Sister with BPD is caregiver to my elderly mom - Horrible Situation

[Depression = 72% of members]

   Wow, I cannot believe this site exists!  I have been struggling for over a decade trying to deal with my sister.  A therapist told me once that she thought my sister had BPD. I thought it was interesting but for some reason I never thought to investigate what that meant until recently!

My sister is 67 yo (10 years older than me) has a drinking problem and I now realize is textbook BPD.

She lost her house about 5 years ago and moved in with my mom and aunt.  She told everyone she was retiring to take care of them when the fact was she was homeless.  My brothers and I were a bit reluctant but she needed a place to stay and they were starting to need help.

Fast forward to now.  My aunt passed away 2 years ago and my mom at 89 needs quite a bit of help. Too much help for any one person especially someone with health issues.  I have arranged for home healthcare, cleaners and for my mom to go to an adult day care 1 day a week.  This is still not enough and my sister compounds the issue by firing every care person after a short period of time for one reason or another.

So, I have been struggling for years to find a suitable place for my mom.  She can't live with me as my place is too small. I have found an assisted living in the next town over that takes medicare!  My sister will not have it!  She vacillates from saying she doesn't want her to go, then she does want her to go, then she will be homeless and she doesn't want to be alone even though she can't stand living with my mother.

 My mom needs better care.  I would help my sister find a place but like others doesn't want to live in senior housing.  She wants me to fund a condo at 2.5x her social security. That's not happening. 

Any thoughts on how to navigate this?

[JuDu64]

   Wow, I cannot believe this site exists!  I have been struggling for over a decade trying to deal with my sister.  A therapist told me once that she thought my sister had BPD. I thought it was interesting but for some reason I never thought to investigate what that meant until recently!

My sister is 67 yo (10 years older than me) has a drinking problem and I now realize is textbook BPD.

She lost her house about 5 years ago and moved in with my mom and aunt.  She told everyone she was retiring to take care of them when the fact was she was homeless.  My brothers and I were a bit reluctant but she needed a place to stay and they were starting to need help.

Fast forward to now.  My aunt passed away 2 years ago and my mom at 89 needs quite a bit of help. Too much help for any one person especially someone with health issues.  I have arranged for home healthcare, cleaners and for my mom to go to an adult day care 1 day a week.  This is still not enough and my sister compounds the issue by firing every care person after a short period of time for one reason or another.

So, I have been struggling for years to find a suitable place for my mom.  She can't live with me as my place is too small. I have found an assisted living in the next town over that takes medicare!  My sister will not have it!  She vacillates from saying she doesn't want her to go, then she does want her to go, then she will be homeless and she doesn't want to be alone even though she can't stand living with my mother.

 My mom needs better care.  I would help my sister find a place but like others doesn't want to live in senior housing.  She wants me to fund a condo at 2.5x her social security. That's not happening. 

Any thoughts on how to navigate this?

[Woolspinner2000]

Hi JuDu64, 

Welcome to our online family! I'm so glad you found us. You will find lots of caring, understanding folks here
 who understand.

So it sounds like your sister won't be happy if your mom stays with her, and she won't be happy if you move your mom to an assisted living home. Do you think the issue is that your sister wants to stay in your mom's house because it's free? If you move your mom to the assisted living site, will you need to sell her house?

Sorry for all the questions. It will help us to understand.

Is your mom able to share what she would like to do? If she is, then that to me is the most important thing to do.

Looking forward to hearing more from you.

 
Wools

[JuDu64]

Hi Wools,

Thank you for your note.  I really appreciate any insight and guidance.

You asked "So it sounds like your sister won't be happy if your mom stays with her, and she won't be happy if you move your mom to an assisted living home. Do you think the issue is that your sister wants to stay in your mom's house because it's free? If you move your mom to the assisted living site, will you need to sell her house?"

Correct my sister says she can't stand living with my mother anymore - "being her maid" but doesn't want to put my mom into a facility to die! "Not on her watch". She has also mentioned that she would then be all alone and won't have anyplace to live. 

I put the house into reverse mortgage over 10 years ago as my mom had refinanced it so many times (to give $ to my sister) that she couldn't afford to make the payments.  So my sister will have to leave the house within the year when we would give the deed back to the bank as it is still underwater.  The house is very old and is in disrepair.

