Ailing Elderly In-Laws on the BPD continuum

[Depression = 72% of members]

I am usually on the Staying Board, but have some family related issue questions – quick history – high-conflict, alcoholic H (who I believe is uBPD), married 21 yrs, together 23 yrs – we have DSS27 (we had standard visitation and he never lived w us, now married), DS21, DS18, DS13, DD11 (who all live at home right now). 

H’s FOO is dad (co-dependent), mom (who I believe is also uBPD), 2 living brothers (who personality wise are very similar to H and both alcoholic) and 1 deceased brother (OD at 37 yrs).  H’s parents live several states away near oldest brother and family and younger brother and family lives in same town as we do.  H and his brothers do not have anything to do w each other or speak to each other for probably at least the last 8 yrs.  H has a very tense relationship w his parents and blames them for “abandoning the family and their grandkids” to move back to their home state to retire.   All lived in the same town we currently live in until about 9 yrs ago.

H’s parents are both 74 and in failing health – H’s mom (my M-I-L) has always used illness and “forgetfulness” as ways to get attention and manipulate/control her world and all those around her (along w a whole host of other BPD-like behaviors!).   Now, I believe she really is suffering a fairly significant level of dementia , but H, B-I-L’s and at least one S-I-L seem to think she is still using her “wiley ways” to control life.  H and I don’t get accurate info from F-I-L or M-I-L about what doctors have said so have no way of knowing what is true and not true.  H has also refused to visit his parents since they moved away (and for the record, he is the black sheep of the family).  His take is “I love my parents – I just can’t stand being around them.”

F-I-L can barely get around and now really needs assistance w M-I-L although “he doesn’t want to be a bother to any one” (really, does anyone?).  The family is in a big kerfuffle because B-I-L who lives nearest to parents, works an overseas job and is gone for months at a time.  He and his wife have 2 young children who, rightly so, take up S-I-L’s time (she is the S-I-L who is reluctant to believe the dementia diagnosis and who is resistant to the idea that anyone else can help M-I-L except her – yes, I know, we are a dysfunctional bunch!)

Question:

1.    Is it possible to really differentiate what is truly dementia and what is well-seasoned BPD behavior based on your personal experience?

2.   Is it likely that if M-I-L got whatever attention she is seeking, she would get better (even w a diagnosis of dementia)?

Family is at a crossroads and F-I-L has presented these options:

1.   B-I-L and S-I-L closest to them can sell their house and build on parent’s property so they are close enough to help with caretaking.  They are currently only 9 miles apart in a small town, rural setting.

2.   F-I-L and M-I-L can sell and move here, live in our rental house (2 houses down the street from our house) and H and his brother here can set-up/provide caretaking.

I am actually quite ok w H’s parents staying several states away because kids and I have our hands full dealing w H, but I am also willing to help his parents if that is what is decided but that would entail them moving here.  I am trying my hardest to just “mind my own business” but it is difficult when they, from afar, appear to be so needy.

[martillo]

I am usually on the Staying Board, but have some family related issue questions – quick history – high-conflict, alcoholic H (who I believe is uBPD), married 21 yrs, together 23 yrs – we have DSS27 (we had standard visitation and he never lived w us, now married), DS21, DS18, DS13, DD11 (who all live at home right now). 

H’s FOO is dad (co-dependent), mom (who I believe is also uBPD), 2 living brothers (who personality wise are very similar to H and both alcoholic) and 1 deceased brother (OD at 37 yrs).  H’s parents live several states away near oldest brother and family and younger brother and family lives in same town as we do.  H and his brothers do not have anything to do w each other or speak to each other for probably at least the last 8 yrs.  H has a very tense relationship w his parents and blames them for “abandoning the family and their grandkids” to move back to their home state to retire.   All lived in the same town we currently live in until about 9 yrs ago.

H’s parents are both 74 and in failing health – H’s mom (my M-I-L) has always used illness and “forgetfulness” as ways to get attention and manipulate/control her world and all those around her (along w a whole host of other BPD-like behaviors!).   Now, I believe she really is suffering a fairly significant level of dementia , but H, B-I-L’s and at least one S-I-L seem to think she is still using her “wiley ways” to control life.  H and I don’t get accurate info from F-I-L or M-I-L about what doctors have said so have no way of knowing what is true and not true.  H has also refused to visit his parents since they moved away (and for the record, he is the black sheep of the family).  His take is “I love my parents – I just can’t stand being around them.”

F-I-L can barely get around and now really needs assistance w M-I-L although “he doesn’t want to be a bother to any one” (really, does anyone?).  The family is in a big kerfuffle because B-I-L who lives nearest to parents, works an overseas job and is gone for months at a time.  He and his wife have 2 young children who, rightly so, take up S-I-L’s time (she is the S-I-L who is reluctant to believe the dementia diagnosis and who is resistant to the idea that anyone else can help M-I-L except her – yes, I know, we are a dysfunctional bunch!)

Question:

1.    Is it possible to really differentiate what is truly dementia and what is well-seasoned BPD behavior based on your personal experience?

