How elderly patients can be stubborn to their own detriment

The elderly population can be fun to take care of (they have more stories than you have time to hear), or they can be a handful in regards to all of their chronic complaints and numerous medications. But then, there are those senior citizens that come into clinic and tell us, “I don’t need to take medications, I haven’t taken medications my whole life, and look at where it’s gotten me!”

I remember one elderly patient’s care I was involved in and she would tell me incessantly “that she didn’t take medications, she didn’t need them.”

I tried coaxing her into taking her blood pressure medications didn’t work. Then I tried the usual patient education about how her blood vessels were not as supple and had become stiffer, hence her problem with having high blood pressure, and her body needed some help. Nope that didn’t work either.

Her typical response to all of my efforts was, “her body hadn’t needed any help for 80+ years, so it didn’t need any help now.”

Even her cardiologist tried repeatedly to tell her she needed to take blood pressure medications, and he didn’t make any headway. Even his telling her that she was facing open heart surgery, in the near future, for an aortic dissection, didn’t ruffle her feathers. She remained adamant, no medications. She unfortunately thought she knew better than her cardiologist as to what was best for her, and blood pressure medications were not going to be a part of her daily regimen.

But that suddenly changed after she survived her open heart surgery procedure for an aortic dissection. She was one of the lucky 9% who survive such a procedure, seeing her aorta was dissecting on the operating table.

Now when she was seen in the clinic by her cardiologist she listened to his advice and took heed to follow it. She even took her blood pressure medications, sometimes against what she considered her better judgment, but by then, it had become a game for her. Every appointment with her cardiologist she made a bet, he would take her off of the medications, because she was doing so well.

Oh, if only her stubbornness hadn’t gotten in the way prior to her surgery. She could have at least put off her open heart surgery for maybe a few more years had she heeded her cardiologist and primary care physician’s advice about taking her blood pressure medications.

But alas, she didn’t.

So this is a lesson that we can all learn, as did I. I learned to remember that being stubborn and proud only leads us to have to pay for the consequences of our actions. A proper physician-patient relationship is a two-way communication, give and take, and in the end for the patient to remember the physician has the education and clinical experience to guide his choices. Choices that he should make in the patient’s best interests, each and every time.

Sharon Bahrych is a physician assistant who blogs at A PA View on Medicine.

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