Seeking advice re elderly uBPD mother currently in crisis

[KO66]

Over the past few months, my 82-year-old uBPD mother has initiated and experienced a series of traumatic events, culminating in increasing self-isolation and suicidal ideation.

Just before Christmas, she initiated a private conversation with my partner/husband of 20 years to discuss their supposed long-standing “shared romantic feelings” for each other.  She did not believe his denial and swore him to confidence that he would not tell me (or anyone) of the conversation. (In shock and disbelief, he told me immediately.)

The next day, the three of us flew from CA to Detroit to visit her terminally ill brother. The trip went reasonably well despite the reverberations from her secret declaration and the sad business at hand.

Upon return, she cancelled the upcoming years’ worth of monthly 3-day visits to our home, which is two hours from hers. While this was somewhat to the relief of both my husband and me, I recognize it as a pulling back that I know will not be good for her.

(This is probably a good juncture to mention that I am my mother’s only child and her stated “reason for living”. Over the years, I have done significant study and work on myself regarding “living with a BPD”. And while part of me is furious with her amorous intentions toward my husband, it’s tempered with compassion for the bind she is in.  Between idolizing me on one hand and betraying me on the other, I recognize she is imprisoned in a self-constructed hell.)

Her brother (who she was close to) died in early January. Her sister (who she did not like, and who had a lifelong disability due to a childhood accident my mother was party to, but not responsible for) died a week ago.

Day before yesterday, my mother initiated a confrontation with my daughter that looks likely to cause an extended estrangement that will of course further her self-isolation.

In addition to the psychological effects of BPD, my mother has been suffering from a significant chronic disequilibrium and dizziness that began about 12 years. (She recently did the math and noticed that the onset coincided with my husband’s proposal to me. Coupled with what we now know of her feelings toward my husband, this explains her suicide threats and abysmal behavior following his proposal and at our wedding.)

So, this is a brief overview of what has led to the current situation. While my mother is doing a good job of keeping up pretenses with me (and me with her), I am watching her deteriorate in terms of self-isolation and suicidal ideation. She adamantly refuses any talk of therapy. As so much of this revolves around the secret she is keeping from me, I feel I need to tell her I know. But my husband, while willing for her to know he broke her confidence, fears this might make things worse. And of course, he may be right.

I am seeking any insights anyone may have, as well as a referral to a BPD therapist for a consult. (Face to face in the SF Bay Area or anywhere via phone.)

Thanks in advance.

p.s. Here’s a link to an article that discusses chronic dizziness and mental illness for anyone who is interested: https://psychcentral.com/news/2018/05/01/chronic-dizziness-may-be-tied-to-psychiatric-disorder/135036.html)

[madeline7]

I took a free workshop in the SF Bay Area 1 year ago through the NEA BPD (National Alliance for Borderline Personality Disorder). Two of the workshop leaders were Sarah Wood PhD and Rupa Zimmerman PhD. Not sure if the workshop is still going on, think they had one in Berkeley and Danville. Definitely check it out. Lots of great info and insight. Note that most of the people who took the workshop had young adult daughters with BPD, I was the only one with an elderly parent. This is not a support group, it is a 12 week workshop with lots and lots of information (thought I knew everything but learned so so much).

[Methuen]

Hi K066

You mention your mom has had dizziness issues for about 12 years.  Are you aware if she has ever visited a specialist Dr (Ear/Nose/Throat or ENT) about those symptoms?  During a visit with the specialist, different clinical tests are done.  If the vertigo is triggered during these tests, a vestibular diagnosis of some kind is likely, which would be a very different underlying health problem causing the dizziness than a mental health disorder. The tests are unpleasant and can produce nasty symptoms, if the underlying problem is vestibular.  If she has not visited an ENT, it might be good to encourage her to do so, to rule out legitimate vestibular problems, which could be treated to alleviate her symptoms.

Your article was interesting, because I was unaware of any medical links between mental health issues/anxiety, and dizziness.  However, the article did mention that vestibular disease was the most common cause of dizziness, with psychiatric disorders being the second most common cause.

