Elder care for uBPD mum - feeling overwhelmed

[chayka]

My uBPD mum is now in her late 70s and has lived alone since my father died. She's lucky enough to be pretty fit and well for her age, so she's able to get out, do her own shopping and cooking, and keep the house in order without help.

However, she's starting to slow down now, and is concerned about how she will cope as she gets older. I'm very concerned too. She's really isolated, having moved away from the area where most of her family lives, and only has a few friends, who she doesn't see that often.

Although she has often complained about her isolation, and I know she suffers a lot because of it, I think it's the lesser of two evils for her. She's a Hermit-type who finds it really hard to trust or even tolerate other human beings. Many of my phone calls with my mum involve hate-filled monologues from her about her neighbours.

I live a long distance away and have severe health problems, which means I can't travel to visit her. Up to now, she has visited me and DH a couple of times a year. The visits are always extremely difficult for us, but they are clearly very important to her.

It's now getting close to impossible for her to manage the journey here and all that goes with it. I have told her that we'll find a way to see her, but I don't know how.

This will probably sound crazy, but I'm beginning to feel that I am duty-bound, as her only child, to invite her to live closer, so that we can see her more often as she gets older, and more easily organise care and visitors for her than we could from a distance. It's not what I want at all, but I feel I can't just leave her to cope on her own.

Does anyone have experience of dealing with elderly parents with BPD? How do you draw boundaries in such a difficult situation? How do you take care of a parent who has emotionally abused you?

I really hope someone can help, because I'm feeling very lost, overwhelmed and out of clues right now. Frankly, I feel like hiding under the bed and never coming out! 

Chayka

[Notwendy]

I hear you as our mothers are similar. While I have other sibs, I am the one who is in the best position to be of any support to her. Others have their own issues that would make this difficult for them but they would help if they could.

I know that I have to have boundaries about this. I said "not right near me" and that didn't go well, but we managed to agree on close enough- and with support for her as I don't want to do that. There is an area that isn't too far from me that she likes- as it has more things that interest her than my area and a continuing care community where she can get help if she needs it. It appears that this is affordable to her.  Now, one doesn't know the future or how this would work out, but it seemed to be a compromise that we could both agree on.

I think my mother's situation suits her well. She is a hermit type who doesn't trust the people closest to her.  I really don't know how she will do in a community where other people are close by. I think she knows that too, which is why she has not moved yet.

Ironically, when I was the one speaking against the idea, I was the terrible daughter who didn't let her move closer. Now, when I said here Mom, this is a good place- go ahead, she hasn't. Something to think about when getting into this discussion with your mother.

[HappyChappy]

Hi Chayka

I hear your predicament, I’m in a similar situation and it’s a toughie. But in my case I have several siblings that just won’t go there, because I was expected to do all that and our BPD is pretty scary. When I went NC, my siblings still didn’t bother, their excuse was distance.

But in your case, sounds like your mother is in reasonable health and in truth if she chooses to fall out with her neighbours that’s not actually your issue. If she's a hermit, again not your issue. I appreciate a BPD can make us all believe that it is.
 
Also on the honour thy mother stakes, well firstly someone needs to behave like a mother, plopping one out of the same blood, doesn’t make you a mother. So in answer to your question, why not consider what you needs are first and foremost, and if meeting your mother fits in with that, everyone’s a winner. But if you do invite her to live close, your boundaries are melting and she will push hard for more and more. So maybe visit her on a holiday, and see if you can manage much greater exposure.

You can help your mother from a distance, get a home help, encourage her to join clubs, it doesn’t necessitate you dropping your boundaries or being physically there.  I know my BPD doesn’t really care who gives her narcisstic supply, so long as she gets lots of it. Distance is an exceptionally easy boundary to keep up. My BPD use to turn up in the middle of the night and scream a load of embarrassing made up rubbish from the street, to embarrassed me in front of my neighbours and to get my attention in the middle of the night. But that’s just my BPD (bless).

Although she has often complained about her isolation, and I know she suffers a lot because of it, I think it's the lesser of two evils for her.

This point makes sense. Do BPD ever stop suffering ? When is it waif behaviour to get what they want and when real suffering  ? It’s more often than not self inflicted, so we can't change that. There seams little point you joining your mum in her suffering. I’d be interested to know what scenario would suite you best ? 

