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I'm posting this for support/advice but also to share that being in assisted living may help with some issues but still is complicated with BPD. It's been a series of "crises" with BPD mother, not unlike how she has been as far as I know. Emotionally, she doesn't tolerate being alone and one on one private care is unaffordable, now that she's spent most of her money. Assisted living is designed to provide a social environment but she won't socialize ( she's too disordered) or attend any of the activities. She stays in her room most of the time. She does have a private aide come to help some of the time but what she wants is someone there all the time. She's constantly calling the floor staff for something- to get their attention, but they have other residents to assist and so can't spend all their time with her.

In addition, she's emotionally and verbally abusive. I think it's obvious the staff is stressed by her and they are keeping a united front when it comes to her. BPD  mother seems to alternate between being lucid and causing a scene and acting crazy. This isn't new behavior- she did this when she was younger too, but now, with aging, she's also having age related cognitive changes. When she is acting lucid, she takes control. During the times of confusion, I have to use the power of attorney if needed.

At the moment, she is confused and not making sense. The nurses are looking at physical causes, her medication, for possible reasons for this. She doesn't have a urinary infection, they are going to change some of her medicine doses. One problem is that no action will be a solution- because she goes in and out of the confusion states- so it's hard to know what to do. Address the confusion - she snaps out of it. I'm not even sure all of it is real or her acting out to get attention. I think it's a bit of both.

I understand the staff is stressed by her behavior- but it's now another issue. BPD mother stopped answering her phone, so I called to check on her. When I try to call and they put me through to the floor staff- they don't answer. It's gotten to the point where I don't even try- they don't respond. Then BPD mother told me one of them hit her. I don't know if it's true or not- she doesn't tell the truth but in trying to look into this (by email to the assisted living since they don't answer by phone) - their response is defensive. Then they reported that she wandered into someone else's room- but nobody called me if she did. I don't know who to believe as I didn't think she was that mobile on her feet to wander down the hall ( she uses a walker around her room but a wheelchair- not motorized- someone pushes her). If I try to ask her more about it, her reply makes no sense.

There's been a lot of staff turn around and I am now getting uncomfortable about the assisted living. I hesitate to move her to another one- if the issue isn't them- she'll just do the same thing with the staff somewhere else. I think though- this staff has had it with her and by extension- they aren't responsive to her family either. I hope someone didn't hit her and they shouldn't- but her behavior could drive someone to lose it with her. Not that this is acceptable- it's not. We have to look into this. If she's being neglected or worse - we have to move her.

And here it is- a voice mail message "please take me home with you, I want to go home with you.  All I want is to go home with you"

When my father was ill, I felt the expectation that my parents wanted me to be her caretaker. I was initually willing to bring them closer to me and help out- not 24/7 but if they had agreed to be in an assisted living situation, I considered it. I even visited some that I thought would be nice ones.

They rejected the idea and refused my suggested ones. During this time period, BPD mother was so emotionally and verbally abusive, it was overwehelming. For the sake of my own family and myself, I had to have boundaries and not facilitate my mother moving closer to me. Even my husband has stated he doesn't want my mother to move closer to us.

My other concern if my mother was in assisted living nearby is that she'd get herself thrown out and it would be a crisis situation and she'd end up with no other option than to stay with me. Her current situation may be becoming unworkable. There are other assisted living options in her area if needed.

She's been in assisted living over a year now. I didn't say anything to her about this- but to me it was also a test situation- if she did adjust, and did well there emotionally- I may have reconsidered the idea- if her needs could be taken care of and she had cooperated with me. I believe that older people need to be as self directed as they possibly can, but if they need assistance from an adult child, it has to be a mutually cooperative situation. This is not. But I now have evidence of how she is in that setting and they aren't able to manage her, her sabotaging attempts to help her and her not being cooperative with attempts to assist her.

As a teen, I was useful to her as an emotional caretaker. The times I did go home for college breaks to see my family- these were "working" visits - doing things for her. It's been that way all along. She wants a 24/7 caregiver. I've tried to help -stayed with her and it's no sleep, constant needs 24/7, and her raging and being verbally abusive. She doesn't care about how the other person feels- her emotional needs drive her.

It has to be a no, it is a"no"but it also feels awful to say that no.

Hi Notwendy,

I'm so sorry you're having to deal with this. Do they use CCTV ? I.e. if you see that, then you can see who's telling the truth. In my country, you have a right to CCTV footage that you appear on - so if the staff are willing to share and your mother isn't, that might give you a clue ?   :hug:

Also if your mum is willing to give permission and the staff "lose" the footage, another clue.

If not, you can offer to pay for a coms / CCTV system in her room. If something is being monitored, then people tend to behave (or switch it off, before doing something they shouldn't).  :hug:

NotWendy,

I can so relate to this, and I have no advice. My mother recently got into a "rehab" home, essentially assisted living. We had hoped that she would stay there for a while, but the staff could not get her to cooperate in any way with her basic care. Even bathing. They sent her home, which I am convinced was due to the fact that she sabotaged every effort that they made to care for her.

We siblings would really like to see her in a place where our dad is not her 24/7 caregiver. But she refuses. I don't know the answer. But it is good to read your account and recognize that even if she were to be in assisted living, the problems don't just go away. They might even manifest more.

NW,

I’m sorry about the issues you have described here especially your mum’s account of being hit.

In Europe you are allowed to keep one of those home security cameras to monitor an elderly person- don’t know if that will be helpful or possible in your mum’s situation.

It may be that your mum hit a staff and they hit back- again not acceptable to hit an elderly person but I can see how someone who’s stressed by her behaviour if physical may snap.

Another possibility would be that your mum has made that up to push your buttons- being her caretaker, she knows that will get the maximum reaction/ attention from you- to the tune of you changing her living situation- the goal being her moving in with you.

Since she’s only been at this facility for a year, is it possible to explore more security for her room eg a camera to monitor things. I see her abusing your sensibilities response to this escalation- eg if you move her closer then she gains a new weapon to use against you- fabricating another claim that’s even bigger than being hit in order to achieve her goals of having you as her 24/7 carer.

Now that you have contacted the facility- might be useful to follow up with their complaints process or any other means of ensuring this event is recorded.

Notwendy,
Perhaps the best criteria to use to decide whether to contact adult protective services is if you have any reasonable suspicion that there is elder abuse going on. The fact that the assisted living people seem to be isolating your mother and there is high staff turnover are red flags. When you visit, you might try to get to know the family members of some of the other residents, so you can have someone to talk with and contact about what they see going on. When I visited my aunt, there was a lady always at the nursing home, and when I asked her about that, she said she spent as many hours there as possible because there was abuse going on and her father had dementia. The staff was not nice to my aunt, the food was horrible, there was high staff turnover, visitors were made to feel unwelcome, and my aunt was not allowed to have any of her pictures on the walls in her room. After talking to me, my cousin who had power of attorney moved my aunt to another nursing home.

Thanks everyone for the advice. I will look into the camera idea. I think once they know this will be reported, it might avoid a future situation.

Mugsydublin- BPD affects all relationships and this includes the ones with the staff at any facility. Of course your mother prefers your father as her caretaker- it serves her better- but it is more complicated. When my father was in a rehab situation for care- after a hospitalization, we were relieved because he was being taken care of and away from BPD mother's behavior. He hated it though- and wanted to come back home.

The not bathing baffles me. My mother has refused to bathe in a long time. I know elderly people are afraid of falling but she would have someone helping her. It's not modesty either. She allows them to give her a sponge bath but not a real bath or shower. This seems odd as she is meticulous about her appearance. Her hair is done nicely and she always has a pretty nightcoat on. It just doesn't make sense.

