Visiting elderly uBPD Mom in hospital

[Depression = 72% of members]

I have recently gone NC with my elderly uBPD Mom, betting help from a T and supportive family/friends. My concern is what to do when (and it will happen sooner or later) my Mom winds up in the ER/hospital. I am trying to focus on the here and now, and "detox" from a very toxic situation, but am still thinking about what I will do when the time comes. Any insight would be helpful for those who have been in similar situations. The timing just doesn't sit well with me, am I enabling, or justified in feeling uncomfortable with being absent at this stage in the life cycle.

[madeline7]

I have recently gone NC with my elderly uBPD Mom, betting help from a T and supportive family/friends. My concern is what to do when (and it will happen sooner or later) my Mom winds up in the ER/hospital. I am trying to focus on the here and now, and "detox" from a very toxic situation, but am still thinking about what I will do when the time comes. Any insight would be helpful for those who have been in similar situations. The timing just doesn't sit well with me, am I enabling, or justified in feeling uncomfortable with being absent at this stage in the life cycle.

[Naughty Nibbler]

Hey Madeline7:   

Will you be involved with having/sharing power of attorney (POA) with either medical or financial situations for your mom?  If you won't, then it will be less complicated for you.

You might want to think about what you want.  Do you want to have a conversation with your mom, before she passes?  You could have a few possible situations with your mom's passing.  Your mom could die suddenly, by a heart attach or stroke.  She could be hospitalized just before death and fully cognizant of what's going on, or she could be hospitalized and not fully cognizant.

You might want to think through the options.  Do you want to have a conversation with your mom, prior to her death (while she still has command of her faculties)?  If you think it would be more destructive than productive, then perhaps it's not what you want.

Would there be some closure for you, to see your mom face-to-face, just prior to death.  Maybe she wouldn't be in a condition to interact, but perhaps sitting by her side and saying some things might be closure for you.  Perhaps you make a decision that if you get a call that your mom is hospitalized, you will respond in accordance with the situation.  Either you don't want to respond to any hospitalization in any way, you respond to all hospitalizations or you perhaps decide to respond to serious situations, but not to others.  Perhaps you just respond and be by her side for comfort, without any plan or need to say anything in particular.  You are just there.

There isn't one way to handle the situation. Don't think that you need to please anyone else in the decisions you make.  You have to do what is right for you and what you think you need for closure.  Some people respond with writing their feelings in some form, some want to express something face to face.  Some want to go to a funeral, but others might not go to a funeral and choose to have a private conversation at a grave site, when they feel ready.

Would it help to make a chart of options you might consider and then prioritize your options.  It might give you some peace of mind to have something like that.  Of course, when the time comes, your priorities might change, and that's okay.   

We never know what we will encounter.  My mom's last 5 months of life were spent between hospitals and skilled nursing facilities.  She suddenly developed symptoms of Pulmonary Fibrosis.  From the time she was hospitalized, she had hallucinations and/or her mental faculties were impaired (infections can impact mental state in the elderly).   She was septic 3 times, caught MRSA in one of the facilities, a different antibiotic resistant infection in another.  The nail in the coffin came when she caught Influenza A, from a roommate in her last Skilled Nursing Facility. 

My dad fell, and broke his neck, during my mom's first week of hospitalization.  For a period of time, my parents were in different hospitals at the same time.  Neither of them were in a state that I could have had a two-sided conversation with them, prior to death.  A one-sided conversation would have been possible, but it wasn't something I pursued.

Do you have any idea what type of closure you need?  Do you think you are leaning towards just being present and visiting.  Sometime, all that is needed is to just be there.





 

[Woolspinner2000]

Hi Madeline7! 

I am glad you came to our site and that you posed your question to us. So many members have parents in similar situations or have already walked through it. There is a camaraderie among the 'family' here in that we understand your concerns all too well! Naughty Nibbler has given you some thoughtful words that may get you started thinking about the options you have.

It is great that as adults we can realize that indeed, we DO have choices, and you can make healthy choices for yourself during this time and for when the time comes and your mom goes to the hospital. Thankfully you do not have to make the hospital choice now, but when the time comes, you will have options. You can always take along a trusted friend or family member who is safe (as in safe, supportive, and trustworthy). My uBPDm was always worst when around family, but put on a great face for everyone else. She was very high functioning.