So, my sister only has her SSI income which won't be enough to rent an apartment (that she would agree to) unless she would consider senior housing but to date she says that is beneath her.

I have tried to talk to her about senior housing apartments in the town next door.  They were just built 2 years ago and have income based rent.  As mentioned that beneath her and then she says I'm trying to put her there.  Not the case, just trying to help.

In regards to your question about what my mom wants.  It varies based on the day.  When she is the target of my sisters ire and rants then she wants to go.  When that subsides she wants to stay in her home.  I think she would go if she knew my sister has a place to live.

And the wheels on the bus go round and round...that's how it feels right now.

Thanks for any thoughts or insights!

[Methuen]

Correct my sister says she can't stand living with my mother anymore - "being her maid" but doesn't want to put my mom into a facility to die! "Not on her watch". She has also mentioned that she would then be all alone and won't have anyplace to live.

Classic.  Just classic. They are expert at creating chaos.

When she is the target of my sisters ire and rants then she wants to go.  When that subsides she wants to stay in her home.  I think she would go if she knew my sister has a place to live.

I'm not sure how old your mom is, or how mentally or cognitively healthy she is...

Does she understand that she is no longer responsible for your sister?  That she can "stop taking care of her daughter now because her daughter is an adult herself?"  It kind of sounds like your sister has trained the people around her to "rescue" her and be her caretaker.

Your mom needs to do what she needs to do to best look after herself.  She's 89.  If she tries to put your sister's needs before her own, the situation will continue to get worse as your mom's medical needs increase with continued aging, and as your BPD sister becomes more stressed. But would your mom be able to see that and follow through with a decision to look after her own needs and go to this assisted living place you found?

If she is, that is great.  The path forward will be much easier for you and your mom. Your sister will have to face this problem sooner or later, and it might as well be sooner.  

If your mom is not able to make the decision to move to assisted living, the path will be difficult for all 3 of you.  It might be helpful to know that you can't solve this for them.  This will be their problem.  They make the decisions, and they also have to live with the consequences.  Sadly, when this happens, they make life H_ _ _ for the rest of us too.  But that is what boundaries are for.

If your sister has made up her mind she will not go to senior housing, it is likely that the more she hears about it, the more resistant she becomes.  You cannot "rescue" her from this problem.  It is likely that any place you find for her will be inadequate for some reason.  She has to find a place on her own.  If you want to support her in that journey, that is up to you.  Perhaps the process of looking for places and then visiting them is too much stress for her on her own.  Does she have a friend who could help her?  My 85yo uBPD mom is resistant to assisted living.  She has stated "she will commit suicide before she goes there".  I have resigned myself to setting boundaries for what I am able to do for her in her own home, since it is her choice to stay in her home.  She is pushing back.  But she is also resistant to even receiving home care.  It has just dawned on me in the last few days that my mom's "plan" for her own elder care was for me to her house every day to keep her company, and do everything she wants/needs done in her home.  I can't do that with a BPD mom. 

It is really hard, and there are no easy answers.

The best path forward is probably if your mom can see the assisted living is the best option, especially since you even found one that accepts medicare.  

[JuDu64]

 I'm not sure how old your mom is, or how mentally or cognitively healthy she is...

Does she understand that she is no longer responsible for your sister?  It kind of sounds like your sister has trained the people around her to "rescue" her and be her caretaker.

 But would your mom be able to see that and follow through with a decision to look after her own needs and go to this assisted living place you found?

If your sister has made up her mind she will not go to senior housing, it is likely that the more she hears about it, the more resistant she becomes.  

The best path forward is probably if your mom can see the assisted living is the best option, especially since you even found one that accepts medicare.

Thanks Methuen, it's amazing how you are able to understand the dynamics so quickly!

Here are some answers and other questions.

My mom is 89 and her cognition is good.  It takes a dip during my sister's rants as everyone can imagine.  She absolutely still feels responsible for my sister.  My sister has trained her and me very well on this and I'm sure there is some codependence that makes it even harder.

I'm wondering based on your comments if I should try to educate my mom on my sister's BPD.  She was a nurse so she should be able to comprehend it if she can see through the FOG.

Does anyone have any advice or experience educating an elderly person on this condition?

I know the assisted living place is the best place for my mom. I fear that unless there is a housing resolution for my sister it will be a losing effort.