My 83yo uBPD mom was clinically diagnosed with Meniere's disease about 35 years ago.  While it's possible that the mental health issues could play a role in her symptoms sometimes, I would not want her going through life feeling like it was "all in her head", when there are clinical vestibular issues causing the symptoms, which can be severe and interfere with daily living, and which can be treated to give symptomatic relief.  I also have a vestibular issue called Benign Paroxysmal Positional Vertigo (which my father also had).  Our daughter also has vestibular issues.  I'm just thinking that if your mom has not seen an ENT, it might be helpful for her to do so, before hearing that it's a result of a psychiatric disorder.

On another note, it was interesting to hear your story of your mother's disclosure of romantic feelings for your H.  

It is very different, but my mother believed a lifelong friend (20 years younger) had romantic feelings for her.  It was truly bizarre.  

My mother grew up in a dysfunctional family where the father was sexually, physically, and emotionally abusive.  To make it worse, my mother's mother passed away when my mother was 14 (hence abandonment), and my mother had to stay home from school for 6 months to care for her whilst she was sick and dying.  I'm pretty sure all that led to the BPD.  Where I'm going with this, is that I think my mother has always had a mixed up idea about what love is, and while she desperately wanted love, her formative years were so messed up that she developed sometimes unhealthy and confused thoughts about what love is.  So if her family friend 20 years younger showed gentleness to her, she somehow misinterpreted it to believe he was in love with her.  Your mom declaring her "romantic feelings" for your H is a bit of a shocker.   That brings a whole new meaning to the words "complicated" and "awkward". 

Seeking a therapist is a great idea.  I have found it really helpful to navigate the minefield a BPD mother can bring to my life.

As to finding a T, where I live, I can go online and search for registered clinical counsellors, or registered psychologists, and this tells me that they belong to a professional organization that has professional oversight of it's members who are in good standing, rather than just some person hanging a shingle on their door who got a degree from a fringy source.  Not sure if every country or jurisdiction is able to source this kind of information, or if licensing requirements are different between countries/states.  I always say finding a T is like buying a car; you have to test drive a few to find the right fit for you.

Welcome to bpdfamily.  We're glad you are here.

[zachira]

You are seeking advice regarding your elderly uBPD mother currently in crisis. You have come to the right place as there are many members on the PSI Board who are dealing with an elderly mother with BPD. My mother with BPD died this summer. Since your mother is 82 years old, I am wondering about what your thoughts are about getting her into assisted living, and maybe wondering if you might want to start the search for a place for her. In my experience with my elderly mother with BPD, I felt that having her in her home was terrible for her children as she continued to mistreat us without any real witnesses to see what really goes on behind the scenes, and she never made any progress in dealing with her ongoing emotional dysregulation.
Does your mother behave better when she is around those she is not closest to? I am trying to think what might motivate her to behave better. I don't know if therapy would help as it usually doesn't in most cases with BPD, though sometimes it does. It sounds like you want to know what are the best options for your mother to improve, and a therapist with BPD expertise would likely be able to help you decide what are the best steps to take.
We are here to listen and help in any way we can.

[Naughty Nibbler]

Hi K066:
Sorry about the situation with your mom. She has had a lot of loss recently. That's hard on anyone, but especially hard on someone with mental health issues.  Perhaps a strategy to use, to get her into therapy, is not BPD, but grief-related support. Grief support counseling can be beneficial, even without addressing BPD traits. The link below has a few BPD trained therapists referenced for your area:
https://dbt-lbc.org/index.php?page=101163

As others have mentioned, dizziness & balance problems are very common with people, after a certain age, & not necessarily associated with mental illness.  Interestingly, even older animals can suffer from vestibular problems.

I'd lean towards NOT telling your mom about what your husband shared. Her behavior could relate to BPD traits, or perhaps some form of dementia. At her age, your best strategy might be to set boundaries (things that you can personally control & enforce) & for you (& your husband & daughter) to learn/use strategic communication tools & strategies. You can check out the Workshops for some coaching.

It could be a good idea to have your mom checked out for dementia, at least to rule it out as a contributing cause.  

As you work through things with your mom, it can be helpful to keep sharing specific situations for suggestions on strategies to use.

