Denial of Her Cancer and Physical Decline plus Mocking Her Family's Concern. A Hard Case. What Can I Ask the Doctor to Do?
My 82 year old mum has terminal cancer. She lives alone in a town an hour away from family help. It is clear to several family members that she is getting weak and sicker steadily. I am her medical power of attorney. She has been in denial of her aging, her cancer and her progressive illness all along. The worst thing is her mocking and sarcastic response to me and others when we try to discuss all this. She has started to lose control of her bowels too. She has agreed to come to her doctors with me this week. Another sister made the appointment and I talked mum into going. It has been five weeks...since her last one. She won't come and stay with us and has refused to go into a care facility. She refused treatment for her cancer in August and I respect that decision but her current dismissive attitude to palliative care is a recipe for drama and distress. She is a high falls risk. We all feel anxious and grieved just thinking of her alone and in trouble. Her response to this is sarcasm. She is a chronically angry person. I really want to make this doctors visit count. I have been to many with her over the years and she always acts patronising to the doctor and blusters on about how super her health is; totally a waste of time. She has only a few months at most as she has chronic lymphocytic leukaemia plus now Merkel Cell carcinoma. What can I ask the doctor to do?
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Both her adult kids lived overseas, communicated often but suspected nothing. Covid prevented visits, so that helped her.
As she neared the end, her cleaner ratted her out to a neighbor. Neighbor call 911; also called kids who were able to fly in and get her on hospice and relieve her pain and ease her passing.
This sort of thing is a miserabke thing to do to your children. Being strong is one thing. Leaving your children wondering "how could this have happenened" is pretty selfish.
By refusing doctors and being snide and sarcastic with everyone trying to help her is because she knows she's going to die and wants to do it on her terms. Not in a hospital or nursing home. Not with nurses and hospice aides coming in and out of her house. Your mother sounds like the kind of person who would take their own life in such a situation rather than go like this.
If your mother isn't out of it with dementia and still sound enough of mind that an elderly person with terminal cancer can be, ask her what she wants to do. See what she wants for herself in terms of care or help or anything else.
My dad had chronic leukemia and lived for 15 years after diagnosis.
When I first heard the news, I was devestated and thought it was "all over". It was not and in the end, he died of something else.
But yes, you are spot on that mom has "lost insight". Keep in touch!
I would call the doctor's office today and ask how best to get the doctor vital information about mom's health prior to the appointment. Then send it the way they suggest-- text, fax, whatever. Keep a copy to bring to the appointment (give it to the receptionist when you sign in) and mail a copy ( return receipt requested) to the doctor so you have proof it was received).
The doctor needs to know that she is refusing/resisting care and safety measures.
At the appointment let the doctor take the lead. If mom brushes off concerns, state calmly that you are concerned about her inability to see that she is going to need someone around at the end to make sure she is not in agony.
Does she have hospice coming in?