[Notwendy]

I think it is hard to watch anyone suffer, especially a parent. I think it is a natural inclination to want to do something for them. This is also part of our "if only" wishes. Relationships change over time, and the natural changes of the parent- child relationship evolves from us being tiny and dependent on them, to us being mature, independent while they age. Depending on the situation and severity of BPD, these relationships are not as we wish they were.

My mother is unhappy with her situation. Her FOO, who sang her praises to me and think I am a terrible child for not doing more for her, rarely have much to do with her, even though they live close to her. She relies on paid helpers, but they are not as emotionally vulnerable to her as her own children, and she is less triggered by them. She has mentioned that friends have wondered why her children aren't around as "much as we should be". I am sad for her.

Yet, even if the world was in her hands, she was unhappy. In many ways, she has been in a good situation. My father would do anything for her, and he did. She was the focus of his attention and resources. We were not extremely wealthy, but he did without, and so did we, in order for her to be comfortable, and he left her with sufficient funds to live without fear of not having money for food, or shelter, or clothing. He was not a perfect person, nobody is, but he did all he could to ease her situation. She has nice kids too, and while we aren't perfect - we do strive to do the right thing for her, but we have to keep a balance between her needs and our own sanity.

From her perspective though, it seems that no matter what we as a family did for her, she sees herself as our victim. She things my father "did to her", the ways we kids made her feel bad. That we can't change. It comes down to me doing what I think I can do, while keeping boundaries. What someone can do is individual - whether that is NC, LC, or being fully involved. All we can do is the best, and with even our best, it isn't what we wished it could be. We have to accept that too.

[Naughty Nibbler]

Hi chayka:  

I recently lost both of my parents within 6 months of each other.  They both passed at age 94 and stayed in their home until the end.  The last 6 months of my mom's life were spent between multiple hospital stays, staggered between skilled nursing facility stays.  When my parent's health began to fail, my sister (who was a bit dysfunctional), split me black and exhibited many of the classic BPD traits.  I was the one who went to therapy, and that is where BPD came to light.

In hindsight, my dad may have qualified as a high-functioning BPD.  My dad's cause of death was a fall that lead to a broken neck. That lead to his death a couple of weeks post fall. At that time, my mom had just been hospitalized for a week or two and eventually got a diagnosis of pulmonary fibrosis (she never came home). Generally, people live for several years on oxygen, with that diagnosis, but it had a sudden onset with my mom at age 94.  

We don't know what will happen with our parents, and how they will pass.   Planning for the worst and hoping for the best could serve you well.  If you mom has long-term care insurance, that would be as good as it gets, when it comes to assisted care.

After my dad had multiple falls, during the course of a year, we reach the time that some decision was needed.  He had his last fall, before we had to make a hard decision.  My dad generally fought against getting in-home help.  I knew I couldn't bring him to my home to live, and he wouldn't have gone willing to an assisted living facility.  I tend to think my dad would have hated going into an assisted living facility, more than breaking his neck.

NotWendy and HappyChappy gave you some great feedback.  You deserve to clear the FOG and set boundaries that you can live with.  I think you may live in the UK.  :)epending on where your mom lives, there can be many ways to get things delivered to her door step and to use some transportation services like Uber.  

Perhaps there might be some living options (within an acceptable distance to you), that offer different levels of assistance.  I know some assisted living facilities can have a menu of sorts, where you pay for various supportive tasks.  

If your mom is in good health, she may be able to exist on her own for some time.  The best situation would be for her to move somewhere that is Sr. Citizen friendly (close to a hospital, businesses, and assisted living services).  If she won't move to an assisted living facility, then she needs to move somewhere that is suitable for an elderly person.  She might need to pay for some housekeeping assistance and have a handyman install some mobility assistance items in her home.

Sometimes, you have to step your way through the finances.  After my dad passed, we came close to having to sell my parent's house to pay for my mom's care.  We were a week or two away from her Medicare limit for a Skilled Nursing Facility, and were looking at alternatives when she passed.

