Elderly dad is being stubborn about going to the doctor and taking his meds

LegacyUser

I'm looking for advice. Not medical advice. I just don't know what to do about my Dad though.

My Dad has MS, and arthritis. Both have caught up on him big time. He got a prescription from when he was in hospital last month, but his own GP doesn't want to renew it without seeing him, and point blank refuses to do a home visit. The MS drugs don't seem to be as much of an issue, but the painkillers are.

I don't know what to do. Dad is increasingly immobile. And trying to get him into a car / out of it again, and waiting in the docs surgery just won't happen. Well he'll refuse to go, and 'do without'. Or if I try to make him go, I know the pain and shakiness will be so bad, and he'll be not only in agony, but also really stressed for a few days before it, and very upset.

My issue is what to do. Surely my dad can't be the only elderly man in this situation. What do other people do? Or is it just in madly busy GP surgeries in Dublin that they make you visit them, regardless of how next to impossible that is for the patient?

They way things are, if the GP won't visit dad, then dad will just not get a renewal of the meds prescribed by the hospital. I just don't know what to do. Amy advice on similar situations, and what you did, would be appreciated so much.

zoobizoo

2554 wrote: »

but his own GP doesn't want to renew it without seeing him, and point blank refuses to do a home visit. T.

Why won't he visit him at home?

Is it far to the house?

redbel05

Sorry for the long reply, and hope this helps!

I know of several elderly people who would have mobility issues. It tends to be the public health nurse who calls out to their home to check on them as part of their Home Care Package. If your Dads mobility is enough of an issue for getting into and out of a car, then he might be eligible for a home care package which (depending on the level of care needed) could get you a home help also. Speak to your doctor about this and (if you haven't already) emphasise the mobility problem, rather than just saying your Dad refuses to come into the clinic (from your OP it seems like both are an issue, but GPs generally won't be as obliging to people who refuse to come in, when they are able to).

http://www.citizensinformation.ie/en/health/health_services_for_older_people/home_care_packages_for_carers.html

Dial Hard

zoobizoo wrote: »

Why won't he visit him at home?

A lot of GPs don't do housecalls anymore.

Is changing GP an option, OP?

2554

2554 wrote: »

his own GP doesn't want to renew it without seeing him, and point blank refuses to do a home visit.

Dad is increasingly immobile

If I try to make him go, I know the pain and shakiness will be so bad, and he'll be not only in agony, but also really stressed for a few days before it, and very upset.

While my first reaction was "WTF? Change your GP!", I do understand how difficult that is. When I moved to a new area, the three GPs closest to my home "aren't taking on new patients", so I ended up with a GP near my place of work (who's amazing so it all worked out), but how long has your father been with this GP?!

Having said that, I know of several surgeries which will do out of hours house calls ... for a fee. Is money a problem?

I agree with Rebel05, make sure the GP understands WHY your father can't (rather than won't attend) and if he still refuses to pop by, you need to look at other options.

LegacyUser

Thanks for replies.

Dad has been going to the same GP for years. Apparently they 'just don't do house calls'. There seems to be zero flexibility on this, despite me asking and asking, and offering to pay double the fee.

I asked about another local GP. He isn't taking on new patients, and my dad is friendly with a patient of this other GP. He too says no to house calls, but did see my dads friend at home - 3 days after he had a fall. So even a patient of 25 years had to beg, and wait 3 days.

I think it would work if we could give the GP a weeks notice and have him call to my dad at any time during the week, but he just says no, that dad will have to come to him. It's not really so much refusal on dads part, more that he just can't do it. The only times he's left the house in the last 2 years have been in an ambulance due to health issues and needing to be hospitalised.

We are in touch with the district nurse, and he gets an hour a day home help. While this is good, it doesn't solve the problem that he just can't get to the GP to get his prescription renewed, and the GP won't come to him. I just don't know what to do.

http://mediserve.ie/doctor-on-duty-1/

OK well at the very least get in touch with these guys, there must be a way to have a doctor call to the house.

RoYoBo

Can you get in touch with the consultant and or the hospital staff where your father was prescribed this medication? If he is unable to leave the house except in an ambulance and the GP will not prescribe his medically necessary medication, perhaps they can make some suggestion?