Zachira- what makes me more suspicious of the staff is their behavior. They are defensive and evasive. It was a holiday weekend and they may have had temporary staff fill in- so it is possible someone did that, and also possible my mother made it up, but I have no way to know. If she is wandering into other people's rooms, then they should have notified me. Admittedly, I don't live close enough to visit in person often, but I have tried to call and be in contact with staff and it's difficult to do that. It's also possible she told them to not speak to me like she did with the Hospice nurses. Whatever it is, I don't know what actually happened.

There are cameras that allow you to communicate too. I’ve owned one in the past for monitoring an empty home. And it can serve as a substitute for telephone calls

Since your mum is not answering her calls, you might be able to chat with her without her needing to pick up the phone.

I’ve worked with elderly patients, it’s not uncommon for them to get aggressive when confused, wandering into other people’s spaces too is quite common. She may have gotten out of her room to call for help or any other reason then forgot her way around.

If the staff are saying she wandered down the hallway, then this would be easy to prove if there are cameras in communal areas.

Also your mum’s fluctuating levels of confusion/cognitive decline may be a sign of dementia ( Lewy body subtype). If there are no organic causes for the confusion, it might be time to look into an assessment for dementia.

My mom will never go into assisted living because her MO is to "fight everything".  She is a "fighter".  And she is extremely "proud" of that trait. Community care used to provide various services for her after her falls, but she has gained a reputation for being difficult and non compliant with them.  Because she is deemed competent, she can refuse service to her house, which any rational person can see is a poor decision and against her own health and safety interests.  They used to try to reason with her, before they really knew her.  They no longer have any conversations with her that I know of.  My mom spews vitreolic "hate" against any form of community care or any person associated with it.

If my mom failed a competency assessment, and went into care, she would behave exactly like your mom.

This is exactly what my mom's sister did after going into a care home.  She stayed in her room and refused to participate in activities.

Since the personality disorder is the person (my mom, your mom etc), it's to be expected that it travels with them, so it is no surprise that your mom is as disordered in a facility as she was in her own home.

Certain things are probably better now.  You are more able to exercise responsibilities over her finances.  There is nursing care available should she need it, or "accept receiving it". 

The chaos she has caused since going into assisted living would exist if she were still living outside of it as well, because physical and cognitive changes with aging bring on more stress for the BPD, and they don't cope with stress. Right now in assisted living, she is still being
 monitored. Who would be responsible for doing the medical monitoring if she wasn't in assisted living?  Who would be doing all the "doing" she would be demanding to have her needs met?  I reckon that you would be hearing a lot more from her and also "doing" a lot more if she wasn't in assisted living. 

That is my lot. The stress of having to deal with my mom has taken a huge toll on my mental health, and also my physical health.  My mom gets to refuse all community care if she wants to.  So who does that shift the burden to?

My physical health issues are serious.  I have been off work for some time and am still off work.  I suffer chronic inflammation from stress on multiple body systems.  I am on medications.  I am in pain, and my daily functional life is disrupted by this.  I can't do the things I normally do.  I can't even do yoga right now.  My mental health?  Well, I'm not sure that I'm not heading towards a nervous breakdown.  I can't even post and maintain involvement on this site like I used to.  I feel the only people who really understand are my H and my T.  There is little support because nobody can really understand if they don't have my lived experience of being responsible for my BPD mom when she refuses all community care in her home.  Her needs as a vulnerable 88 year old living alone with pages and pages of physical and mental issues are a bottomless pit.  Yesterday she "had it out" with my H screaming that she "wants to die" (she doesn't).  He was delivering her groceries when this happened.  She makes up the grocery list, and he makes the purchases based on her list.  Of course "everything was wrong". Up until two years ago, I was her "caretaker".  Then I returned to work, and he took over certain tasks (grocery shopping, appointments etc) to give me a break because I burned out.  I used to come home from those visits saying "nothing I do is ever good enough" all while taking the abuse.  Now, after two years, he "gets it".  Before he was responsible for her, even though he lived with me and saw her, he couldn't really "get it". 

Be very careful with how you proceed on your mom's allegation moving forward.

To shift gears, have you read "Stop Caretaking the Borderline or Narcissist. How to end the drama and get on with life" by Margalis Fjelstad?

https://bpdfamily.com/message_board/index.php?topic=203887.msg12271876#msg12271876


I have seen you post the story from SLATE about the borderline daughter "letting go" the caretaking of her mother, and "choosing herself and her family". 

I have also seen you post the poem The Bridge (written by ? a monk? a priest?).  The man at the bridge choose to "let go".

My H and I are in crisis mode all the time.  Mom texts us each multiple times a day.  It's constant chaos and dealing with her. 

From my perspective, assisted living is a dream that will never happen because she will NEVER agree to it. From my perspective, assisted living means someone else who is trained and professional gets to deal with her behaviors, in an environment where there is actually medical care available if she should need it, and monitoring happening.  When I use the word "hate" as in mom "hates" community care and anyone associated with it, you know that a pwBPD will never capitulate and agree to something they hate.  This translates to my H and I never getting a break from being responsible for her.  This is her power.

Of course I still love her.  She's my mom.  My whole life I tried above and beyond to please her and have her love me back.  Being "the good daughter" was futile.  I can see that now at 62, as she ages and only gets worse with her behavior.  Her family Dr doesn't even do cognitive testing on her anymore.  Both her Dr and home care recognize she is non compliant and difficult, and so they let her execute her choices, and focus their time on their patients who do want the help and are compliant.  I can't really blame them. 

Again that shifts the problem to me and H.

I am currently reading "Stop Caretaking the Borderline/How to end the Drama and get on with life".  I'm about 1/3 of the way through.  I recommend this book, or a re-read whichever is relevant for you.

I used to do so much for my mom.  For example, I used to bring my mom 2-4 meals a week.  I no longer do this.  At some point I realized that all the things I was doing as a loving daughter (to be the "good daughter") was actually enabling her to refuse all community care.  Why would she accept "meals on wheels" when I bring her home cooked food?  In healthy families, daughters/sons can do this and feel good about it because there is appreciation and reciprocal love.  However, I feel only resentment.  The cumulative time and energy I have put into my mom over a lifetime because I love her was one sided.  It is never enough.  My mom is negative and toxic and abusive, and her behaviors became too much and finally overwhelmed me.  That is when I returned to work which provided a safe "boundary" where she didn't have the same access to FOG me.  Now just 2 years later, my H is kind of where I was, and also full of resentment.  She is toxic.  She was a terrible mother/mother in law. 

We would be jumping for joy if she were to go into assisted living, not because it changes her behavior, but because we wouldn't have to be the ones to deal with it on a day to day basis.  The paid and trained staff would.  And they are trained to deal with difficult residents, just like teachers are trained to deal with difficult students, and counsellors deal with difficult clients, and doctors deal with difficult patients. 

You can lead a horse to water but you can't make him drink.


Now in a "normal" family, of course this is the right thing to do. No question.  Ours is not a "normal family".  Perhaps some important questions are:  "How did it get to this?  Who is ultimately responsible for this outcome?  Who should pay the price for her behaviors (which aren't going to change regardless of where she is)?    If she moves to a different facility, is it reasonable to expect a different outcome in the long term?  Or might it lead to "going from the frying pan to the fire?"  How is her behavior affecting your well being?  What is her goal?  Where will she stop?  What are you willing to put up with?

At what point to we "let go" and stop the "caretaking"?  What choices do we have?

I can't say what a good path forward is for you in your situation.  The way I see it with an elderly BPD parent, there is no good path forward.  So it becomes a choice between how to balance our needs and values with the needs and chaos that our aging BPD parent brings into our life.  How do we choose?  Is being the "good daughter" worth our own health and life? I can see how much courage it takes to be the guy that "let go" on the bridge, and the daughter of the woman in the SLATE story.

It sucks. 

