Not coping with frail ubpd mom

[Methuen]

 !
My ubpd mom had a fall in early sept with a soft landing.  Shes 83, frail, and has had an eating disorder her whole life.  She also has osteoporosis, and lives alone.    At first, xrays indicated no fractures.  But since the fall her pain has increased and her mobility decreased.  She uses a walker, but can hardly cope with the pain to get to the bathroom.  Multiple trips to the dr and hospital emergency have resulted in a recent CAT scan that now shows 4 fractures including 1 causing inflammation around her sciatic nerve.  Her pain has been excruciating.  The doctors give her pain meds and send her home.  After she was sent home again tonight, I became distraught.  It’s wrong to leave her alone in this condition.  Its pathetic because she cant move from her pain, let alone toilet, bathe, or otherwise look after herself.  After hubby and I arrived home after our evening in emergency and then driving her back home, I flipped a gasket.  Im an only cild, I have a lifetime of baggage in a difficult relationship with ubpd mom, and nobody in my town has a clue.  I got back into the vehicle to drive to her house to sleep at her house for night because shes not safe alone.  But I don’t want to be there and I feel trapped.  In the car driving over I just started screaming in a rage.  And now Im stuffed up from crying.  What to do when the medical system doesn't help, and nobody in my town has a clue about the bpd?  I do see a therapist, and have been managing self care up to now, but I no longer feel like I’m coping.  It’s too much.  She needs medical care, and I need a break.  However, who else is going to look after and advocate for her?

[Harri]

Hi Methuen.

I am so sorry to hear of the struggles your mother and you are having.  It is a lot to deal with for the both of you and I can relate very well to the anger you express at having to take care of a parent who is physically ill in addition to having abused you all of your life.  I was n that position when my mom had cancer and then again after she died and I was responsible for looking after my father.  it is not easy and I am sorry you are dealing with this.

Re: care for your mother.  I suggest calling her doctor and telling them she is not mobile, she can not bathe herself or use the toilet on her own and that you are not able to do these things for her.  There are home health services she may qualify for.  Certainly nursing visits to check and home health aides who can bathe her at the very least.  Sometimes aides to sit with her can also be arranged.  A lot of this is covered by insurance as long as it is doctor ordered though the an in home aide may require some payment on the part of your mother depending on her insurance.

What do you think?  Can you call her doctor?  That will at least take part of the load off you and will keep her safe and help her recover.

[TelHill]

Methuen,

Sorry about your situation and your mom's fall. My parents had hospital stays and rely on Medicare for insurance with a small supplemental policy. We are in the US.

Medicare gave us two options: a few months of in-home care and rehab for both at no charge to them or some weeks at an in patient rehab facility.  I have called Medicare for help. They were extremely competent and caring.  I was expecting the worst (like Amazon.com or Comcast).  The customer service crew at Medicare is top notch. 

[Methuen]

Yes Applying for home care is a good idea.  I had initiated this already, and today I got the call from the intake nurse.  Mom will get referrals for some services such as meals on wheels which the client must pay for.  She will also get 2 1/2 hr per week for things such as bathing.  She can also get a daily safety check.  If I know my mom, she will say she doesn't need these things, (because she thinks of herself and would rather rely on her family and friends).  So...how to present the services available so that she agrees to receive them...without JADE ing?

[Methuen]

She is also on a “waitlist” for the RIE assessment (risk assessment tool used for long term care evaluation).  As she has always been vocal about stating publicly she wants to live with us (we very early set a boundary indicating that would not be possible), the conversation disclosing the RIE assessment is going to be a hard one.  I think I will save that for a later time, and try to sell the home care services first.  But how to sell even this to ubpd mom?

[Harri]

If I know my mom, she will say she doesn't need these things, (because she thinks of herself and would rather rely on her family and friends).  So...how to present the services available so that she agrees to receive them...without JADE ing?

I would keep it simple and direct if it were me.  I am not sure this will work for you though.  I am thinking saying something like "I understand you would prefer friends and family help out and I sympathize.  This is too big for me to handle and I am not properly trained to help you with these things.  You need help from home aides and nurses who can take care of and monitor you properly".   I am not sure that selling something like this is possible.  I would take more of a thins needs to happen and see if I can get her doctors to chime in and support you.  Let the doctor know you can not take care of her full time.  "I'm not in a position where I can provide the level and depth of care she requires".

Chances are she will argue and possibly call you uncaring.  I would stick to my guns (with care and empathy though).  

As for the RIE, how did that come about?  Was it through you or through her doctor?  