2.   Is it likely that if M-I-L got whatever attention she is seeking, she would get better (even w a diagnosis of dementia)?

Family is at a crossroads and F-I-L has presented these options:

1.   B-I-L and S-I-L closest to them can sell their house and build on parent’s property so they are close enough to help with caretaking.  They are currently only 9 miles apart in a small town, rural setting.

2.   F-I-L and M-I-L can sell and move here, live in our rental house (2 houses down the street from our house) and H and his brother here can set-up/provide caretaking.

I am actually quite ok w H’s parents staying several states away because kids and I have our hands full dealing w H, but I am also willing to help his parents if that is what is decided but that would entail them moving here.  I am trying my hardest to just “mind my own business” but it is difficult when they, from afar, appear to be so needy.

[PrettyPlease]

we are a dysfunctional bunch!)

Welcome to the Universe!  

1.    Is it possible to really differentiate what is truly dementia and what is well-seasoned BPD behavior based on your personal experience?

Based on my personal experience, no. I say this because:

1) I didn't discover the extent of my own mother's dementia until I studied her home and record-keeping after her death; long-distance by telephone it seemed like the usual manipulative uBPD stuff, but it was more than that.

2) A friend who I discussed this with, who spent twenty years as a nurse in a long-term care home for the elderly, explained that it's especially common for elderly women to hide any dementia very well because they believe admitting to it will entail loss of control -- and as women they have better skills at this kind of hiding (men punch, women maneuver, to put it bluntly).

2.   Is it likely that if M-I-L got whatever attention she is seeking, she would get better (even w a diagnosis of dementia)?

Gut response: of course not— —if you mean better in her BPD symptoms. If getting attention was the solution to being BPD, then we wouldn't need this site, would we?  

Better in dealing with dementia, though -- maybe. But that would depend on how she's dealing with the dementia -- see the answer to the first question. If it's like that (purposely hidden), or otherwise enmenshed with the BPD, it still seems possible to me that the attention wouldn't help -- her.

But it might make other people in the family feel better, and that's nothing to sneeze at. Of course, if they'll only be happy if she's happy... . you still might have a big problem. Maybe even a bigger one than you have now.  

I am trying my hardest to just “mind my own business” but it is difficult when they, from afar, appear to be so needy.

Yes. Maybe mulling over the Buddhist idea will help: do your best but don't be attached to the outcome. Easy to say, hard to do. But it makes a nice goal.  

[P.F.Change]

PrettyPlease makes some good points.

2.   Is it likely that if M-I-L got whatever attention she is seeking, she would get better (even w a diagnosis of dementia)?

Are you asking if she can have dementia and malinger at the same time? (Yes). I agree with PP that if you're asking if giving her attention when she fishes for it will change her personality disorder symptoms, then, no, probably not--more likely it will reinforce/enable them.

Family is at a crossroads and F-I-L has presented these options:

1.   B-I-L and S-I-L closest to them can sell their house and build on parent’s property so they are close enough to help with caretaking.  They are currently only 9 miles apart in a small town, rural setting.

2.   F-I-L and M-I-L can sell and move here, live in our rental house (2 houses down the street from our house) and H and his brother here can set-up/provide caretaking.

Those are two options. They are not the only two.

I notice the first option requires BIL and SIL to give up their own home and spend time and resources building on their parents' property--which will presumably still be owned and controlled by the parents. That is a significant loss of autonomy and control for BIL&SIL. Of course if they both like this idea and decide to do it, that's fine as they are adults and have a right to make their own choices about where to live.

The second requires you to allow them to live in your rental property. My gut says this is not something you offered as a suggestion. Am I wrong? People with BPD tend to expect others to have very lax boundaries, and I would be surprised if your FIL wants to sign a lease and pay you rent. Would you and your DH be ok with letting them live in your property and giving up the income you would have if you leased it to a regular tenant? How would you handle it if they do not properly care for the home or cause damage or make unauthorized changes? Do you want your inlaws within spitting distance?

There are other options. The family can talk with social workers or look at assisted living facilities, for example. There may be independent living facilities near one of the children that could accomodate seniors and/or low-income residents, or a house or apartment for lease that would not have one of you as landlord. Can you think of any solutions that would work for you and DH? It sounds like it may be difficult for him to discuss things with his siblings, but if they are willing to go over some solutions together it might be worth a try.

Wishing you peace,

PF

[martillo]

2.   Is it likely that if M-I-L got whatever attention she is seeking, she would get better (even w a diagnosis of dementia)?

Gut response: of course not— —if you mean better in her BPD symptoms. If getting attention was the solution to being BPD, then we wouldn't need this site, would we? 

Better in dealing with dementia, though -- maybe. But that would depend on how she's dealing with the dementia -- see the answer to the first question. If it's like that (purposely hidden), or otherwise enmenshed with the BPD, it still seems possible to me that the attention wouldn't help -- her.

