Need Advice: Enjoy LC or Reach Out to Share New information

[Mommydoc]

I need advice on whether to update my uBPD sibling on a new healthcare development with my mom or whether to let it lie as I am enjoying low contact.

The good news is my mother’s health has stabilized to the level that she no longer qualifies for home palliative nursing care. It is a great thing, but the services were amazing.My mother continues to need maximum assistance with all activities of daily level ( so no change in level of care) but no longer has skilled “Nursing Needs”. My sister “hated” the prior Palliative Physcian (because she had made the recommendation for higher level of care and my sister felt that was not a HC decision). In recent discussions she has emphasized her distrust of my mothers physician. When I was notified this week that mom would no longer receive these services, I decided to use the care transition to also transition my mothers primary physician back to her prior out patient geriatrician who has better communication skills and who is willing to engage (neutrally) with my sister and do home visits. I expect her professional opinion will be no different than the prior physician. She will have clean slate with my sister and likely better able to engage her positively. I don’t expect a different outcome, but given my sisters concerns, this has potential to be positive step for my mother and my sister and me.

It has all happened fairly quickly and while I was traveling for work. Interestingly, my sister who was so keen on weekly meetings has been LC last 3-4 weeks. Our last meeting was almost 4 weeks ago and we don’t have any time scheduled to talk. As everyone has said, LC/NC is so positive and allows me to focus on so many other things. As HC POA, this is all squarely my responsibility and I am not obligated legally to infrom her but I feel a moral obligation to do so.

I want a better relationship with my sister, but I am realistic that even this positive development will likely get distorted and create a new eruption. ( my sisters belief is my mom should be in hospice and this is going the other direction, the new doctor is not likely to put my mom on hospice or downgrade her care recommendations ) I keep coming back to her request to be included and my commitment to keep her informed. I want to be authentic and true to my values. If roles were reversed I would want to know about this. I am trying to figure how to frame it with her so it doesn’t erupt. I worry that she will misinterpret the no longer having skilled nursing needs to mean she can go to a lower level of care (not the case, daily care needs have increased not decreased, but my sister will likely choose not  to understand that logic)

I am considering focusing primarily on the opportunity to address “Her expressed concerns” regarding the prior physician and to get her input on the new physician, rather than focusing on the loss of home nursing benefits. That is making it more about her and her feelings. I am hoping that will be validating to her. In the past, however,  most my attempts to involve her, despite how well intended, created swirl.

I have so many other places to put my energy and attention and am hesitant to stir the hornets nest. I am conflicted though as I feel like I should keep her informed and have a sliver of hope that informing and engaging her with the new physician could be a step in healing some of the recent conflict. I am realistic that the chances of that might be < 50% and there is also a risk of more drama. At the end of the day, however my desire to treat her as I would be want to be treated, and to be authentic is compelling me. Avoiding conflict has not really worked, but being consistent with my values has helped me navigate the inevitable conflict.

I am a big Brene Brown fan, and in my normal life and relationships outside my sister, I  err on the side of transparency, vulnerability and openness; that has served me well. Much trickier here. My husband is vehemently against any contact or notification,  but I am leaning the other way. Interested in others thoughts.

[Riv3rW0lf]

I am not obligated legally to inform her but I feel a moral obligation to do so.

I am considering focusing primarily on the opportunity to address “Her expressed concerns” regarding the prior physician and to get her input on the new physician, rather than focusing on the loss of home nursing benefits. That is making it more about her and her feelings. I am hoping that will be validating to her. In the past, however,  most my attempts to involve her, despite how well intended, created swirl.

The thing is, the "swirl or no swirl" often has nothing to do with the actual situation, and everything to do with them. What would happen if you were to just: give her the information without trying to frame it, without trying to "manipulate" the reaction... Just tell her the latest developments and disengage. Let her react. And then reassess as needed?

I noticed, in myself, when dealing with my brother and mother, that I am rarely genuine. I am always looking for ways to frame what I am saying and often I find myself feeling stuck, knowing that no matter my answer: there will be blame. And so... If there will be blame and drama no matter the road... Maybe I should just be genuine from the start and then disengage from the reaction...

I think, for me anyway, the worst with BPD is : I end up changing myself over time to try and mitigate the crisis... Going as far as saying things I really don't think (like telling my mother I forgave her and she was a great mother (I really betrayed myself on this one and still feel angry at myself for telling her that). Then the crisis happen anyway, and in the process, I lose myself.

