Elderly uBPD mom, driver's medical, and subsequent dysregulation

[Methuen]

My 85 yr old uBPD mom recently saw her Dr for a driver's medical.  I wasn't at the appointment, but I think she failed it.  She told me she "wants a new doctor." "Her doctor treats her like her dad did." "Her doctor has a temper."  "Her doctor made her cry."  He told her she has to take a road test.

I live in a small town (6 min away from her). I have the same doctor.  He has an excellent reputation, and amongst the townspeople, if he is your doctor "you are lucky".

My mom has all of the following:
-impaired vision due to macular degeneration (she's already had a consult with a rep from the blind institute, but with new glasses and reading assists, can read a book in large print again)
-hearing loss (I have to repeat things even when she has her hearing aids in),
- TIA's (the new normal is she has a hard time getting her words out because of the TIA's)
- heart issues (she's on meds not sure of exact diagnosois)
- Parkinson's
- anxiety
- ADHD
- uPTSD
- dementia (2015 CAT scan showed binswangers, and although she's demonstrating impaired capacity to do and think the way she used to, she still appears capable to most people who don't know her like we do)
-mobility issues (can't walk without a cane or a walker...standing straight for her looks like she's pivoted about 30degrees forward at the waist),
-weakness (she has about 1 bad fall a year which results in fractures and breaks resulting in home care),
-osteoporosis (Tscore -5.4),
-Vertigo (Meniere's),
-chronic nausea (wore a gravol patch for years),
-and of course uBPD.

 There's undoubtedly more I've forgotten.

Yesterday I stopped by her house to do something for her.  She said the only place she feels safe is in her car, because she doesn't have to walk.  She also said all those things about her doctor that I mentioned above.  Then she showed me a "script" someone had written for her. She was expecting a phone call back from the motor vehicle licensing branch because she was "telling her story" about all the things her doctor did wrong during the driver's medical and why it was unfair.  I asked "who's writing is this?"  It belonged to someone she has recruited to be a flying monkey for her.  She's not facing reality.  We have already talked about how hard it is to deal with change, and how hard it will be one day for H and I to give up our driver's license.  In that earlier conversation, I already pointed out that the doctor was simply doing his job, and filling out the medical form provided to him by the licensing branch, and it was ok to not be happy about how it went.  Nobody would feel good about that, and that was ok.  While she acknowledged it at the time and got quiet, it is giving her something to be angry about and act on, which energizes her, gives her a mission, and other people to blame.  She is in full blown victim mode, and it's giving her an adrenaline rush.

She responded with "when the going get's tough, the tough get going".  When she was telling me about "her doctor treating her like her dad did" and her doctor "having a temper", she was working herself up into her pre-tornado state.  Every muscle in her twisted body tensed, and she stuck out her lower jaw, and clamped her teeth so that her upper lip was on her thrust out lower jaw (like biting her lip) and her whole body was quivering.  The anger was so thick it could be cut with knives. The message to me was clear.  Support her, or have her rage thrust on me.  Whilst I was there, the phone rang and it was the motor vehicle licensing branch returning her call.  I excused myself and left so she could do what she had to do.  She texted me later feeling very empowered, because she had told her story, and it had all been  noted on her file.  The agent advised her not to worry, because they were so far behind with the pandemic, it would be months and months before she even got a letter.  

Meanwhile, she recently told me she wants to change her Will.  

I try to balance  between supporting her, while also trying to guide her towards reality.  I'm probably wasting my time with the latter.

H and I keep supporting her by looking after her house maintenance, doing her grocery shopping, bringing her meals, looking after her financial affairs and investments, solving her computer problems, taking her to appointments, and doing everything we can to assist her, while still trying to look after ourselves.  She texts us multiple times every day.  Sometimes it's to tell us how tired she is after having her toenails done.  Sometimes its to remind us we haven't done something for her.  Sometimes it's to say the supper I brought her tasted good.  I bring her small servings because she's had a lifelong eating disorder (forgot to mention that on the earlier medical list), and if I bring her servings that are too big, she gives them away or they may end up in the garbage. After telling me the lasagne was good, she also add's "that's all I ate".

I'm an only child.  There is no other family.

Meanwhile, her flying monkey has started leaving me messages "_____ asked me to call you and tell you_________".  If/when I ever see her, I will suggest she remind mom she can pass those messages on to me firsthand.

Just unbelievable.  Having a not so great day.  Gonna go do some yoga.  While yoga helps me cope, and can give temporary relief, I also know my mom and her toxic behavior is only going to get worse as her health conditions get worse.  She will NEVER accepted assisted living.  My H says (and I agree) that it will be a critical fall or stroke that puts her over the edge into complex care.  Once there, she will be one of those people who strikes out at everyone, and is mean and hateful because she is angry and wants vengeance for being "put in a home".

Be mindful and live in the present.  I know.  It all just hurts so much.  It doesn't have to be this way.  But the BPD makes it this way.  All this started because her doctor was just doing his job.  Doing his job conflicts with having her needs met, which was to sign off on her driver's medical and say she was fit and healthy for driving, with no road test needed.

[pursuingJoy]

oh M. Hugs to you. I agree that you're not likely to be successful in guiding her towards reality. Not looking forward to the chaos it will create when my MIL approaches this stage.

Don't take on her emotions, M. Just because she's angry and anxious doesn't mean you need to feel that way too. 

After telling me the lasagne was good, she also add's "that's all I ate".

For some reason this comment irks me. It's like a constant drip drip that never stops - even in response to something nice, she has to bring it back to her frailty. Sometimes I want an eye roll emoji.

Meanwhile, her flying monkey has started leaving me messages "_____ asked me to call you and tell you_________".  If/when I ever see her, I will suggest she remind mom she can pass those messages on to me firsthand.

Yeah no, person-who-is-over-involved, you can communicate directly with the individual you're trying to help. Can you call this person and express your preference that she talk directly to your mom?

My H says (and I agree) that it will be a critical fall or stroke that puts her over the edge into complex care. 

This will be my MIL too. Sigh.

[GaGrl]

Such a difficult period...you've been there awhile and seen the worst of it coming. It definitely will continue to get worse.

Much of the medical condition report by the doctor will hinge on the macular degeneration. Eventually, your mom will lose central sight and have only peripheral vision. My mom was virtually blind ,5-6 years after being diagnosed with macular degeneration. She was extremely frustrated by its limitations. Still, and made the decision to quit driving on her own (glad I didn't have to convince her!).

I would let her doctors be the bearers of bad news.

[Woolspinner2000]

Methuen,

What a time of turmoil for you! I'm so sorry. I can only imagine how hard it is to be faced with the thought of losing your ability to drive, but it really sounds like she shouldn't be driving. Her reaction reminds me so much of my uBPDm. Any perceived threat to take away any of her independence or put her in a place where she wouldn't be seen in a good light would be akin to war against her. I once told my T that it's like they become a hurricane force gale and there's no place to get safe from those rages.

The best you can do is let the doctor and others in authority take the brunt of the force, and for you to stay as safe as you can and out of the line of fire.

Is it possible for you to always have someone with you when you go to see your mom from now on? Perhaps someone she likes? Typically those with BPD won't unload on you if you're with someone that thinks she's wonderful. It might be a good protection for you. A pwBPD doesn't often show their true colors to those outside of the family. At least that's how my mom was.

 
Wools

[GaGrl]

Although my mom had a few BPD traits, she was not nearly as difficult as her uBPD/NPD stepmother eventually was re: aging. My mom trusted that I would act in her best interest. All accounts were joint with me, and she had put funds in my name to be used for her elder care.

What I found most difficult was not taking it personally when she was frustrated and rebelled at her restrictions. She had a lot of free-floating anger, not aimed at me per se but definitely creating a tense and angry atmosphere.

I learned to validate better in dealing with my mom than with any other relationship. (Fortunately, I'm not the one who deals with H's ex, aka The Dark Princess, but God help my stepdaughter when her mother ages.)

[Notwendy]

Methuen-

I understand the dynamics even though my mother doesn't live near me- so she has other people do some of the things you and your H do for your mother. I honestly don't think I could do all that you two do as often as you do them. My mother treats her home health helpers, and her own kids like this too. It's interesting to see her engage in the same dynamics with them as she does us, but it's also demoralizing to not have your efforts acknowledged.

My parents have been cared for by the same doctor for decades. I have known him for a while since I did go to some appointments with my father as my father got older to help him recall what to do. It's interesting that my father was open about his medical care with us. BPD mom was not. It's only recently that she signed consents for him to speak to us. But like you, I know her doctor has a good reputation.

However, BPD mom has been telling me how terrible he is and how she thinks she's getting terrible medical care. She's not. What's interesting is that one of her family members called me recently during the time she said she wasn't feeling well to ask about it, and I replied that I think her doctor has treated the problem and it seems to be getting better.  The reply was interesting. " but the doctor is incompetent isn't he?" To that, I replied " not at all, he's a good doctor". So she's been telling them the same thing.

She also tells me how terrible her home health helpers are, and then when we visit, we also got to hear about how we upset her too and I get your frustration because this is how she perceives things- and we can not change that.

I understand the concerns about the driving. We had similar fears about my father driving when he was older. My mother doesn't drive.  We did try to intervene and there was nothing we could do about it but pray nobody is harmed by it. That's in the hands of the legal system. BPD mom also feels empowered when she tells someone off and they go along with her- receptionists don't want to deal with that.

My mother also would not accept an assisted living situation. She's not going to comply with that. You and your H are far more helpful to your mother than I am.  When I do help, it's demoralizing and I know it has to feel that way for you since you do so much. I know it's not personal though. It's sad to know that this is how she perceives things.

Take care of you  

[GaGrl]

Methuen, do you think your mother is trying to maneuver you into having her life with you? You may need to clarify again to her that isn't an option.

[Notwendy]

The difficulty with this situation ( like my mother as well) is that, emotionally they need the constant attention and supervision of a small child, but are also legal adults and are used to having the control that a legal adult has.

What my mother needs emotionally is constant attention and someone to attend to her needs at all times. One would not leave a toddler unsupervised. But with a toddler, the adult is in control. With my mother, it's the opposite, she's in control and prefers to tell others what to do.

Comparatively speaking, the material needs are easier to meet than the emotional needs. My mother has a place to live, she has food, clothing, health care. It's the huge and constant ( and seemingly impossible to meet) emotional needs that are challenging.

Methuen, you are providing a lot of needs for your mother and I understand it would feel good to know that it has meaning, but I think the emotional needs are overwhelming. I think we can only do the best we can reasonably do.

[Turkish]

She sounds like she shouldn't be driving. The last time my mom visited us in the city, I had to physically stop her truck from rolling backwards when she put in the clutch or it would have hit the car parked behind her.

Two to three years later, I didn't have the guts to call DMV to lodge a complaint, but a few people in her small mountain community did, and she was sent a notice to get tested, which she failed. She parked the truck and took the bus.

I knew that she no longer should have been driving, yet I felt like I would have been betraying her if I'd turned her in. Even anonymously, I should have, to keep others safe.

[Methuen]

Thanks everyone for the support and the hugs.

Don't take on her emotions, M. Just because she's angry and anxious doesn't mean you need to feel that way too.  

Thanks PJ.  I know this, but because I'm in the eye of the storm, the reminder is good for me. I needed that.

After telling me the lasagne was good, she also add's "that's all I ate".  For some reason this comment irks me. It's like a constant drip drip that never stops - even in response to something nice, she has to bring it back to her frailty.

Thanks for "getting it".  I get a daily dose of this  .  Really.  I ignore all of it.  But it still wears me down.  

Much of the medical condition report by the doctor will hinge on the macular degeneration. Eventually, your mom will lose central sight and have only peripheral vision.

One would think.  Mom's been getting macular degeneration shots in both eyes for over 5 years now.  I drive her to those appointments.  They're difficult for her because she's such a nervous person, and her "shaking" gets worse, making it harder for the doctor to give her the shots in her eye.  The way mom described it, it was probably both a cognitive test, and maybe a motor skill test she failed.  The first test had numbers (1-26) and letters (A-Z) and she had to match them.  She said she couldn't do it because she couldn't see it.  Who knows if that was the problem.  It's also possible she didn't get the pattern until after it was over, or he explained it.  The second test he had her hold something with her Parkinson's hand (the one that shakes constantly), and then she couldn't articulate to me what she was supposed to do with it.  But she was MAD as H_ _ _ _ that he had her do that test.  She thought it was terribly unfair.

Any perceived threat to take away any of her independence or put her in a place where she wouldn't be seen in a good light would be akin to war against her.

Bingo! WAR!  And my borderline just loves a good fight.  It energizes her and gives her an adrenaline rush.  

The best you can do is let the doctor and others in authority take the brunt of the force, and for you to stay as safe as you can and out of the line of fire.

Agreed.  The doctor is doing his job, and I'm just going to quietly let this play out, and protect myself as best as I can.

Is it possible for you to always have someone with you when you go to see your mom from now on?  Perhaps someone she likes? A pwBPD doesn't often show their true colors to those outside of the family.

This is helpful.  I've been doing this to a degree for almost two years already, when my mom is dysregulating. The person most willing and available is my H.  I really don't have anyone else I can ask.  Her friends are all as old as she is, and have their own issues, so I don't want to impose.  There's an ick factor to asking my friends.  I have a lot of gratitude for having an H who is so understanding, supportive, and helpful.  

She also tells me how terrible her home health helpers are, and then when we visit, we also got to hear about how we upset her too and I get your frustration because this is how she perceives things- and we can not change that.

Isn't this the truth.

Methuen, do you think your mother is trying to maneuver you into having her life with you?

Even if she's not intentionally maneuvering, it's still a goal. This is a nonstarter.  H has told her "No" in the past.  He will do so again if she brings it up. She's tested me with less direct conversations, but I will NEVER take that bait.

The difficulty with this situation ( like my mother as well) is that, emotionally they need the constant attention and supervision of a small child, but are also legal adults and are used to having the control that a legal adult has.

This is spot on.  Thanks for articulating it.

I didn't have the guts to call DMV to lodge a complaint, but a few people in her small mountain community did, and she was sent a notice to get tested, which she failed. She parked the truck and took the bus.

I am curious about her parking the truck and taking the bus.  Did she do this without a big fight?  My mom is too handicapped to take the bus.  It would be far too much effort, and most importantly, she doesn't want anyone to see how much she struggles.  Image, right?  Instead she gets her needs met by obligating people to take her where she wants/needs to go, even now when she still has her license to drive.  She also benefits from the attention of having someone she likes come to pick her up.