When my uBPDm was in the hospital, I too worried as to how it would go. I had all these imaginations that it would be so similar to the way she treated me in the past. While her illness exacerbated her BPD symptoms, I was able to have compassion upon her. I remember telling myself I could get through this, just like I got through all the past days when I lived with her. It was my last chance to try to just love her, without strings attached or looking for anything more from her. I knew I wouldn't get the love I had always desired in the last few days of her life, so I set aside my desires and am thankful that I was able to love her to the end of her life. Did it fix things? No. Do I have regrets? No, I don't, for I had already done all I could. I am at peace with the hospital time. I was careful to take care of myself as much as I could during that time, reached out to friends and my T, and set boundaries as to when I felt able to go to the hospital and when I needed a break.

I think each situation is unique, and as you continue to heal and detox, then you will continue to be more and more prepared for the time when it comes. We are always here to support you and be an outreach for you whenever you need it.

 
Wools

[madeline7]

Thank you Naughty Nibbler and Wools, your responses were very helpful. I am hoping that as I continue to detox, it will be easier to respond accordingly when the time comes. The issue is that my Mom is starting to fall and is hospitalized for brief periods of time and is fully cognitively intact and very mean and needy. I remember reading a story in a book called "It's easier than you think" about an elderly woman on her deathbed who no longer remembered "why" she was angry with her daughter, but did remember "that" she was angry with her daughter. I chuckled at the time, but clearly it is not funny. I know I have to wait and see what unfolds, but somehow it still feels like the only predictable thing is the unpredictability and chaos of life with a narcissistic borderline.

[Notwendy]

I struggle with this too. My mother is an elderly widow. Perhaps if she were younger, had remarried, I would have considered the idea of NC. I know it is a choice, and sometimes the best choice for some people, but I don't think I can do it at this stage. Not because of her, but because of me.

I think as you detox and learn skills to deal with your mother, you will hopefully feel some clarity on this issue. I also think it depends on how abusive your mother is and your capacity to deal with her- without causing too much distress to yourself.

That is the key. My conversations with my mother do cause some stress, but a major difference now is that I can recognize her "playbook" and not take it personally. She is who she is. She has a set of tools she has used on her children for decades- and they worked. They are : being the demanding Queen and ordering us to do something. If we say no ( which we were not allowed to do as kids) then she snaps into Waif. Waif is the hardest- because it is also realistic- it isn't easy to be elderly and alone. It is scary. The difference is that Waif isn't new for her- it's a role she has to get what she wants. So it is hard to know what is really her situation or not.

That's her though, and I can't change that. My role is to see the situation, not take the drama bait. If Waif doesn't work she goes to sentiment- " I am going to give away this memento from your childhood" and then, " I am going to get rid of something that belonged to your father". 

Detachment is the key to not taking the bait. In Waif mode she will say " I have never done anything to you, asked much of you, how dare you". I don't even reply to that. What she says to me in the moment is not about me. As to family possessions, I had to let go of that too. They gave her too much power. If she asks me if I want something, I simply say " if you would like me to have it, then please send it to me". That doesn't satisfy her- and she will often ask again and again.

These conversations take energy, but they don't upset me. I learned that my part was to react to them. These patterns are all she knows. She's going to try what works, and all I can do it not participate in them. It's a work in progress.

So why do I do it? She is old and alone, and that is scary. I can have empathy for her. Learning the tools has helped me in other relationships too. It's shed some light on my own learned behaviors. Not taking the bait helps me to realize that I am not affected by this as much. And, as we are all human, sometimes I do fall for the pattern- but I recognize it better and can get out of it faster than before.

[Naughty Nibbler]

Hi Madeline7:

The issue is that my Mom is starting to fall and is hospitalized for brief periods of time and is fully cognitively intact and very mean and needy.

Your quote struck home with me.  In my situation, with my father, I would replace the word "mean" with stubborn, grouchy and critical.

I used to chuckle at commercials for alert devices for the elderly, with the line, "I've fallen and I can't get up!" The falls became a reality for us, and I quit chuckling at the commercials.  Before my dad's death, he had had multiple falls and his death was a subsequent result of his last fall.

You have limits on what you can do.  My father had some strong BPD traits.  He was a stubborn man, and things ended with him staying in his home until he had his last fall and broke his neck.