I agree that the more I push or suggest on places for my sister the more resistant she gets.

 Any suggestion for getting her to take action on this?

Thanks for all the insight. It is just amazing that I'm not the only one going through this!

[Notwendy]

I am sorry for your situation. Unfortunately, I don't have a working solution for this dilemma. Several of us here have or are facing, similar dynamics.

My BPD mother was the designated caregiver for my ailing father. Although I was concerned about this situation, my father's strong drive to protect her resulted in his resisting attempts to gain better care. She disliked many of his home health workers. Both my parents refused assisted living. I even called social services to intervene and since my father was considered "legally competent" and basic needs such as hygiene were met,  they could not intervene.

My mother is now elderly and a widow. She needs considerable assistance but has refused assisted living. She does have assistance at home. She's considered mentally competent and at this point, doesn't share her financial information or medical information with her adult children. She resists our attempts to assist with any of this or accept advice from us.

Question- should you attempt to inform your mother about BPD?

I wondered about this with my father. However, his relationship as rescuer to my mother was very strong. If I were to say anything about her that might be construed as negative, he'd get angry. Relatives and friends assumed she was a wonderful caregiver to him and I think this is what he wanted.

My father was an intelligent man, and he had access to the internet. He lived with my mother on a daily basis for decades. He knew her better than anyone else. Surely he already knew.

Likewise, your mother has been a parent to your sister since she was born. Your mother is also intelligent and as a nurse, can easily seek out and read medical information. I will bet she already knows about BPD. She's also a mother and likely protective of her adult child- who she still sees as vulnerable.

Just as being a rescuer to my mother was a part of my father's identity- I surmise that your mother is first, a mother to your sister. She's likely to put your sister's needs first. Although I wished for better care for my father, he would put my mother's needs first.

The Karpman triangle helped me understand these dynamics. If I intervened with my mother, I became the persecutor in the triangle. My mother assumed victim perspective. My father would be rescuer to her against me. You may face the same triangle dynamics with your mother and sister.

On your part, you can do your best to offer advise or assist, but it is still your mother's choice about what she does.

[Methuen]

She absolutely still feels responsible for my sister.  My sister has trained her and me very well on this and I'm sure there is some codependence that makes it even harder.

Does anyone have any advice or experience educating an elderly person on this condition?

I am sorry JuDu64.  My thoughts are that this has “approaching zero” chance of being successful. 

If your mom didn’t feel responsible for your sister, and if your sister wasn’t living with her, It would be different.  But your mom might be too far down this rabbit hole to come out. 

You are thinking rationally.  PwBPD have an emotional brain, not a rational one, and your mom seems fairly stuck in the web of your sisters disease. 

Do you get the sense that your mom and your sister, while living with plenty of conflict, talk about everything? 

Has you mom ever successfully kept a “secret” from your sister?  Especially a BIG one?

What would happen if your mom told your sister you said she had BPD?

This is typically what happens.  Then the Karpmen triangle rears its ugly head.  As bad as the situation is now, that would make it a lot worse. 

Telling your mom is a huge risk, with an unlikely chance of reward, although it looks very tempting. 

I would instead feel your mom out on her openness to move to assisted living for herself.  If she’s not open to that, telling her about the BPD is unlikely to be helpful, and could make a bad situation worse. 

This would be my worry.  You know both her and the situation best.  I know very little.  So you must do what you feel is best.  But be aware of the risks. 

If you have access or resources for counselling with someone familiar with BPD, you could seek professional advice.

[JuDu64]

Thank you both @notWendy and @methuen.  Your insight is so very helpful.

Learning about BPD was so eye opening for me that I want to share it with my mom in the hopes that it would "turn the light switch on" but of course that will not be the outcome.

@methuen my mom absolutely would not keep that secret.  She has zero filter and both of you are right that it would be an absolute disaster. 

I am a problem solver and can't stand to see my mom and sister living in this situation.  I would like to get both of them settled in places so that they could enjoy the rest of their lives but I'm now realizing it's probably not possible and not what they want.

So my next question, is what do I do when my mom dies and my sister will be homeless because of the reverse mortgage?

 I don't believe I could walk away from my sister but I also don't want to become her caregiver.  I have the means to help her pay for a place (rent or own) but as was already correctly said "nothing will ever be good enough".