S26 has been home for a week on a working visit (he can work remotely).  Yesterday we took a drive for an outing for the day.  The separation from mom was fantastic for me.  Everytime thoughts of her crept into my mind, I pushed them away and focussed on being in the moment.  That happened quite a few times.  She's taking up a lot of real estate in my brain.

The support you are all offering is really helpful.  Thank goodness for this community.

[GaGrl]

Is it possible for you to have a conversation with her ophthalmologist about her ability to drive? If you state your concern with a few exampkes, the doctor might take the lead on that at the next appointment.

My mom took a four-month series of eye injections before she admitted they didn't help enough for her to continue driving. She then had a caregiver two days a week to take her to appointments.

Another thought -- would she tolerate (or vice versa) a live-in caregiver -- room and board plus a small salary for X hours of caregiving a week?

[Turkish]

I was 130 miles away so I'm not sure how recalcitrant she was about having her license revoked. Months later after I picked her up to live with us and had my buddy take her truck to his house so it wouldn't get stolen, she said we'd stolen it and got into my face and threatened me with a lawyer.

[Methuen]

Is it possible for you to have a conversation with her ophthalmologist about her ability to drive?

My mom took a four-month series of eye injections before she admitted they didn't help enough for her to continue driving. She then had a caregiver two days a week to take her to appointments.

Another thought -- would she tolerate (or vice versa) a live-in caregiver -- room and board plus a small salary for X hours of caregiving a week?

I've thought about having a convo with her ophthalmologist, but since I've already had conversations with her doctor (and he has just recently done a medical and recommended she do a driving test before a license renewal), I've decided I'm not comfortable with the risk.  Her doctor is onto her driving because of multiple disclosures I have made to him. The ophthalmologist has no knowledge of the dynamic, and if she absentmindedly commented to mom "I've heard you are still driving", life as I know it now would be over.  This kind of slip should never happen I know, but once bit, twice shy.  It's happened to me in the past, many years ago.  I'm just too fearful of the potential for things to go bad.  It's bad enough now.

I'm curious - the caregiver that drove your mom to appointments, was that a friend who volunteered, or was it provided through  insurance monies, or did she pay for it?

As for paid caregiving, that is going to be an option.  Live-in really isn't an option, because her house is very small (she has a fettish for all things small) with only 2 bedrooms, and the second bedroom is her "craft" room, although she isn't really strong enough to do much with her crafts any more.  Home care or paid caregiving are probably the best options.

The problem is that as BPD, she will view my not doing all those things for her, as not loving her enough.  She has issues with not feeling lovable - in my opinion.  She has told me many stories of adult children who "have taken such good care of their parents".  One of them committed suicide recently, about a year after her mother died.  My mom's interpretation of that is that her life wasn't worth living without her mother any more.  I could tell she liked that narrative.  It felt like a direct challenge to me.

Since the blow out with her doctor, she seems to be spiralling.  She's not eating.  Her stomach is acting up.  She's nauseated all the time.  Two days ago, S26, H and I went for a drive for a day.  Yesterday she told me she had driven to town to get her Andansetron (anti-emetic) for her nausea (the day we were gone).  She had to wait 20 min. at one place, and 20 min at another place.  "It killed her".  S26 was visiting her yesterday afternoon.  She was so nauseated, S26 said she couldn't stand up.  So she took an andansetron.  She said to me (when we were at her house later cs we brought supper to have with her and S26 at her request) "Andansetron is the drug they use for cancer treatment patients".  The message was clear to me on several levels.  It was said very deliberately.

I have been down this road with her so many times before with the nausea.  About 4 years ago, she wore a gravol patch on her neck for about 2 years straight.  She has a prescription for Pantaprazole (for her stomach), but I suspect she may have stopped taking it some time ago, because last night she said "she was going to have to go back to looking after her stomach".  I never know what she's up to because she doesn't know how to talk straight, and she doesn't normally tell the truth.  Her "truth" is whatever she wants you to hear.

Turkish, your story about your mother accusing you of stealing her truck doesn't surprise me.  I see creeping signs of paranoia in my mom.

[GaGrl]

Methuen, my parents had a woman from their church start housecleaning for them about 12 years ago, just one day a week. As they aged and needed more help, she was available as needed. She was a CNA and was able to help with meds and my dad's oxygen.

We had bought our retirement house but knew we wouldn't move into it for 3-5 years, but hoped we could persuade my parents to sell their house and move into our retirement house, which was much closer to their doctors than the rural area they lived. But no way Dad was going to move (talk about stubborn). So after he died at age 93 in home hospice, Mom did sell and move into our house. At that time, the caregiver started coming to the house two half-days a week. Dad left Mom financially secure, so she paid for the combination of cleaning, laundry, driving, shopping, and some personal care like help with showers. We had not retired yet and lived 360 miles away.

After Mom came out of rehab into home health, we upped the caregiver to five mornings a week. I could not have handled it by myself. We had retired and cared for Mom for two years by then -- the physical demand doubled after her hospital ization.

Once a doctor certifies a patient as hospice ready, Medicare pays for much more, but the caregiving cost is still on the patient. I could not have done it by myself.

This is where long-term care policies are so valuable.

[Turkish]

She accused me of stealing her money which was investigated by APS, and my kids of getting into her portable file expander and stealing things. It's hard to feel betrayed even if there is a medical explanation.

[Notwendy]

Turkish, I agree. When my mother makes false accusations, it's very demoralizing. I think it's more a way of maintaining control. She doesn't want to share her financial information with us, so she accuses us of wanting her money because when she does this, we back off because the accusation is offensive to us.

We have an interest in knowing that she has adequate finances, because we know that dad left her with a comfortable income, and she has a history of excessive spending. We would like to see it go to her needs. The cost of care is considerable. When we do help her, she's verbally abusive and non cooperative. It's better that she hires people to do that.

This is different than helping an elderly and sometimes irritable parent. I recall helping my mother in law and she got a bit snippy with me. I imagine it wasn't comfortable needing someone to help and having to ask me. This wasn't her usual demeanor and I knew that. I can handle this kind of irritability. I know this can be common with elderly people.

With my mother, it's different, it's cruel and hurtful, name calling and humiliating. it's not an accidental slip when being upset. It's intentional.  One can only tolerate this kind of verbal abuse so much. Although she gets into these dynamics with her home helpers, it's less than when with us.

She knows we don't want to take her money. However, we would like to know she's doing OK financially. We realize she won't share that information with us for whatever reason, and accusing us of wanting to take it is her way of keeping us from asking.

[Methuen]

Update: after her doctor's appt where she failed the driver's medical, I suggested she could think about booking some driver's lessons to give her confidence and then do the exam.  She was all over that, and even called the driving school.  She was reactive, and determined to show the doctor he was wrong.

Today she said "I can't do a driving exam".  It only took her two weeks to process that.

The truth is she probably couldn't have done a driving exam 30 years ago.  Today she struggled to make a phone call for an appointment. Her nerves are so shot, the stress of phoning to make an appointment was too much (she has a Parkinson shake in her right arm which gets worse when she's excited or nervous), so she stuttered and couldn't get her words out (related to TIA damage).  She had to try 3 times (3 different phone calls).  She has difficulty explaining what she wants.  She isn't really living in the reality of her condition, so I supported her by being there beside her, but not doing it for her.  It was difficult to watch.  But I commended her for getting it done at the end.  She managed to navigate a phone call to get her vaccine passport recently, so when she wants something, and there's no one there to boss around to do it for her, she gets it done.  She wants to live independently, and refuses to consider assisted living, which she qualified for a few years ago.  It feels like tough love with her, but she is so difficult and impossible, I feel I have no choice but to encourage her to demonstrate her independence (eg make her own phone call), and not enable her dependence (make the phone call for her which is what she wanted me to do)...

The truth is, she's been living assisted for years, thanks to us (and to some degree from other people she knows).

After that, the next thing out of her mouth was "______(friend) is 91 and Dr ____ (same Dr as mom) passed her on her driver's medical!"  

She's still blaming the Dr for indirectly taking away her driver's license.

Later, the phone rings.  Her landline is two steps away from the chair she is sitting in.  But she asks me to go get her portable phone from the living room because she forgot to bring it into the kitchen with her walker.  She's essentially too lazy to walk 2 steps.  I said "Mom, your phone is two steps away." So she got up and took the two steps to answer her phone.  But it wasn't lost on me that she would rather order me into another room to fetch her portable, rather than take two steps to answer the landline, simply because I was there.  If I wasn't there, she would do what needed to be done to answer her phone.

She has fooled herself into believing she can drive as well as anybody.  She brags about her driving, and said she hasn't had an accident in her life.  That's a really big stretch, but I let it go.  What's the point?  Add to the conflict?   Heck no!  She has had numerous encounters with trees, other vehicles (including hit and run on her friend's car which a different friend told me about, but mom never took responsibility for) throughout her life etc.  Thankfully she's hit just about everything except a person.  But for some years now, she can't even turn her head to do shoulder checks any more.  Getting in and out of her car is a chore.  

Her awareness, processing time, reaction time, decision making...?

H and I think she will just let it slide - do nothing with the exam, and keep blaming the doctor.  It may be months before dept of motor vehicles mails her a notice to book a driving exam to have her license renewed (Covid backlog).  Whenever it finally comes, she will do nothing.  She absolutely doesn't have the emotional capacity to do a driving exam, much pass all the required physical skills.

While I can't be sure, I suspect she hasn't driven since her doctor's appt.  The truth is, she hardly drives at all anymore.  She says it's too hard to gas up her own car, so she asks our son (golden child) to gas it up when he comes home for visits.  He's gassed it up about twice this year.  She didn't drive all last winter because she doesn't drive in the snow.  She started getting lost in the dark over 10 years ago, so she stopped driving in the dark too.  At least those were good decisions, but they're driven by her fear, not by rational thinking, or any awareness of her own abilities.

Meanwhile, at the end of the visit today, she said "if it wasn't for you I would ask for euthanasia".  

It was another terrible visit.  Kind of at my wits end.  



 

[pursuingJoy]

She managed to navigate a phone call to get her vaccine passport recently, so when she wants something, and there's no one there to boss around to do it for her, she gets it done.

This stands out. It is SO true of my MIL. She's a hot mess when there's a witness then finds energy reserves to pull of the 'impossible' when there isn't someone around to help.

Love that you're setting even small boundaries, like not picking up the phone for her, but is there any way to actually reduce the amount of time you're with her, at least temporarily? Can you claim illness (mental health, not that she needs to know that) and tag your husband or someone else in for a week or two until you feel better? I hear the anxiety and exhaustion and boy have I been there. Your nervous system needs a break, M. 

Meanwhile, at the end of the visit today, she said "if it wasn't for you I would ask for euthanasia".  

This just made my blood boil. What an awful thing to say to your child, and it's not even true. She exhibits MORE capacity when you're not there. So wrong.

[Notwendy]

I think losing the ability to drive is a huge blow to self image. Remember the excitement of getting the license- it meant independence. Losing it is the reverse of that, a visible sign of dependence and loss of control.

My BPD mother has not driven in years, yet still keeps a license and a car. We don't dare mention that she doesn't drive it, she gets furious, insists she could drive if she wants to. She hasn't, so we leave it at that.

Our mothers are similar in that, if someone else is there, she becomes helpless, but she's quite good at getting what she wants done, either herself of having someone else do things. But if I am there, I need to be waiting on her. Stairs are not easy for her but she can do them. Last time I was there, she asked me to come upstairs with her and at the top of the stairs, asked me to do down to the kitchen to get her water and bring it back up. Of course, I was not going to have her go down stairs and then up again for water, so I would do it, but I did wonder if she did that on purpose- waited for me to be upstairs to  ask.

Of course, it's not a big deal to bring an elderly parent water, or make a phone call. I would do that for anyone really. It's the dynamics of being ordered around. It fills some emotional need for her to have me be subservient to her, and that on some level makes these requests irritating. Visits with her consist of her telling me things to do for her. I don't mind helping, but it's the whole of the visit, as if it defines our relationship to her. She controls what we do when I visit.

That last comment, ew. I would not say anything back but it's upsetting.

[zachira]

Methuen,
The things your mother does to you and what she says to you are hurtful beyond words. I have found the only thing that really allowed me to heal fully from certain incidences in my life and not be so upset by the latest round of cruel behaviors of my family members was EMDR therapy. I was very sad when my therapist decided to not do EMDR anymore because too many clients were too dysregulated by it. A lot of what your mother says and does, are other forms of moving the goal posts so she can control you, yet the underlying messages seem to be similar.

[pursuingJoy]

Of course, it's not a big deal to bring an elderly parent water, or make a phone call. I would do that for anyone really. It's the dynamics of being ordered around. It fills some emotional need for her to have me be subservient to her, and that on some level makes these requests irritating. Visits with her consist of her telling me things to do for her. I don't mind helping, but it's the whole of the visit, as if it defines our relationship to her. She controls what we do when I visit.

I love the way you put this NW.

[Methuen]

PJ and NW

Meanwhile, at the end of the visit today, she said "if it wasn't for you I would ask for euthanasia".  

This just made my blood boil. What an awful thing to say to your child, and it's not even true.
That last comment, ew.

Until I joined this forum, I didn't really know the things my mother said to me weren't normal, because I was just so used to them, and she was "mom".  I just knew they made me feel bad, and I also knew I would never say things like that to other people.  It gives me relief to know you had reactions to this comment too.  Thank you for validating...  

Zachira:

The things your mother does to you and what she says to you are hurtful beyond words.

Thank you for this.  Again the validation is so helpful.  On another note, I am sorry to hear that your T has discontinued the EMDR therapy, which you found so helpful.  It is curious that s/he has discontinued it with all his/her clients, even though other clients such as yourself found it so helpful. I've read up on it a few times, and it seems an accepted therapy.

Of course, it's not a big deal to bring an elderly parent water, or make a phone call. I would do that for anyone really. It's the dynamics of being ordered around. It fills some emotional need for her to have me be subservient to her, and that on some level makes these requests irritating. Visits with her consist of her telling me things to do for her. I don't mind helping, but it's the whole of the visit, as if it defines our relationship to her. She controls what we do when I visit.

It's absolutely about control.  Whilst I'm getting better at setting boundaries, using SET and validation... etc. to manage her feelings and controlling behavior, I still make slips which I'm not even aware of in the moment, and fall back into trying to be the daughter she wants.