As an aside, I am 53 but disabled and have had visiting nurses for the last 5 years or so, anywhere from 2 to 3 times a week mostly for wound management.  It is humbling and annoying and something I fought for about a year before giving in.  In my fantasy head, where reality and rational thought do not really come into play , I have friends and family who all pull together and help me... reality is that even if I did have those sort of people in my life I would never want them or expect them to take on such a role.  Even not having BPD I struggle to accept that this is a necessary part of life for me.  I think it is a struggle for anyone.  BPD is going to complicate it for sure.

[Methuen]

Thanks for your words Harri.  It's all helpful.  I know it must be hard for anyone to accept these changes.  

As for the RIE, how did that come about?  Was it through you or through her doctor?

Well, her family doctor made the referral for home care services when I requested them.  My mom gave permission to arrange services through me.  When the intake nurse conducted the interview with me, he summarized all the services mom would qualify for (including meals on wheels, Lifeline, Occ. therapy, meal assist, safety checks), and also stated he was going to put her on the "waitlist" for a RIE assessment.  So to answer your question, it indirectly came from the referral from her family doctor for home services through our local health authority.  Where I live,  a "waitlist" probably means a "year" or more, but I'm guessing.  

I have had an appointment with mom every day for what seems like 2 weeks, but maybe it's less.  Doctors, CAT scans, hospital emergency, different services related to home care, and so on.  It's been emotionally draining, negative, and stressful.
 She is putting up resistance to some home care services, but then I phrase it so reasonably in front of the doctor or home care worker that she goes along with it.  For example, she is "resisting" Lifeline, which is a sensor she would wear around her neck which would detect if she has another fall.  She says she doesn't "need" it (she's 83, reportedly lost 10 lbs since her last fall in September from which she sustained 4 fractures in her pelvis and sacrum, has osteoporosis, has 6 screws in her back from a spinal stenosis surgery some years ago, 2 hip replacements, 1 knee replacement, and currently is too weak to answer the door with her walker, or lift a coffee pot to make her own coffee...but she says she doesn't "need" the Lifeline service).  After her resistance, I pointed out that the Lifeline wasn't just for her, but also for her loved ones.  The health care worker was sitting there nodding, and told a story about an elderly woman who fell (and couldn't move), and wasn't found for 13 hours.  Then mom agreed to "try it for 1 month".  If I had to guess, when the month is over, she will decide it's not worth the cost, and since she won't like wearing it,  will discontinue.  I guess if that happens, I will just have to accept it, but HOW NOT TO FEEL LIKE IT'S MY DUTY TO GO THERE EVERY DAY AND CHECK ON HER?  This is what mom would want and expect.  She has an emotional "need" for this kind of attention.  Of course if I don't, it would be affirmation that I don't love her, in her mind.  It's so messed up!  I'm really struggling with resentment from all this, as well as the lifetime of baggage leading up to this particular situation.  I've already told her I can't do everything she wants/needs as I also have to take care of myself.  I've told her this with the health care worker present.  In that way, I've set a boundary.  But I'm expecting her to decide after her self-imposed "trial" periods, that those services aren't working for her, or she doesn't need them.  Then I will be left holding the bag.  I also recognize that I'm anticipating problems before they happen, and in that way not living in the moment.  But after a lifetime with my mom, I can predict her behavior with almost 100% accuracy.

On another note, mom recently became aware I had baked a pumpkin pie.  As mom has had a lifelong eating disorder, I didn't bother bringing her a piece, as she would just give it away to the next person that comes to visit her as a "gift".  (She doesn't like food).  But when she found out I made a pumpkin pie, she asked me for a piece.  So I gladly brought her a piece.  When I asked her how she liked it, she replied "it's not apple".  
 

[Harri]

Hi Methuen.

Your mother sure is stubborn isn't she?  I think you are doing a great job with setting limits and talking with her in addition to using the presence of the health care worker when you do have some of these discussions.  Very wise.

I don't know if anything at this site can help you but you might want to check it out and see if any laws apply or resources are good for your situation with your mom https://libraryguides.law.pace.edu/elder  I think it has been recommended that you contact the department of elderly affairs in your state as well to see if they can offer you any strategies to get your mom help.  

HOW NOT TO FEEL LIKE IT'S MY DUTY TO GO THERE EVERY DAY AND CHECK ON HER?

Well, this is a tall order but you can work on it.  Detaching with love, setting boundaries for your mother and for your self, self-differentiation, etc will all help with this.  I am not sure there is a point where you do not feel torn or some degree of guilt but there is a point where it is not all consuming.