You mention often in your post how your values is authenticity, how you feel it important to share the information with her. I think the best thing you can do for yourself is to be loyal to yourself and to your value. The drama will happen, but at least, you will have been true to yourself. If you don't share, there will be drama anyway because you didn't share, and then not only will she blame you, but you will blame yourself too for not respecting your own values.

For the phrasing, I am sure other members here will have valuable insights.

I am personnally still tiptoeing around my brother, and always wondering how to talk. I think he knows I am not being genuine though, and I think this, in turn, might be one of the reason behind his own discomfort in the relationship somehow...

I have to learn to detach myself from their reaction... I know I have to stop my management of their emotions and crisis... It is not easy. But it's like... When I try to manage and it fails, and a crisis ensues, I feel even worst because I failed? If I would be genuine and true from the start, without manipulation, without control, then it falls on them to manage their own reaction? I don't know if that makes sense...

Once, I tried to manage my brother reaction and he saw right through it and then accused me of acting like I was better than him... And part of me felt guilty, because in a way, he was right. I did think I could manage him and failed.

[Mommydoc]

Riv3rWOlf, great feedback thank you.

I tried to manage my brother reaction and he saw right through it and then accused me of acting like I was better than him... And part of me felt guilty, because in a way, he was right. I did think I could manage him and failed.

My sister with uBPD is highly intuitive and definitely zeroes in on things if I were to try to manipulate her. I also find it is hard to be genuine with my sister. It is more about our relationship and her baggage and also less about me. I am a genuine person, I know that. In the past during brief positive periods between us, I made the mistake of being genuine, open and honest with her. It always came back to haunt me, and I have learned we just aren’t can’t have the relationship I would hope for. My therapist has emphasized the same thing. Being concise, factual and not worrying about the reaction, and basically expecting the typical/predictable reaction regardless. There is a beautiful freedom in that.

I definitely need to tell her, but it is how much and how to frame it to maximize the validation part  and minimize the risk of new can of worms, so I am not creating new problems for my self. Thanks so much!

[zachira]

Mommydoc,
I feel sad that you are having to try to figure out whether to reach out to your sister and how you would do so, after having some peace with no interaction with her recently, and knowing full well that she will likely turn your reaching out to her with new information about your mother's medical care into more drama and misery for you. There is really no right or wrong way to address this, just what feels the most comfortable for you, and is in yours and your mother's best interests. I have had to be extremely self protective with my dysfunctional family members at times instead of generous and kind, which is not my nature at all, yet I have learned that using the golden rule to interact with them, always backfires into an open invitation to accelerate their abuse.

[Notwendy]

My sister with uBPD is highly intuitive and definitely zeroes in on things if I were to try to manipulate her. I also find it is hard to be genuine with my sister.

Oh boy, I feel you!

So, there are many things we don't tell BPD mom ( boundaries ) and she knows it. She is highly intuitive and also manipulative. She will ask a question - as if she knows something- to bait you to reply. One example is calling up a sibling and asking " is everything OK with NW and her husband? " she made that up, but she's fishing - she's hoping sibling will "spill the secret" whatever it is. I went away for the weekend, didn't tell her much. She could tell I was being evasive. What she came up with is that I was sneaking off to get a face lift and didn't want anyone to know. FWIW I haven't done that. She made it up.

But my ethics are such that I don't want to embarrass her and one thing that does embarrass her is if we tell her extended family something and they ask her about it and she doesn't know. She needs to present herself as "in the know" about the grandchildren. I wouldn't tell them much either, but sometimes in conversation, they ask. So the other day they asked about one of the kids and I replied and realized that I had not told that to BPD mom, not to intentionally leave her out, but just didn't. So I tried to do damage control and she knew immediately. My tone of voice was anxious. She was triggered. So while my motive was to avoid her feeling left out, it backfired.

Why? because I was trying to mitigate her feelings. Trying to say something in a certain way to lessen her reaction and it didn't work.

The other option would have been to say nothing, let her get angry when the relatives tell her.

Mommydoc, I believe that when we aim to manage their feelings, we are darned if we do, darned if we don't.