My uBPD sister had expressed a desire to bring our mom back to our mom's home and have us care for her there (with some level of assistance, but not likely 24/7 paid assistance).  Mom was on oxygen 24/7, couldn't get out of bed, struggled with bed sores and has acquired MRSA and another antibiotic resistant super bug while in medical care facilities. I knew I wasn't capable of participating in that, even without a raging uBPD sister in the mix (who painted me black).  I maintained my boundary that is wasn't realistic.  We could have had a similar situation with my dad, if he were to recover from his broken neck.  I knew I wouldn't be able to provide that level of hands on care either.  

You need to take care of yourself and not feel guilty.  :)ecide on what you can live with, for the near term and the long term.  Your mom can accept that or choose her own alternative.  If she comes to your area, the more built-in aides and support possibilities for where she lives, the better.  I'm thinking that you might need to set a boundary that if she moves to a new home (closer to you) that isn't suitable for her age and future needs, that you have certain limitations in regard to the level of assistance you can provide.

End of life realities are a struggle.  :)on't stress out over the situation.  Your mom could have a sudden and peaceful ending, and stay active and reasonably self sufficient until the day she dies.  I certainly don't wish my mom's situation on anyone, as her last 6 months were tough on all of us.  At one point, she said,"I never thought I'd have to go through something like this.  I thought I'd just die and that would be it".  I believe she alluded to perhaps dying from a massive heart attack or stroke with a quick death.

One possible approach to your anxiety is to schedule a "worry half hour".  Write down thoughts that pop up in you mind, then save them for the "worry half hour".  :)ecide on what you can offer your mom, should she actually move to your area.  In the meantime, you mom is active and in good health.

Best wishes.  let us know how things progress.  There are a lot of good people her who can offer support along the way.

[Needless2say]

 
Do they have senior apartments where you live?  In my Mom's case, she was handicapped in a wheelchair and when Dad died, never would I have believed she would live another 17 years alone.  It wasn't assisted living, it was her own little apartment.  They had staff in the lobby during business hours, a number to call in case of emergency and if the senior chose to could eat in the multipurpose room for a fee (it was actually Meals on Wheels) but she had her own little kitchen and would make her meals there. 

To be honest I always feared that with her BPD that she would be beaten in a nursing home.  But when she got to that point, she was well loved and became a totally different person.  So happy and very loving.  In many ways I wish we would have made the decision a few years before we did about nursing home placement.  She passed five months after she was admitted to the home happy and well taken care of. 

Good luck to you whatever you choose to do.  It isn't easy being a child of a BPD parent; especially an elderly one.

[chayka]

Thanks for your replies. They're all very interesting and helpful, and it's particularly good to see a range of different views and experiences.

Notwendy, your situation sounds very similar to mine. I do anticipate my mum being hesitant to take up an offer to live closer. She's ultra-sensitive to rejection, so she would want a lot of reassurance that this was what I really wanted. That could be tricky, as it's not exactly what I want, but it may turn out to be the best compromise.

HappyChappy, I've been reflecting on your question about what would be the best scenario for me. I think it's more a case of finding the least bad scenario! The main issue is that I can't travel to visit her because of chronic health problems and she is becoming less able to visit me. So, do I want to be able to see her in future? Yes, I think so; but not all the time. If she's in the same city, I'll have to set up boundaries. Your mom sounds very different from mine, in that mine wouldn't come to my house without being invited because of her fear of rejection. So that would help to keep the boundaries in place.

Naughty Nibbler, thank you! Lots of really good advice there. I'm sorry you've been through so much difficulty recently.    It's good that you found out about BPD, though! For me, that moment was one of the biggest breakthroughs of my life. I hope it has been as helpful for you as it has for me.

Needless2say, we have 'sheltered accommodation' (as we call it in here the UK) of various kinds, depending on people's needs. Because of my mum's dislike of being around other people, an apartment could be awkward, but we'll see what's available when she needs it. There may be something that would suit her, like an independent house under warden supervision.

The hardest thing is going to be talking to her about any of this. Attempts to discuss serious issues with her, especially ones that she finds scary, like getting older, often result in her becoming childish and insulting. I think it's partly an attempt to create a diversion so that we don't continue to talk about it, and partly just that her default reaction to anything she finds painful is throwing anger at whoever happens to be there - usually me.

Thank you again for all of your input! I feel better and more confident for having talked it through and heard about your experiences.

Chayka