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Sometimes I think the drs are just ripping off the elderly. Visits and prescriptions are so expensive, So very costly using medical transportation just to have vitals checked, same questions asked, medicine list reviewed and changed—my mother is dying and her health will not be improved. She gets false hope and agrees to make follow up appointments. I’m at the point that I’m not trusting the medical staff. Seems there is a monetary interest investing in my mother's fate while they line their pockets. Is it abusive to deny my mother medical assistance for fixing things that cannot be repaired or even improved? She’s ready to join my father but the drs seem to be prolonging her life for their benefit and not hearing her wishes to let it be God’s will. What to do?

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Jlaroche - If you keep going to the doctor looking for answers they will usually continue to help you look for them, it's up to you and your mother to decide which appointments are still worthwhile..

Although the OP's profile page includes a long list of their mother's health problems none of those things are imminently fatal and neither is her age - my mom was living independently with most of those same conditions in her early 90's. I was furious when a doctor told me "sometimes they just get tired" when I took my mother to the hospital seeking a reason for her sudden decline - ageism is real and not every 90 year old is teetering at death's door.
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How does mom feel about this?

I know my mom, with advanced CHF, was more than ready to go into hospice and end the constant round of doctor visits/hospitalizations/ rehab & recovery. When her cardiologist tried one "last ditch" effort and put her on a constant infusion pump treatment, she said "enough", told her cardiologist she wanted the PICC line removed and hospice brought onboard.

There are a lot of reasons that doctors continue to push to treat patients that seem to have no real hope of recovery. I am sure in some instances greed plays a part, as does fear of litigation; however, I believe that not only are many of them (the medical people) hardwired to "do something", many of them have forged long relationships with their patients, and don't want to seem to be "giving up" on their patients. It's for the patient - or their advocate if the patient is unable - to make clear their wishes to their doctors.

If mom has said to you something to the effect of she's getting tired of all the appointments, all the poking and prodding, the never-ending cycle of treatments that don't seem to be of much use, you need to ask her how she feels about seeking hospice/palliative care, and then encourage HER to make her wishes known to her doctors. Certainly be there to support and advocate for her while she does it, but it seemed to me that once my mom was the one who spoke up the doctor was much more willing to engage in the conversation about hospice.

You and mom are in my prayers; this isn't easy for any of us to get through; there are many of us who have stood right where you are now. Making the decision is really the hardest part of the equation; at least it was for us.

Good luck and hugs.
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I agree with ZippyZee. YOU are the one who must agree to having your mom seen by all these doctors and charged accordingly (if you are her POA)! If you don't agree, then get her evaluated for hospice care and stop all the insanity of these doctor visits and poking/prodding that's involved. It's definitely NOT abusive to cut out all these useless doctors and get her hospice care or even palliative care at this point.

I think we're all brainwashed into thinking it's 'the right thing to do' to extend our elders' lives to 100, even if they're living in misery, pain and advanced dementia, when it makes NO sense at all! Allowing nature to take its course is a much better alternative, in my opinion, than taking extreme and expensive (not to mention invasive) measures to keep them alive when there's no quality of life left!

Wishing you the best of luck devising a plan that works best for you and your mom.
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Have her evaluated for hospice.

If a person presents themselves for treatment, doctors have to do their job and treat them. They're not going to turn people away just because they're very eldery or sick.
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Doctors do not decide your care for you (assuming you are conscious and cognitively able) -- you must agree to do what they suggest in order for them to act. They will never tell you to stop a treatment, they will tell you options and what will happen if you start or stop a treatment or surgery. This is why I always ask the doc, "What would YOU do if you were in this situation?" Then I ask them why and most of the time I do what they themselves would do.
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On the subject of doctors wanting to maintain schedules, etc. even though a patient may not need so much attention, there's also the issue of favors from medical companies, drug suppliers and others interested in cultivating business with the medical profession.  

If I remember correctly, U of M hospital some years ago issued a mandate disallowing acceptance by doctors of any favors.  

Some years ago I was waiting in the lobby for an appointment with a female PCP.    It was around noontime, and I saw a delivery person arrive, deliver several lunches to the receptionist, then leave.   Just on a gut feeling, I commented to the receptionist that it was generous of the medical firm to provide lunches for staff.   She (perhaps in an unrecognized indiscretion) said that it wasn't the firm; it was a medical supplier (I don't recall of what).  

That said a lot to me.   After the appointment, I never went back to that practice.   (And the ease with which the female doctor had recommended meds was just too unacceptable for me.)
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Geaton777 Oct 2021
Having worked in med-tech my whole life what the supplier may want is not necessarily for the docs to prescribe their product or direct sales to their entity, but to gain favor so that the docs will give them a bit of their time. Med-tech and pharmaceutical companies need input from docs regarding the development of their products and we all know how busy doctors are, especially nowadays. It's not always nefarious, not to mention docs don't have that much power -- they can't order products or therapies without having an actual diagnosis, (which has a code) and then the treatment has a code and this is the ONLY THING that allows them to bill and get paid by the insurance companies.
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There's another side to the philosophy that doctors are padding their pockets at the expense of clients.    Think of the medical mandate (Alva could probably explain this better than I):  Do No Harm.  (I apologize if this isn't still the standard; I'm not a medical person, so it's just my understanding that this guideline still applies.)