The fact is, your mom is mentally capable of making her own decisions until her doctor declares otherwise.  You can not force her to take care of herself.  You can set boundaries like you have (you are doing well here!) and implement them in other areas.  You would also benefit by working on acceptance.  Accepting that there are limits to what you can do and what you choose to do is in fact a choice.  That your mothers emotions are hers and do not define you no matter how you may feel (this gets easier over time).  That you can not control her actions or her opinions and she has a right to these things just as you do.

It is a lot to think about and break down and accept but it can be done over time and with support.  Therapy will help with that and so will posting here.    

But I'm expecting her to decide after her self-imposed "trial" periods, that those services aren't working for her, or she doesn't need them.

That is her choice to make.

Then I will be left holding the bag.  I also recognize that I'm anticipating problems before they happen, and in that way not living in the moment.  But after a lifetime with my mom, I can predict her behavior with almost 100% accuracy.

You can pick up the bag and hold it again or you can choose something different.  Nothing changes without change... so change it up (and this change can happen as gradually as you want it to).

 

[GaGrl]

My situation is different -- my mom has a few BPD traits that I attribute to growing up with an uNPD/BPD stepmother -- but there are some similarities just in trying to deal with persuading elderly parents to accept help and services.

My father was incredibly stubborn. I had bought our retirement house with the intent that my parents would move into it and we would retire in a few years and he able to care for them. Unfortunately, my 93 year old dad developed pneumonia that summer. I told him of the house situation while he was in rehab and got -- "I appreciate the offer." Truth is, he was determined to die at home, which he did only 10 days after going home first to home healthcare and 2 days after hospice care began.

It's difficult to balance their legitimate wishes with What we see them beginning to need. Throw in our own needs, and it gets very complicated.

My 93 year old mom gladly sold their house, moved into our house, put me on all her accounts, have me POA, gifted money for some house renovation to help her (walk in shower), and frankly is living the life of Riley. She has a caregiver come in three days a week who takes her to most appointments. When I retired, she asked if she should cut back on the caregiver days, and I said, "Oh, no!" That is my lifesaver. She has enough quirks that my husband and I need to escape sometimes - - but this is what I wanted to do, so I'm realistic. She has had a few falls, so she wears a bracelet like Lifeline when we are out of town.

Your mother sounds like a double handful -- we saw this with my stepgrandmother. My thoughts are with you, because I know you are trying to do the right thing, the right way.

[Methuen]

So as I've mentioned previously, I've been working hard for almost 2 weeks supporting uBPD mom in her home (as she recovers from 4 fractures after a fall), and also with health care professionals to set up community supports for her such as meals on wheels, meal assist, lifeline, bathing etc etc.  I'm sure some of you have been waiting for the push back, as I've mentioned there as been resistancefrom her, even though she has signed off on the paperwork for all the supports.  Her rage came today, as I was driving her to yet another doctor's appointment.  She raged at me for "making her" go to a physio appt (I didn't - she had already made her own appt, and drove herself), accused physio of injuring her at the appt, and screamed at me that all her pain was my fault because I made her go to physio.  I sat a safe distance from her in the doctors office, and either practiced my breathing with my eyes closed, or went on my phone.  The good news is that inside the doctors office, she told the doctor her pain is less, and she is feeling better.  As the appt was coming to an end, I said I had a question.  I told the doctor mom had said the pain got worse after a physio appt and she felt like the physio had injured her.  The doctor immediately said this was not possible unless the physio had swung her around the room and dropped her on the floor.  He actually said that...and repeated it!  Silence in the elevator on the return trip down (we were alone).  Silence in the car on the ride home.  Silence as I helped her inside her house.  Then I said something like this:  "Mom the doctor said physio had nothing to do with your pain.  You raged at me this morning that all your pain was my fault because I made you go to physio.  I did not make you go to physio, and the doctor said physio was not the cause of your pain.  Sometimes you  just find it necessary to rage at someone.  That someone is always me. What you did this morning was abusive and it hurt me.  For weeks since your fall, I have dedicated hours every day to helping you in your house, taking you to appointments, and for all that, the thanks I get from you is another one of your rages.  I am tired of your rages."  Then she started railing at me about some plant, so I picked up my shoes (didn't take the time to put them on) and walked outside closing the door (I may have slammed it behind me).  As I put my shoes on outside, she was still raging at me through the door about a plant (no idea what that was about).  Tonight she sent me this email:

That was not a conversation of two educated women.
I am sorry and leave it at that.
ON MY PART I DO NOT  AGREE ON HOME CARE COMING AT SUPPERTIME.   Two weeks ago that might
Have helped me.  I have a lot of companionship so that is not  what I need.
I was happy with the doctors visit.  
After today I don’t know if you love me or hate me, One thing for sure if I have not proven my LOVE by now, I give up.

