My Dad has Untreated BPD

[Merry342]

Hello, everyone - Nice to meet you all. I'm in my early fifties and my Dad has untreated BPD. He is 81 and will never change. We are estranged, yet he reaches out periodically. I've watched him destroy his life, career and relationships through so many different means - alcohol, drugs, sex, reckless spending, etc..

He has an incredibly unstable sense of self, is prone to mood swings, tirades, boundary-crossing.

He is reckless, has been homeless and pushes away every single opportunity for change with a million highly-elaborate excuses as to why life is so unfair. I'm not in any physical danger with him, but the emotional toll is very hard, as you all undoubtedly know

I've fought his distorted mindset with every breath in my body and built a stable life, but today I'm seeking some resources to help understand better how to cope as a daughter with a father like this. I'd love recommendations on support groups, good books to read, anything to connect with others who have similar experiences with this complex disease and knowledge on how to cope better and move past it. Thank you in advance for your consideration!

[Notwendy]

Welcome to this board and yes, several of us here have experience with an elderly parent with BPD. Are you in the US? If so, he should have Medicare and Social Security. If he has few resources and ever needs further assistance, he would probably be eligible for Medicaid.

It was helpful for me to learn about these services and eligibility. My mother (recently deceased) was not eligible for Medicaid, but it was still helpful to know about it. Your father may be able to manage on his own at the moment, but if he ever were to need skilled nursing, Medicare does not cover that but Medicaid will- if the specific rules are met.

Here is one possible scenario that happened with a friend of mine. Her parents were divorced. NPD father was living with a girlfriend in her home- it was not a stable relationship and he didn't have much in his own resources. He had to be hospitalized for an illness. On discharge- the GF refused to let him come back. With nowhere to go- they can not discharge him, and so he was sent to a Medicaid covered spot in a nursing home.

Medicaid covers that but not the personal items. This is where family can assist if they wish. They have a safer relationship because- his basic needs are being met and he has a place to stay- my friend can visit him on her own terms, and she does. She brings him snacks and personal items - this is her choice to do so. It's a situation with built in boundaries as he's in a safe place and she can visit at her own choice.

To deal with the emotions, I have had counseling and also ACA groups have been helpful. The dynamics with alcohol addiction and BPD in a family are similar. There's also peer support in these groups and working with a sponsor was very helpful. In addition to the emotions, there are the basic needs of a parent and if they are elderly and ever need more care- having them be in a safe place like skilled nursing isn't a perfect solution but you do know he will not be without food or shelter or medical care if he needs it. There are ways to learn more about this. I consulted an elder law attorney at the time because my BPD mother had resources but if there aren't many- social services can assist with telling you what is available and helping him become eligible- if he cooperates.

[Merry342]

Wow - this is so incredibly helpful!  Thank you! I will look into Medicaid for my Dad. Yes, he is still independent (for now), but at 81 years old, I worry constantly about when that will suddenly change. ACA groups sounds interesting. I have had quite a lot of 1:1 therapy but never participated in any support group. I'm considering exploring that. Did you find ACA groups helpful in recognizing the circumstances for those with BPD parents? Thank you again 

[Notwendy]

The issues with family dynamics are similar to those with alcoholics and BPD, so ACA is good for both or either one. I found the groups to be very helpful but to get the most out of the program, working with a sponsor was key.

How much to be involved in your father's elder years is up to you but your local social services can help guide you on these issues, and an elder law attorney- has costs but can also help with Medicaid planning if there are assets.

While I think we naturally want to assist with an elderly parent, that also included the issues with BPD. Long story short- BPD mother kept all her affairs secret from us kids and yet, also made us POA and Executors in her will- but with no information or ability to do that role. She had resources, blew through most of them, and we only got information later. She remained "legally competent" and so we had no ability to do anything about her own self destructive behavior.

Medicaid is only for people who are truly without resources and they "look back" at 5 years of financial information. If your father has no resources and is eligible- they won't cover his regular expenses but can cover some home health, nursing homes, should he need them later. They may supplement his Medicare? That I don't know.

He can designate someone as his POA or in the event that he can not make decisions for himself, he can become a ward of the state if nobody is willing or he won't designate someone.

After my father passed away (before BPD mother), BPD mother had little to do with me and didn't want me to have access to any of her personal information. I was actually fearful when she designated me as POA and Medical POA but I accepted it because, she did have assets and was vulnerable to exploitation. I felt that I was in the best position to act on her behalf and I think, even though she may not have acknowleged it, she knew that too, but it involved the BPD dynamics and a power struggle.