Very recently, she told me she wanted a DNR on her medical file.  
Me: how will you do that?
Mom: you call the doctor for an appt.
Me: I can help you make the appt.

Later -
Me to H: When I help her make the appt, can I make it for a Thursday? (I work on Thursday, and this means H would take her to Dr).
H: Yes

Next-
About a week later, I assisted mom with the phone call to make the appt, the doctor's office offered a Thursday.  I replied that I worked that day, so could we do it any other day?

As I reflect on this, I suspect that I fell back into caretaking mode (which I've been programmed to do over a lifetime), and I "lost" the awareness I had to schedule a Thursday appt so that H could take her.  Did I just completely forgot about it because I slipped back into caretaking mode?  

How does that even happen?  It's not like I don't know better. I'm just stunned (and annoyed) that it even happened.  Is this programming?  Brainwashing?  

Getting back to control...

So now the appointment is on a Monday, but it's a phone appt (his nurse said this could be done by phone).  H can still go so that mom can't put me in the position of demanding "I tell the Dr she wants a DNR".  What could the optics of that be?  But now I have lost my excuse of being at work that day.  I think this is a demonstration of just how much power she still has over me, and how I was groomed into the caretaking role as a child, a young adult, and throughout my whole life.  I have worked so hard at detaching with love, and setting boundaries and learning to take care of myself, but I slipped up big time, and had zero awareness of it in that moment.  Reflecting, it's just unbelievable I screwed that up...

[Notwendy]

Caring for an elderly parent is an important ethical value.  It's an expectation of society and also major religions. The difference in our families is the degree of co-dependency we were conditioned with, to be a caregiver to the point of neglecting ourselves. I think with a normal parent- child relationship, there'd be some reciprocal caring. Not caregiving at this point, but some genuine concern on the part of the parent for the adult child's well being so that the adult child is not expected to neglect their own basic needs to provide care for the parent.

I also fully expected to help my parents. What made me consider the situation was a complete lack of concern for my own physical well being when my father was ill. They did not care if I got sleep, or had to drive after not getting enough sleep. They did not care that I left my own children with a sitter to come help them. I would have done this regardless but at some point I needed to get home to the children. I know this was a stressful time for them and didn't expect much but there was no acting like I was a daughter to them/

Not that I expected gratitude, but instead there was so much verbal and emotional abuse, I began to feel physically affected. And no matter what I did, it was not enough. I realized that no matter what I did, it would not ever be enough.

I learned through working on co-dependency that I was allowed to take care of myself and that while it's a good thing to help- we are not required to allow people to abuse us.

I began having boundaries and they were angry about it. I was sad to disappoint my father. I didn't want to do that. Like you, Methuen, I grew up thinking the way we were was "normal".

[Methuen]

is there any way to actually reduce the amount of time you're with her, at least temporarily?

So, the last visit was Wednesday, and it was a terrible visit.  Thursday I worked.  Yesterday was a chore and project day at home.  Today I received this text:

Mom:  "I gathered up a bucket of plums, and missed falling so many time.  They were perfect and there are still some on the tree.  I can't risk falling."

This just makes me boil with frustration.  What she is telling us, is that we haven't picked her plums yet for her.  Two years ago she fell under her plum tree and was in a wheelchair for 3 months healing from multiple fractures.  We've been picking her  plums for 15 years.  We're busy.  We also need a break...

 Help!  Do I ignore this?  What should I say?

[Notwendy]

Isn't that a passive no win statement.

Perhaps it's time to consider hiring out some of the tasks you do. It will cost some, but if you can do it, I think it will help you keep some boundaries. Someone could mow her lawn, pick her plums and do some of these tasks that you do.

Once there was a family event and I knew that my mother would need assistance. I was willing to help, but I imagined that she would need someone with her the whole time, and if I did it, I would miss most of it- I would not be able to see other family members or friends, or enjoy the dinner conversation as I would need to be meeting my mother's needs. I feared she would not accept any other help, but I found a nice companion, a few years younger than she is, who assists elderly people. This lady was wonderful and got along well with my mother. She could assist my mother with basic needs, which allowed me to visit with everyone, including my mother.

I am so glad I made that decision and it was well worth the expense for those few hours.

What can you hire out? Consider this an investment in your well being. Nice if your mother would contribute to regular care, but for the occasional assistance with tasks like lawn mowing, plum picking, maybe consider hiring someone to do that?

[GaGrl]

"I agree, Mom, you can't risk a fall. Since you got a Hicksville yourself, why don't you call _______ and ________ and tell them they can pick as many as they can use?"

[Turkish]

I know there are orange pickers on poles. Is there something similar for plums?

I remember telling my mom to stay off her roof to tarp it.  That was risky enough for me and my buddy (slippery, and the apex on the 1 story was high). Gravity doesn't care about tough old broads (as my mom used to refer to herself).

It was repeated falls and calls to EMS that resulted in the APS worker removing her from her property to regime into a single story strip motel room. It was actually nice, next to a creek.

[zachira]

All these stories sound so much like things my mother with BPD did. My mother had a badly injured leg she refused to keep elevated, despite the doctor telling her she could lose her leg. Eventually the doctor put her in a nursing home for couple of weeks with the staff continually reminding her to keep her leg elevated.

[Methuen]

we were conditioned to be a caregiver to the point of neglecting ourselves. I think with a normal parent- child relationship, there'd be some reciprocal caring. Not caregiving at this point, but some genuine concern on the part of the parent for the adult child's well being so that the adult child is not expected to neglect their own basic needs to provide care for the parent.

 Yes.  I would assume my mom cares about me, but there is nothing in her words or behavior that demonstrates this.  I have stopped looking for it.  I once shared with her that whilst she has back problems, they didn't start until she was in her 70's.  Mine started in my 50's - twenty years earlier.  Instead of empathy, I got a look that said "why are you telling me this?"  Of course she would have found that invalidating, but I didn't know about BPD back then, and had no clue about her disease.  My mom's demands and FOG are all about her needs.  It all equates to love.  If we don't do something she wants on time, we don't love her enough.  

We ignored her text for now.  To buy time.  H said he will tell her that she can invite her friends or their families to pick her plums.  Thanks GaGrl.  Such a simple solution, but being inside the eye of the storm, I couldn't think of it...

I know there are orange pickers on poles. Is there something similar for plums?

This made me laugh a little bit Turkish.  Thank you for that.  If my mom looked up, she would fall over.  That's how bad her balance is.  She can't stand still unsupported any more.

I remember telling my mom to stay off her roof to tarp it.  That was risky enough for me and my buddy (slippery, and the apex on the 1 story was high).

This sounds like my mom. Their brain isn't wired up to think or care about consequences right?  My mom is such a hazard to herself too.  Several years ago, home care suggested she get a Lifeline as she lives independently in her home.  She got the Lifeline, but has refused to ever wear it.  It sits in a drawer.

It was repeated falls and calls to EMS that resulted in the APS worker removing her from her property to regime into a single story strip motel room. It was actually nice, next to a creek.

 My mom would say "I walk to the creek every day".  I can't fall in.

Perhaps it's time to consider hiring out some of the tasks you do.

You are right, I think it is time to do more of this.  She already has a housekeeper, and a gardener.  We do everything else, and I wouldn't mind doing them, but the passive/aggressive and controlling texts and comments are becoming too much alongside all we do.  It's clear that despite everything we do, it's never enough.  In her mind, doing less (eg not picking the plums we've always picked) will equate to her not being loved.  Being "abandoned".

My mother had a badly injured leg she refused to keep elevated, despite the doctor telling her she could lose her leg.

Yep.  My mom too, has spent her life doing "what she wants", rather than what is safe, healthy, right, or simply good decision making.  

Mom has really been inside my head more than usual since she failed the driver's medical exam.  I'm having trouble sleeping again.  I'm doing my self care, but this stretch is tough.  D24 called home last night after FaceTiming with her gramma, who disclosed she had failed her driver's medical.  She's two clinicals away from finishing her physiotherapy degree.  Everyone agrees that it's just a waiting game for the next catastrophic fall, and then dealing with the aftermath.  She will blame everyone around her, which translates to more abuse.

It's hard to manage the anxiety, and not let her take up real estate in my brain.  The whole situation is going to keep getting worse.  It's like the train is racing towards an oncoming train, and the brake is not working, and there is nothing to do but wait for it, and then deal with the crash.
 

[Notwendy]

Yep.  My mom too, has spent her life doing "what she wants", rather than what is safe, healthy, right, or simply good decision making.  


I understand and your train analogy is how we have thought about it too. We have tried to be proactive and yet, she does what she wants, when she wants, and we don't really know much about what she does. We realize that we just don't have the ability to manage what she does, and so hope for the best and realize we are dealing with an unknown situation.

It is anxiety producing as it's now how we'd manage things. It's also an example of why assisted living is not a workable option and really, it's their choice. I think what is needed for you is to decide what you can do for her and what needs to be hired out.

It's interesting that you have no signs of caring from your mother. I don't either but I no longer believe she cares either. I respect that she is my mother, and that ethically that relationship is significant, but I don't have any expectations that she feels a connection with me. I don't wish any harm to her, I hope she stays well, and I will do what I can for her, but she's in charge of her decisions.

[Turkish]

It's interesting that you have no signs of caring from your mother. I don't either but I no longer believe she cares either. I respect that she is my mother, and that ethically that relationship is significant, but I don't have any expectations that she feels a connection with me. I don't wish any harm to her, I hope she stays well, and I will do what I can for her, but she's in charge of her decisions.

This sums up where I ended up.

Many months, maybe a year, before I took her to live with us, I traveled up to her county to see how she was doing. I stopped at the local General store and she pulled up. She cried, "I thought that you had abandoned me! Everyone else did." I felt compassion, but also obligation. Some of her friends did take advantage of her. Like the ones that "borrowed" her shotgun (illegal) but she bought it at a garage sale (illegal), so I didn't pursue it.  

I almost cut off from her when I was 18 and she was in the midst of a major breakdown, but thought "this is my mother, I have no one else and neither does she." That was when she was 50 and still tough, physically. She screwed up any financial aid I could have gotten because she kept claiming me on her taxes even though her support was only $1200/ year around 1990. That's not me as a dependant. But... obligation.

[GaGrl]

My mother was disinherited by her stepmother. So (step grandmother) had married my grandfather at age 18 -- grandad was 32, my mother was 6. SM had been in an abusive household and had already had an earlier marriage annulled when she was 16 -- I do empathize with her difficult family roots.

But she took on my mother 's parenting and then did an abysmal job of it.

My mother tried to support her after Grandad's death, but she was not allowed -- even though my mom was sure there was no assets to be left to her. SGM had never legally adopted my mom, so Mom had no legal standing. No one else in her blood family was willing to take on legal responsibility for end of life decisions.

In the end, SGM lingered in hospital for 5-6 weeks on life support because no one had a clear ability to make a decision. It was horrible.

I first disliked her, then actively hated her. It has been a difficult relationship to overcome. The damage to my mother was unspeakable.

[Methuen]

I am so so tired.  

We suggested to mom she invite her friends to come pick her plums.
M: "no need.  I swept them up yesterday.  They are toast. Last night my heart gave me a bad time".
Us: "Do you need to see Dr?  What do you want to do?"
M: "NO (all caps) I don't.  After 15 min I was ok.

Yesterday:
M: "The plums are laying all over the ground under the tree".
Me: "I think they are going to have to stay there and turn to compost. We are busy with work and our renovation."
M: "I'll have to sweep them up".
Me: change of topic

Today (after delivering groceries to her):

Me: "How was your lunch with your friends today?"
M: "Not that great.  We got to talking, and we all agreed we would rather die than go into care".
Me: "Everybody gets to choose their own path.  H and I have talked about it, and agree that when our time comes, we will be OK to move into an assisted living suite where we can live independently, but with supports if we need them, so that we won't be lonely".  But everyone is different, and gets to make their own decisions.  
M: "they beat people in there".
Me: "I should go as I have to get my groceries home".

So tired.  It just never stops.  

[zachira]

So frustrating and so sad the conversations with your mother. In the last years of my mother's life, I let her initiate the conversations and I didn't reveal much about me, as I had pretty much accepted she really wasn't interested in me. It seems you are still trying to have back and forth conversations with your mother. I realize your situation is very different from mine, as your are in charge of your mother's care.

[Methuen]

So frustrating and so sad the conversations with your mother. In the last years of my mother's life, I let her initiate the conversations and I didn't reveal much about me, as I had pretty much accepted she really wasn't interested in me. It seems you are still trying to have back and forth conversations with your mother. I realize your situation is very different from mine, as your are in charge of your mother's care.

Yes the conversations with mom are all negative, and do make me very sad, frustrated, and despairing.  Like you, I also let mom initiate the conversations, which are always about her needs.  i.e. the plums.  It's making her crazy that we haven't come to pick them, because she can't stand seeing them on the ground, and, I suspect, also because she wasn't able to "control us" by "making" us come pick them this year.  One year we picked them, we had to store 1 case in her fridge, because our 3 "fruit tree fridges" were full (also with apples and pears), and when we had finished dehydrating the plums in our fridge, we went to her house to pick up the last case, and she had thrown them in the garbage (that's after nagging and nagging us to come pick them).

I would love to not have to be responsible for my mother's care when it's like this.  She hijacks my life.

[zachira]

This you have probably considered: Is there any way to hire a case manager to be totally in charge of your mother's care with the case manager directly interacting with your mother and the case manager letting you know what is relevant? I realize this is a shot in the dark, and not likely to be realistic. What would happen if suddenly you and your husband were literally unable to be responsible for your mother's care?

[Notwendy]

I agree with Zachira about getting someone like a case manager involved. Fortunately my BPD mother seems to like having other people help her, and really it's got to be that way. She treats them better than she treats me and sometimes she isn't nice to them either, but it doesn't hurt their feelings as much as they are not related to her.

Part of the hurt I think is that you are emotionally attached and wish things were different. I understand this but also have come to accept that there's no hope for the kind of relationship I wish things were, she is what she is.

It's almost as if she can't help herself. Even though I had not seen her in a long time due to Covid, it's as if no time had gone by and the visit didn't even seem to matter to her. I left thinking what's the point, but then I keep in mind - it mattered to me- as I would have felt bad about myself if I didn't see her. But also, I don't want to get into these interactions with her too frequently- they do hurt my feelings. I am not sure she cares or is even aware.

