What to do if patient refuses to be evaluated by a physician?

by Laura
(Doniphan, MO, USA)

Question: My Mother had a stroke about a month ago. She is highly paranoid. She doesn't trust doctors or anybody else for that matter. We can't get her evaluated to determine the cause....it makes me highly concerned about her having another one. She sees a chiropractor who refuses to adjust her neck now because of all the obvious side effects from what appears to have been a right-brain stroke, but he did write down three things he wanted her to take: fish oil/2000mg, COQ10/400mg, and an aspirin.

She won't quit driving and there has been quite a few close calls due to her cognitive impairment. I know this because I keep finding a way to go with her. I can't keep this pace up though. I have a little boy who was diagnosed with Cystic Fibrosis and has to have alot of care. She used to be my back up person, but now I don't have anyone. Its been really hard on me not having her connect with me the same way and not having her support, but rather becoming hers.

I did call 911, but they said they cannot make her do anything if she is coherent enough to refuse. She suffers from a personality change, shes no longer outgoing, but rather withdrawn. She generally doesn't talk unless you speak to her first. Her speech has wrong context and misused wording and she is too impulsive when driving. She has this strong urge to pass everyone, even if their going the speed limit, and she won't consistantly use turn signals. She's dangerous. Nobody can talk to each other away from her because we're all suppose to be plotting against her when we do.

She's also eating too many sweets now. She used to be deciplined with it, now...she won't eat without dessert.

I don't know if theres any advice you can give me, but it helps to talk since I don't even have a support group to confide in. Thanks for your time.


Answer: If you haven't already, you should express your concerns to your mother especially regarding driving. You might be able to use driving as a reason to get her to visit the doctor telling her that you don't feel comfortable letting her drive until she has been examined and cleared to do so. A stroke can affect your vision, reaction time, and cognitive abilities so it is important to be cleared by a physician prior to driving. You may not be able to get your mother to listen regarding other issues, but unsafe driving is not okay. This endangers the lives of others. You can explain to her that if deficits are found that she can participate in driving rehab to help correct deficits (thus getting some therapy or stroke rehab she may need).

If she won't listen, then I would contact the motor vehicle department in your state and see what the procedure is for reporting an unsafe driver. I know in some states that as a relative you can report an unsafe drive without your name being revealed to the person. The motor vehicle department can then look into the situation further and may even require release from a doctor before the person can drive. Information for reporting unsafe drivers in Missouri can be found at: http://dor.mo.gov/faq/drivers/unsafe.php#1

The best way to handle parents who have declining mental or physical abilities is with honesty and respect. However, if your mother has cognitive deficits, she may not be able to reasonably respond to your concerns. I highly recommend that you find an online caregiver support group to share your frustrations and find helpful answers.

Visit www.stroke-rehab.com/caregiver-assistance.html for a list of websites dedicated to helping caregivers or if you are looking for a quick link directly to a caregiver forum, you can try one of these below:

eldercare.infopop.cc/6/ubb.x

mikegamble.websitetoolbox.com