Advice on dealing with elderly dad basically committing suicide by refusing treatment of multiple dental abscesses?
My 84-year-old father has been diagnosed with six dental abscesses after already losing two teeth, one with a crown, which he hid from my mom under a placemat on the dining room table. His breath smells of the tell-tale pus odor, and two dentists--the regular dentist who took the evaluation x-rays, and the oral surgeon have stressed to him the serious state of his mouth and the need for immediate, life-saving treatment. The infection has advanced to the level where sepsis could occur within, at the outside, three weeks.
Despite both the dentists and myself (I work in laboratory medicine) laying out in gory detail the end-point of not treating his multiple infections, my dad has announced that he won't undergo treatment. Even when I said to him, with tears in my eyes, that he is essentially choosing to commit suicide, he was unmoved. I was unable to reason with him, as he is of the belief that he will be healed by divine intervention.
My mom, my sister, and myself have accepted his decision, since we can't *force* him to receive life-saving treatment, but we are all now filled with sadness that the new year will begin with the messy, septic death of my dad. Any advice on support for our trio would be appreciated.
I'm so sorry to hear of your dad's decision and pray for a quick and painless passing for him. I hope he's open to hospice, too.
As I replied to Beatty, I'm certain he'd refuse hospice with the same illogical response that he doesn't need it, that God will heal him. And the irony of the situation is that hospice doesn't even need to be part of the discussion, if he would just follow through with the necessary treatment...
If someone had told me, even a year ago, that my rational, mathematics professor father would take such an irrational, unreasonable course of action, I would have told them they were full of çaça... The situation seems surreal at best.
Choosing to refuse dental treatment will avoid treatment pain & cost, but will bring other consequences of the most severe nature.
Is there a religionious/faith leader your Dad would like to speak to about his situation & decision? Or for the wider family to speak to?
What a hard situation. Sad indeed.
As for myself, I would describe myself as spiritual, but I don't follow any structured religion. Mom and I reside in Washington State, while my sister is in Oregon. I find myself alternating between sadness and an intense frustration that my dad, typically a logical and rational person (he taught math at a number of levels), is now refusing to receive reasonable medical treatment on the grounds that God will heal him. I'm certain his response to offered hospice would be similar: "I don't need that because God will heal me."
And the irony of the situation is that hospice doesn't even need to be part of the discussion, if he would just follow through with the necessary treatment...
As long as he has not been officially diagnosed with dementia, he is in control of his medical care. The oral surgeon's office told Mom that they must abide by his wishes.
I’m sorry you are facing this . I had a friend , her father was too scared to get cardiac bypass surgery and chose to just let nature take its course . He died fairly young , in his early 60’s . Her Mom is 93 , a long time widow .
Who knows? Maybe once all the neighbors in their large condo complex find out what he's doing, they'll overwhelm him with "You crazy, man!" and he'll change his mind by brunt of sheer numbers plus embarrassment in the neighborhood arena...
He thinks god will heal him but maybe tell him sometimes god sends angels in the form of doctors and the creation of medication to do his healing for him. Then ask him why is he rejecting gods help?
I have a hope that maybe once all the neighbors in their large condo complex find out what he's doing, they'll overwhelm him with "You crazy, man!" and he'll change his mind by brunt of sheer numbers plus embarrassment in the neighborhood arena...
I would involve his PCP and a perhaps a psychiatrist asap.
Would you or mom consider asking the courts for emergency guardianship?
As far as I know, there must be a valid medical diagnosis of diminished mental capacity for legal action, and my dad has torpedoed any examination Mom has attempted over the years. Same response and stubbornness we're seeing at present.
If dad has dementia he can no longer make important decisions for himself . (this is different than asking him if he wants a ham sandwich or soup for lunch)
The person that is POA is the one that makes decisions like this for him.
If he has not been diagnosed with dementia and this is a "new" thing, or change in his personality I would get his to his primary for a urine test. UTI can often result in personality changes and poor decision making. A stroke can also effect decision making abilities.
On the other hand if dad is cognizant and he has a lot of other medical issues he may be just "done" and if that is the case this is his choice that he is making and your next step would be to consult with the Hospice of your choice and let them manage his medical care now.