I have also stopped making any suggestions. She won't hear them and she won't do them. So for instance, your comment about how you might consider assisted living, this doesn't register with her. She's not going to consider it. My mother doesn't follow her doctor's advice sometimes. I have tried to reinforce it and say it's a good idea to follow his advice but it's useless, she won't hear it and won't do it. She'll then tell me the medicine he gave her doesn't work and then complain about him, but she doesn't take the medicine. I've learned to just say OK, and not say anything otherwise. She is critical of her helpers too. There's a pattern here. People can only help her if she lets them. All we can do is try the best we can.

[Methuen]

This you have probably considered: Is there any way to hire a case manager to be totally in charge of your mother's care with the case manager directly interacting with your mother and the case manager letting you know what is relevant? I realize this is a shot in the dark, and not likely to be realistic. What would happen if suddenly you and your husband were literally unable to be responsible for your mother's care?

I would love to hire a case manager.  Where I live, we have national health care.  Because my mom has had past falls, and I have stated to the emergency room doctor that I am not able to provide the level of care she needs after a fall, the doctors release her from hospital to publicly funded home care.  This was a difficult step for me to have to take.  Long nasty story.  But because she has had home care multiple times, she is "in the system" and has a "case manager".  But the case manager works with mom, not with me, although I have completely disclosed the situation to her confidentially.  They have sympathy, but mom would have to sign away control of her care.  She refuses to do that.  The case manager told me this is not unusual for some elderly people.  Generally, there has to be a catastrophic fall (with no recovery prognosis) and then they are released from hospital to a care facility instead of to her home.  After her second fall (under her plum tree) two years ago, there were discussions with the case worker and I and mom, around planning for the future.  Mom went nuclear.  The rest is history.     

Hence the comments "I would rather die than go to ______ (assisted living and/or care facility).

As to what would happen if H and I were suddenly unable to care for mom, she would then become a ward of the public health care system, and undoubtedly be assigned to assisted living, as she is completely unable to care for herself, with the exception of personal care (although I now also find I have to clean the toilet seat before I use it when at her house). 

I suspect even she can see what is coming.  Her mobility is terrible, her neurological symptoms are getting worse (Parkinson's), and her memory is declining.  I believe this is why failing her driver's medical was such an emotional trigger.  It was someone else giving her the objective facts that she can no longer deny.

[Turkish]

My mom said similar things, that she wanted to "die on the hill." She had 5 acres in the forest, a beautiful property aside from her hoard. She almost did die, but calling EMS for rescue after a fall finally resulted in her removal, legally. Then her brain partitioned, in a way, after she couldn't live in the long term residency motel and off to skilled care she went. After some adjustment of meds, she came to like it there.

[Methuen]

Then her brain partitioned, in a way, after she couldn't live in the long term residency motel and off to skilled care she went. After some adjustment of meds, she came to like it there.

Thank you Turkish.  This gives me some hope. 

[Notwendy]

I think losing control and accepting assistance is hard to deal with no matter what. I know it is common for elderly people to act out sometimes. The difference for me is that this isn't a new thing for my mother- the acting out may be over age related issues rather than other ones, and a long history of emotional and verbal abuse that continues. Being available to her becomes a cat and mouse game to her, that she is determined to win. I don't know if she realizes how she acts, because sometimes I think she is well aware of what she is doing playing on my own vulnerability. When you help her, she insults you. If you show any weakness, she makes fun of you. She's cruel. She's always been that way.

One reason I don't think my mother would do well in assisted living is that she does these things with her helpers, to a lesser degree, but insults them and acts out. She also doesn't cooperate with them or her medical team. She needs to be in charge, so suggesting things to her results in her not doing them to maintain control. She also lies a lot so we can't tell if what she tells us is true or not. She's hidden all her assets and any bills/debts from us so if we ever needed them to help her - to assist with bills or anything- we don't really know what she has or not so we could not assist with a budget. We know the approximate costs of assisted living but don't know what her coverage is. I have suggested she speak to a financial adviser but I don't know if she will or not, or if she has.

I can't help her, because helping her becomes a game to her. How can anyone have a discussion when she won't tell us or she lies and then insults us. When we visited, I arranged a nice meal with some of her family and she decided to pretend she wasn't coming and when I asked her to reconsider,  she then insulted me. At the last minute she decided to come. She didn't consider not coming in the first place. She was angry at me and so decided to be hurtful.

I think the sum of the difficulty is that good intentions get twisted and thwarted. We, her kids, don't visit with any bad intentions, or expectations of anything from her. But when our good intentions are perceived by her as bad ones, and she resists them and then gets verbally abusive, we don't know what to do. Another reason why I don't have hope for the relationship is that, as humans, we want to be "seen" for who we are. I don't know what sad trauma she is experiencing with us, but it's not us. We aren't doing that to her but I don't think she can see that. That's very sad for her and for us, but we can't change that for her. We do what we can but we are not effective help to her.

[zachira]

Methuen,
Would it possibly provide some relief if you had the right kind of person actually witness how your mother mistreats you and was there to help you then and immediately after she mistreats you? I don't think we can underestimate how much we our hurt by the cumulative emotional damage done by lifelong mistreatment by a BPD mother. You have said in the past that you could not find anybody to be with you most of the time when you are with your mother and your husband is finally more understanding of just how badly your mother treats you. You did say you had a therapist. Would it possibly make sense to make part of your therapy having your therapist accompany you to your mother's house and actually witness her behaviors and how you interact? I say this because I have noticed how having a witness that has empathy for how the victims of the abuse of my family members are affected has been extremely helpful for me in healing and moving forward. When I was a child and teenager, I noticed the sad expressions on other adults faces when I was abused by my mother. As an adult, distant cousins and family friends have been present when other family members abuse others, and have shown empathy for the victims. If none of this helpful, I am not offended and I hope I have not been disrespectful with my suggestions. I know the lifelong pain of dealing with the behaviors of a mother with BPD and trying to think what might help you. Every time, I read your posts all I can think of, is I hope it is not much longer that your mother is in her home, and you are stuck having so much contact with her. If your mother were in an assisted living or nursing home, there would be many witnesses to see how she interacts with you, and you could choose when to go see her, and have more ways to limit the types of contact with her that now are so distressing and exhausting. I realize your mother refuses to go to assisted living and there is little you can do about that right now, though she will likely be in assisted living or a nursing home soon because she is now unable to take care of herself without the help of you and your husband.

[GaGrl]

I read that your mother will go into assisted living only after mother call episode and only when a doctor tells her that you and your husband are physically incapable of providing the care she needs.

In fact, she may skip assisted living and end up needing skilled nursing care.

[pursuingJoy]

and then deal with the crash.

These six little words give me anxiety. I expect the same here. And because of their relationship, MIL and H will blame me for the entire crash because I 'didn't want MIL to live with us.'

It's got to be ok to still have boundaries, even after the crash, right? It is, after all, self induced. They make choices along the way that result in consequences. We love them, we wish them well, like NW said. But do we have to deal with the crash? Isn't it ok to allow some natural consequences to take place?

[GaGrl]

Yes -- the "crash." I think that even mentally stable older people have a negative reaction to the loss of control as they age. My mother, with a few BPD traits, keenly felt and resented her loss of independence and control. This was the root of our disagreements and her frustrations in the past 2-1/2 years of her life when she lived with us.

For pwBPD, who hang onto the control as strongly as they can, it sometimes takes a severe crisis for them to relinquish control in order to have the very minimum of their needs met.

Had my mother been fully BPD, I could not have had her life with us. It would have been impossible. It was hard enough as it was.

[Methuen]

When you help her, she insults you. If you show any weakness, she makes fun of you.

This jumped off the page at me.  It's really really disturbing.  

My mom shows flashes of that, but it's not a routine pattern of hers.

However, for years (since I was a child) my mom would tell everyone (friends or family or neighbours - it didn't matter) a story about how I bit into a glass ball decoration on the bottom of the Christmas tree as a baby.  She told it as if I was a stupid child to do that.  She thought it was a funny story.  She was making fun of me.  A few years ago, I had enough, and finally spoke up and said "well why did you hang it on the bottom of a tree where a crawling baby could find it?"  Since she told the story in front of visitors, I asked this question in front of the same group.   She couldn't blow up at me since there were people there.  She hasn't told the story since, so it seems like bouncing the ball back to her court may have been the thing that put the brakes on that particular story.  The thrill of humiliating me, lost its lustre when it boomeranged back at her.  As long as I politely stayed quiet and let her enjoy her story, she kept telling it - for over 50 years.  

[Methuen]

" and then deal with the crash."
These six little words give me anxiety. I expect the same here. And because of their relationship, MIL and H will blame me for the entire crash because I 'didn't want MIL to live with us.'

Yes, odds are good for that PJ.  Anxiety yes. All we can do are the things we are already doing.  But it's really really wearing and taxing.

Your H is super lucky to have you.

[Methuen]

In fact, she may skip assisted living and end up needing skilled nursing care.

Agreed.  So sad - and unnecessary.  The assisted living facility here is a nice facility, has amazing people who work there, and my mom even knows one, and years ago used to say what a "special" person she was.  All that seems forgotten now.  It's not rational, which is what makes it so frustrating.  My mom is a social person - and loves having people around.  I know she's lonely in her house alone.  The decision is hers.  So are the consequences.  If she falls or has a stroke, it will be some time until someone finds her, whereas if she would wear her lifeline, she could push a button and get help.  So as you said PJ, it is OK for them to live with the natural consequences because the choices were theirs. Unfortunately though, the consequences for all of us on this forum also filter to the children/siblings (or children/siblings in-law) thanks to the toxic behavior that affects their closest relationships. Navigating that is like crisis management flying by the seat of your pants.

[Notwendy]

My mother tells a story about how, as a small child, I wouldn't share my cookie with a sibling. I guess, implying that I was so selfish. I was a little kid!

She seems to recount these childhood stories of things I did wrong, or didn't do- when they were decades ago.

She did says something to me that I never heard before. Once she was angry that I made something from her last cake mix and burned it, so I made another one from scratch. She said recently that it impressed her I could bake from scratch. She has not ever said this to me- it was decades ago. Strange, because she was angry at me at the time for "burning the cake on purpose".  I don't think this came from her. I think maybe a friend said something to her about how I could cook because it was totally out of character for her to say something like that. My mother doesn't bake, but I learned how to do that as a teen.

PJ - good question- why not let her deal with the consequences of a crash? I agree that natural consequences are the best way to learn and we let them happen as much as possible unless they are harmful. If a child forgets their homework, we don't bring it to them- we let them face the teacher, so they remember to bring it next time. But we still keep them from harmful things. We are not responsible for our BPD mothers' choices, but also at their age, it also would involve how much we could manage, ethically. It's a fine line between enabling, leaving them to their own choices, or neglect at their age. We also can't watch them all the time- and if they decide to try to do something like pick plums, we can't avoid that, but we hope they don't take that risk.

[Methuen]

It's a fine line between enabling, leaving them to their own choices, or neglect at their age. We also can't watch them all the time- and if they decide to try to do something like pick plums, we can't avoid that, but we hope they don't take that risk.

The word "neglect" has tripped me up.  I'm very familiar with what neglect means in the legal sense.  But is the "fine line" you are referring to this:

On one side of the line is their autonomy and independent choices as adults with the natural consequences which follow (such as choosing to take the risk to pick up plums from under the same tree where you fell previously which resulted in 4 fractures, home care, and 3 months in a wheelchair, but you choose to take this risk anyway with the full knowledge that you have been assessed by experts to have a high risk of falling).

On the other side of the line is the right of other people to take away your autonomy as an adult, and commit you to an institution for safety reasons, against your will, because your choices and behavior could be deemed to be a risk to yourself.  Could failing to commit someone in this way be considered "neglect"? Or could the "system" be neglecting her?

Or are you referring to some other line, that I'm perhaps not thinking about yet?

I must admit I am struggling with this word neglect in this context, and what it could mean.

My mom has been assessed by our health care system, and been deemed to have the mental capacity to make her own choices, including where she lives.

I see and know things that the people doing those 1 hr assessments don't have a clue about.  I have enlightened them confidentially, and shared the situation as I see it.  They have been empathetic in most cases, but until her situation worsens, or the assessment tool changes and she is deemed to not have capacity, there is little anyone can do to "keep her safe from herself", as long as she chooses to live independently.  In fact one of the people I spoke to confidentially (an elderly services consultant who works for our local public health)  suggested I have suffered emotional abuse, and could even have PTSD.  So I'm confident she got an accurate picture of the dynamic.

As GaGrl suggested, mom has very likely been manipulating and maneuvering to FOG and ply me with guilt, with the goal of coming to live with us.  Our firm boundary is "no" on that issue.  Our life as a married couple would be over.  We would become her servants.  There would be 24/7 chaos.  Our freedom would come to an end.  Few people outside of this community can empathize with what would result. There would be an implosion.

So if she chooses to decline the opportunity offered by our health care system to go into assisted living, and continues to make her own autonomous choices including putting herself into risky positions such as raking up her plums from under her plum tree, and I am aware she is making risky choices, am I neglecting her?

Because that possibility terrifies me...

Somebody please clarify.

[Woolspinner2000]

Hi Methuen,

I don't think It's considered neglect at all when a person has been determined to be mentally and physically competent to live independently and take care of themselves. Typically I think neglect is when you live with someone and don't provide for their physical needs and care which can be seen in elder abuse. Be at ease that you are not neglecting your mom just because of limiting your connection with her. Hopefully others will chime in as well. I know that Turkish went through quite a lot with his mom.

 
Wools

[GaGrl]

NotWendy had a point a while back that I have always temembered. Her mother had been assessed, and she was told, " Your mother is mentally capable of making her own poor decisions."

You are not neglecting your mother. You are, right now, going over and above.

I hear what you say about the results of your mother living with you. My mother was in her 90s when I retired, and the next 2-1/2 years were difficult on our marriage. My husband is a saint. So...that isn't an option.

You certainly can clearly and bluntly express your opinion, your concerns, and your preferences to your mother regarding her ongoing care -- both to your mother and to her medical team. Once you've done that, remember...

She is mentally capable of making her own poor decisions.

[Turkish]

The APS social worker told me that my mother was an independent entity, free to live as she chose, no matter how poorly we all thought that was. "We can't just go grab her from her property she has rights."

My therapist told me, "you have a home. You're not a hospital and that's what she needs." Supervision not to wander off, medical care including medication to stabilize her hostility.

She threatened me with a lawyer (getting into my face as I was making lunch), told my neighbors that I was holding her against her will and that I and my little kids were stealing from her (the latter two things accusations of criminal elder abuse). She told both of those last things to cops from two different jurisdictions.  