I am thinking with your sister, maybe a biweekly update email on your mom to your sister. Scheduled and factual. So the next one "Mom is not eligible for hospice care and her primary doc is now in charge. If you set up some kind of schedule, it takes away the need to contact her for every update right away. Other than something urgent, just update her on a schedule. Takes the emotions off for you.

[Turkish]

in my normal life and relationships outside my sister, I  err on the side of transparency, vulnerability and openness; that has served me well.

I'm similar, and I think most of us here may be the same. It resulted in friction for me at work this week.

You have POA. Your mother is being taken for care of. I wouldn't volunteer information unless asked. That provides a target. You're doing the right thing taking care of your mother. Your sister doesn't need to be taken care of. Stress from her intereferes with your role in taking care of your mother. Default to the most vulnerable here (your mom) and be assured that you're doing the right thing.

[Methuen]

I'm probably mis-remembering, but wasn't there something a while back about your sister not replying or wanting to talk to you, after insisting that you keep her updated?  You mention you haven't heard from her in 3-4 weeks...

The whole situation is - blichk - uge - yucky.  Regardless of what you do or say, it's going to affect her "feelings" about you, your mom's situation, etc so you are going to be damned whatever you do.  Accept that.  

Can it be a simple short and factual email update?  Niceties probably aren't authentic, so just brief, informative and friendly.  To the person (BPD) who needs chaos, it probably doesn't matter how you frame it, she will erupt because she needs chaos, so I wouldn't bother investing energy into figuring out how to frame it.  Write it exactly as you would if it was a patient.  

I worry that she will misinterpret the no longer having skilled nursing needs to mean she can go to a lower level of care (not the case, daily care needs have increased not decreased, but my sister will likely choose not  to understand that logic)

In my experience, once a person with BPD "thinks" something, for them it is a "fact", and no amount of rational explaining will change what they think.  It will only escalate their feelings because now their thoughts have been invalidated.  To avoid all this, could you remove yourself as the relayer of the information (even though you are a doc) and have your mom's doc explain the change to your sister if further explaining is needed (after the email)?  That's an independent 3rd party and it takes the target off your back.  I know when my FIL was declining and advancing to end of life, his Dr would have phone conversations with both my H and H's sister (they live far away from each other).  Just a thought - maybe this could work for you too.

[Mommydoc]

Thank you for all the advice. I sent her the email. Brief, informative, friendly. Totally prepared for the eruption with no intention to own her reaction. I have been printing out our emails and text chains to create a paper trail.

To  avoid all this, could you remove yourself as the relayer of the information (even though you are a doc) and have your mom's doc explain the change to your sister if further explaining is needed (after the email)?  That's an independent 3rd party and it takes the target off your back.  I know when my FIL was declining and advancing to end of life, his Dr would have phone conversations with both my H and H's sister (they live far away from each other).  Just a thought - maybe this could work for you too.

I am  hoping that the new doctor can take on that role. I had tried that previously with my moms doctor, nurse and social worker team, but she painted them black and at a certain point they refused to talk to her because of her unreasonable behavior. Given she wasn’t POA, they just wanted to deal with me. The new doctor knows the story and is willing to engage. She is definitely a better communicator than the prior doctor. I also know she will be objective and be a neutral advocate for my moms needs. Ultimately from a documentation perspective, having a new doctor validate my moms needs and consistent recommendations creates a better paper trail.

No response to the email so far, but I stand ready for the eruption. It is what I have come to accept. I feel good about being straightforward and direct, and have no intention to get sucked into the dance.

[Notwendy]

Good for you.

It's good that the current doctor is willing to communicate to your sister. However, in time, she may paint them black as well.

With my BPD mother, she's painted most of her providers and helpers black over time.

I think my mother's primary doctor has done a great job with her care. For a while, my mother was painting him black. I was speaking to one of her relatives and mentioned this doctor and they were surprised that I liked him. My mother had told them he was terrible.

So it's hard to predict how your sister will perceive this new change but you holding on to what you know is the best for your mother and staying out of the drama as much as possible sounds like a good plan.

[formflier]

Hey Mommydoc,

It will be interesting to see how she responds to this.  I'm heartened that the new doctor seems open to communicate directly with your sister, I hope that is a blessing for you.

One thing I noticed.  Sometime along the lines of "I'm trying to figure out how to say it without her erupting".  Sadly..that's just not possible and also it will likely take up a lot of your time which is better spent on your Mom.