Methuen- I absolutely recognize that your situation is far worse than mine. I tried be more involved when my father was ill. I don't live near them but I would visit and stay and help and it was more than I knew I could do.  I knew then that I couldn't be in that situation. At the time, I was considering moving my parents closer to me and even suggested some assisted livings near me. Dad refused at the time. I know now that this was to protect my mother from discovery- if they were there, her behavior would be noticed by someone.

I also wanted to be a good daughter but what they expected was for me to allow my mother to be abusive to me and be her caretaker- but if I wanted to be emotionally intact for my own family- this was not something I could do. By not doing it, my parents got angry at me. While I had experienced BPD mother painting me black- I didn' think my father would. I loved my father and looked up to him.

While I haven't completely stepped away from my mother, I have kept a distance. Does it take courage? I don't know if it's courage. I think for me it was being "discarded" by my father. People have reassured me that he really didn't mean it -that he was sick, and not making sense. But I still experienced it and with BPD mother refusing to let me have any of his belongings it felt that way.

I read all the books on BPD. But mostly my relationship with her was due to my attachment to my father- and he was connected with her. Mostly I grew up feeling afraid of her.

So I don't have courage - I think this experience was a sort of "hitting bottom". The reasons I am still involved with my mother - I think- are due to what I think is a level of decency for me- what can I do for her- and still keep a distance. It's also because she's at risk for elder financial abuse so it's better for her that I have POA- (when she allows it)

I don't meet her expectations. I think people who don't know the situation are probably thinking her kids are horrible people. We don't visit as often as we probably should. This is not normal. Normal would be that she would be closer to me and I'd be helping more. "Normal" is what I have wished for. A "normal" Mommy- someone to take care of me and love me as a child, and I would care and love her in her older years. I tried "normal" - it doesn't work.

I did "let go" of the bridge rope. I am the "monster" who isn't keeping close to my elderly mother. It's unsettling as I don't want to be the monster but it seems that in a relationship with someone with BPD we have two choices- let go of the rope or go over the bridge- and so the bridge is not an option.

I am wishing you courage to take care of yourself. I agree- there's not a comfortable "balance" between our needs and theirs. It feels more like a wobbly balancing act and leaning to one side or the other.

Post script:  Karpman Triangle

I am wanting to come across as an observer here.  From afar, it is easier to see the bigger picture than it is for us when we are caught in the eye of the drama storm just trying to survive moment to moment.

So from afar, this is what I think I see, but if I've got it wrong, I know you will set it straight.

The Karpman Triangle has 3 roles.

Persecutor = the assisted living facility, and the people who work in it (doctors, nurses, aides etc).  Eg. the person whom she reports "hit her".  

Victim = your mom

Your mom has reported she is being abused at the facility.  I would be surprised if there wasn't another side to this story, knowing how a BPD can twist things.

This is followed by an email:
And there it is.  You are her designated caretaker.  Every pwBPD has a caretaker.  They NEED a caretaker.  

Rescuer = you

Moving forward, having a conversation with a supervisor is a good idea.  Since the facility staff aren't answering your calls (your mom told them not to talk to you at some point?), this may mean a trip there to meet with a supervisor.  There is a cost of time and energy to you.  And your mom gets you to do stuff for her.  Always chaos. And rescuing.  But probably necessary under the circumstances.  I would exercise caution in how to approach it though, so that it doesn't come across as "accusing", but rather as a daughter trying to keep in touch with how things are going for the facility with a difficult resident that happens to be your mother.  You might get better results if they know you are also on their team, and not just there to take your mom's side.

Setting up a camera is a really good idea.

Help me remember, but when she first moved there, weren't you quite happy with the facility and the staff?  Has there been a change in how you see the people who work there doing their job, or did you have concerns from the time she entered the facility?  Does your concern stem from what you have witnessed, or from what your mom reports to you?

My dad was in a facility for 1 year before he passed (Lewy Bodies).  My opinion of the staff never changed - if anything it improved.  One difference is my dad was well-liked, gracious, grateful, kind, compliant and agreeable.  The staff were so good to him.  There were a couple of exceptions, including one time a staff smacked him, but it was dealt with and that person left. There were other residents there that were more like your mom.  One was also a screamer, and terrified our little kids every time we went to visit dad.  There were also "wanderers".  One time, someone's teeth went missing.  They were found soon enough, and cleaned and returned to the rightful owner.  The way most people approached it was with calmness, and a sense that it is what it is, it's going to happen, and everybody just worked together to locate the missing teeth and return them to their owner.  Humour in the mix didn't hurt either.  Dad's facility also a "group" for family members which met regularly.  Along with the family members there were a few members from staff representing the facility.  The goal was dialogue, communication, listening to concerns, solving problems.  Not sure if your mom's facility has that, or if it's even something you would want to participate in since you don't live in the same town/city.

Beyond that, my advice is to proceed with caution, and beware of "rescuing" from a situation that she herself has created, and will probably create again at the next facility.  Of course, if she was mistreated, it needs to be dealt with, but does this reflect on the employee or the facility or both?  Nothing is ever perfect, and so I would proceed cautiously and slowly and carefully.  Because now you know what your mom's goal is.  And she gave it to you in writing. She wants to move in with you.  So she will stop at nothing to put you in the caretaking role to achieve her need.

I get the "hitting bottom".  Yes.  But I have to loudly disagree on the courage piece.  NW, I think you have so much courage. You, like to many, have had to grieve, make really hard decisions, and live with the sadness.  Those really hard decisions always take courage. 

I think we undersell ourselves, and do a poor job of acknowledging ourselves because we were raised to believe we were never "good enough", despite doing many folds more for our parent than some of our friends whom we hold in high esteem as being "good sons/daughters" to their elderly parents.

You, NW have courage.  I believe it with my whole heart, and it hurts me to see you write that you don't. I can think of so many examples from the stories you have told over the years.  But I think it is for you to come to on your own.  Just know that I and probably everyone else on this forum believes in your courage.  You are a role model and have provided support to other members here for years.  You have faced your mom and her behavior with so much courage. My mind is being flooded with examples.  I think it might be a good exercise for you to examine why you think "I don't have courage".

Me too, but I unfortunately don't have the distance.  My advice is to hold fast to keeping the distance you have, regardless of what she reports to you.  Trust me when I say as bad as it is right now, it CAN get worse. 

Hugs  :hug: :hug: :hug:. I wish we could cry with each other.  But this forum has a different kind of benefit - safety in anonymity.

It is so hard living 5 min from her and not going over the bridge with her

Thank you.  Just please don't jump to be her rescuer because of an "allegation" that may or may not have any basis in fact.  Both our mom's are pathological liars, so it is hard to believe anything that comes out of their mouths, especially when it is followed by "Please take me home with you".  OMG the FOG alone is traumatizing. 

I'm so sorry NW.

Thank you for your kind words and encouragement Methuen. I don't believe someone hit her and I am not going to "rescue" her from that place. On the other hand, I have been concerned about how the staff is treating her for a while. I understand they most likely don't like her due to her behavior- but she is also paying to be there. I rarely call the facility but when I do, I often can't reach someone there. I did ask to speak to the director that "my mother expressed concerns"- I have tried to speak to her and she does not respond. My mother also told a nurse advocate and the advocate decided we need to report our concens- for mediation, not an allegation that someone hit her- so an advocate is stepping in to facilitate communication. We are not assuming it's a real accusation but the staff is avoiding her, avoiding us and that makes me concerned about how they are treating her in general.

If we moved her it would be due to overall hostility or neglect. They can have boundaries with her and don't have to tolerate abuse but they should not treat her poorly. If this advocacy results in things getting worse, we may not have a choice. I hope not.

But if we do, it will be near where she is. I will not bring her closer to me.