[TelHill]

Hi K066,

Sorry about your mom’s erratic behavior. It’s typical but still unpleasant. My elderly dBPDm has had BPD symptoms ever since I can remember.

She’s had lifelong vertigo/dizzy spells, too. She recently fell on her head a few times and experienced delusions. She had a CT scan and an MRI.

The diagnosis was a congenital arachnoid cyst on the left side of her brain. This explains the vertigo. It may be the cause of or a contributing factor to her personality disorder. Surgery to remove or a stent to drain the cyst are the treatments. Unfortunately, she’s too old for surgery.

You may wish to take her to a neurologist. It may help with the diagnosis.

Am in the SF Bay Area, too. Please let me know how your therapist search went. I’ve had a difficult time finding someone, too.

[KO66]

I took a free workshop in the SF Bay Area 1 year ago through the NEA BPD (National Alliance for Borderline Personality Disorder). Two of the workshop leaders were Sarah Wood PhD and Rupa Zimmerman PhD. Not sure if the workshop is still going on, think they had one in Berkeley and Danville. Definitely check it out. Lots of great info and insight. Note that most of the people who took the workshop had young adult daughters with BPD, I was the only one with an elderly parent. This is not a support group, it is a 12 week workshop with lots and lots of information (thought I knew everything but learned so so much).

Thank you. I will check it out.

[KO66]

Hi K066

You mention your mom has had dizziness issues for about 12 years.  Are you aware if she has ever visited a specialist Dr (Ear/Nose/Throat or ENT) about those symptoms?  
 

My mom has been evaluated by many medical professionals including an ENT and a neurologist several times over the years. Although the ENT did not come up with any organic cause, she went through a course of vestibular rehab, which did not help her. In Mom's case, there doesn't appear to be any physical condition at the heart of it. The closest diagnosis we've found is that of Persistent Postural-Perceptive Dizziness (PPPD): https://vestibular.org/pppd  It all fits her profile pretty perfectly with the exception that she didn't seem to have a specific triggering event. However, it now appears likely that the triggering event was witnessing my now-husband's proposal to me. (Without explaining the broader context to me, she's the one who very recently pinpointed the onset of her symptoms to that time period.)[/font][/i]

On another note, it was interesting to hear your story of your mother's disclosure of romantic feelings for your H.  

My mother grew up in a dysfunctional family where the father was sexually, physically, and emotionally abusive.  To make it worse, my mother's mother passed away when my mother was 14 (hence abandonment),

My mother also lost her father at an early age (7) and has had lifelong struggles with issues of abandonment.

 

 So if her family friend 20 years younger showed gentleness to her, she somehow misinterpreted it to believe he was in love with her.

 

I think this is exactly what happened in my mother's case. (And even though my husband has repeatedly told her he does not have romantic feelings for her, she refuses to believe it.)

[KO66]

Since your mother is 82 years old, I am wondering about what your thoughts are about getting her into assisted living, and maybe wondering if you might want to start the search for a place for her.

KO66: She is vehemently opposed to leaving her home. She just recently took out a reverse mortgage to be able to stay in her home. Before doing so, I experimented around the edges by taking her to some independent living communities in our area. She is adament that she will "take her pills" before anyone removes her from her house. (Btw, to the greater world, she is still quite competent, taking great pride in her appearance and going to exercise classes with people 30 years her junior three to five times per week. Her grandmother lived independently to 102, her mother to 98.)

Does your mother behave better when she is around those she is not closest to? I am trying to think what might motivate her to behave better.

Yes! She most definitely behaves better with those she's not closest to. She cares tremendously about how she appears to outsiders. I will think on how I might leverage this, though I don't have much of a relationship with her "outer circle" friends at this point.

I don't know if therapy would help as it usually doesn't in most cases with BPD, though sometimes it does.

Any mention of therapy lands in the "vehemently opposed" column.

It sounds like you want to know what are the best options for your mother to improve, and a therapist with BPD expertise would likely be able to help you decide what are the best steps to take.

Yes. Exactly.

We are here to listen and help in any way we can.

Many thanks!