This is an interesting article on the no harm issue:
https://www.health.harvard.edu/blog/first-do-no-harm-201510138421

There's also another side of the issue of medical treatment, regular appointments, and their value:  People have become so litigious, and from what I've especially read at various sites on the Internet, including here, do NOT understand what constitutes malpractice.  And sometimes it's difficult to discern, as well as determining whether treatment is appropriate for the condition and circumstances.

So they think:  SUE!    PI lawyers have contributed to this swell of litigation.   This was kind of a joke at some of the white shoe law firms where I worked:  if you can't go into transactional, international or similar levels of law, you can always be a personal injury lawyer.   "Ambulance chasing" is an appropriate description.

Plaintiff and defense law has changed drastically since I first worked at a defense firm.  

When I was in an accident in 2014, having been hit by a truck which was hit by a driver not paying attention to her driving, within about a week I was contacted by half a dozen (or maybe more) chasers trying to convince  me to discuss suing. 

Apparently they get police reports (and I hope the police charge a large fee!) and then contact people involved.

So there are two contributing factors at the legal level that encourage people to think that suing is an answer.    Doctors need to protect themselves from unfounded accusations and suits.  One of the ways they CAN do that is to ensure that patients are seen regularly, tested, and monitored.

The other contributing aspect of ambulance chasing attorneys and aggrieved patients/relatives who don't understand the basics of medical malpractice.
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What are your Mother's wishes in all of this. Have you POA for her? Have you two discussed palliative care which will eliminate all other doctors and give medications according to the COMFORT, not the cure they may bring? It is time to do that. It is difficult to think of our doctors as people wringing money out the pockets of elders; remember, they are trained to treat, to address issues, and to never give up UNLESS they are trained in palliative care. I think any thought of being self serving is hidden, but the sad truth is that when they can talk people in to newer (and often little better) medications that are not out of patent they get as much as 6% of the cost of the prescription. Tests also come into it when they are invested in the cost of some high-price machinery. Many elders live for their medical appointments and medications; many others fine visits and meds onerous and burdensome. Speak with your Mom and find out what she wants for end of life care. To my mind your previous advisers on this thread are right A move toward palliative or hospice care may be the best move. Explain to the doctors that this is the wish of your Mom, and that you need guidance now of palliative medicine.
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Cover99 Oct 2021
GI doc kept visiting (and charging) seeing my mom, even though his services were no longer needed, up to the day she passed.
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I helped my dad let go of a good number of his acquired medical specialists. Most were no longer bringing anything helpful to him, but all very much wanted him to keep coming. Meds that we thought were wise to continue were done through primary care doctor. It can become a seemingly endless merry go round if you let it. And do look into hospice services.
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You consult with her PCP, tell her Mom wants to move to comfort care (hospice, if possible), and then with the hospice folks you can have the conversation about what treatments to stop. They're infinitely more willing to have those conversations because quality of life, not quantity, is their business.

With hospice, the trips to specialists stop, and the hospice doctor becomes Mom's doctor. (Ending those relationships with the specialists is remarkably freeing.)

Once Mom's on with hospice, the whole focus on her care shifts to her comfort -- hers as well as yours. If you have a good hospice provider, it's a wonderful experience for everyone. If you aren't clicking with them, get another provider. They'll coordinate with the first company to make the change as seamless as possible.
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Cover99 Oct 2021
Not in all instances, Doc still came around (and charged for his visits) with my mom even though she was on Palliative care, up to the day she passed. He even came around while I was there, checked a couple vitals, said she was pretty sick and left.
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Sometimes the amount of appointments are really excessive. If some doc tries to followup with my mom every X months, I just cancel the appointment if there is nothing new going on.

When you say your mother is dying, what do you mean by that? Just because she's 92 or because there is a terminal issue or some sort? If she is actively dying or does not wish to treat her issues, perhaps looking into a hospice evaluation might be in order? Or at least finding out about shifting to palliative care?

With my 95 yo MIL, I ask my husband and her - if we go to see the "insert doctor like neurologist" and they say you need an operation will you do it? She says no and we agree so we don't do the appointment.

Does anyone go to these doc appointments with your mom?

Some things, like a proper prescription for glasses if she still needs them for TV or reading, etc., make sense.

But look at the purpose of the appointments and what can be gained? Neuro - why? Cardio - why? If there's an issue, will they operate? Would she want life prolonging surgery? All surgery has risks so at her age it's iffy at best for the risk/benefit analysis.
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againx100 Oct 2021
Also, does she have a living will? Do you have POA?
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