Probably more helpful to take an attitude of  "I feel morally obligated to reach out.  My sister often erupts at this type of news, so I need to mentally prepare for the consequences of communication."

Then...if she is fine..it's all bonus.  If she freaks..you are prepared.

Did the trip reimbursement all get handled?  Is she still making demands for support from those funds?

Good to "hear" from you again.  Hope you are doing well!

Best,

FF

[Mommydoc]

After 2 days, I got a response. “ I don’t why she doesn’t qualify given it is a progressive disease. It is my understanding that she probably qualifies for Hospice. Have you discussed?”  The doctor and team have  explained to her multiple times but she doesn’t accept their explanation. Both Home Health and Hospice are regulated and you have to have qualifying conditions. My mother is highly disabled requiring maximal care but her disease though progressive is not actually terminal. I don’t want to get into the same circular conversation. I offered to have her talk with my mothers new doctor, but of course no response to that. My response will be. I will ask her new doctor to discuss with you.

She sent a second follow up email. (they often come in threes) “Are you ready to start talking about her entire situation. The last time we talked you said you needed to take time off. I still haven’t received her records and agreements from the facility.” When she was here about 2 months ago, she went to the Director of Facility asking for “all records” for last seven years including for my dad who died 6 years ago. The Director initially said she couldn’t release to her, but I told her I was OK with giving her what she wanted in terms of any bills or financial documents. They have been communicating via email and now she wants to pull me in. I want to stay out of it.

I told her I was going away for my anniversary and couldn’t meet with her that weekend. We have had multiple calls, they are all circular, so do I want to resume them, no. Am I willing to, yes. But the list of topics financial etc that  I gave her of things to discuss have never been on her agenda. It is always a rehash of her feelings. If I say no, she will claim I am not including her in decisions. I intentionally stayed out of the request to the director for the records. It’s just like all the records she has requested from me. She gets them, probably doesn’t even read them, and it is a lot of work for nothing.  Because my list included cashing in a 5K life insurance policy and considering sale of out of state real estate, she is now morphing the conversation to mom shouldn’t be in this facility if we have to sell trust assets. I raised those things as things to discuss as doing both would make our jobs as executors much easier, not because my mom is running out of money. Probably not going to happen.

I have decided since it is a Monday work day, not to respond immediately. She waited more than 36 hours to respond, so I can do same.

Thanks for listening.

[Riv3rW0lf]

She really is trying to pull you in! But it's good that you notice! Congratulations on keeping your cool and choosing to "act" instead of "react". This is much harder that I initially thought when I went low contact with my mother, so I want to recognize your strength here. Waiting a few days before answering will also give you all the time you need to find your truth and how you want to approach this.

Letting the doctor discuss with her is a good idea. Another approach if the doctor doesn't want to , could be to " get her point " ... Like : "I understand you want the best care possible for our mother, this is also what I want for her. All possibilities were discussed with the doctors, and I have no further power over the situation. This is what the doctors thought best for her situation and I trust their professional judgment." How would she react to something like that ?

For the records : "You haven't received anything? That's strange! Maybe there was a mixed up, have you checked with them? Since there is nothing else new with her situation, I don't have anything more to add. I kept in mind your worries and opinions from our last discussion, and will update you as things continue to evolve."  Just brainstorming answers, but you will know what is best for you.

I think you are wise not to engage ! Hopefully, you can regain your headspace soon !  

[kells76]

Quick thought when I saw this:

My response will be. I will ask her new doctor to discuss with you.

What if we could help you do less?

I wonder how saying something like:

"Don't hesitate to reach out to New Doctor at 123-456-7890 about your thoughts on Mom and hospice"

would go...

It's not your job to ask the new doctor to call your sister. She's an adult and if she wants to discuss something with Mom's doctor, then as long as she has contact info, she can call. Not your job! Yay!

[Methuen]

What if we could help you do less?

I wonder how saying something like:

"Don't hesitate to reach out to New Doctor at 123-456-7890 about your thoughts on Mom and hospice"

would go...

It's not your job to ask the new doctor to call your sister. She's an adult and if she wants to discuss something with Mom's doctor, then as long as she has contact info, she can call. Not your job! Yay!