A few years later, with Dad fully recovered, they sold the house my sister and I grew up in, and moved into their current condo. They had a nice nest egg from the house sale and Mom's inheritance from her mom's passing. That's when Dad's behavior turned bizarre, and he spent all that money (over $200K) on propping up a church member's store of African imports. In the middle of this situation, my sister overheard said church member discussing with his "partner" how much money they'd be able to get from our dad. Turns out the "church member" was a practiced scam artist, and he used the religious angle to con my dad but good. When my sister, my mom, and myself tried to explain what was going on to Dad, he first asked why we were "bearing false witness" against the church member. When we persisted, adamant that we were telling the truth, Dad became hostile, and refused to listen. When Mom stated that 50% of the money was legally hers, and Dad had taken it without any discussion, he responded that *he* was the head of the household and all financial resources were *his* to do with as he pleased. Mom ended up having to file joint bankruptcy, and it was a long road till they were financially clear once more. It took a court official browbeating Dad with legal chapter and verse before the gravity of the situation got through to him.
The present situation is more of the same willful obtuseness, only it's not just money on the line this time, it's what remains of his life. He's fairly healthy for his age, and could enjoy a number of years more with proper medical treatment of his dental infections. Dementia is the unanswered question in this equation, because every time Mom attempted to schedule him for the requisite medical evaluation in the past, he pulled similar passive-aggressive crap and either canceled the appointment behind her back, or simply refused to go. After a decade of trying, I think my mom is now redirecting her energy toward preserving herself.
As long as he has not been officially diagnosed with dementia, he is in control of his medical care. The oral surgeon's office told Mom that they must abide by his wishes. And as I originally posted, from his side of things, the conversation is over. Trying to browbeat him with the inevitability of a nasty hospitalization then death at this point will result in either being ignored with this smug little smirk, or a hostile response that could escalate to physical violence. So Mom and I have withdrawn from the situation to prevent further problems; that doesn't lessen our own sadness and helpless frustration, however.
Regarding hospice, pursuing that is up to my mom, since she has her own support group outside of immediate family. And no one can truly predict how his infections will advance at this time. There may come a point where he reaches screaming agony before finally allowing himself to be hospitalized. Or he may develop Ludwig's Angina and his trachea becomes occluded, ending in suffocation. (Mom signed him up for the Neptune Society, so no matter where he expires, his remains will be taken care of.)
Who knows? Maybe once all the neighbors in their large condo complex find out what he's doing, they'll overwhelm him with "You crazy, man!" and he'll change his mind by brunt of sheer numbers plus embarrassment in the neighborhood arena... Life is strange and constantly in flux.
Best of luck to your dad, maybe he is ready to leave this old world and he is going to do it his way. I say good for him.
Dad has his rights. He has been told what will happen.
You say this is your father's choice.
The only real question now is whether or not he is mentally competent to make his own decision. If he is, then it seems that he has made that decision. I am very sorry. I hope that he understands what he is doing; with his expectation of divine intervention, I suspect he does NOT. But there is little you can do about that. You honestly cannot force treatment and especially dental treatment on someone; just doesn't work. Clearly, with abscesses this severe this has been going on for a long time. I would be ready to call in hospice. He will need them.
I just heard a podcast about a woman who had rectal cancer and refused treatment, believing that all these bogus therapies would cure her. Her daughter basically begged her to get treatment. She died. There isn't a lot you can do about our right to choose. I am so terribly sorry for all involved.
Unfortunately (or fortunately depending on how you look at it) people with mental health issues are allowed to make their own medical choices unless they are declared mentally incompetent. And getting someone declared incompetent is pretty difficult. Even a person with schizophrenia cannot be forced to take medications for their mental illness or for any sickness they have (though there are some states working on laws to force the mentally ill to take medication if they are a danger to themselves or others).
As for the dentists that treated your father they could have prescribed and should have prescribed antibiotics for his procedures. But I think you said one dentist said your dad refused to take the antibiotics or get them prescribed for him.
What will probably happen is your dad will get so sick he will have to go to the hospital. If he is capable of speaking he will be able to refuse or allow medical treatment. If he can't speak for himself your mom will be able to speak for him and allow medical treatment to happen.
It sounds like you are going to have a long road with your father in regards to his mental and physical health. As these things tend to keep getting worse not better. And with each problem dad has you will probably have a fight on your hands to get him to seek treatment.
But then, if your father becomes so ill he can't refuse, why allow medical intervention and for what purpose.
Like a few others below have written, maybe he's ready to go. If that's the case, honor his decision and try to be at peace with his decision. I am sorry.
My issue with him currently is that, after 63 years of marriage and all the negativity he put my mom through in their life together, he *still* refuses to share any type of meaningful communication with her regarding this situation. I'll grant that, perhaps, his neurotransmitters are so compromised that he's unable to articulate his thoughts--but it doesn't seem that way from our most recent conversation. I guess we've arrived at the I-don't-give-a-damn point with regards to making your wife and daughters watch you suffer until you die.
