In a bit of an awkward spot...

July 19, 2011 8:28 AM

What is the most ethical choice in this situation?

This could get long, but I'll try to spare you any details of the family crazy that are not relevant.

My grandmother (on my mom's side) is 89 years old and lives with my mom and dad. The relationship is strained, to say the least; there is a whole lot of resentment, anger and downright hate between my mom and grandmother and you can feel the tension when they're in a room together. They've never had a good relationship, and my dad just blindly supports my mom in this. My mom resents everything to do with my grandmother living there: taking her grocery shopping, or to other stores, and basically having to interact with her at all. They are just barely civil toward each other.

I was home this past weekend and my grandma told me that she's had a constant headache for the last six months, some days it's worse than others. She thinks it might be arthritis in her neck, but says she's afraid to go to the doctor in case it's a tumour or something. She hasn't told my mom. When my weekend visit was over, I went into her room to say goodbye and she seemed really disoriented. She wasn't looking at me, just sort of off to the side. I went to give her a hug, and she seemed like she didn't know how to react, or what was going on. She'd said earlier in the morning that her headache was quite bad, but only about 20 minutes before I went to say goodbye to her, she was perfectly lucid, if subdued.

So, I'm not sure what to do. Should I tell my mom about it? If I do, she will almost certainly make my grandmother go to the doctor and it might result in a huge fight and more resentment, and my grandmother will be angry with me (and she can hold a grudge like no one else). On the other hand, my grandma has the right to make decisions about her own health, but I don't know if avoiding the doctor out of fear of the diagnosis is taking a well-thought-out approach to this. Whether it's arthritis or something more serious, I expect the doctor would at least give her something for the pain.

Reluctance to ask my mom to take her to the doctor may also be a part of it, but usually she would just come out and tell me that, so I'm not sure (there's all kinds of weird manipulation and passive aggressiveness between them that often encompasses the rest of the family as well). My mom doesn't handle any kind of emotional upset very well, and there could be all kinds of fallout here that I'm probably not even anticipating; nor is she terribly empathetic. She won't relate to my grandma's fear very well, and may call it ridiculous.

What's the right thing to do, mefites? Tell my mom and increase the odds of grandma getting this checked out, or leave it alone because she can make decisions about her own health?

posted by anonymous to human relations (20 answers total)

The ethical solution is to tell your mother, when she is not lucid your grandmother can not make proper decisions about her health.
posted by stormygrey at 8:31 AM on July 19, 2011 [9 favorites]

What option gives your grandmother (potentially) the best quality of life in the long term? Tell your mom.
posted by hermitosis at 8:32 AM on July 19, 2011

The right thing to do is to tell this dependent senior citizen's primary caregiver that she potentially has a very serious health problem, and that she needs professional attention.
posted by mhoye at 8:33 AM on July 19, 2011 [5 favorites]

Tell your mother. My grandma is still independent and lucid, and I still have to nag her to go to the doctor for whatever problem du jour seems to be ailing her each time we talk on the phone. (For her I think it's a symptom of growing up during the Depression and not wanting to "be a bother" to anyone else.) Tell your mom, get your grandma in to see a doc.
posted by phunniemee at 8:36 AM on July 19, 2011

Your mom isn't all bad its a big job caring for an aging relative and the fact that she has your grandma living with her means she probably loves her and wants whats best for her even if that isn't always apparent.

I think you should tell her.
posted by SpaceWarp13 at 8:37 AM on July 19, 2011 [3 favorites]

i would stand on the side of your grandmother's personal choice. You say she is mostly lucid- tell her your fears and convince her. She's an adult, and she hasn't given up her right to make her own decisions about her privacy and health.

She's also really freakin old. How long is it really going to be before she goes to the doctor again anyway? If she down right refuses to go for this, try convincing her to mention it at her next appointment.

as for her relationship with your mom- I wouldn't get involved. It's really not any of your business and they might (rightfully) resent the crap out of you for getting in the middle of something that may have been going on for many years before you were born.
posted by Blisterlips at 8:39 AM on July 19, 2011 [2 favorites]

Do not tell your mom without talking to granny first. I would offer to give grandma a ride to the doctor without your mom's involvement first. If grandma refuses to go to doctor or to talk to your mother and you notice the disorientation again, then tell you mother.
posted by JohnnyGunn at 8:40 AM on July 19, 2011 [2 favorites]

I agree that the most important thing here is to get your grandmother to a doctor as soon as possible, but is there any possibility of your persuading her to seek treatment? For a lot of older folks, the only frame of reference they have for elderly health care issues is how their own parents were treated years before, which doesn't really reflect the current state of medical technologies or practices.

Can you talk to your grandmother a bit more sometime soon, when she's lucid, to figure out exactly what her anxieties are (all cancer is a death sentence, if I seek treatment I might be treated against my will, I don't want to be on a ventilator, etc.) and see if you can assuage them? Make it her decision to seek treatment, and then go to your mom?
posted by amy lecteur at 8:41 AM on July 19, 2011

Perhaps your grandmother told you about these headaches as a plea for help. If there is a lot of tension and resentment between her and your mom, especially around assistance that your grandmother needs, I understand her hesitation about being perceived as even more vulnerable/needy by your mom.