[KO66]

Hi K066:
Perhaps a strategy to use, to get her into therapy, is not BPD, but grief-related support. Grief support counseling can be beneficial, even without addressing BPD traits. The link below has a few BPD trained therapists referenced for your area:
https://dbt-lbc.org/index.php?page=101163

K066: Angling toward grief related support is a good idea. I rather doubt she'll go for it, but I will give it a try. (And thanks for the referral list.)

I'd lean towards NOT telling your mom about what your husband shared. Her behavior could relate to BPD traits, or perhaps some form of dementia.

K066: Interesting. In hindsight, both my husband and I think the romance fantasies have been playing out for a long time. But the question of dementia has been entering my mind lately. Any advice on how to bring up the possibility of a consult without triggering her?

[KO66]

Hi K066,

Sorry about your mom’s erratic behavior. It’s typical but still unpleasant. My elderly dBPDm has had BPD symptoms ever since I can remember.

She’s had lifelong vertigo/dizzy spells, too. She recently fell on her head a few times and experienced delusions. She had a CT scan and an MRI.

The diagnosis was a congenital arachnoid cyst on the left side of her brain. This explains the vertigo. It may be the cause of or a contributing factor to her personality disorder. Surgery to remove or a stent to drain the cyst are the treatments. Unfortunately, she’s too old for surgery.

You may wish to take her to a neurologist. It may help with the diagnosis.

Am in the SF Bay Area, too. Please let me know how your therapist search went. I’ve had a difficult time finding someone, too.

Thanks for sharing your experience and I will let you know what I find.

[KO66]

Sincere thanks to everyone who has replied.

I would still be curious to hear more opinions/insights regarding whether it would be better or worse to open communications by telling my mother I know of her conversation with my husband.

(I'm still figuring out the site. I think I saw a "poll" function. Would this be a good use of it?)

[Naughty Nibbler]

Interesting. In hindsight, both my husband and I think the romance fantasies have been playing out for a long time. But the question of dementia has been entering my mind lately. Any advice on how to bring up the possibility of a consult without triggering her?

Perhaps it's something you can discuss with her doctor, in advance of an annual physical or other visit. I was just thinking that perhaps there is a female equivalent of "the dirty old man".  Some men around your mom's age get grabby & sexually flirtatious around young women.  I believe it's generally identified as a minor form of dementia.

From some of your comments, just wondering if your mom has some narcissistic traits? A narcissist would tend to think there is romance, where there is none to be had.

[zachira]

I am wondering if maybe you can do everything you can to get professional help to take care of your mother, since she behaves better with those who are not close to her. It is so difficult for others to understand what it is like to be a child left alone with a mother with BPD which is prime time for her to be abusive with no witnesses. Have you thought of telling your mother you can't take care of her anymore and she will have to pay for outside help?

[Spindle0516]

I am wondering if maybe you can do everything you can to get professional help to take care of your mother, since she behaves better with those who are not close to her. 

Some insurance companies will pay for a "home health aide" which can help her with daily tasks if she needs additional support and wants to stay in her home. She can also pay out of pocket if it is a financially viable option. Home health aides can do a variety of tasks ranging from taking her food shopping to helping her clean to helping with bathing.

This is our plan for my MIL if she finds being independent too difficult as she also behaves better with outsiders.

[GaGrl]

A discussion with her primary physician could lead to a consult with a geriatric specialist who could assess what is needed. There are geriatric psychiatrists also who are very, very skilled at assessing mental health issues in the elderly.

I highly recommend a part-time caregiver for help around the house. My mom has someone who comes in three times a week for four hours, and she helps with driving to medical appointments, shopping, laundry, light housekeeping, and some activities like baking that my mom enjoys but can't see to do herself anymore due to macular degeneration.

In addition to insurance coverage, there are programs for veterans and spouses of veterans that reimburse for home healthcare costs -- if your mother qualifies.

[Methuen]

I am wondering if maybe you can do everything you can to get professional help to take care of your mother, since she behaves better with those who are not close to her. It is so difficult for others to understand what it is like to be a child left alone with a mother with BPD which is prime time for her to be abusive with no witnesses. Have you thought of telling your mother you can't take care of her anymore and she will have to pay for outside help?

