In crisis with un-diagnosed 79-year old BPD mother

[KO66]

Greetings,

My husband and I are at a crisis point with my un-diagnosed 79-year old BPD mother following an ultimatum by my husband (also raised by BPD parent) that she seek help or he will no longer be in her life.

Triggering events happened during recent disastrous family trip to Hawaii to attend my daughter’s wedding where my mother first had an inappropriate outburst following the ceremony and then two days later when my husband did not acknowledge a dream she had had to her liking, she went into one of her typical icy cold aggressive and punishing day-long silences that ultimately led to my husband nearly flying home.

On hindsight and review, family weddings seem to be a trigger for her in general.

Other Issues . . .

She has severely isolated herself

**She has made very few friends since moving to California in 1991

**She refuses to deepen the friendships she does have

**She only wants support from “family” and is unwilling to embrace my daughter’s new extended family who regularly demonstrate their desire to embrace her. (“Family” is very small (myself, my husband, her step-brother, my two grown kids with their own increasingly busy lives.)

**She turns down many more social invitations than she accepts

**She refuses to get involved with organizations/activities that might lessen her isolation

**She vehemently refuses any kind of therapy or psychological help

She is almost out of financial resources

**Refused to get any type of small part-time job after retiring from nursing 10 years ago and has drained all of her savings

** Her step-brother has been subsidizing her; may need to stop soon

Suspected, concurrent psychological issues

** Severe chronic anxiety disorder

** Chronic low-level depression

** Current major depression

QUESTIONS

Is there any research or specific recommendations for how to support aging BPD’s as their condition intersects with those of “normal” geriatric issues?  i.e. Depression related to “feeling invisible”?  Issues related to physical/mental decline?

We’ve issued an ultimatum that she is not swayed by.  Now what?

What are the considerations in telling undiagnosed BPD that we think she is on the BPD spectrum?

Could her behavior of diligently keeping up her physical appearances (exercise, precise grooming, fashionable clothes) while aggressively refusing anything that might bring light in her life be considered a form of self-harm?

[Naughty Nibbler]

Welcome K066:    

Sorry about your problems with your mom.  Weddings seem to be a source of conflict what someone in the family has BPD.  It's unfortunate that she ruined the Hawaii trip.

What was her inappropriate outburst after the wedding about?  Is she getting her meds from her primary care doctor of a psychiatrist?

It's probably not going to be realistic for a 79-year old to find a part-time job.  The job market is rather tight right now.  Unless she has some unique skill that is in demand or knows someone who will give her a break, it could be difficult.

Could her behavior of diligently keeping up her physical appearances (exercise, precise grooming, fashionable clothes) while aggressively refusing anything that might bring light in her life be considered a form of self-harm?

None of the above sounds like self-harm. It even sounds a bit contrary to a major depression.  Could be a bit narcissistic.  If she is squandering money on spas, clothes and beauty treatments, then she is living beyond her means.

How long has it been since you have had contact?  Is her step-brother the only one currently in contact with her?

What the current situation between your husband and his BPD mom?  One option can be that your husband stays no contact (NC) with your mom, but you have some degree of limited contact with her.  Have you thought about that?  

Even if she gets therapy, you won't likely get a miracle cure with a 79-year-old.  Boundaries and various communication skills will be essential.  They are for your benefit and will help preserve your sanity.

There is a large green band at the top of this page.  Within it, is a "tools" menu.  That can be a good place to start learning some helpful communication skills.  Good to be prepared for future contact.

[KO66]

What was her inappropriate outburst after the wedding about? 

Following the ceremony and before the reception, she publicly ripped the wedding dress out of the groom's sister's hands in order to put it away "properly".

Is she getting her meds from her primary care doctor of a psychiatrist?

She is taking low doses of Xanax and Buspar for Essential Tremor and anxiety-related disequilibrium disorder, but refuses evaluation for any perceived psychological issues.