I took her into my home in the dead of winter (she had no heat), likely saving her life.

It was so stressful to me that I broke down in the Chem lab at work and cried one day. Wolves don't cry. The hopelessness and guilt were overwhelming as well as FOG from a stranger who gave my mom a ride home one day after she lost her license, and my mom's former neighbor "frenemy" who berated me on the phone: "you need to DO something, she's your mom!"
The same lady also  at me.

It took me a while, but I finally realized that I can't control what I am unable to control. Who can do that? No one. It's not possible.

[Methuen]

Thank you for the responses, your points,  and reassurance.

I shared recent events  with my T yesterday.  Before I had even finished the story a laugh escaped her at one point, and she said “where’s the popcorn? This is more entertaining  than the movie I watched last night.”  I asked her too about neglect, and she promptly responded by listing everything I do for her, and adamantly confirmed it was not neglect.

Of course society may see it differently because they don’t know the dynamic or have all the facts, but probably believe they do.  

Today mom told me that one of her good friends and the H had come to rake up all the plums.  They filled the larg garbage can right to the top.

[Notwendy]

Well good. Glad someone else got the plums for her.

You do way more for your mother than I do. I suspect my mother's neighbors and friends think her kids are awful.

[Notwendy]

My mother set her med alert off in the middle of the night. Since I am the emergency call person ( and there are others on there too) they woke me up. I didn't get much sleep that night and later I called the ER and spoke to the nurse who checked her out and said she was OK. I went about the morning trying to get things done and then fell back asleep.

When I woke up, I got a call from my mother telling me how much I hurt her feelings by not calling her to ask how she was feeling. I explained that I had spoken to the nurse who told me she was OK and that I was not able to get to the phone after that.

Well then, she called me back to then tell me I should not have spoken to the nurse but to her instead.  I explained that her med alert woke me up in the middle of the night and I needed to get back to sleep and the nurse could assure me she was OK.

She then said " oh I told them not to call you at night but they don't listen to me" which is a lie because they call when they get the notice.

So, I called the service and took myself off their call list. I don't live near her. There is nothing I can do for her in the middle of the night. The service is there to assess her and make sure she gets what she needs. Her home health team is notified. They have my number and if they need to call me they will.

[Methuen]

Well then, she called me back to then tell me I should not have spoken to the nurse but to her instead.

Yep.  No matter what you do, it doesn't measure up, and it's never enough, or, never "right".

If you had called her directly, she probably would have criticized you for calling her when she was on her way to emergency, and said you should have called the hospital, since she wasn't well enough to take calls.

It's a lose-lose proposition.

You did what any reasonable person would do.

[Methuen]

I've been reflecting on this whole driver's licence drama with my mother, and I had a flashback to a story I heard my dad tell once, many years ago.

He and mom were newly married (this was 1961).  I can guarantee he did not know what he married, but what he knew of her he genuinely loved.  He was a gentle, kind, helpful person.  Anyways, mom did not have a driver's license.  My dad knew how to drive (he was actually a logging truck driver in those days), so they decided together he would give mom lessons, so she could drive and have her independence.  As I recall the story, he took mom out to a field somewhere.  The car was a standard.  They did some practice with shifting, and then they decided she was ready to learn how to "back up".  He went and stood a good distance behind the car to give her a place to back up to.  Well you can guess the rest of the story.  In true BPD form, she put the car in reverse and stomped on the gas with no feel at all, no care, and no sense of consequences.  He very narrowly missed being run over.  She thought it was funny.  Her was terrified.  He came to understand his new wife a lot that first year.
 She also threatened him once with a butcher's knife.  Twenty -six years later, I got married.  When H and I returned from our honeymoon, she picked us up from the airport.  She was so excited, that she forgot she was driving, and let off the gas right on the highway, and stopped the car right on the highway.  God bless my new husband, he stayed calm, and asked her if she didn't want to take us home please.

Let's just say that her driving never improved, because she didn't have the capacity to stay focussed while driving, or make good decisions.  

This past weekend when I visited her, she said to me:
"I haven't driven since I saw Dr ___.  It makes you not want to drive when Dr tells you could hit a child."

I replied that anyone would be sad to have to stop driving.  When we get our driver's license as a teenager it is a monumental milestone that gives us independence and freedom.  When we have to stop driving, we lose that same freedom, and so a sense of loss happens.  Anyone would be sad about that, and it happens to all of us.

She didn't say much, but I hope it was validating.  She didn't rage at me so that was good.
 What I got from the visit is that she is "processing" the loss of her driving.

Even though it's going to be more work for me driving her to more appointments, the roads are safer without her driving on them.  Our kids haven't driven with her since they were about 10 and 12 years old.  They are 24 and 26 now.

[Notwendy]

Methuen,
I think the increase in her leaning on you to drive her could be an extra toll on you. Driving my mother is stressful because, being alone in the car with her is an opportunity for her to start yelling at me. Being alone with my mother can be a set up, and it's better with other people around. I have had to tell her I will turn the car around if she keeps this up when we are driving, because I don't feel safe on the road driving as it distracts me.

My mother has gotten quite resourceful with finding people to drive her.. She's taken cabs, had her helpers drive her. I realize each exposure might be a Covid consideration, but she needs assistance. She's vaccinated, wears a mask in the car. It's working for her.

This might be an opportunity to introduce the idea of someone else helping your mother by looking into resources for transportation for her.

[Notwendy]

One reason I spoke to the nurse first, is that my mother often lies to me. She may call me up acting as if she's sick, and then call my sibling and act as if she is totally fine. We don't wish for her to feel badly, but can not tell what is actually going on with her.

It's very alarming to get a med alert call in the middle of the night and so, the first thing I wanted to do was to call the ER -because that is the best way to get accurate information. Once the nurse told me she was stable, and they were getting ready to send her home, I was reassured.

I guess she was upset that I didn't call her to show concern, but I would not be able to rely on what she tells me.

[GaGrl]

I agree that getting help with transportation would take a huge portion of carrying off you, Methuen.

We lived 360 miles away when my mom quit driving. She already had a caregiver coming in for light housekeeping and other household tasks, so she upped the visits to three mornings per week, and Mom made her doctor appointments so that her caregiver could drive her. Sometimes, a caregiver visit would be nothing but baking a cake or cookies.

When we retired and moved to our retirement house, where Mom had been living for three years, she asked if she should cut back on the caregiver visits, now that I was "home." The voice inside )…was screaming, " Oh my God, NO! " But I managed to quietly say that she was so helpful in so many ways, we should keep the 3x week schedule. By the time Mom was in hospice, she was coming 5 mornings a week plus coming over every evening for nighttime prep.

Now might be the time to find someone who can be a companion/caregiver for the long haul.

[Methuen]

One reason I spoke to the nurse first, is that my mother often lies to me…I guess she was upset that I didn't call her to show concern, but I would not be able to rely on what she tells me.

I get this.  It is the same with my mom.  Sometimes she is truly unwell from any number of things.  But sometimes like you say, she tells me something is wrong - like the earlier post where she texted her heart was making her unwell again.  This demands a response,  but as soon as I asked if she needed to see her doctor, she replied it was fine 15 min later.  So what was rhe point of telling me?  We think it’s all about a high need for attention. Speaking to the hospital nurse was what any reasonable person would do if they found out a parent went to the hospital.  The thing about BPD is that they always respond in whichever way necessary to create chaos, because chaos is their normal (my mom’s FOO was 24/7 chaos).  The difficulty for us is in that chaos they say things to control our feelings and take us down there with them.  Misery loves company.  I am sorry your mother said that to you, because words like that do permanent damage.  But you did nothing wrong.  

About the car and chauffeuring to appts:

This might be an opportunity to introduce the idea of someone else helping your mother by looking into resources for transportation for her.

You are right.  I have to look into this now.  We have something called a handi dart.  Boy is she going to push back hard on that.  I’m already dreading it.

[Methuen]

Now might be the time to find someone who can be a companion/caregiver for the long haul.

I am going to have to think on this.  There is no one that comes immediately to mind.  But it would be good for me to start thinking on this.

[Methuen]

What she has told me in the past (eg. after a fall when her needs including nursing care are higher) is that "she has friends who will help her if I won't do it".  She is even resistant to home care after a fall, and usually cancels it before she is ready.  

I can foresee that finding the right person to be a home companion would be a challenge.  Her friends are all in their 80's and 90's, so that isn't an option, and they would refuse to be paid anyways.  Even they might be uncomfortable with the "obligation" element as well.

She's also cheap.  

This will be tricky.  I will have to start making enquiries for info.

[Notwendy]

I think it would help you if  your mother used her resources to help herself ( which also helps you) if she has them. It's good to be frugal, but up to a point.

I guess I am fortunate in a way that my mother loves to spend money for her own needs and she loves to have people do things for her. I do wish she was a bit more careful to use it wisely, but hopefully she will continue to have enough for what she needs.

[GaGrl]

What she has told me in the past (eg. after a fall when her needs including nursing care are higher) is that "she has friends who will help her if I won't do it".  She is even resistant to home care after a fall, and usually cancels it before she is ready.  

I can foresee that finding the right person to be a home companion would be a challenge.  Her friends are all in their 80's and 90's, so that isn't an option, and they would refuse to be paid anyways.  Even they might be uncomfortable with the "obligation" element as well.

She's also cheap.  

This will be tricky.  I will have to start making enquiries for info.

It's not an easy task to find the right person.

Mom's caregiver is a member of the church Mom belonged to for almost 70 years -- she is my younger sister's age, and been in youth group and played league softball with her. CG is a CNA and had worked in a rehab facility, so we were confident of her abilities. The trust factor is huge -- this is someone you need to trust in your household, with personal and valuable items. I can imagine that, with a BPD, that level of trust would be difficult to achieve.

[Turkish]

My mom didn't trust anybody. More accurately, she trusted the wrong people. So many "friends" stole from her, including her shotgun. Which she bought at a garage sale illegally (California) so I didn't pursue it.

Yet I was the one who would steal her property and kick her into a nursing home, said to me 20 years ago, long before dementia set in. It really triggers me to impugn my character. My uBPDex also did the same thing. It's like they knew some secret about me that no one else in my life who knew me very well had ever suspected.

[Methuen]

It's not an easy task to find the right person...The trust factor is huge -- this is someone you need to trust in your household, with personal and valuable items. I can imagine that, with a BPD, that level of trust would be difficult to achieve.

Yes this is complicated.  Trust is one thing.  Another is the fact that I live in a small town and can't really ask too many questions or attempt to "sniff out" the right person for the right job...'cause in a small town, word would likely get back to mom.  That would be a disaster.

I'm thinking I need to find a way to make this her idea.  All the stars need to line up at just the right moment.

On another note, I'm sorry so that your mom put you through that Turkish.  BPD is truly a horrible disease.  Just horrible.

[Notwendy]

I guess in a way, I am fortunate because my mother loves to hire people to help her, but she's not happy about any of them. Some of them have stolen from her.  Yet, like Turkish's mother, she doesn't trust her own children. She also won't give us anything of value, and instead, people have stolen family valuables from her. She also gives things away to them that she won't give to us.

On the other hand, we are grateful she has people to take care of her.

I hope you are successful with finding help Methuen. You are right, if it's not her idea, it might not go over well. I hope you can convince her.

[zachira]

Methuen,
Don't  underestimate the knowledge of some of these home health care agencies whose staff are well trained and experienced in dealing with people like your mother. Unfortunately, there are many elderly people like your mother and the agencies dealing with the elderly are often quite familiar with them and know how to work with them. It is kind of like hiring a divorce lawyer that gets high conflict personalities.

[GaGrl]

Zachira, I agree. Professional caregivers with a good deal of experience have seen enough to have this amazing combination of empathy and the ability to not take words and behaviors personally -- they just roll with it while continuing to take care of the necessary tasks.

Methuen, what if you found three qualified caregivers and had your mother interview and select one? That could give her a sense of control.

Sooner or later, you'll need to have the conversation with your mother about your limitations in doing things for her. Don't let the FOG deep in on this! I think we all sense you are reaching a limit on your physical, mental, and emotional capacity.

[Methuen]

Methuen, what if you found three qualified caregivers and had your mother interview and select one? That could give her a sense of control.

This is a good idea for me to keep in mind.

Sooner or later, you'll need to have the conversation with your mother about your limitations in doing things for her. Don't let the FOG deep in on this! I think we all sense you are reaching a limit on your physical, mental, and emotional capacity.

Yes, you are right.  The conversation is coming.  I think when the time is right we will seize the opportunity.  The walking on eggshells never ends, because we are aware it is important to pick the right time.  Of course there's never a good time to have this conversation, but with pwBPD, there are better or worser times for sure. When she's dysregulating, I am at or beyond my capacity, because she is completely irrational, impossible, manipulative, relentless, and she strikes out by being vindictive and even hateful.  This becomes a living nightmare.  Failing the driver's medical invoked a trigger - like pouring a huge fuel tank of gas on a smouldering fire.  It's been about a month since that driver's medical, and after bringing her groceries yesterday, I am sensing that she is maybe coming to accept what it means for her (loss of driving independence).  

For me it means more waifiness.

We actually had a "visit" yesterday (an actual exchange of conversation topics), which I can't remember the last time that happened (years?), and talked about a few different things before the conversation somehow segwayed into her home life when she was a kid.  I worked with young adults in my career, and after retiring, I worked for a year in a women's shelter, so I am familiar with trauma.  I have always been able to empathize with her, but I am aware that because she refused to see a counsellor or get help with processing her trauma her whole life, she and her trauma are one, which along with the BPD, also means the same old stories (which I used to hear as a kid when she visited with her far-a-way sisters) keep resurfacing.  She skirts around certain topics, uses euphemisms, and never ever declares what really happened, but just dances around it.  I don't want to come out and ask because it's not my business unless she choses to disclose it.  So I just listen reflectively, but, in another 2 years she'll bring it up again.  I did ask her yesterday if she thought her dad had a mental illness.  She thought about it, and said yes.  She also said he ruled the house with fear and hate, and she said it with emphasis.

If only she could make the connection between her  trauma and her rage and her relationships, but she can't.  There is zero awareness for self-improvement.   She also often has zero social skills around me (selfish, demanding, lists of jobs for me when I show up downright mean-ness etc).  It feels a bit bizarre to have had a "visit" yesterday.  It feels strange, uncomfortable really, like I'm not sure what to make of it.  One in a million interactions.  The others can be a form of torture.  So unpredictable.  Jekyll or Hyde?