I don't meet her expectations. I think people who don't know the situation are probably thinking her kids are horrible people. We don't visit as often as we probably should. This is not normal. Normal would be that she would be closer to me and I'd be helping more. "Normal" is what I have wished for. A "normal" Mommy- someone to take care of me and love me as a child, and I would care and love her in her older years. I tried "normal" - it doesn't work.


NW,

I don’t speak for the staff looking after your mum but from my own experience of dealing with families in your situation- generally staff dealing with difficult patients/residents know far more than you think about the dynamics between you and your mum.
I personally don’t remember a relative being seen as horrible when the patient/resident in question is as difficult as your mum.
They may keep their distance because generally your mum has been labelled as difficult and that’s enough for them to deal with and they may be expecting you to be as difficult as her. There also legal implications for the facility if a staff member shares information about your mum that may be inaccurate.

The worst I’ve seen-and I’ve been around residents/patients who were both verbally and physically abusive to staff- is were relatives behave as if their difficult elderly parents were oil paintings that could do no wrong- relatives who lacked empathy for staff and would go the mile to launch all kinds of legal attacks. That could be the reason why the facility staff maybe distant and not because they see you as horrible.

Like you have described it’s expected that relatives visit their parents more and from the behaviours your mum has displayed at the facility no one is in doubt of your reasons for keeping a sensible distance.

Don’t be hard on yourself NW, you have done more than enough to keep your mum safe and to maintain her dignity.

That's the sense I am getting- that they are avoiding me due to her behavior and may assume I am also difficult.

My mother lies a lot, so the only way I can know what is really going on is if I can talk to the staff and medical providers so their distance makes that difficult.

Thanks for the reassurance. It's an odd in between. I don't feel a warm emotional connection to her and yet, I also don't want her to be in a situation were she's neglected or worse- harmed- at least to the best of my ability. I can't control how the staff interacts with her.

On one hand, she's cruel and manipulative, and on the other, dependent and also is elderly, frail, and can't do a thing to help herself. It's like 2 people in one. I know who I am dealing with but how much to let her experience the consequences of her behavior isn't as clear as if she were a competent and physically healthy adult- especially if she's confused at the moment.

She hasn't been diagnosed with dementia. At the moment, they decided to go ahead and treat her for a possible urinary infection- and they reduced some of her medicine doses and see if her confusion gets better.

Notwendy,
I am under the impression from what you have shared that your mother is making constant demands on the staff and that if anybody walks into her room, she makes all kinds of unreasonable demands on them. My aunt who had strong BPD traits wanted to stay in her home and have her daughter who was in poor health herself be her full time caretaker. Her children hired an agency to give her 24 hour care. The problem was that my aunt would not allow her caretakers one minute of peace, constantly demanding they do something for her, like get her a glass of water if she saw they were idle. Eventually all the caretakers quit with her daughter spending a few nights sleeping on the sofa to provide care for her mother. My aunt met the qualifications for nursing home care determined by an outside evaluation, though she might have qualified for assisted living if not for her disordered personality.

I went to visit my aunt in the nursing home. From what I saw, she was the most able bodied mentally alert resident there, able to walk and interact with people. The staff at the nursing home told her children she was the most difficult resident that they had there. I am wondering if the staff just avoids your mother so they are able to provide the necessary care to the other residents. My aunt's children tried to take over her finances because she was not filing taxes. My aunt hired a lawyer to keep control over her money. My cousins were honest people and would never have helped themselves to their mother's money. Much of the inheritance was lost due to penalties because my aunt did not file taxes in the years before she died. I don't know if this story helps or not. I think you are up against impossible odds to figure out what is going on, with your mother determined to fail at the assisted living, so you will have to take her in. My aunt was determined that her daughter was going to take care of her, and made sure to be the worst person to care for while at home with caretakers and at the nursing home. Do you think this is what is going on with your mother?

Yes, Zachira- this is a lot like my mother and I don't put it past her to do anything to get what she wants. We will not bring her to our hometown- my husband also feels the same way.

BPD mother even as a younger person would threaten to "cause a scene" if she didn't get her way and that could be extreme- screaming, destroying things, calling up people and saying things to them and self harm. Sometimes she did these things when dysregulated but other times, deliberate.

I can't tell if she's truly confused or faking it.

Got an email from the nursing director that the staff can't manage her and she needs to have private  care there. She can not afford that. Apparently she put one of the nurses in tears.

Assisted livings centers can evict a resident if they make the case that they can't provide the level of care they need. There is a memory care unit- with a higher staff/resident ratio, that might be possible but I also think they may just want her to leave. They haven't said that yet. They have to give 30 days notice if they do.

I am already looking at other assisted living situations in her area but it could be the same issue anyway. If she truly is that confused, my power of attorney would be effective- but she also sometimes snaps out of it and also she might be faking it. She can't live on her own. She's very dependent -  but she's still in better physical condition than people in nursing homes.

Since she is already in a facility, can you request a geriatric psych assessment? 

Hi Notwendy,

I'm so sorry to hear this. It's a bit like expelling the difficult children at school, it's all they can do with limited resources. Do you think there's any chance your mother would change her behaviour, if people proved to her it no longer works ? I ask, because the only time my BPD has conceded has been when everyone including the authorities - block her. I.e. she can't get what she want's by being rude and disrespectful, so becomes complainant ?

... Correction, not "complainant" I mean, compliant - i.e. does what she's told. It's the system that works with the "worst offenders". Maybe offer to work with the nursing home on this - i.e. united front ? The BPD system is to set people against each other - so a united front may help ?

She will face a united front- that is- she will need to stay in the area- even if it means another facility. She has limited funds now- so she doesn't have a lot of choices. She's responsible for that. She had money but she chose to decide how to spend it regardless of our advice to please save it for her needs.

With all behaviors- people use the behaviors that have been reinforced. This is an elderly person who for decades, has been enabled by my father- ( and by extension- us kids because we had to behave) because we all feared her escalation. These are the only behavioral tools she has and they have worked for her until recently. It's not likely she's going to undo decades of reinforcement.

The assisted living has tried- this has been going on for a while. I think they are fed up. They called me again with another behavioral issue that they are documenting. I suspect they are documenting to build their case for eviction.

While I don't want my mother to be abused or neglected, I agree with the lesson of "natural consequences" and to not rescue someone unless it's a danger to them. She only agreed to move out of her house when the risk of the bank repossessing it was there. She didn't slow down with her spending until her funds were too low to continue that. If she gets evicted- I will ask the assisted living to address that with her- she needs to know that and that she needs to move. I don't think they will give her another chance.

Family will not rescue her but there is a limit to the extent of the consequences. One can't just put an elderly and infirm person out on the streets. She has to go somewhere that meets her care needs. Likely social services will be involved. They will present her options to her. I have a say in where she goes, but we are all aware that pwBPD take advice better from other people rather than family members. It's better to have her be aware of the consequences and choices.

The psych evaluation sounds like a good idea. Let the assisted living do what they have to do to get your mother a placement that better fits her needs. I suspect they will try to place her in a nursing home, like what happened with my aunt who to me would have seemed to be able to be in an assisted living if it weren't for how demanding she was to the staff.

I am wondering if a better fit for your mother would be a mental health facility.

Or perhaps the memory care unit could be explored.

Notwendy,
 
You're very wise, it sounds like you know how this must roll out. You've clearly done your best for your mother, you can't do better than your best. Be good to yourself, you must be exhausted by all this.

Zachira- There really aren't any. There are facilities for shorter term issues- addiction, to get someone stablized on medicine- with the goal of the person going back home to their regular lives. There may be a few in certain areas of the country- not any I know of.

GaGirl-It would be good if the assisted living offers to move her to memory care but by the defensive tone of the staff and nursing director- I get the sense that this would be an opportunity for them to evict her if they wanted to do that.

They have made some medication changes to see if that is the issue. If her state of confusion doesn't improve- I will ask for a mental health evaluation and also to determine mental competency.