YOUR MUMIE

Any thoughts about all of this?  

PS the real reason mom doesn't want home care at suppertime is because she has a lifelong eating disorder, and feels like theworkers are watching her eat.  She has lost 10 lb since her fall, and has been telling people about it.  All she has ever wanted is to be thin.  Now she is thin, frail, osteoporotic, weak, and has fractured bones from a fall.  I believe her rage comes from a sense of loss of control as community supports have been set up inside her home.  The reason doesn't really matter to me.  All that matters to me is her abusive raging, and how I should respond beyond what I already said to her today.  Typically, I go NC for a while, she pretends nothing ever happened, and carries on as if nothing ever happened. 

[Methuen]

For me the real problem with her email is the last line.

After today I don’t know if you love me or hate me, One thing for sure if I have not proven my LOVE by now, I give up.

YOUR MUMIE

Again, she's blaming me with the second half of her sentence.  

[GaGrl]

You say you don't typically respond. Are you feeling the need to respond this time?

[madeline7]

You brought her pumpkin pie, her response was that it wasn't apple. This is what my uBPDm does and always will. No matter how much I do for her, it will never be enough. This realization is what has helped me to detach, to start to accept she will never change, to accept she is not able to nurture and care for me the way a mother is generally supposed to. I am in the midst of having an elderly uBPDm very slowly declining, and it isn't pretty. Some issues appear to be typical aging according to the health care professionals, and they are likely mixed in with her BPD traits, but I do believe that the BPD is the over riding issue and everything is worse because of it. At times it seems unbearable, but self care for me has been key. You may also want to contact Senior Services or a private care manager for additional support.

[Methuen]

No GaGrl, I am not feeling the need to respond to her email.  Tell me, is that good or bad, healthy or unhealthy?

[GaGrl]

No GaGrl, I am not feeling the need to respond to her email.  Tell me, is that good or bad, healthy or unhealthy?

I would see it as positive that you don't feel the need to JADE.

[Methuen]

I would see it as positive that you don't feel the need to JADE.

Hmm.  I feel like this sentence is maybe meant to be followed by a "but"...?

I'm open to suggestions if it is, as I am at a loss.

The email she sent me feels like one of those no-win situations with a borderline, which is why I decided not to respond...a sort of cooling down period.  

My problem was with the final sentence in her email "One thing for sure if I have not proven my LOVE by now, I give up".  I feel it was her attempt to draw me into more drama after she raged at me that her physical pain from her fall was all my fault and I was the cause of it all (she fell on her grass six weeks ago when I was not around).  I guess I don't understand how raging at me over a lifetime including the rage just a few hours before sending me the email is proving her love for me.  I just wasn't feeling safe.  But if anyone thinks the email from her merits a response, I would really like to do the right thing.  I just don't know what is best anymore.

[GaGrl]

I don't see any progress being made by responding...really. It won't make a difference in how she behaved in future -- her words were just written rate and manipulation.

What is important is how YOU are reacting, what your emotions and reactions are in reading it. That you don't jump to respond by defending yourself is a very good reaction.

[Harri]

The email she sent me feels like one of those no-win situations with a borderline, which is why I decided not to respond...a sort of cooling down period.

I think not responding is a wise thing.   I think the best time for the cooling off period was before you said anything to her about her raging at you though.    Let's talk about that a bit.

My problem was with the final sentence in her email "One thing for sure if I have not proven my LOVE by now, I give up".  I feel it was her attempt to draw me into more drama after she raged at me that her physical pain from her fall was all my fault and I was the cause of it all (she fell on her grass six weeks ago when I was not around).

 
Maybe.  Maybe she is just angry and frustrated and expressing it very poorly and lashing out at you.  I'm not saying it is right, I am offering a different more centering perspective.   A lot of people who have difficulty with processing and expressing their emotions will get an emotional release when letting it all out, often on someone they feel close to in one way or another.  It is not necessarily an attack even though it sure feels like one.

I guess I don't understand how raging at me over a lifetime including the rage just a few hours before sending me the email is proving her love for me.

 Raging at you all your life and sending your email were not, I think offered as proof of her love for you.   This could be how love looks to her.  Not so much raging at you but the closeness that allows her to feel 'safe' or comfortable in your company to act in such ways.

