At 86 why wouldn’t you take painkillers?

I'd also consider hypnosis for long term pain management
RA, like so many conditions is terribly cruel

She needs a visit from a doctor. Older people tend to take the advice of a professional.

She may be worried about the side effects increasing her need for intimate care by causing drowsiness/ incontinence/ nausea.

Sounds like a GP visit to get the right thing for her issued as a required medication maybe, not a PRN.

Then the relief would be given routinely and although i guess she can say no, maybe theres less chance of it.

At the end of the day though its her choice but it would be nice to know its been discussed with her GP so shes making her own informed decision

I have a similar disease to RA. Pain killers make life bearable. Blunt but true.

As do the DMARDs prescribed for it. Yes they have side effects such as nausea and hair loss but I can move and function - so that’s less bad.

I am in my 30s.

My husband who is 71 is the same but moans constantly. I myself have rheumatoid arthritis, l can imagine how bad the pain must be, I take everything I’m given and it’s still bad. You can lead a horse to water etc..

Has she had any kind of rheumatology review? Has she actually got any prescribed pain relief? Psychology support?

if she can’t get to an appointment like that or won’t go, maybe palliative care? They are experts on pain relief too, and may also have a psychologist attached.

it’s quite frightening that she is in this state tbh. If she does have a prescribed regime, just keep banging on about taking it.

She’s probably afraid of becoming addicted on opioids or of stomach ulcers from things like ibuprofen.

Sounds like she’s watched a documentary or read newspapers about people getting horrible afflictions from them.

Any chance the Gp or district nurse would speak to her - most people will accept instruction from them

My sister has had RA for a long time. She takes all the painkillers plus PPI medication to stop her getting stomach ulcers. She has to take laxatives all the time but she leads a good active life and walks nearly every day. She retired a few years ago which was six months past her retirement age. Her friend, who also has RA, will not take the painkillers in case they cause side effects and spends her life sitting down moaning about the pain.
OP, I just think you need to keep on at your MIL to take the pain killers. Maybe suggest to her that the doctor give her other meds ( proton pump inhibitor and laxatives) to combat the side effects of the painkillers.

How can you know it's a generational thing when younger generations are not yet at that life stage?

Usually it is a control thing. Being in poor health and in pain makes people feel scared, vulnerable, stressed, all of which lead to emotional reactions, some of which don't make much sense to onlookers.

Other people's problems are simple!

My mum refuses anything stronger than paracetamol. And she only started taking that when it was literally prescribed by a doctor.

She says she doesn't believe that any medicine actually works. But she also doesn't want opiates to make her feel 'stoned'. Despite never ever having even tried one codeine tablet?!

She just moans about her pain all day long and flatly refuses it. It's really frustrating.

I don’t think it’s just a generational thing - I know many younger people who won’t take tablets like paracetamol. I think my daughter has probably taken less than a dozen in her entire life, and she’s 33. Some people just don’t like taking medicines unless they are more or less life saving.

It's so hard to get the balance, isn't it? She might be looking for sympathy, but she might genuinely be struggling with the side effects of the medication. For us constipation may be a mild inconvenience. For someone in pain already it can be genuinely frightening.

Looking at your op again, I would not assume that this is 'nonsense'. But equally, there is nothing that you can do for her. End of life is inelegant, unpleasant and difficult. You can't be there to hold her hand because of where she's chosen to be. Just try not to get annoyed. Keep reassuring her and repeating that the lovely nurse will help. She might not be lovely, and she might not help, but you are giving her hope and the possibility of trusting others, who might help.

She can also be really nasty

Many narcissists or covert narcissists refuse to take painkillers because they enjoy using their own suffering for attention or to manipulate those who care about them. Sometimes it goes on for so many decades that they're not even consciously aware of it. But it boils down to getting a narcissistic supply from making other people feel they are responsible for your pain/illness and being able to have full control over the "mood" of the family. As long as you have some sort of physical affliction, you can use that to control the attention from those around you.

Covert narc mum did that for decades. Every illness was a huge drama and it seems the only thing that made her feel better was guilt-tripping other people around her about why they didn't do more to prevent her discomfort, instead of just taking medicine and getting on with it. She would deliberately go outside without a coat in winter, come down with something and then moan and moan about how cold it was when she went outside. Nobody forced her to go outside but she bizarrely made it feel like they were at fault.

I can see why she doesn’t want to move closer to you.

As someone who has RA, it’s not as straightforward as taking some painkillers and everything is ok. They have lots of side effects that are just as unpleasant and they often just dull the pain a bit but the pay off isn’t always worth it.

Your MIL has capacity and hopefully she keeps it throughout so she can control the medication that works best for her.

My dad broke his back in 1975. He wouldn't touch anything other than 2 paracetamol maximum of once a day. He just adapted himself and took himself to bed whenever the pain got too bad. But, that essentially meant he opted out of large chunks of life. He died at the end of September, still refusing to accept anything at all, by which point he had fibrotic lung disease, prostate cancer, heart failure, an indwelling catheter that blocked constantly and had fractured his hip which resulted in post operative delirium. His world was VERY small (he was 88) yet that's how he decided he wanted to live. He wasn't a social person, wanted to keep all of his money to himself and was married to my mum for 64 years (we still haven't worked out how!) It's their decision to make. Turn your phone off. The home will call you if there's any cause for concern.

Yes this is my Stepdad and my mum to a degree but he is worse, his dc make Drs appointments for him

With my mum, her 'logic' was if you are ill, you take a tablet. So if you don't take the tablet, then you can't be ill!!

We got round it by finding a mantra to repeat gently (for her it was "the doctor says . . . " cause she trusted doctors) We also found using the word 'lovely' helped - let the lovely nurse give you some medicine. It will help. Just repeat and infinitum and hope that it sinks in.

Everyone saying about side effects, tbh when you're in that much pain you need to remember the benefits outweigh the potential side effects.
Also issues like constipation are easily remedied and it's hardly worth worrying about addiction when you're in your 80s.

OP I think I'd be giving her some tough love. Tell her to stop being a martyr, either take medication to help or stop complaining about it, there are no other options really.

Agree @P00hsticks

When I or rather my husband got utterly fed up of my mother not taking on board any suggestions I made to improve her life, one of my siblings told me I was the problem as I was constantly looking for solutions. Well sorry but if you are ringing me with problems and moans then yes of course I will put forward ideas to improve things. He also went on to tell me just to put my phone down somewhere and let her ramble on whilst getting on with other jobs….so essentially ignore her.

That's all fine, but if you make that choice not to have pain medication, you shouldn't then phone people up several times a day to tell them how much pain you are in.....

Tough love. What does she expect from you if she won’t help herself? Sympathy fatigue is real.

Ask for the care home to arrange a visit from her GP to discuss pain relief. They may suggest alternatives that she hasn't tried. If this was happening with my dM, I would have a chat with the nurses in charge and explain how distressing you are finding these phone calls, I know they would be trying to find a solution.