Elderly mom- refusing to take care of self vs. cannot take care of self?

[2much4me]

My BPD mom lives in the same city and me and my sister. In her 80's, there is nothing physically wrong with her (takes only thyroid), is very smart and cognitively intact.  She was very controlling and  high functioning when she was younger. She was often bullying and intimidating to me and my sister and anyone who disagreed with her or crossed her in any way.  About 10 years ago, she had a health situation that basically took away her power to control and bully and she switched over to being a victim and trying to get everyone to take care of her. She was in the psych unit but refused all follow up care and meds and attempts re-admit her have been unsuccessful because of the BPD diagnosis. She lives alone and has a lot of friends and family nearby but has pretty much pushed everyone away except me and my sister.  (because she's trained us well!) Our relationship consists of her dumping an endless stream of complaints, irrational fears (I am going to jail! the refrigerator is going to catch fire!) on us while we try to sort out and address what she actually does need. Of course, she declines all medical, mental help or any help that we CAN offer- household chores, groceries etc. but will not stop endlessly recounting her fears, anxieties and dumping things on us that we are powerless to help. Here is my question- the standard for getting elder help is usually that they cannot take care of themselves but is this the same things as refusing to take care of yourself? She is bathing less, looks like a disheveled mess, her house is now very dirty. Anyone have experience with this? Maybe just try to get her assessed by a neutral 3rd party?  I suspect this helplessness is really for our benefit and that if we bring someone else in, she will downplay her needs. But, that could be valuable for our setting boundaries with her too.  Anyone have experience with trying to sort out how to help an elder BP parent? Will assisted living take her? any suggestions are welcome.

[2much4me]

My BPD mom lives in the same city and me and my sister. At 78, there is nothing physically wrong with her (takes only thyroid), she is very smart and cognitively intact, has a nice home and resources.  When she was younger, was often bullying and intimidating to me and my sister and anyone who disagreed with her or crossed her in any way.  About 10 years ago, she had a health situation where she switched over to being a victim and trying to get everyone to take care of her and got stuck in this new role. She was in the psych unit awhile but refused all follow up care and meds and attempts re-admit her have been unsuccessful because of the BPD diagnosis. She lives alone and has friends and family nearby but has pretty much pushed everyone away except me and my sister.  (because she's trained us well!) Our relationship consists of her dumping an endless stream of complaints, irrational fears (I am going to jail! the refrigerator is going to catch fire!) on us while we try to sort out and address what she actually does need. Of course, she declines all medical or mental health care or any help that we are capable of providing or arranging- household chores, groceries etc. She will not stop endlessly recounting her fears, anxieties and dumping things on us that we are powerless to help. Here is my question- the standard for getting elder help is usually that they cannot take care of themselves but is this the same things as refusing to take care of yourself? She is bathing less, looks like a disheveled mess, her house is now very dirty. Anyone have experience with this? Maybe just try to get her assessed by a neutral 3rd party?  I suspect this helplessness is really for our benefit and that if we bring someone else in, she will downplay this. But, that could be valuable for our setting boundaries with her too.  Anyone have experience with how to sort out how to help a BPD parent who will not cooperate in a conversation about this?  any suggestions are welcome.

[2much4me]

My BPD mom is 78, there is nothing physically wrong with her (takes only thyroid), she is very smart and cognitively intact, has a nice home and $ resources. As she's aged, she's now stuck in the role of victim and trying to manipulate me and my sister to take care of her. She has been hospitalized in the past for SH behaviors, but she refused all follow up care and meds and attempts re-admit her have been unsuccessful because of the BPD diagnosis. She lives alone and has friends and family nearby but has pretty much pushed everyone away except me and my sister.  Our relationship consists of her dumping an endless stream of complaints, irrational fears (I am going to jail! the refrigerator is going to catch fire!) on us while we try to sort out and address what she actually does need. Of course, she declines all medical or mental health care or any help that we are capable of providing or arranging- household chores, groceries etc. Even simple questions like "do you need groceries?" will elicit a response like "I do not know what to eat.  I am so tired of eating and sick of food. The problem is that I do not know what to do with myself. what do regular people eat?..."   She is bathing less, looks like a disheveled mess, her house is now very dirty.

I do not know if we should force help on her or just let her be, accepting her choices and continuing to try and set boundaries with her?  It's confusing because I would, of course, help my elderly mom under normal circumstances but find it exhausting and nearly impossible to do with someone who cannot participate in a normal conversation and/or refuses any and all help?

Anyone have experience with this? Our latest thought is to try and get her assessed by a neutral 3rd party like a case manager or nurse for a home care agency?  Maybe she will listen to someone else saying she's benefit from help.  Or, what I suspect will happen is that she will not present as this helpless old lady to another person (I have seen this with my own eyes) and then my sister and I can feel reassured that she can take care of herself, even if she chooses not to do so.