I'm coming to the conclusion that he's made his choice, and he's going to have to exist in the resulting state. I believe I have run out of both patience and sympathy for him...
Your father, from all you tell us, almost certainly has undiagnosed dementia. However, even in the fact of that and a POA, no one can force dental care on another.
You describe your mother as being severely depleted by care of this gentleman, who has already squandered more than 200,000 if I read you right, on scams.
It would seem that your father has decided to risk sepsis.
When he is severely ill of same, do have him transported to hospital.
At that point they may attempt IV antibiotics against his will if he is (and he likely will be) demented. That may in fact lead to C-diff, and almost certainly his death.
To be honest, this is his decision. He has always been stubborn. His decisions have for decades been bad. He is about to take his poor wife down with him.
I would honor his wishes at this point. It is too late for all the guardianship and diagnosis stuff and with teeth neglected for a lifetime almost certainly then too late for that as well.
When the time comes you, your Mom, and other family should request hospice and keep your dad blessedly calm and out of pain.
I am so very sorry. Not everything can be fixed. This is sad indeed. You are not alone in seeing this in an elder. I wish your family luck.
It just leaves a sour taste in my mouth, knowing that after all the negativity he injected into our family, he gets one last poke at all of us by forcing us to watch him go through the inevitable nastiness. And with my mom having to suffer through the process, up close and personal. After what she gave and invested as his wife, the whole thing is just not right. Or as The Dude would say, mega uncool.
Are his papers in order? Does Mom know where the bank accounts are? Does she have a copy of his pension papers or anything else she might need once he dies? Has she ensured she's the beneficiary on all their accounts and the house's title is held as joint tenants with rights of survivorship?
Time to get practical and leave him to his choices.
Fortunately, Mom has been fielding the finances for many years--Dad's pension and SS get deposited to an account with only immediate family female access. I'm pretty sure she has the condo title properly arranged, since she oversaw the mortgage restructuring after Dad pushed them into bankruptcy. She also signed him up with the Neptune Society, so wherever he shuffles off his mortal coil, they'll be there to handle the remains and process them to cremation. So, when all is said and done, Mom is covered for the resulting paperwork, etc.
It just...hurts my heart. He's my dad, yet my feelings mean nothing to him with regard to the pain and suffering he'll experience. My words, my love, all without worth. This is the hard part, right now. When there's no true answer to the question of why...
Look, your dad sounds mentally ill. Neither you nor mom can do anything about that. And it appears that she's had difficulty maintaining boundaries to prevent him from damaging her financially for a long time.
Right now, it's time to divorce mom and yourself from this madness. Get out of there.
If there is no POA and he does have Vascular Dementia Mom is the one that will have to make tough decisions.
If he does have Vascular Dementia he can no longer make medical decisions for himself. (Nor any other major decisions)
The other option is to obtain Guardianship and "force" treatment.
(If he does have Vascular Dementia if it were me I would prefer no treatment and opt for Hospice. )
This gentleman has apparently not been right for his entire marriage. He clearly didn't take care of his teeth over a lifetime it would seem. And now he is declining care. And wouldn't want an assessment. And has a wife who for SIXTY-FIVE YEARS had bowed to his wishes.
I say continue to bow to his wishes. This will go where it goes. When sepsis occurs it will likely be fast enough that considering whether or not to call in Hospice won't even be an issue.
Like u said, Dad has made his decision. Everyone else just has to live with it.
If he is no longer of sound mind, why prolong his misery anyway? He’s not going to get better.
He truly believed there was NOTHING wrong with him .. It is not the same thing as denial . It was real to him in the reality HE lived in … It was not easy , but I learned to stop taking the things that were happening as being directly aimed at me . It was the disease. . I watched his Quality of Life fail . All the things he valued in his life were slipping away . All the things he loved to do were disappearing. There came a time that with the help of the doctors and my therapist , I was able to step back and just keep him comfortable and safe. Because of the disease he was NOT ABLE to do anything different than what he was doing .. Over the years I slowly and quietly made sure the paper work was taken care of . I hope there is a POA out there . I was fortunate that it was signed before he got bad. It was a long hard road , a 6 year road that ended in October. I am still dealing with Guilt and Relief . I could have been less frustrated near the end . I am feel guilty because of the amount of relieve I feel . I wish I knew then what I know now. I feel my CareGivers meetings over the years have helped maintained My sanity .They CAN NOT change but WE can change our reaction to them .