I just wasn't feeling safe.  But if anyone thinks the email from her merits a response, I would really like to do the right thing.  I just don't know what is best anymore.

Of course you did not feel safe.  She was directing her anger and frustration towards you and you did not deserve it at all.  She can't see that though.  Trying to get her to see that when she is upset is not going to work and in fact will only escalate the situation.  She can't see you or hear you when she is upset.

I think you responded the way a lot of us would and do respond.  We feel angry and hurt especially after doing so much for our loved one.  The thing is, if she is upset (after hearing what the doctor said) it is not the time to have the conversation you tried to have with her unless you just wanted the convo as a release for your own frustration (valid but not constructive in this case).  If you were hoping to be heard, to set boundaries, to let her know that you care about her and have done everything you can to help her, it was not the time to have that particular discussion.  Does that make sense?

As the healthier one, it is up to us to use the skills we learn or develop, to recognize when it is time to speak and time to be quiet or even when to disengage when necessary if we hope to keep the relationship on more level ground.  That said, there will always be imbalance in your relationship with your mom with her traits of BPD.

There are a couple of articles we recommend for our members in romantic relationship who want to improve their relationship.  I am going to link 2 of them here with the caveat that you will obviously have to extrapolate some of the info to apply to the situation with your mom.

PDF | Before You Can Make Things Better, You Have to Stop Making Things Worse  

and

The Do's and Don'ts in a BPD Relationship

Since you are in a very difficult position as caretaker with your mom I think a different approach is needed than the one you took.  If one way of doing things is not working, change it up.    I am not saying you are wrong or that she is right.  Right and wrong don't really come into play here.  It is about you acting in healthy ways that will help you and make your situation as you help you mother more successful and less stressful for you.  

See what you think.  

[Methuen]

I think the best time for the cooling off period was before you said anything to her about her raging at you though.

I agree.  I have a ways to go in my personal development with my mother.  It is interesting that she waited to attack me until we were in the car and I was in traffic.  I couldn't "exit" the situation as I was trapped behind the wheel of a vehicle driving her to her appt.

It is not necessarily an attack even though it sure feels like one.

So her rage was entirely "personal" as she was yelling at me  "YOU caused all MY pain since YOU made ME go to physio which was when her REAL pain started after her fall".  So just to clarify, I did not make her go to physio.  She had been going to physio ongoing long before her fall...for years really (making her own decisions to attend physio, and driving herself there before her fall).   So I guess I don't understand how screaming at me that her pain was my fault wasn't an actual attack on me, since she fell under her plum tree when I was not on her property.  Having said that, it would be a great relief to me to understand WHY it WASN'T an attack on me.  In that moment, and afterwards, as I reflect on the last 14 years since dad died, and all her personal rages on me, I am convinced she absolutely hates and despises me.  I don't feel she loves me when I'm mistreated so often.

This could be how love looks to her.  Not so much raging at you but the closeness that allows her to feel 'safe' or comfortable in your company to act in such ways.

OK so my husband agrees with you; his theory is that she does this to me precisely because I am her daughter.  If she did it to a friend, the friendship would end.  She has lost one friend in the last year this way.  She also lost a sister for 10 years.  Her relationship with her SO since my dad died has been tempestuous.  He is now moving away.  Amazingly, through her life she has had a personality that attracts friends, so she always has friends, but I have observed that she does cycle through them.  She always gets new ones though.  As the daughter I feel trapped because I can't just walk away.  Somehow, the possibility that she rages at me because she feels safe to do so does not bring me any comfort.  This abuse and drama is destroying my joy for life.  It is consuming me.

 The thing is, if she is upset (after hearing what the doctor said) it is not the time to have the conversation you tried to have with her unless you just wanted the convo as a release for your own frustration (valid but not constructive in this case).  If you were hoping to be heard, to set boundaries, to let her know that you care about her and have done everything you can to help her, it was not the time to have that particular discussion.