10 thumbs up  This "line" of advice is the type of thing my husband suggests and I have had such a hard time learning. I wouldn't have thought of it myself, but when I read it, I thought of my H who says this kind of thing to me ALL the time

Honestly, after a lifetime of tiptoeing around and trying to please a disordered person, it's like we have been "trained" to take the responsibility to "help" and "do" these things for them.  Of course she could think of this and ask your mom's doc herself right?  Why would she need you to tell the doctor to call her?  It's all a bit of a paradigm shift for us.  We just always try to be helpful, but sometimes I wonder if our "helping" feeds the drama.

What Kells76 (and my H) are suggesting  is a kind of shift in thinking - like a positive "re-education camp" - to the end of learning how to put the ball squarely back in their court.

[formflier]

I'm giving thumbs up to Kells76 suggestion. 

You can likely expand that to "can my sister do (fill in the blank) herself"  If it is possible, then you should back away.


So...switching gears.

Do you regret sending the email?  If I remember you felt some level of obligation to send her an update.

Best,

FF

[Mommydoc]

Wow, this is really great feedback. I love it! Thank you Riv3rWOlf for the acknowledgment. The email is written in my drafts and I am holding back on pressing send. It is concise but  puts everything back on her, while still being friendly. I agree it is harder than it seems like it should be, as I am literally de-programming myself to wait to press send.

kells76, your comments are brilliant in the simplicity, something I need to make a mantra

What if we could help you do less?

. Methuen’s comment further reinforces this for me.

What Kells76 (and my H) are suggesting  is a kind of shift in thinking - like a positive "re-education camp" - to the end of learning how to put the ball squarely back in their court.

Before I learned all the tools, I felt like a victim, and that she was the problem. It is very empowering to think of this as my journey, focusing on my thoughts, feelings and actions, while accepting her “as she is” and realizing I will never change how she feels. Her job, her work. I like Formfliers simple question:

can my sister do (fill in the blank) herself

And yes, I am glad I sent the email. I was enjoying LC and didn’t want to put more energy towards her. Having said that, one of the reasonable  things she requested of me was greater transparency. Transparency and authenticity are important values to me, and the way I was interacting with her was not consistently transparent, which didn’t feel good to me. Part of my forward journey, will be to balance transparency and kindness towards her with my own boundaries, assuring I am focusing my energy on my feelings and actions rather than hers. There is almost a yin/yang subtly to this, but I am feeling good about where I am.

I got a call yesterday from our property manager that our tenant is not going to renew their lease, which means this trust real estate investment will likely go negative cash flow. Realistically the property has appreciated nicely and we should sell before interest rates go up further. The  property has sentimental value for her, and she honestly thinks “It’s hers” . There is no way to have a rationale discussion. In the past, I would have avoided the conversation as it would trigger her, but now I feel differently. I will ask her opinion, will share mine, and if we aren’t on same page (which is likely), I will let it go. I don’t need to be right, I don’t need to win, but I also don’t need to fashion my comments to avoid triggering her. If me saying we should sell triggers her and she distorts my intent, so be it. It is the outcome I expect and am prepared for.

[formflier]

Are they going month to month or are they quitting the property at the end of the lease.

Why not just put it up for lease again.  My rental rates have skyrocketed...you may get a lot more per month.

Best,

FF

[Notwendy]

I agree with the other to do less. Is there someone else who can keep your sister informed- such as a social worker who can regularly update? I am thinking an email to both of you on a regular basis?

Not only are you doing your sister's work but also you may be over functioning on the medical side. You understand what is going on better than most people, so you feel you need to be the one to explain to your sister what is going on. However your mother's care team can do that too- speak directly to your sister.

One thing I noticed is that, even if I have experience or knowledge in an area, my BPD mother would prefer the opinion of a total stranger than mine- because BPD impacts the closest of relationships. You are an expert in your field, people believe you. But your sister may not be able to do that.

[Mommydoc]

You make a great point Notwendy.

you may be over functioning on the medical side. You understand what is going on better than most people, so you feel you need to be the one to explain to your sister what is going on. However your mother's care team can do that too- speak directly to your sister

This has been a challenge for sure. As POA most health information comes to me, and I am supposed to relay it. She then asks questions, and I would answer them. This created a power dynamic that was unhealthy for us and triggered her. I actively and intentionally stepped away from that role and asked the HC team to take that role, and they did, until they didn’t. My mothers nurse, her social worker and her physician took on that role willingly, and  went above and beyond consistently.  She behaved badly, so they moved away from individual conversations to family meetings, and worked to align and provide consistent messaging, then  finally at a certain point, they individually and collectively refused to deal with her and told me they were only going to deal with me. And that is where we have been for over a year. I continue to “Inform” her, but have stopped trying to explain to her. I ask for her input, but I make the decisions.  With minor things, I don’t bother, as it doesn’t seem worth it.