It's hard to tell what is "real" with her and what is her being manipulative. She calls me being all sweet- "I'd really like to see you". She doesn't usually do that or even ask me to visit.  It would be nice if it were sincere, but I can't believe what she tells me. Her usual demeanor with me isn't "nice" or affectionate- unless she's manipulating me. She may be confused but she still has her manipulative behaviors.

HappyChappy-thanks, yes, it takes time and attention. I know I am doing what I can to the best of my ability, while protecting myself from her behavior and exploitation. It seems that with BPD, they are emotionally unsettled much of the time.

I also wonder how much of the "confusion" is real or she's faking it. She's been "confused" before- and it has generated a crisis situation and medical consults. No cause has been found. After a while, she snaps out of it- becoming completely lucid. During these "crisis" - decisions are made and when she's lucid again, she takes control again, sometimes reversing decisions.

I wonder if plans are made to move her to memory care or she's evicted if she will become lucid and refuse the plans. If she's evicted though- she will not have the choice to stay where she is.

I feel sorry for her in her situation but also, I've experienced her behavior.

I don't think the assisted living can just put your mother on the street, that they have to find her a placement somewhere. Perhaps it would be better that you do not visit at all, because maybe the assisted living could say we are evicting your mother and you would have to take her home with you.

Exactly !!

I had planned a visit before all this happened and postponed it. She’s been asking people to “come get her”. Better that I let this settle first.

My BPD mum, always falls back on "I don't understand", even when she had understood a few hours earlier. As you stated earlier Notwendy, the nurses will be better placed to know if she doesn't understand.

On a lighter note, my BPD mum's sister was a compassionate nurse, when my Dad died, she made a point of giving me a copy of Alice in Wonderland and saying, make sure your mum reads that.  lol

Notwendy,
I am so relieved you get it that you cannot visit your mother because you might be forced to take her home with you. For those of us who are raised by disordered family members to be the caretakers and blame ourselves for the abuses, it takes a lot of soul searching, often many years of therapy, to no longer be enabling the manipulations of disordered family members and their abuses of family members. You've got this!

Good decision!  Do NOT go visit her while she is saying "get me out of here".

OMG, the last time my mom fell and broke an arm, I had explained to the emerg Dr why I couldn't look after her, and told them that after previous falls, home care had been set up.  That takes time, so they had to "admit" her to hospital for 3 days until they had home care set up.  OMG.  She was "dysregulated" in there.  She drove the staff crazy, and even her doc told me "he had to get stern with her". The texts to me never stopped, and included the language "get me out of here".  The guilt was nuclear.  I was a wreck.  But I stuck to my plan.  I know you will too, but it can be quite intense once they have "decided" they are leaving, and they've also decided it's your job to rescue them from that institution.

Fast forward 3-4 years, to now.  I have a LOT of health issues going on right now.  I am extremely stressed, and I suspect that a lot of my physical issues are related to the stress imposed on me by the behaviors of my BPD mom.  We are supposed to be leaving on a one month road trip into the wilderness in 3 weeks (no cell service for most of it), so I know everyone here can understand how our leaving town will ramp up my mom's feelings of abandonment and behaviors.  It got to the point yesterday morning where I blocked my mom on my phone.  Like the daughter in the SLATE story, yesterday I chose myself.  It's still blocked today.  I need to let my nervous system calm down so that I can begin to heal physically, and actually go on our planned holiday into the wilderness.

My T yesterday asked me what that was like to block her, and the first word out of my mouth was RELIEF!  Emancipation! OMG - it felt so foreign...and so good to know that she couldn't reach me...

I did not tell my mom I blocked.  I believe that to be escalating and foolish.  I only did this because I was at a point where I needed to take care of myself, and "choose me".

I only mention this to plant a seed for you.  I have read about other people blocking their mom on the phone in my years on this forum, and could not imagine ever doing that myself.  It seemed like a terrible thing...

But I really want to go on my trip, and to do that, I know I need to be healthy enough to be confident to be going into the wilderness where there is little to no health care for a month.  So, yesterday I chose myself and blocked her for the first time in my life.  My nervous system has been whacked for some time now.

Looking back, I could have saved myself an incredible amount of stress if I had blocked mom while she was in hospital sending me truckloads of texts to "get her out of there" while she was in hospital those years ago.  Looking back, there's probably a lot of things I could have done to take better care of myself, and mom would have been just fine regardless.  Why do we let them do this to us?  Why?  Why?  That is the question...

The book "Stop Caretaking the Borderline or Narcissist" does a good job of pointing out that we can change our own thinking and behaviors, and work on our own self-confidence so that we can see a path to stop accepting some of their behaviors.  I took that first step yesterday when I blocked her to give myself some relief from the stress of her, and time to heal from my own medical issues before I leave on my trip.  It is a sad thing to have to do, but in the moment I was determined, I knew it was necessary, and I am not regretting it.

I just put this out there as an idea for you to contemplate, should you get to the point where you might actually ever be ready to consider it.  I am not suggesting it for right now, but what I can say, is that for me, when the time was right to do it, I knew it. There was no second guessing. Of course you would never block the facility, and you could stay in touch with them, it's just her and the behaviors and the invasive texts that get blocked, for as temporary a time as needed.  The way I see it, they are manipulative and emotionally abusive, and at some point when we are finally ready (because we hit our bottom?), we can decide to stop accepting that behavior, and start looking after ourselves.  

Strangely, I have believed I have been taking good care of myself because I eat healthy, do regular physical activity, have meditation apps, do yoga, am socially engaged, but through it all over these past 10 ish years, I've continued to allow mom to exercise her behaviors on me because I am afraid of her.  I think this is where many of us struggle.  

I will unblock her when I feel ready.  

I hope you can take care of yourself through this crisis.  Sending you strength and hugs. :hug:

One giant step to better health Methuen !

I’m just here again to cheer you and NW on.

My mum and dad and most of my siblings have been blocked for years now going 2 to 4 years.

It feels awful but I realised that I too was ‘ addicted’ to the drama. Not like I went seeking for it but the fact that it was always there made it difficult to unplug from. The story being spread in my case is that I’m going crazy. I’m loving it because nobody bothers a crazy person.

It’s a huge relief and it will take time to get used to. Once I started blocking disordered people in my life it was like wildfire spreading through my relationships because they all had to be blocked.

You will find that life’s not as stressful as you have become accustomed to and your body will thank you for it.
NW I’m glad you are not going to visit her distance you are keeping will allow your mum to experience the natural consequences of her behaviour.
Like I asked Methuen in the past, what will happen to your mum if she didn’t have any relatives to look out for her. Will she end up homeless on the streets, would the services ignore her needs. The answer to that is no.

The doctors and nurses and other professionals involved in their care will step in to make best interest decisions that your mums will not oppose.

It’s a privilege (not a right) to have kind, caring and responsible daughters like your mums have and that privilege has been immensely abused.

This made me laugh.  A lot.  And I needed a laugh.

This rational and logical point is extremely helpful.  We have been conditioned to think and feel like we are responsible for solving the BPD's problems.  But there is a "system" that also has responsibility - and at some point, we are going to have to trust in that.  So thank you TM.

And thank you also TM for your words of encouragement.  You are like the angel above that just told me blocking is ok - and with humour "What took you so long?" :heart: |iiii

Methuen,
You have taken a big courageous step in blocking your mother and most likely will start to do this more often when you need to focus on self care.

I think I see what is going on here.  She is being oppositional and defiant and is resisting all help.  Now she is mistreating people.  She probably has the knowledge that if she behaves bad enough, she will be evicted.  She doesn't care if she is because she doesn't have servants there.  BPD's never think about "consequences" or what comes after.  Alternatively, she may want to be evicted, because then you (or someone else?) will have to look after her.



Right?  I'm no psychoanalyst, but my mom was "demanding" me to "get her out" of the hospital when she broke her arm. 