It's probably not going to be realistic for a 79-year old to find a part-time job.

I don't consider this an option now.  But it was one that, had she not refused it over the past 15 years, would have yielded her more options now. I only mentioned it as a demonstration of isolating, self-limiting behaviors that have contributed to a pretty bleak place. (Btw... .until very recently, my mother has had the constitution and physicality of someone 20 years her junior.)

How long has it been since you have had contact?  Is her step-brother the only one currently in contact with her?

I am still in contact with her, as are both my adult children (to the extent their busy lives allow) and her step-brother (who lives across the country). The only one not still in contact is my husband. (She is very upset at the loss of her relationship with him; though is not willing to submit to his boundary that she seek help.)

What the current situation between your husband and his BPD mom?

His mother died several years ago. Five years before she died, and after lifelong struggles which included multiple suicide attempts and severe alcoholism, he imposed a boundary that she stop drinking or he would break contact.  She continued drinking. A year or so, before she died, he adjusted his boundary that she just be sober during potential visits.  She opted for continued estrangement.

I have spent the four decades of my adult life coming to terms with, understanding, processing (and largely growing beyond) my embodied care-taking survival mechanisms from being the only child of two borderline parents.  I have defined my own life, found my own passions and managed to find a fairly healthy balance of caring, connection with my mother.

But with my mother entering her eighties and having eliminated (and/or refusing) most avenues of financial and emotional support--other than me--I sense we are entering a new playing field.   

Whether consciously or not, I think she sees the possibility of finally getting me all to herself as she makes it so there's no one else to take care of her.  And I feel the BPD part of her shining up the silver, getting ready to consume me.

Which leads to my central question: "Is there any research or specific recommendations for how to support aging BPD’s as their condition intersects with those of “normal” geriatric issues?"

(Btw... .my estranged father recently contacted me following the death of his second wife with a desire to make amends.  I will be visiting him with my son next month for the first time in 15 years.)

[Basenji]

Which leads to my central question: "Is there any research or specific recommendations for how to support aging BPD’s as their condition intersects with those of “normal” geriatric issues?"

Coincidentally, I've been posing the same question. If you simply "Google" the terms "geriatric care and borderline personality disorder" your search will produce some references as a starting point

If you also Google to locate the home page of "PubMed - NCBI" from that page you can run searches into the primary medical / scientific literature itself: that is basically a web search tool which specialises in medical and science literature and the universal entry point for any student / professional in those fields.

I have done some cursory searches myself and I'm not finding that much of direct relevance. So at this point I can't recommend any specific sources beyond those cited on this website itself.

I also approached informally the retired psychiatry professor of our local university, who I know socially. He could not identify any professionals in our local town who had the expertise in both geriatrics and BPD for me to seek the conventional medical wisdom. When I expanded the search through him nationally he came up with one name in a major city (here in Australia).

The unfortunate reality is that people with BPD are extremely difficult to treat let alone handle. One therapist I spoke with informally avoids such patients if she can! They are in the too hard basket.

To complicate matters, signs of dementia may be confused with symptoms of BPD in later life according to some sources.

Just some thoughts - hopefully it's OK to share them... .

My mother is 85 years old and overseas in the UK.

I have come to the conclusion that I am not suitably medical qualified to provide any care for her (not that I want to anyway). In any case, to do so would endanger my own healing process and I have sacrificed enough over my life.

Now my mother is moving next door to her best friend who is 15 years younger: I think that's her move to entrap the BF into being a care provided (shopping, etc) should the need arise (lucky BF!). I assume the BF doesn't realise mother is uBPD an is in for a rude shock when the heightened expectations of living next door become a reality. Time will tell.

I know that sooner or later the wheels will come off that arrangement.

My strategy will be to try to locate suitable care facilities, if and when my help is sought for such or the situation has deteriorated to the point where that move is mandated.

She's on her own, with or without the support of her BF, as far as I'm concerned until such time I am, needed to sign any papers. Mother has refused to sign power of attorney papers.