I am so grateful I found this site and forum.  Thank you all so much!

[Woolspinner2000]

Hi again JuDu64, 

Thanks for answering all of those questions. I can see that it was helpful to all the posters responding to you. It's such a complicated issue you're dealing with, one we we see repeated over and over here. I agree with all of the things others have shared; such valuable advice. You have a lot to think about.

A couple more questions for you...who is the responsible person for your mom in the family for POA and DPOA? It sounds like your mom is still mentally capable of making decisions, so at the moment that isn't an issue, but it most likely will be in the future.

Let's say your older sister is the POA, and your mom gets to the place of not being able to make her own decisions. What does that look like? Of course it's not known, but we have seen the process here long enough to estimate what will happen when you're dealing with a sibling who has BPD.

Does the place close to you have opportunities for your mom to visit there, Stay overnight, do a trial day visit? Could your mom come and visit you and would she like to do that? If your sister learns of it afterwards, as long as it was your mom's decision to do so, you can point to the fact that your mom made the choice. Your sister will of course feel threatened to abandonment regardless of whether your mom decides or if she leaves or even if she stays because abandonment or potential abandonment means it's a threat to your sister no matter what. There is no way around that. Thus the encouragement to let your mom try to decide.

Based on the Karpman drama triangle, your mom will lean towards whoever she is closest to at that moment, thus her probability of rescuing your sister over and over. In the end the can would be kicked down the road, but eventually the can will stop being kicked and everyone will have to make decisions.

One of the hardest and most revealing moments in my life was when I grasped that my uBPDm could not be rescued by me. I thought of the scenario when a drowning person is flailing in the water, calling for help. I imagined myself swimming to rescue my mom, then realizing that she would cling to me and cause me to drown in my attempts to rescue her. It was a very helpless feeling to know that in order to save myself, I could not swim to her rescue. We have been trained that we must give up ourselves in order to save our pwBPD, otherwise we are being selfish and bad. Unlearning that false belief is a process that doesn't come overnight. Your mom is most likely struggling with this too, and your sister probably feeds the fire of need.

Escaping Conflict and the Karpman Drama Triangle

Please keep sharing!
 
Wools

[Notwendy]

When nothing is good enough, you determine what is good enough.

This is tough. It's not a good feeling to be the "bad guy" but trying to not be the "bad guy" is probably a no win situation when whatever you do isn't good enough.

So, accepting that things won't be good enough, you need to set your limits and stay by them.

I feel fortunate that my father left my mother with enough money for her needs. But, she's not used to limits and isn't careful with it. We have feared that she might run through it too quickly so I do understand the concern.


I would not want to see my mother homeless or not having food. However, she has very expensive preferences that could drain our savings if I allowed her to, and she'd have no hesitation doing that. It would not faze her and she would not even care about it. Since she doesn't have a boundary of concern for our stability, we have to be the ones to do that.


One option for your sister is a Medicare funded nursing home- but your sister probably won't qualify at the moment for due to her age and relative help. But it may be an option at one point.

Another option is to do nothing and let her fend for herself.

When "nothing is good enough" and a person can not fend for themselves, we have to determine what is good enough. Basically: clean, safe, and within our budget.

If you are 10 years younger than your sister, you are also not far off from retirement. You may not wish for her to be homeless but first- you need to establish that you also won't be in financial straits when you retire. If you don't set the limit on what is realistically affordable for you, she won't. You have to look at your needs first.

After that, it's what you are able to afford and what you choose to do. You are not responsible for her, so it is your choice.

[JuDu64]

A couple more questions for you...who is the responsible person for your mom in the family for POA and DPOA? It sounds like your mom is still mentally capable of making decisions, so at the moment that isn't an issue, but it most likely will be in the future.

@woolspinner2000 Thankfully, I have the POAs and share the Healthcare proxy with my sister.  When my elderly aunt got sick and passed away, my BPD sister let my brother and I make the decisions. 

Does the place close to you have opportunities for your mom to visit there, Stay overnight, do a trial day visit? Could your mom come and visit you and would she like to do that?

I brought both my mom and sister to check out the assisted living place and they really liked it at first.  Unfortunately, soon after my sister realized that she wouldn't be able to tap into my mom's social security check and convinced my mom that she was being dumped there and wouldn't have any money.  The place doesn't do overnights and I think one night would not be enough for my mom to be comfortable.  It would cement the belief that she would be unhappy there.