I think your mom's game could be to misbehave because her distorted view of the world is that the assisted living workers won't cater to her every need on demand.  They aren't meeting her needs.  Therefore, she will behave however she needs to so that she gets a new place to live.  By telling people to "come get her" she is telegraphing she wants a caretaker. 


I suspect her extreme behavior is why some care facilities "medicate" some residents.  Could you ask the nursing director for a cognitive assessment test and geriatric psych assessment asap?  Does the facility do these or would you have to arrange it privately?  Also, could you ask the nursing director if there is some medication she takes that they could increase or give her to "calm her"?  Do you have healthcare POA?  Could you authorize this?  My mom has never authorized healthcare POA to me, and never will, so I will never have this option.  But if you have the option, it may be time to exercise it, even if you don't want to and find it distasteful.  Nobody wants a parent "medicated", but at some point we have to stop enabling our own torment and abuse from the BPD parent, and also that of the workers who have to take care of her. 

Even if you are successful in finding another facility to move her to, how much time do you have to invest to do that and move her?  Is she going to do the same thing at the new location, and every location, until there are no more locations? 

I still haven't unblocked my phone since yesterday.  Now when my phone "notifies me", my heart doesn't leap, and I don't panic that I will see her name lit up.

Glad to know it made you laugh- laughter is a good medicine too.

Methuen- I am so happy for you that you have chosen to give yourself some space and peace! You will have a nice retreat from all of this on your holiday!

I know that if my mother was closer to me, I'd have had to block her and stop contact. It would have been difficult. Due to distance, she can not call me for daily tasks like errands or meals. While I haven't blocked her, I do put my phone on silence and don't answer calls at times.

The stress during my father's illness showed itself physically for me. That scared me. I won't put myself in that situation again. My mother didn't seem to care if I slept or got any rest while staying with them. There was no routine, or regularity to meals ( I would bring them in when visiting). She might be up at night, sleep in the day.  I stopped staying with my parents and chose to stay at a hotel when visiting. I think we need our own space to be able to feel safe. We might be able to be rational about that feeling as adults but I think we are on "alert" around our mothers.  It would be a challenge to feel safe if she were closer. I am happy for you that you are creating some emotional safety for yourself.

I don't know what my mother's agenda is. If I had to identify the most difficult aspect of her behavior - it's her secrecy and lying. If she wants something, she won't reveal that- she will manipulate the situation. I have no way of knowing if what she tells me is true or not. I also can't tell if she's truly confused or it's an act as well. As scary as her dissociations and rages are- they are the one thing about her that is "real"- as she doesn't control them.

Of the three personas, "witch" is actually the easiest to deal with because it seems to be the most authentic. Waif is an act- and that is awful to see- she can be so pitiful. Queen seems to be her most comfortable persona- if there are people to meet her needs but putting the staff in that role isn't appropriate.

Her caretakers seem to think she is truly confused. I think there's a combination of confusion and manipulation. If the confusion persists after changing her medicines, I will ask for a cognitive evaluation. She knows that if she's not legally competent, I have the POA. If she is not truly confused, she will not let that happen and will be lucid again.

Methuen- your mother has made a mistake by not making you POA. In the US, there's another route- if a person isn't mentally competent and there isn't a POA, or the POA isn't willing to take that on- the person can become a ward of the state. If you aren't the POA and your mother can't make decisions for herself- someone will have to do that for her. It was a friend of my mother's who worked in a law office who suggested she make her children POA and so she took the friend's advice.

I don't know if she's aware of possible eviction or not. If she's evicted - there won't be much choice but to move her.  She will have to go somewhere. It would likely be the same thing anywhere. I would leave that to social services to help decide where. Before any facility accepts her- they'd look at her records to be sure they can acommodate her and if there is space available. So I don't know where that would be.

She is on medication to help calm her. I read somewhere that pwBPD seem to have no emotional skin. She is a bundle of nerves without the medicine- truly suffering emotionally. Hospice understands this and so they make these medicines available to her. The challenge has been to find the right dose. At a lower dose, she's so anxious, she's miserable. When they increase it, she gets confused and still acts out. I don't think they can ethically keep her over sedated, but it's been difficult to find what works best for her.

I understand the jumpy feeling when you see your mother's name calling. I think the silencing the phone helps with that as there's a sense of control- you don't have to answer it. I don't answer it all the time either.

  If my mom loses capacity (she does have mild cognitive impairment), this is the way it will go (ward of the state), because she is far too dug in about her control over her own health to ever willingly sign it off to anyone else for any reason. She "fights" everything, including the things that would help her.  It's the classic example of a child learning a strategy in childhood to survive in dysfunctional and unsafe home (feistiness and fighting was her way  to keep herself safe), and then carrying that same strategy into adult life and relationships when she didn't need it anymore. A geriatric mental health consultant I had been disclosing my situation to when this all first started a few years ago suggested "I talk to mom about this health POA "  and ask her to sign it.  After I had disclosed everything about mom and our toxic relationship.  I asked her to open that conversation with mom, and that's where it all died.

The second best case scenario I see for you and your mom is that social services works this out for her.  That lets you step off the triangle, and lets her be responsible and accountable for her own behavior.  The best case scenario is if you mom comes to her own conclusion that staying here is better than going to a different facility.  I just read in Stop Caretaking the Borderline or Narcissist today, that BP's hate change and can't cope.  Well that's no surprise to us, but if she could figure out on her own that staying in this facility is her best option (therefore backing off the bad behaviors) I guess that would be the best case scenario.  As long as she believes she can get you or some other family to "come get her", the best case scenario can't be.

We can't help them if they won't help themselves.

I can't see your mom but I can try to imagine her (unsuccessfully I'm sure). I'm trying to imagine this anxiety and the dosing challenge you've described. If I had my mom's anxiety, I think it would kill me, but for her it's just normal.  If she's not anxious, she has to create drama to feel her normal anxiety.  It's craziness.  No sane person wants to live in that state perpetually.  My mom of course refuses all medication (because she doesn't like feeling "drugged").

I remember there was a medication that GaGrl said was effective for her mom, but I can't remember what it was. Iff dosing is a challenge for the reasons you've mentioned, I'm wondering if there could be a different drug, but I'm sure all that has been explored already by you and her Dr and her assisted living facility and care teams.

It just is what it is. 

I hope you are ok today.

Thanks Methuen-
BPD mother remains confused. The other times this has happened- she's cleared up with medicine changes and antibiotics- this time not. It may be that she's having some sort of dementia now. She isn't formally diagnosed and it's probably too soon to determine for sure- but I am going to request that her providers evaluate her- because it will determine what level care she needs.

It would be best for her to not move- but if she's evicted, she won't have the choice to stay. If she has a form of dementia- she will need a memory care unit.

We are involving social services- not to accuse the assisted living of anything but to help with determining what her needs are and what is the best situation for her. I think it's clear that the staff is overwhelmed with her needs. We were discussing options for placement and I also mentioned- being in my home town is not an option. It seems like a logical decision in "normal" situations and so I need to make it clear that BPD mother needs to stay around her area.

Hopefully GaGrl will post what medicine helped her mother. I think it's a watch and wait trial to see if BPD mother's thinking clears up soon and if not- then look at other medicines.

We assume that people will judge us but what social services said was a helpful surprise- she said "no judgement here" and that she sees situations where children go NC with their parents. I explained that BPD mother is better behaved with people that are not her family and that we, her children, need these boundaries, and we also need to be sure that BPD mother is in a safe situation. She understood!

My mother was not on a heavy medication regimen until well into her home hospice care, when she began having hallucinations in the night. She was given Ativan for anxiety and Haldol.  It worked for her most of the time. She was having both visual and auditory hallucinations.