To piggyback off what Zachira wrote, I actually did this last Oct/Nov.  My mom had a fall (she was alone at home) which resulted in 4 fractures in her sacrum and pelvis.  I doted on her hand and foot for a month, but in one of her dysregulations, got raged at because all her pain was my fault.  So I responded by requesting community home supports, which got set up.  That was a LOT of activity and change for her, because she was receiving a LOT of support (a good reminder to me of how much I was actually doing).  My mom responded by cancelling all these supports after 2-3 weeks of receiving them.  She was healing. Since then we have been in a kind of homeostasis in our relationship.  It's what I would call congenial but superficial, and also low contact compared to what we used to be.  So I guess what I'm saying, is that Zachira's suggestion to you, is currently working for me.  At the time, I couched bringing in all those supports by saying that I could no longer meet all of her medical needs.  Since I responded to her by bringing in home care supports, she is suddenly finding her own way to have her needs met (instead of demanding so much of me).  I don't know how she's doing it, and I don't ask!

I should mention that my mom has also been on antidepressents for about 6 months now, which has been life changing for me.  She went on them because two of her best friends are on them, so she went to her doctor and asked for the same one (copycat again...but it's sure worked for both of us!).

[GaGrl]

My mom lives with us ( she is 93), so getting home health care gives my husband and me some space and despite from 24/7 care. She is pretty demanding but doesn't realize it.

[TelHill]

I doted on her hand and foot for a month, but in one of her dysregulations, got raged at because all her pain was my fault.  So I responded by requesting community home supports, which got set up.  That was a LOT of activity and change for her, because she was receiving a LOT of support (a good reminder to me of how much I was actually doing).  My mom responded by cancelling all these supports after 2-3 weeks of receiving them.  She was healing. Since then we have been in a kind of homeostasis in our relationship.  It's what I would call congenial but superficial, and also low contact compared to what we used to be.  So I guess what I'm saying, is that Zachira's suggestion to you, is currently working for me.  At the time, I couched bringing in all those supports by saying that I could no longer meet all of her medical needs.  Since I responded to her by bringing in home care supports, she is suddenly finding her own way to have her needs met (instead of demanding so much of me).  I don't know how she's doing it, and I don't ask!

I agree with bringing in part-time help if she needs it. I also doted on my enabler father during his heart surgery & dBPDm during 3 major falls. I made a mistake doing this as my mother’s dysregulations/psychological manipulations and my dad’s dishonest enabler behavior caused me undue stress.

I’ll offer and if they accept or not, at least I did my part to help them.

[KO66]

Perhaps it's something you can discuss with her doctor, in advance of an annual physical or other visit. I was just thinking that perhaps there is a female equivalent of "the dirty old man".  Some men around your mom's age get grabby & sexually flirtatious around young women.  I believe it's generally identified as a minor form of dementia.

From some of your comments, just wondering if your mom has some narcissistic traits? A narcissist would tend to think there is romance, where there is none to be had.

Interesting. And yes, I do think she has some narcissistic tendencies. (I have sensed a competitive undercurrent coming from her my whole life.)

[KO66]

I am wondering if maybe you can do everything you can to get professional help to take care of your mother, since she behaves better with those who are not close to her. It is so difficult for others to understand what it is like to be a child left alone with a mother with BPD which is prime time for her to be abusive with no witnesses. Have you thought of telling your mother you can't take care of her anymore and she will have to pay for outside help?

At this point, my mom is taking care of herself completely and is capable of conducting her own affairs. However, I realize that could change, perhaps sooner rather than later, as I observe her getting "fuzzy around the edges". (I will keep everyone's insights in mind.)

[zachira]

One tactic I used with my mother with BPD to reduce the abuse was to try to have people around that she wanted to impress and would not be mean to me in front of whenever I could. I realize this is not practical all of the time, and also it depends on the person whether they act badly in front of nearly everyone or just mainly in the presence of family members, particularly the children they have painted black. Certainly being abused by one's own mother is painful and leaves many bad memories, so it can help to reduce the incidents of overt abuse if you can, and I realize sometimes you can't.