His previous fall could have been his last.  He initially fell forward into the stationary side of a large sliding glass door/window, then he fell back onto the floor of the den (thankfully, he didn't continue with his forward momentum and get cut by the glass).  It wasn't tempered glass, so there were large shards of glass.  My dad wouldn't accept the help of a neighbor to button up the exposed area (it was Winter).  So, the next day, I came over and removed the glass shards from the door frame.  Luckily, I've had experience with "mickey mouse temp repairs".  Using a very large sections of card board, a tarp and a lot of duct tape, I managed to construct a make-shift cover for the  exposed window section (ceiling to floor). It kept the elements out until a new door/window assembly could be installed, approx. 3 weeks later.  My dad even complemented me on the mickey mouse effort, .

I still wrestle a bit about my thoughts on the day my dad broke his neck - his last fall.  At that time, my sister and I had to alternately leave our respective homes, and trade off sleeping over at our parent's home and baby sitting our dad. (our mom was hospitalized at the time) My uBPD sister had been exhibiting strong BPD traits for a few weeks.  I was painted black by her and she had given me the silent treatment for a few days straight.

I was staying overnight with my dad, on the evening he broke his neck.  My sister left in a rage an hour or two earlier.  I called my sister, after the paramedics arrived.  Upon the news, she snapped out of giving me the silent treatment.  I had some awful thoughts at that time, thinking that the torment of dealing with my sister might be near an end and thinking we might not have to force my dad into a care facility (this is likely the end for him).  At the time I thought "what an awful person I must be to have those thoughts".

I guess the moral to my story is that once an elderly person starts falling, there will be more falls.  If your parent won't agree to options for assistance in their own home (fall alert devices, paid in-home care assistance) or moving to an assisted living facility, you've done all you can do. They set the stage for their final act.

[madeline7]

I am happy to be a part of this supportive network of individuals who get it and don't judge me by my actions or rather, lack of action at this point. My uBPD is what you would call a help seeking rejecter. A few months ago, she called me and said "Help me, I need help" and hung up. When I attempted to call her back and got no answer, I rushed over to her house to see if she was ok, had fallen, etc. She didn't answer the door so the front desk person (lives in an IL community) let me in, I found my Mom in bed, "pretending to be asleep". I say this because I stayed in the kitchen for a while, answering emails on my phone and then I left to make a phone call down the hall. When I returned, the TV in her room was now on, but again pretended to be asleep even thought I could tell she heard me. Why did I stay? Why did I play the game? I was aware but still enabling at that point. So I finally talked in a VERY loud voice and she pretended to wake, then proceeded to eviscerate me about how I should be taking care of her, she shouldn't be living in a community with strangers, and then threw me out. This behavior is becoming the norm for her. She used to be stable for periods of time in between the outbursts. Now it is a more chronic and constant abuse, but she still feels like she is the Mother, and now old and alone, and I should be taking care of her. I just can't put myself though the constant manipulations, am very sad that this is how it is going to be. There is no way that I can show up while she is cognitively intact, she would rip me apart immediately. So as of now I will probably not go to her, and then, of course she will rip me apart for not going to her, a no win situation, like always.

[Grandmotherbear]

My BPD mother sold her house and moved into a retirement community with assisted living options. I live across the state with a bad back and chronic pain which forced my early retirement. She insisted on having me come over to help her pack, then refused to allow any packing to be done. Her control issues and crazies like trying to force DH to drive the wrong way down a one way street went into high gear. She actually told me to come see her without my husband- I refused to see her without him for the last 35 years, because she only acted in a decent manner when he was around.

I was having a real bad time with my pain and my mother was trying to get me to drive 4 hours to see her because she couldn't get out of bed. This was in a retirement center with around the clock staff to respond to situations like this. She refused to call the people there to help her. (This whole move had been her idea and she said it was specifically because of the staffing and how it would help her feel secure) Well, I talked my DH into driving me over there to see how she was doing and I spent most of the drive as reclined as I could get but still in a lot of pain. We got a phone call when we were a half hour from the center. She was screaming she was in so much pain and couldn't get out of bed and I had to drive over and get her out of bed NOW!