She is lonely.  She also told me yesterday she can't go more than 2 hours without taking a "nap".  Sometimes her "naps" go from 2pm to 6pm.  Then she's awake all night.  Honestly, she's never been able to regulate much of anything throughout her life, be it sleeping, eating (eating disorder), emotions, interactions, what comes out of her mouth when she's talking...even her driving.

H and I are convinced that she could actually thrive in assisted living, because she would be around people.  Probably be the life of the party, except for the ones she didn't like, where she would become the needle in their arse.  She's always loved being around people, who feed her need for attention.  When she had a dizzy spell, or got another attack of nausea, or her heart gave her trouble, or she fell, help would be down the hallway.  The down side is she would give up autonomy, and her house.  Nothing trumps the latter, not even loneliness or personal safety.  Yesterday she expressed how relieved she was that her gardener told her she would look after her yard again next year (the gardener is currently recovering from a hip surgery and couldn't do it this summer, although she still managed the spring cleaning that goes with landscaping and flower beds).  I think that solved a huge worry for her, because it equates to being able to stay in her house (and she knows we won't do the gardening).

The conversation I foresee having with her is pointing out the benefits of assisted living, which she can't do on her own, and balancing those with the costs.  And doing the same benefit/cost analysis for staying at her house.  Help her compare them.  You can lead a horse to water, but you can't make it drink.  She isn't going to drink.  But at least we can know we did our best.  She has to live with her own decisions, whatever that means.  But,  , everybody's quality of life (including hers) would be better if she decided on moving to the assisted living facility here.

Her decisions are driven by her emotions, and fear of losing her house, fear of change, fear of abandonment, fear of the unknown will trump any benefits to moving in the cost/benefit analysis.

My H thinks her window for assisted living is closing, especially since there is such a waiting list and she refuses to go on it.  It will be a catastrophic event that puts her into complex care. She will hate everyone (doctor's, nurses, us, her friends), and trash everyone.  When she's angry, the poison and vindictiveness comes out.   The binswangers are also making things progress faster (vascular dementia).

Meanwhile, I just got a text that tells me she needs another $600 cash from the bank to pay for all the people who come to help her.  I don't want her to give her bank card PIN to a non-family member, so it's another job.  

I don't want to think about which jobs I can do, and which ones I will tell her I can't do any more.  But I guess I will have to.  Hopefully it doesn't  trigger another dysregulation.  Eggshells again.  Then I have to find my way through another tunnel of fire.

there are many elderly people like your mother and the agencies dealing with the elderly are often quite familiar with them and know how to work with them. It is kind of like hiring a divorce lawyer that gets high conflict personalities.

. Yes thank you for the reminder.

I will get through this.

[GaGrl]

Include the cost of paying for what you can no longer do in the cost-benefit analysis, and just make it sound as much like a financial aspect as possible.

On the "conversation"...I had a similar conversation one day before my mom had her call and went into the downward health spiral. We were talking about her stepmother, who was uBPD/NP D and was o e of the meanest, self-centered, jealous, nasty persons O have ever known. She did my mother immeasurable damage from the time she married my mother (mom was 6 and had already been traumatized by the death of her mother two years earlier). Mom was talking about forgiveness -- people do that at age 94. But it was the first time she said, " Sometimes I wonder if the way SM treated me is the reason I am the way I am. " I was floored but validated that everyone close to her knee what the situation with SM was like. My mom had never before gotten close to admitting that some of her behaviors were "off" -- a few BPD traits like the inability to handle anger, giving people the silent treatment, etc. It was a strange conversation .

[Notwendy]

Methuen,

Our mothers are so similar. While in theory, I thought she'd like assisted living, and I suggested it when my father was ill ( as he needed it), they rejected all my suggestions. She's rejected any suggestions except for the fantasy of one near me. Somehow "that one" is the best of all of them. But she's not ever seen "that one". There are nice ones near her too. This is a common behavior with her- do decide on something based on how she feels about it, not that she's ever seriously visited any assisted living.

But this: She will hate everyone (doctor's, nurses, us, her friends), and trash everyone.  When she's angry, the poison and vindictiveness comes out.  

I see this now with her helpers. She's also lashed out at nurses and others. I realize now, after seeing this, that she'd be like this in assisted living too. Even with nice people to meet and activities, she'd likely have none of that, find something wrong with everything- because this is what she does now, even with her own children.

It would be the same no matter where the facility is.

I agree, she is acting out on her own trauma but I don't know what that is. My guess is that she's disassociated from it. But she sadly plays this out with those closest to her.  It seems she perceives us as disappointing and hurting her no matter how hard we try to do the opposite.

[Methuen]

This is a common behavior with her- do decide on something based on how she feels about it, not that she's ever seriously visited any assisted living.

This (they dcide on something based on a feeling).  Anyone out there ever found the antidote to this?  Please share urgently!

 It would be the same no matter where the facility is.  

…including if the facility is her own independent home near you…

I agree, she is acting out on her own trauma but I don't know what that is. My guess is that she's disassociated from it. But she sadly plays this out with those closest to her.  It seems she perceives us as disappointing and hurting her no matter how hard we try to do the opposite.

Maybe.  But I think its us perceiving that we must be a disappointment because of what they say and how badly they treat us.  In fact what multiple T’s have told me is that we are the people they feel safest around to dump all those toxic bottled up feelings they have, onto.  It’s counter intuitive. Somewhere in this  is a backhanded compliment.  It’s just super messed up.

[zachira]

Methuen,
It sounds to me like you have to be the last person to tell your mother anything because she will use whatever you say as a means to abuse you. I had a cousin who had BPD. Off and on for years, she refused to get her infected leg treated for months at a time. Everybody was after her to get an appointment with her doctor. One day, I took my cousin to do some errands. My cousin told me she wanted to invite me to eat out to reciprocate my taking the time to drive her around to do errands. I told her if she really wanted to repay me, she would go to her doctor to get her leg taken care of. That day she made an appointment with her doctor, and actually went. She told me that she had also been told that same day by the person doing her manicure, she needed to get her leg looked after. I was being recognized by the family as having somehow magically gotten my cousin to get her leg looked after. The truth is she was just ready to do something about her leg. So many fine people who are kind, tactful, and good at influencing others had failed to get my cousin to care for her leg. I suspect you may have somewhat of a similar experience with your mother. When circumstances make it so she can no longer live in her home, than either she will decide to get the help she needs or the circumstances will leave others with the authority to make the choices for her.

[Notwendy]

Zachira- credit to the manicurist! I mean this seriously.

At one point, I did visit some assisted living centers- a while back. I found one I liked that I thought would be a good choice. Well that was flat out rejected. But then, a neighbor mentioned another one was "good" and that one became THE ONE, based only on that comment. While that never happened, the comment from an acquaintance carried more weight than the one her daughter actually visited and checked out. Now, logically, who would be more concerned about finding a good fit than her daughter? But that doesn't come into play.

Often my mother will say " my hairdresser's third cousin's wife say this is the best______________. And that becomes the best______.

Yes, Methuen, maybe they do feel close enough to us to lash out at but it is messed up.

[Methuen]

I did visit some assisted living centers- a while back. I found one I liked that I thought would be a good choice. Well that was flat out rejected. But then, a neighbor mentioned another one was "good" and that one became THE ONE, based only on that comment. While that never happened, the comment from an acquaintance carried more weight than the one her daughter actually visited and checked out. Now, logically, who would be more concerned about finding a good fit than her daughter? But that doesn't come into play.

Often my mother will say " my hairdresser's third cousin's wife say this is the best______________. And that becomes the best______.

All this!  Exactly!  All of it!

The day mom learned that two of her friends were on the same antidepressant,  she made an appointment with her Dr to ask for the same one.  I have soo many examples of how she sees the actions and ideas and decisions of other people as gospel!  Then she copies it!  But her daughter?  Things Ive suggested have been dismissed or repudiated or worse, but then later when a friend makes the very same suggestion, it’s a brilliant one, and she has to do it.

What is needed, is for one of her friends to choose to move into our assisted living facility.  Then it would suddenly be the “best ever”.  And she would want to move to.

I have a deep need to have the psychology behind this explained to me.  Please…anybody?

[Notwendy]

I'll give it my best guest. I think it's similar to them projecting their low self worth on to the people closest to them in a similar way they tend to mistreat them. Combined with a poor sense of self, they may tend to be more middle schoolish about looking to their friends for a sense of self. I recall when the middle schoolers all had to have the same style clothes and hair as their friends no matter how it looked.  If Mom liked something, they rejected it. This is the stage where they don't know who they are, but begin with "not Mom". Mom was soo embarrasing...Mom might suggest a hairstyle- well that had to be rejected, but if their friend died their hair green- well that was the best and they wanted green hair too.

[Methuen]

So I am desperately trying to grasp this, because this very thing has been bothering me for a very very very long time.  I don't understand it at all.  I've come to accept the psychology behind why we get all their toxic feelings dumped on us (even though I reject that as an excuse for abuse).  I don't like it, but I can understand it because of the BPD.  But I'm feeling a bit thick in the head, trying to comprehend the incomprehensible...when it comes to why I can suggest something which is viewed as unworthy, but later a friend of hers can suggest the very same thing and it is not only a good idea, but suddenly she has to have (or do) the "friend's" idea.  

a) It's a role reversal; because they see us as caretakers for them, they've reversed roles so we are mom and they are child, and since teens (i.e our mothers) like to rebel and form their independent self, they reject mom's ("us" being mom) ideas as not worthy

b) Since they have a low sense of self and self-worth, they project that onto us and therefore anything we say has no worth.  It's similar to why they rage at us but not their friends, and is related to who they feel safe rejecting.  They want to be like their friends, so they embrace those ideas.  If this is the psychology of  what is going on, why don't they want to embrace the good ideas of their daughters (or sons)? Especially if there is a benefit?  (Since they see the benefit when their friends make the same suggestion).

c) they are emotionally developmentally delayed (probably related to the age at which their trauma occurred) and their choices and emotional capacity to make decisions is about the same age as their emotional developmental delay

d) all of the above

e) none of the above (meaning I'm still not getting it)

  Thanks in advance for being patient with me, as I try to grasp why a BPD mother rejects a loving daughter's ideas, but admires the same ideas if her friend's have them.  This is just so messed.

Or could it be plain and simple but deep insecurity - related to narcissism (we had a good idea, which they didn't think of, so in a narcissistic way if they didn't think of it, it must be a bad idea coming from their daughter), or alternatively, could it be plain and simple jealousy of their daughter (kind of related to "c" above)?

Sigh.

Several years ago, mom was in a serious long term crisis, which meant my life was in crisis (because they are parallel lines on the curve).  I offered the idea of checking in with her doctor, to see if antidepressants would help.  Well, the   hit the fan because somehow suggesting she might need antidepressants was taken as a terrible insult, and life got worse for everyone.

About six months later, two of her good friends told her they were on Mirtazapine.  That very day she called and made a doctor's appointment, and came away from the appt with her script of Mirtazapine.  

Could have done that 6 months earlier when I suggested it mom!  (Thoughts only - I bit my words as we all learn to do.)

Same thing with my suggestions of handrails (rejected).  After a subsequent fall, someone else suggested it and she called and had handrails installed.  Words can't describe what   my life becomes when she has a fall and breaks bones at the age of 85 and can't use her walker or do the things that need to be done for daily life (like eat, bathe, use the toilet etc).  All preventable, if she had just said "handrails! What a good idea!" when I suggested it, instead of rejecting the idea.

Really really really trying to grasp the psychology.

[zachira]

Methuen,
I believe there are many explanations for why a BPD mother would reject the ideas of her daughter while being open to the same ideas from either a friend or even a stranger. Here are a few: People with BPD see their children and other close relatives as extensions of themselves, and not as separate people. People with BPD are terrified of intimacy and only feel comfortable in superficial relationships. People with BPD have poor boundaries and treat relationships with strangers as being more intimate than they are.

[zachira]

Understanding why the disordered persons with BPD in our lives are the way they are does not take away from the frustration and ongoing suffering of having to deal with them. The reality is people with BPD function on how they are feeling inside at the moment. Close intimate relationships are where they seem to be the most triggered and likely to act out as intimacy and closeness seem to trigger the fears they could be abandoned at any moment.

[Methuen]

My H has just reminded me that the elderly services consultant we spoke to after mom's last fall, believes my mom could have another diagnosis called "pathological demand avoidance".  Basically, anything can be a "demand", such as the expectation of needing to get up at a certain time, having to go to an appointment (such as a driver's medical) or even to get her hair cut, or a pedicure.  These have all become "demands" because she has to get herself ready to go to them, or do something, and even going to an appointment she wants (such as a pedicure) is an extremely difficult process for her.  When she comes home from that, she takes a 4 hour nap for example. 

So if H or I indirectly try to steer her towards acknowledging the struggles she is having living independently, and diplomatically lay out alternative options to help her see how she could make her life easier (eg assisted living), for her to even make a decision to move would be a "demand" she can't handle.  Not to mention that her emotions would get triggered along the process, and once that happens, everything is lost.

This "demand avoidance" fits mom perfectly, although the other elements of "pathological demand avoidance" don't line up.  The demand avoidance seems like a solid pysch explanation of why she rejects my ideas or suggestions.  She doesn't like an idea.  It "feels" perhaps like she is losing control.  It triggers her.  She rejects it.

In addition, a CAT scan for a minor stroke back in 2015 also showed binswangers.  The neurologist told us that, but mom didn't hear at the time.  I don't think she even knows.  To my knowledge, her family doctor never followed it up.  Binswangers are essentially vascular dementia I believe. 

So I'm kind of thinking there are other elements in addition to the BPD going on here.  Age-related dementia, and possibly "demand avoidance".  She's definitely struggling.

Earlier in this thread (on page 1), I mentioned a friend of mom's who was over-involved with her, and has on occasion told me "what I need to do for mom".  Yesterday mom accidentally sent a text to me which was intended for this friend.  Since I didn't understand the text, I inquired as to it's meaning.  Turns out the friend diagnosed mom as needing a higher dose of antidepressant. Apparently the friend is a physician now, instead of a retired teacher, and whatever she says is gospel (whereas she hates her doctor now that she failed her driver's medical).  I am pretty sure mom has the friend in a Karpman triangle, with the friend being the rescuer, and me either the persecutor or negligent daughter.  Turns out mom (a retired nurse) was confused about the prescription dose of her current antidepressant.  The dose is on the prescription bottle, along with the instruction to take "half a pill" daily.  Even though mom was only taking half a pill, she thought she was getting the full dose.