As an example, I don’t report every doctors visit, only if there is a change in treatment or new condition. Yesterday she had a video visit and got a cream for her skin. Didn’t mention it. Last week she got her 4th COVID shot. I let her know about that.

The doctor change might be a new opportunity. The new doctor has a clean slate. She is a better communicator and she is willing to have direct conversation with my sister, with my permission and appropriate boundaries. She is bringing a new social worker in as well.  It doesn’t change the circumstances and the recommendations are unlikely to change. My sister frequently rejects the medical recommendations regarding care as irrelevant, and goes to these are “Family” not “Medical” decisions. That is went it unravels.

I appreciate the new doctors willingness to take this on, and since the situation with the prior team had deteriorated so much, it is likely this will be better for a temporary time. But unless my sister’s behavior changes in response to the new team, it is likely to begin well (during her charming phase) and then deteriorate once they set boundaries.  I think there is a <10% chance that she will change her behavior towards this new team in the long run. My mindset is  different this time, as I will be as neutral as possible and act as a passive observer. The prior team was trying to support me and be a buffer, they really tried too hard, as they thought they could make things better. Realistically, the only person who can change the course of this is my sister, so the rest of us, have to just be clear on our roles and accept her reactions but not own or try to change them. I can do a better job in setting this team up for success by helping them set and maintain boundaries along with me.

[Notwendy]

But unless my sister’s behavior changes in response to the new team, it is likely to begin well (during her charming phase) and then deteriorate once they set boundaries.  I think there is a <10% chance that she will change her behavior towards this new team in the long run.

This is how my mother is with her health care team. As soon as any of them ( from helpers to providers ) has a boundary with her, she paints them black. She replaces the home health agency workers frequently. She was working with an excellent social worker who set some boundaries with her, then transferred her care to a nurse manager, now both are out.

This is the main issue: she needs to be in assisted living but refuses and needs to stay in control. She likes home helpers who she can control. If they don't comply with her, she wants someone else.

The heart of the issue is that she's non compliant with her medical team. At one point, her primary care doctor along with the social worker pushed the idea of assisted living. The social worker is now out of the picture. My mother decided to change doctors, then dismissed the new doctor and is back with her primary care doctor.

This doctor knows her well and is great with her, but he has boundaries and while she doesn't like that, I think she knows that he's the best choice for her. It can't be easy to deal with difficult patients, but he knows how to do that. Your sister may be difficult, but you can trust that your mother's doctor can handle her better than you can since this doctor is not related to her.

[zachira]

Maybe it would make sense to suggest that any communications with your sister and the medical team be only through email with you as a cc on all communications. The challenge is to limit the drama and your sister wearing out the medical team and you to the point that the medical team wants nothing to do with her, and you are back to square one, being the person who has to communicate with her.

[Mommydoc]

I am feeling good  about the medical part, and really trust the new doctor. I like your idea Zachira and will see if the team is willing to do it. They typically only communicate on the HIPPA compliant email app, which she doesn’t have access to as she is not POA, but maybe we can work something out. Giving her access is not something I am willing to do.

Now things are heating up in another way! My sister has been demanding 7 years of bills/ledgers and the original contract when my parents both moved into assisted living from the facility. I kept referring her to the facility director. The Director texted me today to say she is sending me the records instead of to my sister as she doesn’t have her listed as POA. She expressed concern that the total amount adds up to a lot and she is convinced it will trigger my sister. I wanted to stay out of it. My husband says just give it to her. He knows that my sister is making a case to say my mom can’t afford her current assisted living and he thinks that I can walk her through why her logic is faulty. I don’t think that logic works with her and worried about adding fuel to  the fire.  My husband is also suggesting we put in writing that we will cover my moms expenses if/when she has exhausted all of her assets. We think that is unlikely, but it is something we are prepared and ready to do. If the underlying issue is assuring an inheritance, which we suspect, it won’t satisfy her either. Well, end of day, nothing satisfies her.

