What if an Elder Resists Treatment?

One of the most common complaints I encounter doing elder care house calls is this, “My—father/mother/aunt/uncle/grandmother—will not cooperate with care. We’re just trying to help, and our loved one fights us every step of the way!” There are so many reasons that the elderly may resist treatment: anxiety, delusions, frustration, old resentments, a desire for control. You could easily write a book on this topic alone.

But I find that as family members and elder care practitioners, it’s easy to overlook two simple causes for resistance to treatment: low-level pain and a lack of pleasure in life.

elder stressOften, I try two simple solutions before looking for deeper causes:

• I prescribe 500 mg of Tylenol, three times a day. It’s amazing how much more cooperative people get when they’re not constantly burdened by arthritis pain, or headaches, or whatever.

• I prescribe ice cream. One of the difficult realities of growing older and of suffering from dementia, is that it’s easy to go days and days without feeling pleasure or joy in life. Elders may have trouble with mobility. Elders may not have the cognitive ability to participate in activities they once enjoyed, whether that’s bridge, golf, reading or needlework. But everyone, even the most frail and ill among us, can enjoy a dish of ice cream. There are even delicious ice creams for diabetics.

Of course, if these simple measures don’t work, more investigation is in order. But as a geriatric specialist, I’ve found that the power of simple painkillers and ice cream is undeniable.

Elizabeth Landsverk, M.D. Specialist in Geriatrics, ElderConsult Geriatric Medicine