I believe this is the dementia.  I know my mom.  There is no way she would have got that confused earlier in her life.  No way. 

[GaGrl]

Is your mom trying to manage her own meds? She could be getting confused, taking the incorrect dosages (I would be concerned about her taking more than prescribed doses), and having increased side effects.

[Methuen]

When the social worker did the most recent Rai Assessment, they determined she was still managing her own drugs well, which she was.  She is very independent on a few things, and demonstrated she could self-manage her drugs to their satisfaction.  As a "nurse", this is something she wanted to maintain control of.  I suspect that until something catastrophic happens, the Rai assessments may keep suggesting she can live independently.  They seem to put a lot of weight on what she reports to them, rather than what the family might say.  May I ask which side effects you are thinking about?  If it's her napping, I've read up and learned that can be associated with cognitive decline dementia.  My 87 yr old FIL was the same the last few years.  He had vascular dementia.  But who knows.  She's far too complicated for me to figure out.

[Notwendy]

I never heard of demand avoidance before- it seems a bit like oppositional defiance disorder, but whatever it is, I thought it was a part of BPD because my mother does this too. Anything can be a "burdensome demand" on her- even asking her to get ready to go to the dinner I planned for her. Predictably, she even refused to be ready- and it was a dinner I planned when we were visiting- all for her. This isn't new behavior. I assumed it was a way to maintain control. I also think it's "victim thinking" as it becomes "how dare you ask your poor mother do to this" as if requesting something is intended to insult or harm her.

GaGrl- brought up a good point. BPD mother has insisted on control which is one reason she won't consider assisted living. So far, she's insisted on managing her own medication but it's been discovered that she's non compliant with her medical providers- deciding not to take it, or not taking it as prescribed. Now  they are leaning towards assisted living, but I don't think she's going to go along with this. She can "hold it together" when motivated, so she may cooperate to avoid this.

[GaGrl]

I would be looking for side effects like sleepiness, confusuion, intestinal upsets, dizziness, etc.

The increased sleep is associated also with vascular dementia, which my dad experienced after age  90.

[Methuen]

She can "hold it together" when motivated

Yes yes yes.  And then when that is over, and they need to unload their emotions, guess where they go to do that!

I would be looking for side effects like sleepiness, confusuion, intestinal upsets, dizziness, etc.

Yes, the tricky part is all those things have been typical through mom's life.  The intestinal upsets and dizziness have been there for 40+ years.  The sleepiness has been getting worse for the past 5++ years. The confusion (eg not understanding that taking 1/2 pill was 1/2 dose on the side of the prescription bottle) has been developing over the past 1-2 years.  Sometimes it is super subtle.  Other times, like the script example, are more obvious.  Sometimes it's hard to sort out the problem; is it that she can't see the script properly (macular degeneration)?  Or is it progressing vascular dementia (which she doesn't even know about).

Here's a question:  Should mom be told she has vascular dementia?

She suffers acute anxiety (going to an appointment of any kind eg haircut) stresses her out.  She suffers from fear of everything - of change, of aging, of being abandoned, of being "stuck in a home" (and repeatedly says she would rather die than go into care)...  So,  would asking her family doctor (whom she now hates because he failed her on her driver's medical) to discuss her dementia (binswangers) with her, be helpful because it is her right to know, or harmful because of all her other underlying health and mental health issues?  If she knew she had binswangers, I know that her quality of life as she now knows it, would be over.  She would be terror stricken, and probably permanently become emotionally dysregulated.  I can't even imagine what would happen with that news, knowing that failing her driver's medical was a disaster.

I am already POA, and she has a Will, so that planning has been done.

So what is more humane? Telling her, not telling her, or waiting until it progresses further? I'm inclined to wait until it progresses further, but would be interested to hear what others think.

[Mata]

My mom does the same thing about discounting all advice from family but accepting it from outsiders.  It's maddening.  But I don't know if it's unique to BPD.  My brother does the same exact thing, and he's bipolar.  I think it is a mix of control, trust issues, and just generalized disorganized thinking. 

As to your last question, I would leave it up to her doctor to tell her about her medical condition.  He may well have, and she just ignored it.  Who knows.  My mom has done that before, kind of a conscious disregard for things she doesn't want to hear.  My T says to me, "do you want to own that?" when I'm debating questions about what's best or better for my mom.  Is deciding to tell her something you want to own, or could you leave that to the medical people?

[Methuen]

Oh I would neve take that on to tell her - not my job.  I’m not looking  to put a target on myself.

I think her GP has dropped the ball on the report from the specialist back in 2015.  My mom and I have the same Dr.  I have seen him for mental health appts for myself (related to my mom), and shared info about mom and disclosed how her behavior was making me unwell.  He doesn’t discuss my mom’s health with me because of confidentiality, but he listens and offers support for my appt.  When I brought up at a mental health  appt I had booked for myself (about a year ago) that mom had binswangers, he looked confused and jumped onto his computer to look up the report.  He’s a good doctor, but can be disorganized.  I think he hasn’t brought it up with her because she’s an overwhelming patient, even for an experienced doctor.  She’s always there for some  other health reason, and he’s always running late.  He focuses on whatever she book d the appt for.  I honestly think the binswangers aren’t on his radar.

But I’m living with the consequences of them.

My question is more of a moral or ethical  question.  Considering her personality, would it be more humane for him to tell her, or not tell her, yet?  I realize none of us are doctors or professionals, but I’m curious about perspectives.

[GaGrl]

I think it is too short on after the driving test disappointment for her to absorb a conversation about dementia.

[Turkish]

I think that would be best shared by a medical professional. They have the experience. I would think, maybe not even then. It would be a brutal diagnosis. I was also told by professionals that dementia is a terminal diagnosis.

[Notwendy]

I would leave that decision and conversation in the hands of her medical providers. This is not something that needs to be heard from you.

Although my mother doesn't have that diagnosis, the medical information I get from her providers is different from what she tells me. This is probably because she's concerned about what other people know. Although it's clear you know what is going on, your mother may not wish to have that out in the open between the two of you. It may also be how she copes with it. I'd leave that alone and let her medical providers handle the medical information.

[zachira]

I don't know a lot about dementia. I just know in some kinds of dementia, the person is completely unaware and in other cases, they know. Do you think your mother knows she is declining mentally or not aware at all?

[Methuen]

I don't know a lot about dementia. I just know in some kinds of dementia, the person is completely unaware and in other cases, they know. Do you think your mother knows she is declining mentally or not aware at all?

At this point I think either is possible.  It has been bothering her a lot for quite a few years that she is so tired all the time.  She knows there is something wrong with that because she complains to me about it all the time (and she used to have so much energy).  I use the broken record technique to remind her and redirect her to tell her doctor that, not me.  She never does.  The last Dr appointment I was at with her was for her prolia shot (osteoporosis treatment), and at the end of the appointment the doctor asked her to write out the same sentence 10 times.  She wrote out "I am happy" 10 times.  An unbelievable lie.  But she wanted to project how well she was doing to her doctor. She was so proud of herself.

My mom, like all our mom's is a master deceiver.  She has been in denial about her mental health her entire life, and always refused to see a counsellor.  So I think she could be in denial about this too, to the point of being completely unaware.  She has never voiced any concern to me about any declining mental abilities.  Only about her physical ailments.

Oh I would never take that on to tell her - not my job.  I’m not looking  to put a target on myself.

My question is more of a moral or ethical  question.  Considering her personality, would it be more humane for the doctor to tell her, or not tell her, yet?  I realize none of us are doctors or professionals, but I’m curious about perspectives.

Like I have said, I have no intention (and never have had) to inform her about her dementia.  I could have done that anytime in the last 6 years.  I am not a fool, or a cruel person.  My question is more about an autonomous person's right to their own personal information.  At what point, if ever, is there a "duty of care" by the medical profession to inform?

The consensus from the forum seems to be that it is better she doesn't know.  Trust me, I get this, because I have to live with her everyday of my life, and I know what she's like.  Again, trust me, I get this.  But it is  very ironic, that a person with BPD, who needs to control every aspect of their life will not be given the chance to learn this diagnosis about herself.  No "right to information" about herself.  Just my observation. 

For example, I remember when my father found out he had Lewy Bodies (a nasty form of dementia).  He was told by the doctors.  I saw him just aferwards.  He handled it with such grace.  He did everything possible to make it easy for the loved ones around him (my mother was a mess and made it all about her).  My FIL had vascular dementia, and was informed about it at the time the diagnosis was made.  My MIL was informed about her ALS when it was diagnosed.  But I agree it probably wouldn't be helpful for the doctor to inform my mom.  However, I would want to know if it was me.  But I am not my mom.

I am already exhausted by her needs.  She doesn't want assisted living.  She doesn't want home care.  But her needs (physical, cognitive, and emotional) just continue to grow.   She's completely overwhelming.

[missing NC]

Randi Kreger, author of Walking on Eggshells makes the distinction between conventional and unconventional individuals with BPD. The former knows something is wrong and may seek help on her own. The latter simply cannot conceive of anything other than those closest to her being solely responsible for her woes. Trying to inform the latter of the true origin of her malady is like trying to feed a person who is actively vomiting.  The information simply will not/cannot get into their brain.  I assume even doctors without a full understanding of BPD develop some intuition over time regarding patients who are so lacking in self awareness that nothing good would come of discussing their condition with them. 

My heart really goes out to you Methuen. I cannot imagine what a hellion my sister will be for medical professionals and her children when she develops dementia (which runs in the family) on top of her BPD/NPD.  I'm assuming your mom would not be open to something like an antipsychotic or mood stabilizer ostensibly to help her sleep. 

[Methuen]

Randi Kreger, author of Walking on Eggshells makes the distinction between conventional and unconventional individuals with BPD. The former knows something is wrong and may seek help on her own. The latter simply cannot conceive of anything other than those closest to her being solely responsible for her woes. Trying to inform the latter of the true origin of her malady is like trying to feed a person who is actively vomiting.  The information simply will not/cannot get into their brain.  I assume even doctors without a full understanding of BPD develop some intuition over time regarding patients who are so lacking in self awareness that nothing good would come of discussing their condition with them.  

 Thank you for this.  Very very helpful.  My mom would be the latter (unconventional).

No mom would explode and implode simultaneously if anyone ever suggested antipsychotic.  I can't even imagine it in my worst nightmare.  She currently takes antidepressant (mood stabilizer?) but in the past has taken herself off of that a number of times, only to relapse, predictably.

Thank you so much for the support.

[GaGrl]

My mom was prescribed Seroquel to help with sleep, long before her call and hospitalization. Her internist said sleep disturbances are frequent as people age. If something like Seroquel (a common antipsychotic) could be prescribed for sleep, that could help.

[Methuen]

My mom was prescribed Seroquel to help with sleep, long before her call and hospitalization. Her internist said sleep disturbances are frequent as people age. If something like Seroquel (a common antipsychotic) could be prescribed for sleep, that could help.

Thank you GaGrl.  I’ll store that info

[Notwendy]

The "trying to feed a person who is actively vomiting"- what a perfect analogy.

I have used the "emotional vomiting" analogy to describe that they feel better after they rage or unload their emotions. Like a small child who ate too much candy - they throw up- and then run off to play because they feel better.

Once my mother has "emotionally vomited"- she feels fine, and to her nothing has happened. Because she feels fine, she assumes we do too.

Because of this pattern, my mother does not learn from her behavior. There's no point in discussing it with her. It all comes right back at you and then it appears to be gone from her thinking. Then when she retells something, it's a different story. History is re-written.

[zachira]

They feel better for a time after the emotional vomiting and then the cycle starts again. Healthy people know how to process their emotions and move through the pain. We can heal. Our mothers with BPD can't.

[Methuen]

I met with a person from our local health unit, who works with the home care team as an elderly services consultant.  I shared with her the highlights and events since mom's last Rai Assessment (about 9 months ago).  The consultant has met mom several times in the past, and I have also met or spoken with her privately probably half a dozen times (usually in crisis) over the past two years.  My H was with me today, as we work as a team when it comes to managing my mom.

I thought I would share several takeaways:

1) When mom says toxic things like "you don't love me" or "I would rather die than live in long term care" what she's really saying is I'm scared, or terrified.  She doesn't have the words to articulate what is really going on because her brain isn't wired up to do that.  So what we (children of BPD's) have to do is look for the hidden message (she's fearful and terrified), and not the literal message (because it's really not personal).

2) When mom says things that FOG me such as "less and less I feel like eating", or "I only weigh 125 lb" (designed to get attention and obligate me to cook more for her, or come over to eat with her), I can use a script such as "what does the nurse in you think you should do about that?"

3) If mom falls and can't call for help and isn't found for a long time because she refuses to wear her Lifeline, "oh well that's unfortunate but that was her choice"

4) When she tells me she would rather die than go into assisted living, don't share what H and I have planned for that period of our life, because she will just find it invalidating.  Just validate and say something like "it's good to know what you want".

5) The next time my mom falls and I end up in emergency with her, and the doctor is talking like s/he will release her to me as the hospital's "after care" plan, I need to speak privately to the Dr and explain that I am not up to that task, and that she has received home care in the past, and has not gone home from hospital until the home care has been arranged.

6) If mom falls before we go on a trip, the consultant said to "go on the trip, of course!"  Home care would look after her.  She reminded us that a healthy parent would tell their kids to "go" and remind them that she would be well taken care of while we were away.  My mom would expect us to cancel, which we have done in the past.

7) When she's telling me another one of her problems, use a script such as "what would your friends say?" (since she values her friends opinions as biblical, but if I ever suggested the same thing first she would either dismiss it or get angry)

8) The elderly services consultant was shocked that mom didn't know about the vascular dementia diagnosis.  She said that within the medical profession, she has the right to know that information about herself, even if she doesn't like hearing it at the time.  As I have written about on this thread, this has been something that has been troubling me.  I discussed with her my concerns that mom could emotionally unravel with this news, and she was firm in saying that it was her right to know.

9) Seek and accept help when it is offered.  I'm so thankful I did not turn down the opportunity to meet with this person when mom's case worker offered to set up an initial meeting with an elderly services consultant.  Seeking and accepting help is hard to do, but worth it.

There were so many takeaways, but these are the ones I can think of to share right now.  