When my sister was undergoing cancer treatment, she also took Ativan. It is addictive, but that isn't a concern with hospice patients. I think it's more about finding the right dosage.

Thanks. My mother has been a long time Atavan user. It used to help her a lot. Without it, she is overwhelmingly anxious. Interesting that, lately- each time, her Atavan is increased due to her anxiety- she gets confused.

They have backed down on it to see if she is less confused. I have read up on her situation- and Haldol was mentioned. I think it's too soon to add on another medicine- but if Atavan isn't working like it usually is- it is possible that Hospice might decide on Haldol.

She doesn't seem to be hallucinating but she is confused, and paranoid. She also asks the same question over again- which I think is a sign of dementia. It's possible that this is also going on- but it probably is too soon to be certain of that.

If hallucinations begin, it's pretty evident. Mom "saw" people in the room and wanted me to get them out. She saw a girl moving across the front lawn and wanted me to tell the neighbors to stay off the lawn. She saw a young woman in her room and wanted me to get her out. She "heard" conversations that weren't taking place. The best was the litter of puppies she saw.

I started to block my mother's calls a year ago. At first the FOG was unbearable but gradually, the more I did it, I started to see that the world did not end when I was not available to her 24/7. When I felt ready to speak with her, I called her. Finally, I was putting some real boundries in place to protect myself. I am so glad for you Methuen and wish you peace and rest on your holiday in the wilderness! I too can vouch for 'Stop Caretaking the Borderline', it's been the most useful self help book I've read on coping with a BPD relationship.

She hasn't done this. She's been paranoid- more than usual. She's also been found wandering into other people's rooms- not on purpose but confused as to which one is hers. Apparently one resident is keeping their door locked to keep her out.

We did speak to the assisted living. Thankfully, they didn't evict her. They offered the memory care unit. They said they can't manage her or keep her safe on the regular floor. That was the underlying message- "offer you can't refuse" because if we didn't agree to memory care- they'd say they can't keep her safe.

They said something about her having dementia and I said I didn't think she was ever formally diagnosed as nobody told me that she ever was. So I don't think they have a formal one. To get to the memory care unit, one has to have that and so they are going to obtain a formal diagnosis and move her.

With their documenting of her behavior, Hospice can make that diagnosis. Of course she holds it together better with other people so seemed less confused with them. She knew the date and where she is but forgot she had dinner and how to use her phone, she forgets where her room is, asks the same question over and over. She's finished the antibiotics for presumed UTI and her medicine is being reduced so it's not all that, but even if she suddenly became lucid, she's gone in and out of confusion over time. The bottom line though is that they can't manage her on the regular floor and she has to move, even if she has periods of being less confused.

It's the best choice for her and not really a choice. Whether she likes it or not, she can't stay where she is. It's the highest level of care they offer and if she can't be managed there- then the only step up is a nursing home and she doesn't want to go to one if possible.

I recently visited a memory care unit to see a friend of mine. The staffing was incredible: a high number of staff to resident ratio and lots of caring attention to each resident. I liked how the staff knew when to interact with a resident and when to leave them alone. In my visits to nursing homes, residents often spend long hours in their rooms with mostly only required attention to their needs. The memory care unit could be a better fit for your mother though may be considerably more expensive than a nursing home. What do you think?

However much you may feel Guilted to step in, for your own sake and sanity your response must be No.  That's just the reality.

Thanks ForeverDad- yes, I agree- that isn't an option. She has her care needs met where she is. I'm glad they agreed to keep her at the assisted living.

It may be that the assisted living could not actually kick your mother out without finding her an alternative placement or getting a relative to take her to live with them. Probably no assisted living would take your mother suspecting or knowing that she is a high maintenance residence who really needs to be in a more restricted environment with lots of individual attention from staff. Not sure what would happen if your mother could no longer pay her bills, though if someone has no money whatsoever and needs nursing home care in the US, their bills would be paid in a nursing home likely with a shared room.

She isn't eligible for Medicaid- she has a monthly income that helps with her expenses. Her savings help her live in a nicer situation than a nursing home. We have tried to prevent her draining them so she doesn't have to be in a shared room in a nursing home.

I just blocked her number. Of course, it's temporary as I will have to speak to her at some point, but she called me yesterday wanting to spend some of her savings. Prior to her "dementia" consideration, it was her money to do what she wanted with. This time, I said no, and blocked her to stop her from repeated calling.

It was already difficult (impossible) to reason with her. Now, there's no point in trying - she didn't comprehend then, and she doesn't now. It's in her best interest to protect what she has left.

Glad you are protecting yourself from being berated by your mother by blocking your mother's number because you won't do what she wants. When we are the ongoing target of a disordered person who blames others for how they feel inside and have no way to stop being the target, limiting our contact with this person when we can't go no contact, protects the target and gives the target time for some peace and time to be less affected by the ongoing abuses. As targets, we do everything to keep things from escalating and it does not work. Right now, my neighbor is invading my private property because I refused to be her flying monkey in siding with her to make the HOA do everything she wants with zero regard for the rest of the neighbors.

You have done the right thing to protect both of you - her savings and your sanity.

The blocking HAS helped me a lot.  I feel safer and more at peace knowing she can't "reach" me with her messages and needs.

I didn't think the blocking would be much different than silencing my phone but it does! I think this is because even seeing my BPD mother's name pop up when she calls- I notice it and there's a sense of obligation- even if I don't answer. With blocking- that kind of intrusion doesn't happen. It feels calmer!

I know I will need to unblock her intermittently so that there is some communication but I can decide when to block/unblock.

Notwendy and Methuen,
We all need time to feel safe from the disordered people in our lives. Knowing that a disordered person can contact us at any time even if we don't have to respond leaves us walking on eggshells and in a state of fear of what horrible things they are going to say or do next. Glad you both are feeling better being in charge of when you choose to hear from either of your mothers by blocking them on your phones from time to time. Methuen, I hope you have a great vacation.

One relative just told me that BPD mother told her that she "isn't speaking to me" so I guess it's mutual!!

I did unblock her for a while today in case she needed to reach me, but she didn't call.

She’s no longer confused then lol!

Let’s hope she can start believing you are going crazy…so she can leave you alone for good.


Even intermittent blocking does a world of good… you deserve peace

She will be evaluated soon. There's no way to know how the evaluation will go. BPD mother still has her "manipulative" functions and sometimes, seems intact, and other times seems very confused.

With the confusion, it's hard to know if she's lying on purpose or confused. It's also hard to know when she is really confused or acting confused.

The main issue is that the staff feels they can't manage her on the regular floor she is in now. She will either have to move to a higher level of care at the assisted living or be placed somewhere else. Whatever the decision is, it's up to the facility and her medical providers, so I will just wait to see what they decide.

Edit- she does have some signs of cognitive impairment but can still "pull it together" for visitors. If she is assessed to have dementia- she can go to that unit. However, it's also possible she will pull it together for an evaluation- because it's hard to know when she's in control or not. So there is no telling how it will go.

Perhaps you can put a bug in the ear of the evaluators that (1) they begin without telling her they're assessing her and (2) do more than one session so they don't catch her when she's least bad.

Bug in an ear...  Reminds me of an author (wish I remembered his name?) who wrote short stories I read in the late 1960s.  They were all zingers on small-scale country life, perhaps gentle mountains of Appalachia.  A kid was playing in the field when all of a sudden he started screaming and jumping about.  Family fetched the doctor and the doc had them hold the kid down while he pulled a bug out of the poor kid's ear.

Would part of the assessment be the assessors talking to the staff and looking at their notes on how your mother has behaved since she has been in assisted living?

Notwendy I don't know if this is helpful but I got curious and asked my husband a few questions to see if he had any thoughts. H is a physician and experiences a lot of difficult patients. He has worked with geriatric populations most of his career, both in large hospitals and in smaller clinics.