When we got there she promptly got herself out of bed after I came up and told her I had a bad back and could not get her up myself but would call paramedics if she didn't want to use the center staff. She had 3 meals a day included but refused to allow us to bring her a tray- insisted we go out to a restaurant she had wanted to try. We had to go dutch of course. She was walking with no limitation and no pain. We had a flat due to picking up some construction trash scattered all over the highway and she went off on DH for the first time in our lives. Between us and a kind Good Samaritan who had a compressor he went home and got to fill our almost-flat spare, we got things fixed and took her back to the center and left.
It was the last time I saw her. She had a horror of anyone but the mortician looking at her dead body and she refused to allow any sort of funeral or even an obituary... which I got around by placing a classified ad with a link to the funeral home obit. I was her designated health care surrogate, which under the laws of FL at that time was restricted to only being able to make decisions for a patient who had been documented by a health care provider to be unable to make her own decisions. She was in and out of the hospitals and the skilled nursing center affiliated with the center constantly. Every time I spoke to her or her nurses on the phone- and they knew she had designated me in writing as her health care surrogate, they denied -and she denied- there was anything wrong with her heart or lungs. Oh, please, I was a Hospice nurse for 24 years and a dam good one, and I knew she was being hospitalized for congestive heart failure, respiratory insufficiency and pulmonary effusion, and in fact those were the 3 causes listed on her death certificate. But they called me constantly between 1 am and 3 am. Your Mother is getting worse. What do you want us to do? And I would say, Do YOU think is capable of making her own decisions? And they would say, Yes, she appears oriented in all 3 spheres. And I would say, Has her DOCTOR documented in writing she is not capable of making her own decisions? And they would say No, of course not. And I would try very hard to be polite when I had been awakened by the phone and say, In that case you MUST know I am legally UNABLE to make her decisions for her and you must go back to her and discover what SHE wants to do and then do it. Thank you. And hang up.

I now realize she was probably trying to manipulate me by playing with her health and she was trying to have the nursing staff on 11-7 force me to her side. It didn't work. I counselled my brother, who is almost 70 and has a dickey heart himself(and still works 30 hours a week), not to drive 7 hours to her bedside - he ignored me and drove down to see her "so she wouldn't be alone in the hospital on Christmas Day", and spent an hour talking with her at her hospital bedside, and then asked if he could spend the night in her apartment at the retirement center. My mother REFUSED! My brother was ALWAYS the favored, the fair haired child, and our mother, (my Egg Donor as I had to learn think of her) REFUSED to let him spend the night in her apartment! He called his wife, upset, and she told him to drive down to the Beach and stop at the first decent looking motel that had a Vacancy sign. It wasn't as if my brother had a spare hundred bucks to blow on a motel since before Obamacare, both of them had lost their health insurance when they were laid off their well paid jobs and both had lengthy hospitalizations culminating in cardiac surgery- hence my brother's part time job at Lowes.

I knew she would spit on ME on her way to the grave. I never expected her to spit on HIM, and he really had been an attentive son when she came back into our lives seven- or eight- years after leaving us.
I have no regrets for my actions during the final weeks of her life, and the only thing I regret about the years we were back in contact was that I ever subjected my children to her. She did horrible, horrible things to them I can not share, that I did not know about for many years.

Whatever you decide about how you conduct yourself during your BPD parent's decline, make sure it is a decision that you will not regret after their death.

You will survive. And I hope you WON'T repeat your BPDs mantras in your head about how you are a bad person and a bad child. You have borne more than any child should have to bear.
Good luck.

[madeline7]

Wow, Naughty Nibbler, your reply was powerful. I am so grateful for your honesty. I know I am doing what's right for me. Unfortunately one sibling is repeating the BPD mantras thru some co dependent BS and the other is detached (so I am feeling ostracized by my FOO), but overall I am definitely on the right path towards acceptance, empathy and emotional health.

[Notwendy]

The issue for me isn't about my mother's behavior but my own boundaries and how I choose to behave with others.  She's mean and manipulative. I just don't want to lower my own standards and those standards also include my own sanity. If she treats me poorly- I won't visit, or if I am there, I will leave. For a while when I visited her, I wouldn't stay with her and I would only drop in for lunch. Once when I was staying with her, she started raging and without a word, I picked up my suitcase and walked out the door.

This boundary isn't negotiated with words. If I even bring up a concern or an issue- she snaps into victim mode " I don't ask you kids for anything" ( no- you don't- you just demand and if you don't get it- rage or manipulate until you get it). It is with actions that she knows- you rage at me and I will walk out that door or hang up that phone.

I also wouldn't visit without another family member for a while, but now, she knows this boundary and I think her behavior with me has improved some. I also try very hard not to react to any drama bait.

Practice makes this better. It isn't perfection, just progress- one step at a time.