannot provide a magical solution that avoids her confronting her anxieties.

Fancy being a GP?

[TheoriginalLEM]

There's not alot you can fo. I'd step back if i were you or it will affect your relationship. Her body. her choice. She is going to have to visit the doc soon enough to get her meds although i struggle to see how she has had enough since August?

[TheoriginalLEM]

i do empathise though. my mum exactly the same and has a complex medical condition. i have a phd in biochemistry but she assumes that means im a dr. no, i work as acleaner and receptionist .

[WitchWay]

Even if you were fully qualified you are not in a position as her daughter to give her medical opinions. She is being very unfair to you, but is clearly frightened about what could well be serious illness. If she does have throat cancer then sadly it is most likely too late to offer effective treatment if she has ignored the hoarseness and weight loss for months, but it would be much better if she has a diagnosis and accesses proper care, even if that care is palliative - for her own comfort and symptom control.

Who is looking after her diabetes if she doesn't have a GP? I'd try to get her registered with a practice "for the diabetes" and try to come with her to address some of the other concerns when she attends.

[uhoh2016]

When she does ask for your opinion can you not suggest she tries some over the counter remedies that she could buy from the supermarket so she doesn't have to go to GP, so you're saying there's a problem but minimising it at the same time. She could buy a throat spray from the supermarket or suggest she gargles with honey lemon and water.

[StrictlyMumDancing]

My GM and a friend were like this too. I ended up treating friend the same as my aunt did GM - when they started moaning saying 'I can't help you if you won't help yourself' and then change the subject.

In the end GM did go to the Doctors, and the fall out of her years of avoidance for the rest of us has been fairly epic. Where some of us were ill and struggling to get diagnoses, GM's problems led our Drs to look into non standard things so we're now all getting sorted as best we can. But apparently she's back to avoiding Drs again now, and the rest of the family have largely given up trying to get her to go back and won't really listen to her moaning any more. Worries me a bit in case something is really wrong, but no one can get her to go so its a catch 22.

[FredaMayor]

You do have an ethical dilemma, OP. You are family member with some medical knowledge, yet you are aware that you should step back from involvement in DM's diagnosis and treatment because you are not her physician. You also realise that if her health were to decline to the point where she needed in-patient or community care you might feel responsible that her condition had reached that point when it might have been avoided.

DM sounds like a person who needs to keep control of her life where she can and does not trust anyone else to hand that control over. Are you able to talk through that issue with her? It may help her move towards taking better responsibility for her own health a bit more.

Keep away from making suggestions on diagnoses if you can, since that will only feed DM's anxiety and fearfulness. (You may or may not have reached the point in your medical education where you realise that there is a great deal more you don't know that you do know )