Ido take my mom to my house for a couple of nights every month or so.  She very much likes coming to my home and gives her a break from my sister (except they talk on the phone several times each day she is here). My mom is so deep into my sister's behavior she would never be able to stick to her decision. My sister would have to give her blessing in order for my mom to decide. Realizing now that it will never happen.

We have been trained that we must give up ourselves in order to save our pwBPD, otherwise we are being selfish and bad. Unlearning that false belief is a process that doesn't come overnight. Your mom is most likely struggling with this too, and your sister probably feeds the fire of need.

I have spoken to therapists in the past couple of years but didn't understand my sister was pwBPD.  I plan to seek counseling from a therapist who understands this who can guide me.

I am now beginning to see my role in the triangle and I have a lot of work to do!

@notWendy

When nothing is good enough, you determine what is good enough.

I love this quote!  I think I'm going to write it on an index card and read it each day!

When "nothing is good enough" and a person can not fend for themselves, we have to determine what is good enough. Basically: clean, safe, and within our budget.

Question on this.  Do I find a place for my sister and present her with the option (which we know won't be good enough) or do I wait until she asks for help.

She is in a cycle now and bombarding me with messages.  She is hung up on the fact that I told my mom I would be willing to give her some spending money each month if she goes to assisted living (her SSI would to pay for her to stay less $75/month).  I was thinking $100 or so.  My sister now wants me to pay much more to her so they could either get an apartment or have more full time help. All which is significantly more than $100/month.

I am just avoiding all contact with her at this point because there is no reasoning with her and have dropped the notion of my mom moving to assisted living.  They have to come to terms with the situation.

Once again, thanks to everyone for your help and support. It has been amazing!

[Notwendy]

First of all- you don't have to support your sister at all.

There are several things to consider here. What is your motivation? Is it FOG ( Fear, Obligation, Guilt)? Is it being co-dependent?

How capable of fending for herself is your sister? Has she ever held a job? Is she able to?

What are her options if you do not support her? Does she get SSI?

If you help her, are you actually enabling her dysfunction?

I have a sibling who does not have BPD. However, this sibling has had other issues such as low self esteem and had gravitated towards low paying jobs- resulting in some financial issues which my parents assisted with. But BPD mother assisting would lead to her control and manipulation as well. The relationship took both of them. They were enmeshed. The financial support enabled a dependency which BPD mom could then have some control over.

There was some issue a while back ( I don't recall what the issue was) where this sibling's apartment was being renovated or sold or something. I recall speaking to a friend who said " I am not going to offer my house, it would  be enabling, I hope you understand" and I did.

When friends stepped back and stopped offering solutions, this sibling figured something out. Some time later, this sibling is fully employed at a stable job, and self sufficient. One significant change I have seen is increased self esteem and confidence.


I have seen a similar process with BPD mother. She doesn't do things for herself. She manipulates others to do them for her. The result of other people helping and doing things for her is that this enabling behavior keeps her from gaining any skills. It also lowers self esteem. Each time someone does something for her because she can't do it- she thinks she can't. It fosters dependence. Now, at her age, she really can not fend for herself financially, or with household tasks, however, she also has not ever had to, and one wonders if she could have learned to do more.

The other side of enabling is that- while we think we are helping and they should appreciate it, they are actually resentful of being dependent.

Stepping in to help your sister may lead to her resenting you for that. Also consider that if you step in now, at her age- you take away any incentive to try to fend for herself and at her age this is likely to be for the long run. If she is truly too mentally ill to be able to support herself, perhaps she might get disability funding, SSI, or some other assistance?

I don't know your whole situation. Of course, none of us want to see a family member homeless. However, sometimes the kinder thing we can do is allow them to "hit bottom" so they can learn to tap into their own resourcefulness. It's much easier to demand or manipulate money from someone else rather than to try to earn it. Your sister will look to that first. Without knowing more- I would not offer. The issue is between her and your mother. Your mother and sister have their own dynamics. I'd let them figure it out.

[Turkish]

Your sister is taking advantage of your mother's largesse. Your sister is an independent woman who knows what she's doing. Take care of your mother. Your sister needs to take care of herself rather than taking advantage of your mother. Or you.