And then she texted me today that she wants to talk about moving her out of the facility. The only good news is the director shared with me that a smaller room is coming available that is 25% less expensive. Yes I would need to move her again, but it would be pretty easy and not disruptive to her care at all. I feel certain this won’t appease my sister at all. I will need to set a firm boundary that moving mom out of her home for the last 7 years, where she is happy and well cared for is not something I will support or compromise on.

[Notwendy]

I think it might help to keep in mind that the demands your sister keeps making- the bills, upset that your mother isn't in hospice are really about a need of hers that she won't articulate clearly. So she's trying to keep a smokescreen around them ( but it seems transparent). You seem to be "putting out small fires" in different places, but it doesn't solve the issue for her, because the reason is different. It's not about your mother. Your sister either wants or needs money but can't say it because she knows it sounds bad. So instead she makes statements about "what dear mother needs".

Finding out your mother isn't in Hospice means, your mother's care will cost more. If money was not the reason for her demands on you, she wouldn't care about the cost of your mother's care. It's your mother's money not hers.

Is your sister that cold hearted? My guess is that it's more out of need/want. You have been accommodating to her, but it's not satisfied her wishes because it hasn't provided what she wants. It may be time for more solid boundaries with her, not less. Keeping her in the loop due to her unfounded accusations of you didn't meet her need.

One boundary is that- this is not her money. It's your mother's. She actually has no say in how it is spent.

Two- your mother put you in charge of medical decisions, not her.

I think it is very generous for you and your H to take over the cost of your mother's care if needed, but you have no obligation to put that in writing for your sister. If your sister hasn't signed anything, she won't be responsible for any of that as it is. It also sounds like she wouldn't have the assets to cover that anyway. If you pay for your mother's care, it's not got anything to do with your sister. In addition, while you may wish to do this now, you don't want to make yourselves liable by a statement that your sister could pull up any time in the future to accuse you of something you didn't do.

I like the idea of the smaller room, not because of your sister but for you. If it will not compromise your mother's care or her quality of life, it makes sense to preserve her assets by doing this. While you may be willing to cover her expenses, you also have your own retirement to save for so conserving your mother's assets, and yours as well, seems like a wise decision.

Your sister is not in charge of your mother's care and has no claim to your mother's money at the moment.  It may be that you need to hold that front, and have some outside auditor or something to protect yourself from her accusations if needed.

[formflier]

Hey...on the demand for 7 years worth of records.   Why not let the facilities decision to only send them to you solve it?  She isn't the POA, so the facility won't send her records.

On the one hand we KNOW that getting her the records is extremely unlikely to solve "it".  (do you agree?)

So, then the benefit of getting her the records is?

Have you consulted with an elder law attorney about applying for medicaid?  Does her current facility accept medicaid?  

(I'm meeting with elder law attorney for my Mom about this very issue on Monday.  All of our documents are in order, my question is about when to apply and how long it should take.)

The smaller room seems like a win win.


Best,

Allen

[Notwendy]

While you value your relationship with your sister, I think you can see how this is playing out. She demands something. You comply. She wants something else. This is the pattern of demand/you comply and yet, it doesn't meet what she wants. She makes accusations, you are on the defense.

Your H is well meaning but he's going on the assumption that a logical explanation of your mother's expenses will suffice. But while that understandably makes sense to him, he's not dealing with a logical person who states what they mean and mean what they says.

With BPD, it seems the issue they raise isn't the real issue. My BPD mother does this. She may want something, but she doesn't say directly what she wants, but makes other circular requests around it.

I posted before about my BPD mother offering to provide dinner for us when we travelled and then getting difficult over the food arrangements and not wanting me to call the restaurant to ask about food allergies because what she really wanted was to invite more people over but knew I wanted a quiet evening. If I had called the restaurant, I may have found out that the food order was larger than for just us.

When I said no to the whole thing, she then replied " you are depriving me of providing a nice dinner for my grandchildren".

You, Mommydoc, are trying to be the good sister to her, but in this triangle, you may be the "bad guy" in your sister's view regardless. You are under no obligation to send her the bills. IMHO, I'd hand them over to an accountant to manage if you have not done so already so you are not the constant subject of her harassment.

She may be in financial straits due to her own mismanaging money but can not be accountable for this. So you become the reason for her situation.