It is only my personal opinion, but I would caution against the urge to get involved in the day to day aspects of your mom's care. If it's too hot for the pros to handle... well., it's a very big ask with a very high potential price to pay... .(others may disagree of course!)... .her creation of financial and other dependencies may need to be challenged or bypassed for the sake of your own family (perhaps?).

I guess it would be ideal if you and your husband had a united strategy (?). Based on my own personal experiences I must confess to having some sympathy for his position (and respect for your determination to find solutions to the inherent challenges of having borderline folk in our lives).

On a practical front, it might be worth starting the process of trying to locate any relevant medical / psych professionals with the relevant expertise you can call upon when the situation moves more into the twilight period of her life, whether or not you elect to become involved in day to day care in the meantime.

Hopefully, my thoughts and observations are not misplaced in your particular case.

Either way, lots of sympathy and best wishes  

If I do find any particular literature I'll post on this thread for you.  



 





 

[madeline7]

But with my mother entering her eighties and having eliminated (and/or refusing) most avenues of financial and emotional support--other than me--I sense we are entering a new playing field.   

My post (visiting elderly uBPD parent in the hospital) is somewhat similar. The playing field for me was my elderly Mom becoming a widow and moving to the same town so she could be cared for by me and my siblings. I sought the advice of an elder attorney, who said that I have no legal responsibility to care for her. She is cognitively intact so still has capacity to make her own decisions. I then sought the help of a private geriatric Care Manager who said that she was unable to help due to the fact that they only take cases that would result in efficacy, and that working with a BPD individual was too challenging since most likely it would not yield any results (and I did not have the money to pay for the services). My siblings and I are not on the same page unfortunately, so I have recently chosen to go NC and they are providing emotional support for her as well as running errands. If and when the time comes, I have identified Assisted Lining communities and other resources, as I am unable to care for a mentally ill person. I have conflicted feelings having sacrificed most of my adult years to dealing with a BPD Mom and co dependent family (including myself), but the support on this board has been tremendous and hope you find it helpful as well.

[KO66]

Hopefully, my thoughts and observations are not misplaced in your particular case.

Basenji: Thank you so much for you kind and caring response as well as your suggestions for research entry points.  Your thoughts and observations are valid and appreciated.   

I guess it would be ideal if you and your husband had a united strategy (?). Based on my own personal experiences I must confess to having some sympathy for his position (and respect for your determination to find solutions to the inherent challenges of having borderline folk in our lives).

I have sympathy for him too.  I'm watching myself (and questioning my own agendas) very carefully as we navigate our individual responses and each set our boundaries/approaches moving forward. 

So far, we've been pretty successful in both respecting each other and exploring our own reactions to my mother's behaviors within the context of the residue of own upbringings. 

He tends to "lay rubber in reverse" as he likes to say.  I used to be a timid doormat of a peacekeeper; whereas I now put up my protective emotional force field and go into mediation mode within pretty well defined personal boundaries (at least so far).

My husband and I have a strong, caring relationship.  We have and continue to learn a lot from each other as we explore our own brands of care taking.

At the same time, I am aware of the danger of my mother's issues driving a wedge between us.  (And her BPD "bad head" would like nothing more.)

He still believes his boundary of "get help or I won't be in your life" can be effective, (though he's beginning to move off of that opinion).  I've finally come to TRULY understand that she has a lifelong mental illness from which she will not "recover".  Thus, I can't expect that her love of me (or him) will sway her in the direction we wish for her. And while I can fully without malice accept my husband's NC boundary, I am coming to see that at least for the "boundary holder", the boundary has a different quality depending on the mind-set from which it is made.

(Thanks for the opportunity to explore this a bit.)

[KO66]

My post (visiting elderly uBPD parent in the hospital) is somewhat similar.

Thank you.  I will look up the thread and will take to heart your suggestion to put a "what if" plan together in advance.