Except she wasn't upset after the doctor's appointment.  Looking back, I can see I didn't do a well enough job of explaining this in my previous thread.  I only stated earlier that "The good news is that inside the doctors office, she told the doctor her pain is less, and she is feeling better."  At that time, he also looked at her most recent CAT scan results, and saw that there were clinical signs the fractures were healing.  His physical exam yielded almost no pain at all where her previous pain had been, and between him and my mom, there were a lot of smiles and relief expressed that things had turned around in terms of her healing, and that things were moving forward nicely.  My mom was proud as punch (despite having raged at me minutes earlier in the car that her pain was all my fault).  This was when I asked my question if the pain could have been caused by a physio appt instead of the fall (and Dr. said no chance).  So the doctor's appt had gone very well, and she had even proudly walked about 6 steps unassisted by her walker so the Dr could observe her gait.  She was elated.  It was about 15 min after that, when I got her back inside her house, that I stated how her words about causing all her pain, and her frequent rages hurt me.  So her emotions were calm when I spoke to her.  I actually thought about refraining from bringing it up, but when I have waited in the past, and brought up a problem after the fact, mom either doesn't remember the situation, or doesn't remember it the way I do, so I felt it appropriate to bring it up when it was still fresh, and since she was calm after the appointment.  I didn't think in that circumstance that it was inappropriate to tell her how she hurt me, and set that boundary.  To do it later, she could have just denied it happened.  To be honest, when I re-read my earlier thread, I didn't explain this particular sequence of events all that well, which I apologise for.  Having clarified this, I would find it helpful to know Harri if you think I still mishandled the situation by setting a boundary.  I know there are things I need to work on such as complementing her and validating her more.  And I'm going to be honest and say that I didn't do that before I stated my boundary.  Clearly I have a ways to go with my personal growth around my BPD mom.  But if I shouldn't have set the boundary after a positive Dr appt, and after he just clarified physio had nothing to do with it, then I feel like it maybe the message is that it's OK for her to abuse and rage at me "and just turn the other cheek"... and take the abuse?

Honestly, I had doted on her for two weeks straight, 4 hours a day, when this happened.  I was worn out, and definitely not feeling valued.  It was the perfect storm.  I once had a counsellor explain to me that my mother's stormy and violent upbringing became her emotional "normal".  So when anything gets too comfortable emotionally for too long, she has to create a crisis to feel "normal and safe".  I don't know what you think about that.  

Since you are in a very difficult position as caretaker with your mom I think a different approach is needed than the one you took.

You are absolutely right.  I know that I need to change.  I know that she's never going to.  I've been working hard on it.  I've read 2 books, ordered 2 workbooks (one DBT and one CBT) and am well into working through the first workbook (CBT Mind over Mood).  I do a ton of research online.  I go to yoga.  I go to the gym.  I have a counsellor.  I learn from others on this board.  Mom just always keeps a step ahead of me and uses new strategies (attacking me while I'm driving her to an appt so I can't leave the situation).  There's always a new trigger.  I'm just feeling worn out and exhausted because I gave up my life for the last few weeks to attend to her every need.  I always thought she was a Waif.  Last Friday she was a Witch.  It honestly just feels hopeless.

Thank you for the links.  I have started with the first one.  I will spend some time with them.  

I really appreciate your time, and dedication to helping us on this site.



  

[Harri]

Hi Methuen!  Sorry it has taken a couple of days for me to get back here.  I have been thinking about your situation though.  It is so frustrating when the pwBPD acts in ways that are harming them and us. 

So I guess I don't understand how screaming at me that her pain was my fault wasn't an actual attack on me, since she fell under her plum tree when I was not on her property.  Having said that, it would be a great relief to me to understand WHY it WASN'T an attack on me.  In that moment, and afterwards, as I reflect on the last 14 years since dad died, and all her personal rages on me, I am convinced she absolutely hates and despises me.  I don't feel she loves me when I'm mistreated so often.

I don't think she actually blames you for the fall or for 'making her go' to physio.  I think she is angry and upset.  PBD is a disorder of emotional regulation.  As such, pwBPD become overwhelmed with their emotions and do not deal with them effectively, often using a defense called Projectionwhich you may be seeing here.  There are others.  Read the article and see what you think.  Basically what happens is the pwBPD feels overwhelmed by their emotion and can not deal with them so instead will project outward on another person.  It is painful and hurts like hell to be on the receiving end of things.  I found once I understood this concept it really helped me depersonalize the behaviors and detach from the emotional conflict and the thoughts of 'she hates me'.  When my mom was raging like that she was not even seeing me, it was her rage, her dysfunctional coping mechanism coming into play.  I was simply on the receiving end of things.

As for whether your mom loves you or not, that is something you can work on.  I found it easier for me to accept that in my mom's mind she felt she loved me, she believed it regardless of my thoughts about it.  I also believe that love does not need to be acted on.  So if someone professes to love us, we can accept it or not.   I wasn't going to convince my mother to see love the way I did nor was I going to convince her to see her actions as abusive.  So I gave up trying.  I did not roll over and accept abuse.  I did not become a doormat.  I simply accepted that she is her own person and feels, believes and behaves differently than I do.  That allowed me to focus on me, to stop torturing myself with the question of whether she loved me or not and to focus on protecting and healing me.

