What to do when they won’t see the GP

[Changingplace]

Until recently I wouldn’t have classed my dad as elderly, he’s in his early 70s but fit & active, and has been in good health.

He’d been complaining of not feeling well for a while, I’d repeatedly asked him to see his GP, he didn’t but eventually ended up collapsing & was admitted to hospital with a serious infection and spent a week in the ward.

They never really diagnosed what had caused the infection, but he now has a consultant and has been called back for follow up scans & examinations.

But virtually ever since coming home he’s been complaining still of not feeling well.

I can’t explain how many times I’ve asked/told/begged him to book a GP appointment.

He hasn’t/makes excuses/seems obsessed that as he’s got the hospital appointments in he goes to them and through the consultant.

I think he probably is getting the infection back again, so may need antibiotics which the GP could prescribe, he won’t get this at the hospital examinations/scans.

He said earlier this week he struggled to get up & down stairs.

He’s going to end up back in hospital at this rate, the GP won’t let me book for him, he won’t do it, his next hospital appointment isn’t until the end of January.

I’m sorry if I sound frustrated, but I am and I’d love some perspectives from
anyone who’s had this situation? What on earth can I do?

To add, he has done a medical power of attorney but I think this falls under ‘making decisions you don’t agree with’ rather than not being sound of mind, because he is actively choosing not to look after himself.

I’d like to know this too. It seems like as long as adults are deemed to have capacity, they cannot be forced to engage with a GP or any services.

You can't use H&W LPA until the person has lost capacity and you don't seem to have had it confirmed that that he has.

Even if the person doesn't have capacity you are limited in what you can do in terms of seeking medical attention. You can make appointments and speak to doctors, but if the person outright refuses to go to the appointment, you're a bit stuck.

Unfortunately if he won't agree to see the GP I think you may have to wait for another crisis lands him in hospital.

This is correct. If he has capacity there’s nothing you can do, frustrating and upsetting as that is. You could write to the GP detailing your concerns and saying you know that the GP cannot go against your fathers wishes but they could possibly invite him in for a check up if there are safeguarding concerns (which it sounds like there are, self-neglect).

Nothing. There's nothing you can do. It's hard and it's horrible, but here we are
Give yourself permission to stop banging your head against a brick wall.

Yeah this is the conclusion I’ve come to, that the LPA can’t be used because he is making decisions, despite them not being sensible ones.

Its incredibly frustrating and feels like I’m just waiting for an inevitable hospital admission in the near future that could be averted if he just saw his GP and got some antibiotics.

Thank you, I’m going to contact his GP and tell them that I have a safeguarding concern and that I think that potentially the infection he was hospitalised for is impacting his thought process.

The GP have all the records from when he was in hospital so maybe they could invite him in on the premise of assessing his medication.

He has also told my brother today that he’s stopped taking one of his other medications properly so I’ll tell them that too, it can’t be good for him to just stop taking something he’s been prescribed for a good reason.

He's allowed to make bad decisions if he has capacity.

Literally the only thing you can do is say if you do not go to the GP, you will end up in hospital again and that you would be very upset.

But he is entitled to ignore you.

It's just one battle after another and it's exhausting, so lay it out clearly and then watch for the inevitable crisis.

I had this with my FiL increasingly poorly, refused to go to GP "oh what they can they do?"

I phoned GP, told them the situation and they came out to see him (i had to insist) 20mins later, he was taken into Hospital, had severe pneumonia, so bad they told us he probably would die, he didn't and made a full recover.

GPs have to consider a home visit, they decide, not the patient.

Mums GP is great. I wrote a letter outlining the situation and my concerns and handed it into reception. I made my way to a nail appointment 5 miles away and had to pull over to take a GP call. I cancelled the nail appointment and met the GP there. Timing was a bit of luck as I unknowingly handed my letter in just before home visits and there was a space but the GP genuinely was pleased to hear my concerns and help

It varies massively between surgeries. My mum's. GP flatly refused to do home visit and insisted that this was because my mum wasn't house bound. My dad would have avoided the GP until he collapsed. That went on for years, even after mum developed advanced dementia. The GP was very very dismissive of any concerns so as I say I think it varies between surgeries and GPS

At the end of the day, GPs are individual businesses and they'll vary hugely in what they will do or not do. Ours was helpful with my Mil, as we could not get her to go in, so did a video and took that to the GP instead. My mum's is less helpful and insist she needs to come in for visits.

With Mil, it helped we had an LPA but she had lost capacity.

Would heconsider a pharmacy? If he’s not wanting to ‘bother’ his gp he might do that and then if the tell him he’ll have to gp he might take it more seriously?

You could do a safeguarding report under self neglect. If you google ‘your county’ get adult social care help, it should help get you to the right area.

In your circumstances i would email the GP Practice. Make it absolutely clear that you are not asking them to give you any information but you are concerned that he says he is unwell, unable to manage the stairs and is refusing to seek medical assistThe phrase that you want is that you are trying to avoid an unnecessary Hospital Admission.

The good thing about emailing is that there is a trace. I’ve ended up emailing a couple of GPs about elderly relatives over the years and luckily they’ve always called them in under something like a Drug Review or a Well Man Clinic.

Thanks all for your advice, I called the GPs again and they’ve let me book him an appointment now.

I told them I was concerned he’s going to end up in hospital again, that I had a LPA and he was happy for me to make him an appointment and he’s booked in later on, I think I said the right things rather than my brother I think just asked can I make an appointment.

Ive framed it to him that the GP wants to see him, slight white lie but if it gets him there who cares and I’ve booked him a taxi to pick him up too, since I live 2hrs away so hoping the GP can help.

Fingers crossed that it all works out for you this afternoon

My MiL had multiple issues and refused to engage with the GP or any service and to be honest we were a bit lost with trying to navigate it all.
We wrote a long email to the GP outlining each issue, being clear that we didn't expect them to discuss the matters with us. We booked a double appointment and told her she had been invited for a check up. She allowed my partner to accompany her to the appointment. The GP she saw was brilliant, powered through each issue, she came out with 4 referrals, each of which has made a significant difference having now been diagnosed / treated.
We have found that although she will push back and make life difficult for us, she is very compliant once sat in front of the professionals. They have the authority/ knack of dealing with her and she won't argue back with them.
So these days it's an email to the practice or service ahead of time with any information/ updates and framing things as 'routine check up' to her. I don't try to cajole or persuade her, or enter into much discussion at all. It's pointless, my job is to drive her there after that I leave it to the professionals....it saves my sanity.

My own dad is a bit younger than my MIL and has much more agency. He's fine for now but his health issues are mounting. I can see it's going to be difficult with him too. Not because he won't engage with services but because he's very independent and won't want to accept any help from us.
Good luck, it's exhausting.

I persuaded my father’s GP to write and call him in for a general check up. My father couldn’t get there quick enough.

Happy to report that my dad went to the GP today, ended up there for two hours as the doctor got him an ECG while he was there and saw the doctor twice.

He’s now absolutely full of praise for this doctor and how they really helped him and also apparently gave him a bit of a telling off for not coming in sooner, at which I bit my tongue 🙄

Hoping now he’s had a positive experience he’ll be quicker to go another time, but also because they are now happy for me to book for him that’s another hurdle sorted.

That sounds like good news then @Changingplace. I’m glad he found it a positive experience which hopefully means he won’t be so reluctant to go next time.