Pretty Please:  Thanks for your reply - M-I-L has a long history of using these tactics to get attention, and much of what S-I-L tells me sounds a lot like depression.  Since we aren't physically there and are getting info from either F-I-L or S-I-L and we don't know what filter they are running their info to us through, it is really hard to know what is real truth!  I guess I am naively wondering if F-I-L and M-I-L are here where there are more family members to visit/sit/supervise maybe she will be less "sick."  Deep down, I know the answer - it has great potential to become a never ending vortex of emotional manipulation, chaos and drama... . from all family members.

The second requires you to allow them to live in your rental property. My gut says this is not something you offered as a suggestion. Am I wrong?

There are other options. The family can talk with social workers or look at assisted living facilities, for example. There may be independent living facilities near one of the children that could accomodate seniors and/or low-income residents, or a house or apartment for lease that would not have one of you as landlord. Can you think of any solutions that would work for you and DH? It sounds like it may be difficult for him to discuss things with his siblings, but if they are willing to go over some solutions together it might be worth a try.

LOL PF Change!  You are not wrong!  We have known for quite some time that in-laws health is deteriorating, but this all sort of came to a head on Easter Sunday.  S-I-L called early in the day to say "Happy Easter" and, "Oh, by the way, younger B-I-L and his wife are visiting today and oh, by the way, my hubby wants to sell our house here and move several states away and oh, by the way, Pop says he will always live here."   So imagine my surprise when F-I-L called that evening and told my H that he was planning on selling and moving back here and oh, can we move into the little rent house until we can get everything in place?  I know you may have renters, but if it is available... .

Yes, we have renters who are very good renters and have been in the house for about 3 years!

Younger B-I-L called H this week telling H that we all need to be there for mom and dad, do something to help dad and mom and get them here and oh, by the way, why did you (H) and wife (me) stop talking to us (younger B-I-L and his wife)?  Huh?  It was the other way around!  And to give my H credit due - H reached out and tried to mend relationships w his brothers on several occasions. 

For all his own dysfunction, H does recognize that his family sucks him dry on lots of levels, but I also know that he can get very easily sucked back in, so you are also correct in your assessment that I am not looking forward to having "whole family dysfunction" camped on my doorstep!

And thank you for the suggestions about other options - my own dad was very ill for the last several years of his life (he passed away in 2009) and my mom had to explore many avenues to make sure he was taken care of and safe as they made the choice for him to remain at home - she was (and is still) working full time and ended up paying to have someone sit w him during the day while she provided night time care during week, and (they live about 5 hours away from us) my S-I-Ls, brothers and I split the weekends and any hospital stays so she could have some respite - it was still exhausting for her , and challenging to get all the pieces in place.  And a very close friend had to move both her mom (who qualifies for assistance) and her mom-in-law (who doesn't) from several hours away to be near her family about 3 years ago, so I am also using her as a resource!

   

I spoke w S-I-L who is nearest them this week and told her since F-I-L doesn't want to put M-I-L in nursing home, they will need to get someone in place to be with her either during the day or at night whether they are here or there because here, we all work full-time and there S-I-L has 2 young children.  We also live in an area that has a lot of retirement options with excellent healthcare options available and I made some calls last week and am going to visit / pick up some brochures in the next week.  Better prepared and somewhat safe than sorry!

If they do end up back here, I will def be spending lots of time here with you all so thanks for the welcome!

[P.F.Change]

Sounds like you are already working on some other solutions. 

H and I don’t get accurate info from F-I-L or M-I-L about what doctors have said so have no way of knowing what is true and not true.

I meant to comment on this the first time. Is there a way you can get permission to speak to the doctors directly? I have found that my mother often feels things are more catastrophic than they actually are, and will convey facts that fit those feelings--this is common with BPD, as you probably already know. It might help to go straight to the source rather than hear it through that filter, if you do end up becoming more involved in their care.

[martillo]

It would be a very good idea if we were allowed to communicate directly with in-laws health care providers.  I am not sure we can make that happen.  My H can't be calm and regulated long enough to gently persuade his parents that this is an appropriate course of action.  Right now, I haven't heard anything else about what is going on or any plans.  I am collecting info for independent senior living, and assisted living in the immediate area and if more comes up, I will at least be ready. 

S-I-L and her kids are coming for a visit in July and she is trying to convince F-I-L and M-I-L to also come, but that will all depend on how they are doing health wise - maybe between now and then we will learn more.

I have to carefully examine my motives also in all this - I used to encourage H to maintain his relationship w his parents and reach out (cause I have good FOO relationships and just can't fathom the angry bubble that H's whole family lives in), but H ends up in a self-righteous angry snit.  I had to learn to let H have whatever relationship he has w FOO be whatever he wants it to be -- but  sometimes the fixer in me overpowers the "wiser" me!

[P.F.Change]

I have to carefully examine my motives also in all this - I used to encourage H to maintain his relationship w his parents and reach out (cause I have good FOO relationships and just can't fathom the angry bubble that H's whole family lives in), but H ends up in a self-righteous angry snit.  I had to learn to let H have whatever relationship he has w FOO be whatever he wants it to be -- but  sometimes the fixer in me overpowers the "wiser" me!

Self-examination is very important. It is good that you are aware of your tendency to "fix." Have you seen either of these workshops?

Our Dysfunctional Relationships with Others

Are we co-dependent?