You get to choose your own path there methuen.  There are plenty of others here who look at it differently and that is okay.  I also think it is okay and even necessary to get angry (healthy anger) to be able to grieve and heal.  It takes time.  It gets better and while it is never easy, it does get easier.

Somehow, the possibility that she rages at me because she feels safe to do so does not bring me any comfort.  This abuse and drama is destroying my joy for life.  It is consuming me.

It is not supposed to or meant to bring you comfort, at least not from me.  It is to give you a possible alternative perspective that is accurate and allows you to get through the remaining years you have left with your mom without further hurt of 'destroying your joy for life or consuming you'.   

Except she wasn't upset after the doctor's appointment.

Okay.  I was reading this as meaning she was upset and silent because she was upset:

The doctor immediately said this was not possible unless the physio had swung her around the room and dropped her on the floor.  He actually said that...and repeated it!  Silence in the elevator on the return trip down (we were alone).  Silence in the car on the ride home.  Silence as I helped her inside her house.  Then I said something like this:  "Mom the doctor said physio had nothing to do with your pain...

That to me smacks like a danger signal that I apparently misread in your situation.  I apologize.

Can you lay out the Value, boundary and action for us to look at?  Here is an article on boundaries if you want a review of how we discuss them on this site:  Setting Boundaries and Setting Limits

"Mom the doctor said physio had nothing to do with your pain.  You raged at me this morning that all your pain was my fault because I made you go to physio.  I did not make you go to physio, and the doctor said physio was not the cause of your pain.  Sometimes you  just find it necessary to rage at someone.  That someone is always me. What you did this morning was abusive and it hurt me.  For weeks since your fall, I have dedicated hours every day to helping you in your house, taking you to appointments, and for all that, the thanks I get from you is another one of your rages.  I am tired of your rages."

Here, I do see you speaking up and essentially saying I am not to blame for your pain and I do not appreciate you saying I am and for that I am standing up and cheering you on!     There is nothing wrong with letting her know you are not going to take the yelling and raging. 

I once had a counsellor explain to me that my mother's stormy and violent upbringing became her emotional "normal".  So when anything gets too comfortable emotionally for too long, she has to create a crisis to feel "normal and safe".  I don't know what you think about that. 

  I am not an expert by any means though I can see this happening.  I know I struggled with quiet, peace, safety for a long time after moving out of my parents house.  It is a hard place to be but still no reason to make others miserable or drag them into your drama right?

I know you are working hard on this and I think you are doing great.  It is okay to talk about the struggles to.  You will have times when it is going to be so hard.  You will also have times when it will be much easier.  Keep changing things up.   

[Methuen]

Basically what happens is the pwBPD feels overwhelmed by their emotion and can not deal with them so instead will project outward on another person.  It is painful and hurts like hell to be on the receiving end of things.  I found once I understood this concept it really helped me depersonalize the behaviors and detach from the emotional conflict and the thoughts of 'she hates me'.  When my mom was raging like that she was not even seeing me, it was her rage, her dysfunctional coping mechanism coming into play.  I was simply on the receiving end of things.

Thanks Harri.  I'm trying to grasp this.  I think it's important for me to accept.  The hurt is so strong, that I'm struggling a little to accept it because the attacks are SOO personalized!  I want to get there...

That allowed me to focus on me, to stop torturing myself with the question of whether she loved me or not and to focus on protecting and healing me.

I'm starting to connect to this...

Okay.  I was reading this as meaning she was upset and silent because she was upset:

That to me smacks like a danger signal that I apparently misread in your situation.  I apologize.

No need to apologize Harri!  I had so much adrenaline still coursing through my veins that my brain was not yet up to full function and I realized too late I needed an "editor" to point out to me that I was leaving gaps in the information of the events I was writing about.

The doctor immediately said this was not possible unless the physio had swung her around the room and dropped her on the floor.  He actually said that...and repeated it!  Silence in the elevator on the return trip down (we were alone).  Silence in the car on the ride home.  Silence as I helped her inside her house.  