From what you've said, it's simply a repeat prescription from a month ago, so it's hard to see what the GP's problem could be from such a recent expert examination. Such a horrible catch 22 situation for you OP - I heartily sympathise.

intheclouds

Ok - you need to change your fathers GP immediately.

I agree with speaking to his consultant in the hospital and speak to the public health nurse.

I would be contacting the HSE and asking them to explain to you exactly what to do in this situation.

If you contact Leo Varadkars office they should also be able to direct you.

Big Bag of Chips

Have you spoken to the GP or the receptionist? Sometimes the receptionists are like guard dogs and keep you away from the doctor! In some cases the doctor won't even be told you're looking for him! The doctor may not be able to reissue a prescription without examining your dad. I know there are many medications that need to be monitored if going to be used long term. They might cause various side affects, or may not be effective etc. So it is understandable that the GP might not want to reissue a prescription without seeing the patient. You should ring your local health centre (Google you local area community health) and ask their advice. There may be a community doctor who does house calls.

If you haven't spoken directly to the doctor then I would advise you to ring the surgery and ask for him to call you back. Or call in yourself and ask to see him. If you have spoken to him, either try again and push harder, or ask him to recommend something. You might also get somewhere by getting back in touch with the consultant. They might contact the GP for you.

RoYoBo

Big Bag of Chips wrote: »

The doctor may not be able to reissue a prescription without examining your dad. I know there are many medications that need to be monitored if going to be used long term.

If the man cannot leave the house and the doctor won't visit him, then the GP will be unable to monitor the patient now or in the future. It seems that some other solution will have to be found and the consultant and/or the hospital will need to evaluate in this instance.

Big Bag of Chips

RoYoBo wrote: »

If the man cannot leave the house and the doctor won't visit him, then the GP will be unable to monitor the patient now or in the future.

I know, but I was pointing out that it may NOT be

simply a repeat prescription from a month ago, so it's hard to see what the GP's problem could be from such a recent expert examination.

It seems that some other solution will have to be found and the consultant and/or the hospital will need to evaluate in this instance.

Which is why I made a few different suggestions as to what you might do next, OP. Unfortunately sometimes information isn't very forthcoming and you have to fight and push for things. Sometimes you just have to keep making a nuisance of yourself before you get results.

intheclouds

What is the GPs solution to this?

He has a duty of care to his patients. If he has a patient who can't get to the surgery and he won't go to the patient, what does he suggest?

redbel05

I don't know if this is a stupid suggestion, but would being transported via wheelchair + wheelchair accessible taxi help your Dad in any way? It might take just enough pain/ stress out of the situation to make it do-able.

Oki9Sedo!

Firstly, I'm sorry for the difficulties you're encountering. Must be very stressful. I would urge you to phone the HSE helpline on 1850 24 1850 and ask what your options are.

LegacyUser

Thanks so much for all the feedback.

We've spoken - repeatedly - to the GP himself, and his reply is that he just can't do house visits, lthat if he were to do a house visit, that's a load of people calling into his surgery that he just can't see. He offers no solution at all. I keep saying so what is to happen my dad. He (the GP) keeps saying 'bring him to the surgery'. But that wld involve a private ambulance service, and them waiting around for dad. While I don't mind going without to pay for that, it will make my dad so stressed that its highly likely he'll refuse to do it.

I think my next step is to take the advice on this thread, and talk to the district nurse. I mean surely she must have come across this situation before. It's just so bloody sad, that a sick man is made to feel in an impossible situation, and such a burden.

Turtle_

Hi Op, sorry to hear that you and your family are in such a difficult situation. I'd echo the advice of calling the hse helpline - the gp has a duty of care to your dad. He shouldn't be messing with his meds and it's horrible that he is prioritising healthier patients who can actually get to the surgery. Any time I've had the gp do a home visit it's been out of hours, it's a normal part of their job.

Seriously though, call the helpline.

qo2cj1dsne8y4k

I would not be dragging my elderly and ill father in and out of cars, having him sit in a waiting room for god knows how long with God knows what germs are flying about. This is 100% on the GP. Your dad is unable to get to the surgery.
You could always call the out of hours dr, they will call to the house when needed.
Also, there's a nurse who can call and will assess what needs doing going forward. She can request a dr attend, or call an ambulance if needs be.