I am glad for her that she had assets as it was more comfortable for her to be in assisted living on her income than a Medicaid covered nursing home, but the cost of any nursing home is prohibitive. In the US, assisted living and long term nursing home care isn't covered but Medicaid will cover long term nursing home care if there are no resources. Medicare will cover short term care but not long term.  I wouldn't hesitate to get Medicaid if someone was eligible. Families can always supplement once basic needs are met. My friend has a modest income but she gets her father snacks, clothing, things he needs like that, and visits him. He's NPD and isn't so nice to her but she has peace of mind that he's in a safe place.

The IRS and Social Security, and many banks, don't honor a POA and require their own. Social security has a place to add someone to get information if needed. The best way to do this is to have him set up an online account and then let you access it if needed. If someone is not able to manage themselves, there's a way to have someone else be the paid person on their behalf- but that wasn't needed in my mother's situation. She didn't set up access for me so there wasn't any way I could get that information unless she gave it to me.

This is the practical aspect of this situation. Emotionally, it was BPD dynamics as expected. But it would be that way anyway whether you choose to do this or not- or if he lets you do it. BPD mother didn't for years and only when it got to where she truly needed someone to help her did she allow it somewhat.

[Notwendy]

While I mentioned the practical, I don't want to underestimate the emotional.  Whether or not you wish to take on being his POA or any other part of it is up to you. One benefit is that- however it goes, you would know what happened, even if you couldn't change the outcome of his behavior.

[Merry342]

Thank you for this incredibly helpful information  . I especially appreciate it because it acknowledges the BPD dynamic, which is a heavy additional layer in navigating the already complicated situation of arranging care for a parent. Obviously, many people simply cannot understand what is at play on the very few occasions I talk about my Dad so this added resource with BPD Family is helping address that underlying issue.

Re: his situation: He has no resources and has been living on Social Security and a small part-time job at a pizza shop. He is a veteran (Air Force) so those benefits have been a life-saver on more than one occasion.

I need to look into what might be available to him if he needs at-home or facility care and look into how Medicaid could factor in as well as being appointed his POA. As the eldest daughter who is definitely parentified in every sense of the word, my family will expect me to accept this role. I'm certainly capable, but I need some new tools (real and emotional) to handle it.

I think that aspect is what keeps me up at night the most. How can I support my family, ensure my Dad is safe but protect myself? Your feedback provides so much good food for thought. Thank you so much! 

[Notwendy]

Re: his situation: He has no resources and has been living on Social Security and a small part-time job at a pizza shop. He is a veteran (Air Force) so those benefits have been a life-saver on more than one occasion.

I need to look into what might be available to him if he needs at-home or facility care and look into how Medicaid could factor in as well as being appointed his POA. As the eldest daughter who is definitely parentified in every sense of the word, my family will expect me to accept this role. I'm certainly capable, but I need some new tools (real and emotional) to handle it.

I think that aspect is what keeps me up at night the most. How can I support my family, ensure my Dad is safe but protect myself? Your feedback provides so much good food for thought. Thank you so much! 

There are several of us here who are navigating similar situations. I also am the parentified child and also the scapegoat child. I was willing to help with my parents but when I tried, BPD mother would insist on being in control and oppose my efforts. She was also emotionally and verbally abusive to the point where I felt the need to maintain a distance and boundaries.

BPD mother had significant assets, but she kept all her financial information secret from us. None of her children would have mishandled her finances. We knew that Dad's wishes would be for her care needs. However, she would not allow us to have any information. Ironically she named us as POA but we had no ability to actually act on her behalf and no information about what to do if it was necessary. She took out a home equity loan on her house without telling anyone and had spent most of her assets. At this point, I contacted an elder law attorney to see if we would intervene to use what was left for her care needs. She remained legally competent so we could not.

Although it's difficult for your father to have no assets, in a way, it's a better position to be in to access services like Medicaid if he were to need it. Medicaid obviously doesn't allow people who have assets to spend them all and then ask for help. For people who have some assets, they can plan ahead if they ever did need assistance and there are ways to do that but these were not options with my mother.

Caring for the elderly in the US is costly. There are some options: care at home (very costly and also leans on family members). Assisted living is self pay and it is a business. It is also costly. BPD mother had enough to cover her basic fees there. We asked her to be conservative with her savings as costs increase as care needs do over time. She drained them quickly. It was self destructive and also, I think in a punitive way.

The other option is long term care in a nursing home. It is possible to have Medicaid assistance for nursing home and some care at home needs if the person can remain in their home. I am not familiar with these options. I think a good place to start for information is with social services. In addition there may be some VA benefits your father can access and so contacting them for information is a good idea. Nobody will speak to you about your father's personal situation without a POA, but they can give you general information.

You also want to protect your own finances. You aren't responsible for your father's costs but families may find themselves in a situation where there isn't complete coverage. So get whatever resources he's entitled to first. He may be able to access reduced legal servives to get the POA done, for instance.