[2much4me]

My BPD mom is 78, there is nothing physically wrong with her (takes only thyroid), she is very smart and cognitively intact, has a nice home and $ resources. As she's aged, she's now stuck in the role of victim and trying to manipulate me and my sister to take care of her. She has been hospitalized in the past for SH behaviors, but she refused all follow up care and meds and attempts re-admit her have been unsuccessful because of the BPD diagnosis. She lives alone and has friends and family nearby but has pretty much pushed everyone away except me and my sister.  Our relationship consists of her dumping an endless stream of complaints, irrational fears (I am going to jail! the refrigerator is going to catch fire!) on us while we try to sort out and address what she actually does need. Of course, she declines all medical or mental health care or any help that we are capable of providing or arranging- household chores, groceries etc. Even simple questions like "do you need groceries?" will elicit a response like "I do not know what to eat.  I am so tired of eating and sick of food. The problem is that I do not know what to do with myself. what do regular people eat?..."   She is bathing less, looks like a disheveled mess, her house is now very dirty.

I do not know if we should force help on her or just let her be, accepting her choices and continuing to try and set boundaries with her?  It's confusing because I would, of course, help my elderly mom under normal circumstances but find it exhausting and nearly impossible to do with someone who cannot participate in a normal conversation and/or refuses any and all help?

Anyone have experience with this? Our latest thought is to try and get her assessed by a neutral 3rd party like a case manager or nurse for a home care agency?  Maybe she will listen to someone else saying she'd benefit from help?  Or, what I suspect will happen is that she will not present as this helpless old lady to another person (I have seen this with my own eyes) and then my sister and I can feel reassured that she can take care of herself, even if she chooses not to do so.

[2much4me]

 

[2much4me]

 

[Notwendy]

Hi and welcome- What you are experiencing seems common on this board. I wonder if this is a part of the aging process for pwBPD or an expression of their needs (that were always there) at this age? I don't know if there are any studies on this. I experienced this with my BPD mother and another poster here- Methuen- has too.

Are you in the US? Some types of assisted living may be a good fit for your mother- however, they are private pay, and she may not be willing to go. My mother refused to consider one until there really was no other choice. Hers was one where residents with few needs could stay and then as their needs increased, they could add more help as needed. Some residents needed help with a few things, like medication, or transportation, and some even continued to drive. Some had extensive needs.

Behaviorally, it still wasn't a good fit. My BPD mother continued with the kinds of behavior you are seeing, refusing to go along with other people who also were there to help her- the medical staff and others. She had been a generally sociable person so I hoped she'd make friends there. The residents were friendly and there were activities but she refused to participate. Mostly she stayed in her room, only allowing visitors when she was in control. She wasn't depressed. I think this was a form of control for her, and control is a way to manage anxiety. She also was on some medication for that. But there isn't a specific medication for BPD.

In general there seemed to be a mismatch between physical and emotional needs. The need for care in assisted living and skilled nursing is based on need for assistance with daily tasks - dressing, eating, bathing. BPD mother's emotional needs were higher than that. As you said, also BPD mother could "pull it together" for someone assessing her and so her needs would not be apparent to them. It was when she needed more assistance and people were around her for longer times that they noticed.

I do feel for you because, I also think that my mother's preference would have been for me to be available to her 24/7 and serve her needs and I sense she was angry at me that I didn't do that. But it wasn't just a choice for me, I wasn't not wanting to help my mother. It's that BPD involves the closest relationships the most and so, if someone is close to her, they will also experience the "other side" of her. I thought this was mostly with immediate family but it also was with nurses and caregivers too. I did what I thought I could do while having boundaries.

I do not know if we should force help on her or just let her be, accepting her choices and continuing to try and set boundaries with her?  It's confusing because I would, of course, help my elderly mom under normal circumstances but find it exhausting and nearly impossible to do with someone who cannot participate in a normal conversation and/or refuses any and all help?

I could have written these exact words.

I think this is a "do the best you can" with what I think is a difficult situation. Another side of this is your mother's material affairs. BPD mother kept all her financial and personal information secret from us- yet at one point made me POA, without any way of having the information to do that if it was needed. I consulted an elder law attorney, for my own information, and found that to be helpful to know what to do, and also about Medicare, Medicaid, what they cover, what they don't. Although my mother remained legally competent, I learned what to do in the case that she wasn't able to make decisions for herself.

When my father was ill, I had some concerns and contacted social services. Their first question was "is he legally competent ?" because, if so, I could not intervene and the statement "your parents are legally competent to make their own bad decisions" is something I referred to often. My BPD mother remained legally competent. It's difficult to watch your own parent make decisions that you don't agree with, that you don't think is in their best intererest, but- if your BPD mother is legally competent, she's the one to decide what she wants to do.

In your situation, I would begin with a call to social services. Since your mother has had a change in self care, they can come and assess the situation. Your mother may indeed pull it together, but the call to social services will be on record and if you had to call again later, they may come back and notice a change. Try what you feel you can do, but also know that your mother has her own autonomy.