LegacyUser

LexieOnRale wrote: »

I would not be dragging my elderly and ill father in and out of cars, having him sit in a waiting room for god knows how long with God knows what germs are flying about. This is 100% on the GP. Your dad is unable to get to the surgery.
You could always call the out of hours dr, they will call to the house when needed.
Also, there's a nurse who can call and will assess what needs doing going forward. She can request a dr attend, or call an ambulance if needs be.

Not that I'm discounting your advice, but ambulance means A&E, which he mostly doesn't need. And having spent a night on trolleys twice, he'll just refuse to go if that happens again, unless he's in severe difficulty.

I believe the doc on call costs about 120 for a home visit. Looks like that's what we'll have to do. That will be difficult financially, putting it mildly. And I've asked around, someone my dad knows has to do the same in order to get his prescription renewed every 3 months, and he's on far less meds, and because it's a different doc every time from the on call service, they keep telling my dads friend that they can't renew his prescription for stronger drugs. And my dad is on heavy duty stuff.

I've rung the HSE every day for a few days now, no reply as yet. Surely they must have hit this situation before though. Is it only Dublin doc surgeries that won't do house calls? How do elderly/ill people normally cope?

Merkin

I know GPs simply don't do house calls any more. I think maybe you should invoke the help of your district nurse and speak with her. I also think your Dad would be entitled to free transport to and from the surgery so this should be explored further. The GP should also be able to facilitate your Dad with a set appointment time outside of surgery hours so there is no waiting around. So if clinic is 1pm-4pm then the doctor should accommodate him at 12.30pm for example. Alternatively your GP might be amenable to conducting a consultation over Skype or FaceTime perhaps? Have you floated that as an idea?

gumgum1

Hi
I don't know if this will help but we had the same problem with my mother in law maybe not to the same extent. . What my partner used to do is ring ahead to the Dr and they would arrange a time for her to come in. He then would bring her in and they would be brought straight in to a n empty room and the Dr would see her as soon as he was finished with current patient. As he was only rewriting a prescription and a quick check up it only evey took a few minutes and every one was a little calmer. .. also if your father is having trouble getting in and out of the car could you look into getting your car adapted . This was a great help with my mother in.law also

Wesser

Hi there. I have read your post. You are clearly in a very difficult situation and my heart goes out to you. Clearly you are doing your best for your dad whom you love very dearly.

I wanted to point out a few things.
Firstly if your dad has a medical card then he does not have to pay any d doc charges for a house call.

Secondly if you still have the original hospital script for the string painkillers, remember this is a valid prescription which is redeemable in any pharmacy, it's just not a free prescription. If there are only one or two items on the script that your doctor is not happy to prescribe then maybe you can pay for these as any private patient would with the hospital script. At least it will
Take him out of pain in the short term.


Also just to let you know that your GP is required by his medical card contract to see your dad at home if he needs it.


Also I wanted to point out that the title of your post suggests that your dad is able to attend the surgery but is too stubborn to do so........ Is there something in this???!!!

Finally I just wanted to Point out the reason why your GP is unable to house calls. As the years have gone by, GP surgeries are getting busier and busier with more and more work being passed from hospital in to primary care, people have more diagnosis more medications and more visits to the dr than ever before, more forms to be filled in, more bloods, more paperwork....GP s have had their payments from the hse slashed 3 times unilaterally, this leads to
Overload on the doctor and the inability to hire a helper doctor to help out. The public get angry with their doctors as they feel the doctor is lazy or unhelpful but the real truth is that these problems arise due to total mismanaging by the hse, as usual, which is construed to look as though it is the GP who is at fault. Poor management at a higher level is the problem.

Wishing you and your father all the best.

LegacyUser

Thread title was cos I left a stupidly nothingy one, a mod fixed it. He isn't stubborn at all; just not able at all, and very stressed and upset.

I do understand why the GP won't do housecalls. Doesn't make life any easier for my Dad tho!

Dad doesn't have a med card, just the norm over 70s free GP visit. He's on the threshold, but because he has multiple illnesses, the district nurse has supported his application for a med card. In my experience, the application alone will take months, and will prob be rejected.

The prescription from the hospital was limited, as in between 2 to 6 wks supply of meds post Discharge. What I have to sort out is what happens next. And I feel totally alone and unsupported in that. I've contacted the HSE and the district nurse, same old answer: bring an old, stressed immobile man to a doc surgery. So a private ambulance seems the only solution. Oh I just hate it all.