She gave us (H and I) a full 2 hours today.  It was an 11am appointment.  She didn't cut us off for a lunch break.  She didn't rush us.  She listened.  She heard.  At the end of it, she volunteered to do the next Rai Assessment in January 2022 (she's qualified).  She said it made sense for her to do it, especially after hearing our stories about the advancing Parkinson's, and the vascular dementia (which was not followed up, but lost in an emergency room report from 2015).  She actually volunteered to do the Rai after I mentioned that mom was unaware about her own vascular dementia.  This person is a mental health professional, and demonstrated understanding and empathy throughout the entire appointment.  She totally gets the "borderline" and "demand avoidance" personality profiles.  I told her that mom had a traumatic childhood, and suffered acute anxiety.

She said that ultimately, to get into assisted living, the person must give consent and want it.  She also said that the longer mom waits, the more likely that her "window to get into assisted living" closes, and eventually something will happen that results in her going directly into long term care.

It did feel like I was betraying my mom a bit.  I struggled with that.  But if I didn't get help for myself, I wouldn't be able to support my mom.  The consultant could see that, and said so in as many words.  I also told her if the next Rai said mom didn't need "assisted living", I would be totally OK with that.  I'm not trying to stick her in a home.  I have mom's best interests at heart, but get burned out, and I can see her Parksinson's advancing (at some point she won't be able to feed herself, and she's already struggling with the toilet which always has poop on it) and her cognitive abilities deteriorating.  She point blank came out and assured me she knew that, and gave me concrete examples to make me believe it.  

My mom was my matron of honour at our wedding.

It was really good for H and I to meet with this person.  

Just thought I would share, as I found the meeting helpful, and know many other people on this board are also struggling with elderly parents or in-law parents.  Hopefully something of this story can help one other person.

[Notwendy]

Methuen,
I am glad you had this consultation. Yes, I agree that our elderly parents are likely very afraid of being in an assisted living situation, and I can understand that. I know that the emotional projections are not personal, even though they are difficult for us to hear.

It seems as if you had a better relationship with your mother growing up than I did. I think I could handle my mother being difficult in her elder years better if this was something new for her, but it's not. She's in sound mind and knows what she's doing, and is also deliberately and calculatingly manipulative and mean.

For instance, my sibling has some medical issues and rather than being sympathetic, she makes a mockery of them. One reason we don't reveal any kind of emotional vulnerability to her is that she then becomes mean and critical of them.

As to the interpersonal dysfunction- she does this with her helpers as well. She's verbally abusive- calls people names and criticizes them. One of my concerns is if she did go to assisted living, she'd be asked to leave due to these behaviors. However, she doesn't want to go to one and so it's her choice.

She can be sweet as candy and perfectly lucid when she wants to be. It's during these times that we can actually question our own reality "is she really that hard to deal with or is it me?" and then turn in an instant to being verbally abusive or pitifully waify. She's in control of this, it's manipulation.

When she's with me, it seems she can't resist getting into some kind of manipulation. She just can't leave it be. She'll ask me to go through some papers with her, then get angry when I asked her about them. Doing something for her means she gives exact orders and you don't say a word or ask a question, you just do what she says. Or she will pry me for information, rather than just have a conversation.

I don't recall her being genuinely affectionate with me. She'll fake it sometimes ( and I know she's faking) and most of the time she's cold as ice. Having a relationship with her means being useful to her.

I really like the advice the counselor gave you about how an emotionally healthy parent would want you to go on the trip and not cancel for them and also to seek support for yourself. It's clear that you do care very much about your mother and there's something there between the two of you that is connected. I am not sure my mother feels any connection to me other than I am useful to her. Maybe this is something she just can't do. I care enough about her welfare to want to know she's well cared for and has what she needs but realize there's probably no possibility of any true relationship with her.

[zachira]

I am so glad you have found an elderly services consultant who took the time to show you she understands your challenges with your mother and how to handle them. I hope you feel you are no longer alone in your community and you now have someone who is really there for you that will do whatever is possible to help you and your mother. I like how she is encouraging you to take your planned vacation and assuring you that you have adequate back up. Thank you for sharing, as there is a lot of wisdom in what you learned in this meeting that so many people with an elderly parent with BPD would find very useful.

[Methuen]

It seems as if you had a better relationship with your mother growing up than I did. I think I could handle my mother being difficult in her elder years better if this was something new for her, but it's not. She's in sound mind and knows what she's doing, and is also deliberately and calculatingly manipulative and mean. For instance, my sibling has some medical issues and rather than being sympathetic, she makes a mockery of them. One reason we don't reveal any kind of emotional vulnerability to her is that she then becomes mean and critical of them.

I am so sorry for the pain you have suffered and what you are describing.  I am speculating here (always dangerous), but your mom sounds like perhaps she leans to the witch personality type (as per Christine Lawson), whereas in my relationship with my mom, she was predominantly waif (although the witch surfaced on occasion).  As a waif, my mom "groomed" me (probably from infancy) to be her rescuer. I can remember from the age of 5, having to "take care of her" when she had her migraines.  These were 3 day episodes like clockwork.  I was also groomed to take care of her feelings.  After a lifetime, and with recent learnings and reflection, I have come to accept that I was probably heavily enmeshed.   I can see that now.  The relationship between PJ's husband and his mom comes to mind here, but every relationship still has differences along with the commonalities.  The enmeshment played a role in my mom being my matron of honour at our wedding.  The process of differentiating from a parent you have been groomed to be enmeshed with (in your late 50's) is complicated.  The process has been slow, and the push back has been crazy making, especially as her health problems grew, and her ability to cope with them declined (an inverse curve). The fork in the enmeshment path really happened when my father became ill about 20 years ago, and she abused him so terribly.  That was when I finally had my eyes opened.  After that, it's a glacially slow dawning of realization that my relationship with her wasn't a normal mother-daughter relationship after all.  With that comes slow recognition of the emotional abuse.  Then becomes the process of differentiation.  With that comes the push back behaviors.  While our mothers have many similar behaviors and characteristics as BPD moms, the witch (I really don't like using that word by Lawson) is very different than the waif.  Although I can't speak from experience, I would hypothesize that the witch is worse than the waif.  While it can be demoralizing to hear everybody's stories on this forum ((when considering the problems of humanity in the bigger picture) as they are so painful to hear and imagine (since we have the ability to empathize),  there is also immense comfort to know we are not alone, and this forum gives us such a great opportunity to both learn and support and heal. Not sure if I articulated that well enough.

The part about your mother mocking your sibling with significant health issues is really disturbing.  I can't help but wonder if she was so terrified of your sister's illness that she minimized it and mocked it in an attempt to just make it go away.  Denial.  I also can't help but think of the cycle where the childhood victim, later becomes the bully. All our pwBPD seem to be bullies when they are FOGing.  That's just my take.  Whatever the underlying psychology behind the behavior, it is horrible that a mother treated her daughter that way, and it must have been traumatizing for you to be a witness.

As to the interpersonal dysfunction- she does this with her helpers as well. She's verbally abusive- calls people names and criticizes them. One of my concerns is if she did go to assisted living, she'd be asked to leave due to these behaviors.

I have never heard of anyone being asked to leave assisted living, but maybe it is different depending on where one lives.  The elderly are at a particular stage of human development in the life cycle, and aging has it's own set of complex issues, both physical and cognitive.  The body and brain both change, hence "geriatrics".  I would expect the staff at assisted living and complex care facilities are educated and trained to deal with complex behaviors that come with aging.  It is hard to conceive that they could "ask someone to leave", when that is the age group and the corresponding behaviors they are trained to deal with.  I would think they should have many tools in their toolbox and resources and experience to deal with the full spectrum of aging adults in their facility.  Asking someone to leave, just seems off, like maybe they aren't informed or trained enough.  

She can be sweet as candy and perfectly lucid when she wants to be. It's during these times that we can actually question our own reality "is she really that hard to deal with or is it me?" and then turn in an instant to being verbally abusive or pitifully waify. She's in control of this, it's manipulation.

Ah yes. "The turn".  I know these moments too.  They are truly terrifying.  So many stories.  I think from our point of view its manipulation.  From where they are coming from, I think it's a learned unhealthy coping strategy from their early life before our time.  Deep psychiatric stuff going on there.

I don't recall her being genuinely affectionate with me. She'll fake it sometimes ( and I know she's faking) and most of the time she's cold as ice. Having a relationship with her means being useful to her.

The cold as ice is probably a defense mechanism.  Mother's aren't supposed to be cold as ice.  The witch comes to mind again.  My mom was never affectionate either.  She couldn't hug.  Hugs came from my father and friends.  She was icy during silent treatment periods, but not on a daily basis.  She was generally thawed, until something triggered her and she dysregulated.  Then all
H_ _ _ broke lose and I would say or do anything to calm her.  I tried hard to be the "perfect child", but in my 50's I finally accepted that I was never going to be good enough. I'm sorry that your mother has always been so unavailable to you and your sister.  

It's clear that you do care very much about your mother and there's something there between the two of you that is connected. I am not sure my mother feels any connection to me other than I am useful to her. Maybe this is something she just can't do. I care enough about her welfare to want to know she's well cared for and has what she needs but realize there's probably no possibility of any true relationship with her.

Like you I care about my mom, but the "connection" you refer to between us is not a healthy one.  It was one of enmeshment (like emotional incest).  The connection only works if I am meeting her needs.  Since I can never meet all of her needs (think plums falling under the tree onto the ground and me not picking them) especially now that she is aging and geriatric, the "connection" is actually quite toxic.  As the elderly services consultant put it, our relationship has changed since my dad died, since I became the next in line to dump all her toxic feelings on, and since the aging process took her over.  I have responded with boundaries, asking validating questions and other tools.  She has pushed back hard with tremendous FOG.  It has been tormenting.  The only connection I have to my mom now, is my usefulness to her, so she says things like "if it weren't for you I would want euthanasia".  On another day she will cry "I just want to die" in the most painful voice possible.  These don't feel like healthy connections.  Everything she says comes with obligation.  There is no escape.  It has worn me down.  I do have some happy memories from the past, it wasn't always bad 100% of the time.  She did have better moments or spells.  But the chaos was unpredictable, and guaranteed, and omnipresent.

I truly hope that your mother does not move closer to you as she is telling you she wants to do.

[Notwendy]

Methuen, our stories are similar in many ways. My mother takes on all 3 roles at different times. She enjoys Queen mode- she's happiest in when we are completely subservient to her and she can act superior. She likes to have people do things for her, like do something for her around the house, or go get her some water not because she wants these things ( she could get them herself if she wanted to) but that she likes being waited on and having people "serve' her. Some of her requests are irritating because she manipulates me to do things for her- for the sake of having me "wait on her" and she likes me to "obey her". My father would do these things for her too and she'd say things like "your father was such a good boy today" or "I told everyone you were a good girl for me today". As if my father were a dog, or a little boy.

If you dare disobey the Queen, you get the witch. And it doesn't have to be much. Like if she asks you to do something and you say "in a minute" the Witch will come out to say "No, I mean no, do it now"

After she's been so abusive and we tend to draw away, she becomes waify and so pitiful, but it's manipulation.

The result of this though, is an enmeshment similar to yours, because we were also groomed to wait on her and meet her needs, out of fear. Fear of the Witch. To avoid the Witch, one needs to be a very good servant to the Queen. I also tried to be the perfect child and be a good servant to the Queen. I did this in part because she blamed me for our issues and I thought it was mostly with me. However, when my father got sick, I saw her abuse him and like you, this changed how I saw the situation.

I did bring up the idea of them moving near me so I could help my dad and yet they both refused at the time. I am grateful that happened. I brought up the idea when I didn't know better. But I see things more clearly now.

My mother wasn't the maid of honor at my wedding, but it was her party. Although my dad didn't have much money to help me for college, there was plenty for the wedding because, basically it was her party and my father would pay for what she wanted. I had little say in it and at the time, I was so enmeshed, I didn't even know I could have a say. Likely it wouldn't have mattered. It would have been her party as it was. Almost all the guests were her friends and family. One person from my father's family was there, my H's immediate family and a few of our friends, but it was her party.  The funny part is that it was my father and maid of honor helping me get ready. She was off getting her hair and makeup on. I was fine with that- quality time with Dad without her. But I don't have a lot of emotional attachment to my wedding day as it didn't really have much to do with me. It was lovely, in every way. She knows how to entertain well- and did a great job, but I didn't have much input- and didn't even know how to speak up if I did.

I hope she doesn't move either and if she brings it up, I plan to tell her I don't want her to. She knows this but if she pushes the idea, I need to firmly tell her that I don't wish for that.

[Methuen]

NotWendy, I agree our BPD mom’s are similar  in many ways. 

I have so much gratitude for this forum and meeting many people including yourself. 

I can’t even begin to imagine where I would be if I hadn’t  found this forum, and this site with all its information and resources.  I was so alone, and angry and terrified when I arrived here. It’s just so important to be heard and understood by people with similar experiences.  This forum has perhaps become to me, what AA meetings  must be to an alcoholic. 

I guess I’m saying thank you to everyone for the support.  It means more than words can say.

I hope she doesn't move either and if she brings it up, I plan to tell her I don't want her to. She knows this but if she pushes the idea, I need to firmly tell her that I don't wish for that.

yes, this is wise. I am putting myself in your place, and I can empathize how hard it would be to say this to your mother. Oh my.  If it was me I might practice in front of a mirror so that when the time comes, you are able to see  it through.  It will be very important to do it if she is serious about the move so that she knows in advance that is your boundary.  Then if she moves, and you are not available, the choice  was hers alone and she had advance  notice you would not be available. 

Brutal, but necessary.

[Methuen]

Zachira, thank you for being you. You often know just what to say. 

[Notwendy]

I made an appointment with a therapist to work on this- I'll see how it goes. I asked her for help stating my boundary in the most respectful but firm way.  Not for how my mother is going to react, but for me to know I said it as well as I possibly could.

It's hard to do because it goes against my own conditioning and also my own feelings for what I wish could be, but she's shown over and over again that a relationship between us consists mainly of me in servitude to her. Not that I expect anything from her except one thing- to respect boundaries and she doesn't do that. This is why distance is necessary for me to maintain a relationship with her.

Ironically, she may not bring it up, as sometimes the "moving near me" is an empty statement. But if she does bring it up again, I want to be as prepared as possible.

[zachira]

Methuen,
Thank you for your kindness. I do hit the nail on the head sometimes and other times I am not helpful at all. I don't even attempt to try to address most of what members say because I am only good at picking out something I believe I have empathy for and can be helpful with. You are talented in going line by line, and really empathizing with nearly everything the member has said.