Both of his parents seemed to have PD traits and when he worked in hospitals he was on a risk team made up on psychiatrists, attorneys, nurses, case workers, administrators, physicians. He's no stranger to difficult people in the health care system (and was married to a BPDx). He's paid his dues  :(

Cases that got escalated to risk team he described as pretty extreme. One time I was in the hospital with (then) S16 and the elderly man next to our room yelled all night long for police, threw urine at the nurses, screamed that he was being tortured. When H came to see us in the morning there were 3-4 security next door and I was alarmed, and asked H what was happening. He didn't even notice. He said if he paid attention to every difficult patient he wouldn't be able to do his job.  

I asked him what he knew about how assisted living handled difficult patients. He said to his knowledge AL doesn't evict people, it's more likely they sedate patients with behavioral issues, or move them to memory care, which in his view is the same as the rest of the facility except with prison-level security to keep people from wandering off or into someone else's private space.

It made me think it's worth looking at her medication to see if they are increasing sedatives. H seemed to think there are really only three and they don't work that great, so often the dose is increased or they are combined until older, difficult patients are not able to hurt themselves or others.  

I don't think they can do things willy-nilly because occasionally there are audits done, but perhaps they are going through the steps to check boxes so they can medicate her according to her needs and/or move her to memory care.

To a great extent your mother is in the care of a support system and you can mostly step to the side.  With your mother being reassessed regarding her meds - though we know meds generally only moderate poor behavior - let them determine whether changed or increased drugging is a solution.

Meanwhile, you should to insulate yourself from the emotional impact of pleas begging to come back into your life.

Interesting idea if it's allowed with someone who still has capacity.  I doubt this would happen in practice with a reputable facility (at least where I live).  My mom (who still lives independently) was offered some dates for her annual reassessment last May, and she "declined" them all because it "wasn't a convenient time".  No surprise there.  She can do that because she has to give consent to have it done in the first place. 

Because we have pulled back and really are doing the minimum we can get away with, mom is struggling a lot.  The "I want to die" messages have appeared a number of times recently.  She is constantly bemoaning her loss of eyesight.  She will never connect that loss to her decision to cancel home care services who were dispensing medication into her eye twice daily for her.  She wails about her loss of vision every single time one of us sees her. 
Because she is struggling more, she has agreed to have community care come assess her again.  The appointment is booked for September.  We shall see.

Like NW, my mom "pulls it together" for these appointments and "assessments".  Suddenly she can talk and sound 10 years younger, and reasonable and witty and charming and completely coherent.

It's like she can have multiple personality disorder.  Really.  The difference between her functioning on the assessment, and her day to day functioning feels like 2 standard deviations. The higher functioning witty personality only comes out for an assessment.  I swear it is the ONLY time it presents.  Then the day after the assessment, she completely falls apart again which can include a demand to take her to emergency for some crisis she has imagined or created.  This has been the pattern for all her assessments.

I have come to have little regard for those assessments.  They take such a narrow snapshot in real time, and they do not include family unless my mom consents.  She consented the first year.  She lied through the assessment, and is not required to "prove" any of her answers. 
Q: "Do you do any of your own cooking ?" 
Mom: "Every day".

Q: "are you lonely?"
Mom: "never"

She hasn't actually cooked for herself in many years.  If someone she knows (friends) haven't dropped meals off, she eats snack food (cookies, fruit, treats).

She tells H and I all the time how lonely she is.  More importantly she ACTS lonely by saying things like "not a single person came to visit me today". (The guilt trip)

She will even tell the assessors she has no problems with her eyesight.  I know the chair she uses directly in front of her TV (about 18 inches away) will be moved back into the living room with the other furniture.

When I added different information/perspectives in her very first assessment, she went nuclear, and I was "left out" of all future assessments.  Right?  You have to "agree" with them at all times, or "suffer" the rage.  Last year she let H attend because she uses him as an interpreter to understand the questions (she can't hear/process well). So frankly, these assessments are probably ok for non-PD geriatrics, but I have found the ones used where I live to not be helpful or a true reflection of the facts (from my perspective) for my PD mom.  Thus, she cagily continues to prove her "capacity". 

As NW says, in the normal day to day it's impossible to tell if they're lying or confused, or just seeking attention or what the heck is really going on.  All year long is like "H_ _ L on wheels" with her, and then the day of the assessment, she has an amazing day.  One geriatric psychiatrist even mused out loud "he was surprised by how well she was doing".  (H was there with her and couldn't believe her "performance"). Every time.  Every year.  So what does that suggest?  "Pulling it together" feels like the understatement of the year.

Good Question!  For NW's sake, I hope yes - because they also have a vested interest since she's in their "facility". I expect there would be weight put on the responses of professionals.  Where I live, family are not included in the assessment process at all except by "invitation" of the person being assessed.

It is troublesome that the people "held responsible" for her "care in her own home" don't get an opportunity to include their observations/perspectives.  My mom leaves her family out, yet demands they meet her needs to continue to live in her own home.

One would think that at some point, "lying" on these assessments isn't enough to "let her pass".  On the other hand, human resources where I live are so limited, that they seem only to happy to accept her lies and not question what looks so obviously like someone struggling.  She also has a "reputation" of being difficult with community care, so I can't see them being very motivated to get the "truth" on these assessments.  Easier in every way to "let her pass" according to her own answers.

I'm hopeful NW, that with your mom being in an AL facility, she gets away with less "game playing" and as other people have suggested here, her assessment gets input from the facility.  Ultimately the facility will do what it has to do (transfer to memory care or alter meds).

This is so wise.  Your mom will continue using guilt to have family come rescue her from the facility.  The trick is to not let the "push pull" or the guilt, or your own kindness draw you back in over time.  I would predict that she will "tell you things" things that will make you question the quality of the facility she is in, or some of the workers. Terrible things will get said, and already have if I remember right. It can be difficult to know what is truth and what is their imagination. And of course nobody wants their parent to be mistreated. But our mothers are masters at creating a narrative that benefits them and is designed to meet their needs.  Since they have made us "their caretakers" (not something we ever "agreed to") they see it as our job to meet their needs and protect them from things they don't like, or we are failures as daughters. She is going to put a lot of pressure on you now or later, and so the advice to insulate yourself from her pleas begging to come back into your life are easier said than done in actual practice.

I hope this makes sense.

I hope you are finding ways to stay grounded through all this, and keep perspective. 

Notwendy and Methuen,
My understanding of confidentiality is that anybody can talk to the assessors and give them information about the behaviors of the person being assessed/treated. The assessors cannot provide information about the assessment of the person being assessed if that person will not allow it. 

Thanks everyone- it has been an interesting few days. BPD mother seems more lucid lately. It’s looking more like medication cause- one of her medicines was decreased but also when these episodes happen it’s found that she has gotten a friend to sneak in over the counter medicines too. These interact with the ones she’s taking which makes finding a right dose difficult. This is one example of her narcissistic “rules don’t apply to her” ideas. If you tell her something is not allowed - she does it anyway.

The assessment does take the information from the staff but if she’s intact - then that’s how it will go. I was actually more anxious about using my power of attorney if she wasn’t - because of her oppositional behavior. The AL sort of gave her a soft warning about her behavior if she stays in the room she’s in - so they won’t jump to evicting her but this may be their protocol to do this first. She is on several medications but they don’t stop her BPD behavior. I don’t think they can sedate her so much that she is sleeping all the time to do that.

Her extended family is done with her - they so much have said it to her but if anyone is critical or angry at her - she dissociates. You can see it happen. Her face goes blank. Her eyes glaze over and after - she acts as if it didn’t happen.

My approach with her is at the task level- from a distance such as helping her with electronic bill pay from her account. I block her but she can leave messages and I call her back if needed. If she does well in the assessment - then it’s up to the AL to decide what to do next- but it will be in her area if they want her to move.