My mother is resistant to treatment for AMD. Any advice?

Thanks windyridge, I think you are correct.. She will grumble , and try to convince me in the waiting room that we can leave, etc.. But she will go along with it, complain afterwards, but will forget about it in a few hours.. I would not be surprised if there are after effects from the shot, that she will ask me to call the eye doctor to make an appointment to look at her eye..

Hi farmjelly- thanks for the input, but my mom is really old tech.. Video of the PCP will not work, but it may work if she challenges me that she never had appointment with her PCP.. But, I would be reluctant to show her, because she is at the stage where she does not think there is anything wrong with her mind.. I would be reluctant to play it back to her, because it would put her face to face with her dementia, and frankly, I think it would put her in a bad place.

With all of you I think I came to these conclusions:

1) I will start the therapy for her because it is minor in my mind.. Depending on the post injection effects will determine if it continues. About quality of life, do not want have the procedure once a month, where it puts her in pain 2-3 days afterwards.

2) Going to abandon the idea about speaking about it every day.. No sense since she will not remember. Think the best option is like windyridge suggested.. Tell her the night before, Ma have an eye doctor appointment tomorrow, will come home early from work to bring you.. Then go through the 45 minute to hour dialogue about why I will not cancel the appt, and that she needs to go..

I want to say to all of you; I am really glad I found this forum because I felt I was alone even though I knew I was not.. Clearly you all have a very large heart , and have been or are dealing with this..I have co-workers, and friends who feel sorry for me because they see me as having a burden, sacrificing part of my life etc.. But to be honest with you, I am seeing this as a blessing, I am becoming a better person because of this experience... Go figure!

AnthonyB -- Would it help your efforts to re-convince her each time if you had a video of her PCP speaking directly to her, using her name, using a calm tone of voice, etc? Maybe even video the interaction between the PCP explaining and your Mom agreeing to the procedure. I have a dear friend who has to have these injections regularly in both eyes. She's mid-40's and in her right mind, and the shots are STILL anxiety producing. I agree with another's suggestion for something to help take the edge off before the shot.

Anthony, My dad is much like your mom, 87 with dementia and no short term memory. As for the reset problem, I've found it to be a waste of time trying to explain and get dad to agree to anything, particularly doctor appointments and treatments.

Mom and I have learned to schedule the necessary appointments for him, don't discuss it or ask for his approval, just tell him when it's time to go, DAD LETS GO TO YOUR APPOINTMENT NOW! He's a pretty sweet old guy and it usually works like a charm.

The bigger issue with my dad is he's refusing to have cataract surgery and is gradually going to be blind. He's not legally incompetent so we can't force him. But honestly with his dementia the post op regime would be impossible: Eye drop regime, no rubbing eyes etc.

Thanks garden artist and country mouse.. Hi Garden Artist, you misunderstood me.. The ophthalmologist will certainly be the one performing the injections, I know the PCP and he would not even suggest it.. The only reason we are seeing the PCP is because she values his opinion and wants him to tell her it is needed and what the procedure is about.. I already spoke with him and he recommends going forward with the treatments.. But unfortunately, with her short term memory essentially being gone, she will likely forget the she saw him.. I just need to be patient (something I am getting good at after 6 years) and keep explaining to her why she needs to go, and that she already saw her PCP,etc.  Takes about 45 minutes before she agrees, several times of  having her cover one eye and telling me how many fingers, explaining over and over again the procedure and that is is not surgery,etc..I  have been doing this once a day in the hope it will stick, not sure if this is such a good idea.. Maybe I should just leave it be until the time of appointment since she will forget the conversation anyway.. Just stresses her out..

Country mouse I will definitely explain to the staff of her condition.. She did well during the initial evaluation were they performed the scans and injected the die, etc.. I was present during the examination and questioning whether I should be present for the eye injection.. Watching how she was acting in the room alone waiting for the doctor compared to when he came in is suggesting perhaps I should not be there, but then again if I am not, there and she is alone, she may just bolt.. Guess I will need to play it by ear..

Reading the posts in this forum has t made me realized how fortunate I have been thus far and that what I am dealing with is minor in comparison.. Will have to wait and see what the future brings.. One change that I did make about a year ago was to start cooking the meals after work and sitting down and have dinner. Between the nutrition, and social interaction ( sits alone all day after her last friend passed on) she seems to be more content..

Anthony, I don't recall whether a PCP or an opthalomologist gave MD shots to my aunt, but I have a general recollection that it was the latter. Your plan to have the shot provided by a PCP concerns me.

A flu shot, or pneumonia shot could be handled by a PCP. But an opthalomologist would be more experienced not only with MD but with administering it. Eye shots are not easy things to give. It's not just the shot but the handling of a patient who probably is concerned about a needle in her eye. I'd seriously reconsider having a PCP do it.

As to your mother's "reset", that's going to be a fact of life, unfortunately. Others here have had more experience with this than I, so perhaps they'll offer some methods by which they learned to deal with this.

Good luck with the shot, and I hope your mother handles it well. You might want to find some special treat for her afterwards...maybe a color tour, lunch at her favorite restaurant, something else she likes.

Anthony, I'd make the appointment but also make sure you tell her eye specialist about her difficulties with memory and decision-making so that he can handle her sensitively. Given the patient demographic he's probably very used to the difficulties and will have a team of skilled hand-holding nurses - certainly that's what happened with my mother's cataract operations. But speaking of which, be prepared for them to abandon the procedure if your mother is becoming distressed - just be guided by their professional judgment.

Thanks.. Once I explain to her that the procedure is not a surgery but rather a shot, she is OK with it.. She just does not want any surgery which is understandable. Problem is she forgets the conversation and even that we went to the eye doctor so every time I bring it up it is like it is a new thing.. If it was not for the dementia and she could retain information I am convinced it would not be an issue.. It is just the constant reset, where I have explain the entire process over again.. She is 88yrs old, and her other eye seems to be OK so far, at least to the point that treatment is not needed..But as the eye doctor said, it is best to stop the MD in the one eye in the event the other eye acts up.. If I knew that she truly understood the consequences of not taking treatment I would certainly respect her wishes and leave the matter alone, but I am not convinced that she fully understands the consequences.. I am going t take her to her primary care physician, and likely make the first appointment for the injection, and we will see were it goes.. On top of that I need to bring her to the oral surgeon to remover her tooth, that is much easier because she has a reminder every couple of days why her tooth needs to be removed,

This is a tough situation. The shots for MD would probably scare anyone; they scare me! My aunt had the shots; it's my understanding that they did help her, but then she might have been at a different stage than our mother.

I think she needs something to help her so that her vision doesn't deteriorate any more than it would already, but the needle in the eye might scare her. Can you discuss with the opthalomologist the possibility of giving her something to relax before the shots?

I wouldn't normally suggest any kind of "relaxation" shot, but the eye and the perception of a needle in the eye is terrifying to some people.