Tell your grandmother that what she told you and what you noticed really concerns you and you couldn't live with yourself if you didn't at least help her to get it checked out. Tell her you would like to talk with either her doctor or her mom about it, and ask her what she thinks. She might just need to hear that she can no longer hide it, and choose to talk about it on her own with one or both of them on her own.

I wouldn't go behind her back, no matter what you do. Whatever you do, give your grandmother a heads up and the opportunity to do it herself.
posted by swingbraid at 8:42 AM on July 19, 2011 [3 favorites]

--Sorry: your mom!
posted by swingbraid at 8:43 AM on July 19, 2011

As long as your grandmother is able to make decisions about her own wellbeing, it is her choice whether or not to see a doctor. I would therefore advise you to first try and convince her to see a doctor. During this process, you should honour her wishes about whether or not to inform your mother.

Try and find a way to talk your grandmother around. Only go against her wishes as a last resort.
posted by londonmark at 8:48 AM on July 19, 2011 [1 favorite]

Does your mom have siblings you could bring this to?
posted by foursentences at 8:50 AM on July 19, 2011

This has a lot to do with dignity. Please remember that going behind her back might feel like a pretty sever breach of trust. She's already forced to live with people who resent her- who she has to depend on just for the very basics.

If you did go to her and do as Seingbraid suggested- tell your *Grandmother* that the pain seems to be causing more trouble than she might be aware- and that you will support her decisions she makes about her health care- she might be more willing to go to the darn doctor. If you just blow past her and tell on her like a child to your mother, why would she think that you'll respect her wishes when she has even LESS autonomy?
posted by Blisterlips at 8:51 AM on July 19, 2011 [1 favorite]

my grandma has the right to make decisions about her own health

Yes she does. Being old doesn't mean its ok to force her to do things she doesn't want to or to go behind her back to your mother, you said she was perfectly lucid. You should treat her like a grown up - try to convince her to go to a doctor (can you offer to take her? - take the whole mother/tension thing out of the equation). You could try reasoning with her - her response is totally normal but irrational - if she does have a tumour, not knowing about it wont make it not there and the sooner its diagnosed the better... but it probably isn't a tumour.
Do not, go behind her back.

she seemed really disoriented. She wasn't looking at me, just sort of off to the side
Could mean there's something wrong - or it could mean she was daydreaming and lost in a world of her own or tired from not having slept well. I'm not even remotely old and I'm perfectly healthy but I zone out sometimes. I would hope that if she zones out like that often, your mother would have noticed and would take action.
posted by missmagenta at 8:55 AM on July 19, 2011

As someone who lived with a relative with "severe headache" who chose to ignore it, I will tell you the consequences of a cerebral hemorrhage are horrifying for everyone.

Whatever course of action gets grandmother to the doctor ASAP, is what you should do.

If it turns out to be minor, the breach of trust can be repaired. Brain damage, not so much.
posted by pantarei70 at 8:57 AM on July 19, 2011

Definitely tell your mom. I don't see how age or lucidity is even relevant. If my perfectly lucid 23 year old sister told me about a secret 6 month headache, I'd make sure her husband knew.
posted by that's how you get ants at 9:52 AM on July 19, 2011 [1 favorite]

If your Grandmother is telling you about the headaches - I believe she wants them to stop. Encourage your Grandmother to seek help because she deserves to live pain free, and not suffer through them. Express concern for her because you want her to be happy, not uncomfortable. If she still refuses to seek help I would tell your mother.

I agree with pantarei70. My headaches were a brain tumor. Facing it head on stopped the pain and saved my life. Had I ignored them I wouldn't be typing this comment to you.
posted by BuffaloChickenWing at 10:36 AM on July 19, 2011

How about this: Tell Grandma you are scared for her and either *she* makes an appt or *you* will tell your Mom. Then leave the choice for her to make, but either way it gets told
posted by Frosted Cactus at 10:40 AM on July 19, 2011

Help her make the appointment, privately, and pay for a cab in her area to drive her back and forth to the doctor.

The reception at the doctor can help get your grandmother back into the right cab after the visit to make sure she gets home safe, so coordinate a bit with them on this. There may also be free senior car shuttle service type things in your grandma's area to save you the cost of a cab - call the local city hall or consult google. Most areas have this type of service available.

All you have to do is get your grandmother to go along and make the appointment for her. If she is afraid to leave the house without your mom's "permission", if your grandmother is too afraid of your mom's wrath to operate independently, then you must face that we might be discussing Elder Abuse, in which case, call a hotline for advice.
posted by jbenben at 10:58 AM on July 19, 2011 [1 favorite]

Apologies if this has already been offered but are you old enough to take your grandmother to the doctor?
posted by R2WeTwo at 5:24 AM on July 20, 2011