 
This comment was about her refusal to acknowledge she had made a mistake.  The silence was about me giving her the opportunity to apologize, and her refusing to grasp it...for 15 min...the whole trip home.   As a nonBP, I can't imaging not apologizing to someone where it is due.  It would make me sick for days/weeks/months/forever, to not atone for that.  I would feel "guilt" forever, and probably not sleep at night.  Her "total" rage and then refusal to acknowledge her mistake immediately afterwards made it seem like hateful behavior.  Loving people don't treat others they love that way.  At least that's what I think I was socialized to believe somewhere along the way by someone (other than my BP mom).  That belief/value is a strong one in me.  That's why I think I'm struggling to fully accept the projection defense.  Do BP's not feel guilt like we do?  Or do they project that on someone else too?
I regret not having communicated this part of the story more effectively in my earlier thread, but that's a reminder to myself about decreased brain function when emotion increases, and I was living a lot of emotional pain when I wrote that earlier thread. That was my bad.

Here, I do see you speaking up and essentially saying I am not to blame for your pain and I do not appreciate you saying I am and for that I am standing up and cheering you on!   Way to go! (click to insert in post)  There is nothing wrong with letting her know you are not going to take the yelling and raging.

Thanks, that is good to hear.  I felt at the time that I handled the moment well, but it is always nice to hear someone else validate it.

Again, thanks for the help, and being patient with me.

[Harri]

Again, thanks for the help, and being patient with me.

You are welcome, and thank you for giving me the very same.    I appreciate it as it is necessary so we can all help each other.

Thanks Harri.  I'm trying to grasp this.  I think it's important for me to accept.  The hurt is so strong, that I'm struggling a little to accept it because the attacks are SOO personalized!  I want to get there...

I know it is hard.  Words hurt no matter what that dumb saying says.  Here is the hard(er?) part and this is where knowing the disorder comes into play along with self-differentiation: 
At the time that she is yelling and raging, she probably means and believes everything she says at the time.   However, what she says has more to do with her internal state at that time than anything to do with you.  She may not ever be able to recognize that.  You can though.  Her beliefs and feelings do not define you.   Feelings do not equal or determine facts.  Not for her.  And not for you.  One of the biggest struggles we have I think is detaching from this aspect of our connection with our disordered parent:  that their feelings define us and that we are wrong, flawed, bad, etc when they are unhappy with us.  Even if we know intellectually that this is not true, on an emotional, or visceral level, it is sometimes very different.  That is what we need to work on changing or at least recognizing and then managing.  We are not and never have had that much power over our pwBPD no matter what their reaction, or ours is.

This comment was about her refusal to acknowledge she had made a mistake.  The silence was about me giving her the opportunity to apologize, and her refusing to grasp it...for 15 min...the whole trip home

  Oh!  I get it now.  Thank you and I am sorry.     

Her "total" rage and then refusal to acknowledge her mistake immediately afterwards made it seem like hateful behavior.

  I can sympathize here.  It can seem like hateful behavior and sometimes it is.   

Loving people don't treat others they love that way.  At least that's what I think I was socialized to believe somewhere along the way by someone (other than my BP mom).  That belief/value is a strong one in me.

I agree, healthy people do not treat each other that way. ;)

That's why I think I'm struggling to fully accept the projection defense.  Do BP's not feel guilt like we do?  Or do they project that on someone else too?

Well, I did not offer the projection information as a defense, more as a possible explanation so you can understand and depersonalize.  See if it fits.  If it doesn't that is okay, leave it.  We'll find something else that does fit.

About guilt, yes, some do feel guilt and we can get a variety of reactions/responses when they do feel it ranging from denial, anger, rage due to their shame being triggered to over apologizing, crying, self injury, self-recrimination due to shame being triggered or even a genuine apology... or an "I don't care attitude".  There is no one pattern that "they" have.  There is no "they".  BPD can manifest in about 256 different ways and can vary further depending on other personality traits, etc.   Here, most of the people we talk about have BPD traits rather than BPD so when we talk in generalities, it is hard to sort things out.  I am being a bit more exacting with you given your situation of being the caretaker and behaviors directed at you that are so damaging.  I swear I am not picking on you.   

I regret not having communicated this part of the story more effectively in my earlier thread, but that's a reminder to myself about decreased brain function when emotion increases, and I was living a lot of emotional pain when I wrote that earlier thread. That was my bad.

Methuen, it is okay and you did fine conveying your story.  We get emotional here.  It goes with the territory and I am glad you feel safe to express yourself.  Plus, we sorted it out right?  Besides, I could have and should have asked clarifying questions to make sure I understood... another evening I might have.   I am sorry I did not.   

Here's to next time and more mistakes and working our way through things as we give each other leeway and a break!