Quote from LibraSunCNM
They were in complete denial about their health (and of course, vascular surgeons profit off of this), and I learned there's nothing you can do about it. Who knows what the deep-rooted, underlying issues are that contribute to the denial, it's just too complex for us to be able to magically fix. All you can do is tell it straight to the patients, it's up to them to make changes or not.
^Yes.^ You are obviously frustrated because you KNOW where this ends. And frankly, they probably know it, too.
Research motivational interviewing (in your spare time, right? I know). The theory behind MI is that you can't "make" patients compliant but you can get them to respond to things that are intrinsically important to them. And it will reinforce the "you can't care more about them than they do."
Example: I had a T2DM patient in a hospital having necrotic tissue amputated - the result of not wearing house shoes and stepping on a nail or a tack or something.
He could not have cared less about this (so I thought). He wanted pie more than an A1C of 8. What he did care about was his woodworking, and when we discussed that there was a chance he might not be able to continue his woodworking if his sight failed due to prolonged hyperglycemia, it was literally like a light came on for him.
Ultimately, if you document rigorously, you have done your job. Sometimes I say out loud "So I'm documenting that you're declining X,Y, and Z and leaving without treatment. Amazing how effective that is...