I understand this. You want to be "seen" by her as the good person you are. I also wish my mother could see my good intentions.

You are a good daughter, and a good sister- whether or not your sister can see that.

[Mommydoc]

Thanks Notwendy and Formflier. Our last few sessions she has dominated the “agenda”, all about her feelings.  I offered to talk with her this weekend, and said we should discuss the condo. It is a time sensitive discussion/ decision as our tenant is moving out, and we need to decide what rent to list it for and/or if we want to list to sell. I am OK with whatever she wants but don’t want another session talking about her feelings and all of my shortcomings…. And then I get the let’s talk about the facility. I will tell her we need to discuss the condo first, stick to 15 min and then if time, we can begin a conversation regarding BV, and I will open with smaller room option.

Notwendy, I remember the conversation regarding your mother and the dinner. You handled it really well, and I am going to try to  use your example to maintain  boundaries. I am a people pleaser by nature  and my parents always drummed in being a good big sister, so it has taken a lot of unlearning old patterns of behavior to allow her manage her own distress and not fix it.

FF, I totally agree that the records won’t solve it. I keep remembering the estate attorney advising that I give her the information she requests ( which is why I finally gave her the medical records and other financial records) which she never even acknowledged receipt of. She is financial POA, so I think if she chose to, she could force it, but it is all about getting my mom to another, less ideal/less expensive facility. I don’t need to  participate in that.  Medicaid is an option but she is many years away from qualifying and  likely won’t last that long. Good luck with your mom FF, agree it can be a long process.

I don’t need validation from her anymore. When she was here a couple months ago and raging at me, she pulled out a cup in a brown paper bag that said “worlds best sister” and shoved it at me. She said, “ I bought this for you a few years ago, but couldn’t give it to you, because I don’t think it anymore. Maybe things will change, so I will give it to you now”.  In the past that might have hurt, but in present it was laughable in the level of manipulation. I left the bag on the floor of my car until my husband cleaned my car out.

I appreciate the support and validation here; it gives me the strength to honor my parents and their intent. My dad before he died and my mom more recently both shared their insights on the relationship which also helped me let go of expecting or striving for a different situation with her. My goals today are to focus  my energy on my mom and immediate family where I can have healthy relationships.

I may offer my mom’s trust account financial advisor up as a resource to evaluate the trust  assets and make recommendations as another neutral party. He is willing to do it.

[zachira]

I agree with you that the medical team will likely only be willing to send emails to you and not your sister because she does not have POA. Maybe you can forward the emails to your sister and your husband. Possibly your husband could read your sister's replies and only let you know what is necessary.
I know you value treating others the way you would like to be treated. Unfortunately, giving any kind of attention to a person with BPD, just seems to add fuel to the fire, and is an incentive for escalating the conflict, many times when there was no real conflict to begin with, and as Notwendy has expressed, the BPD rarely tells you what they want. (It is always about something else; often they don't  know what they want, and there isn't anything anybody else could do that would make them happy.)

[Methuen]

It sounds like you are Health POA and your sister is financial POA so by demanding 7 years of health records, perhaps your sister is within her legal rights?  But is she alleging that the facility has mishandled the expenses or overcharged?  Did your mom express a desire to be there?  Are there independent 3rd parties that can verify that?  What is behind her demands?

He knows that my sister is making a case to say my mom can’t afford her current assisted living and he thinks that I can walk her through why her logic is faulty. I don’t think that logic works with her and worried about adding fuel to  the fire.  My husband is also suggesting we put in writing that we will cover my moms expenses if/when she has exhausted all of her assets.

Rational logic works when we are dealing with rational people.  It does not work with people who think with their feelings.  Furthermore, like NW states, the BPD does not express the real reason they are demanding something. IMHO this is based on shame.  So when you state you don’t think this will work, I suggest to you that you are right.  Rational arguements and defenses do not work with irrational people.  There is mental illness operating, and we cannot expect normal outcomes in an abnormal situation.  

I am wondering if there is any way you can think of to instead meet your sister on her emotional level?  Myself, my T and my H strategized this when my H had to deal with a disrorded sister over an inheritance.  To make a 7 year painfully long story short, when my H built and presented his case to his sister last summer on an emotional and factual level, rather than a rational level, he met with success.  While as executor he walked away with less than half the inheritance, before negotiations started, he was at zero for an amount.  We had access to certain information that we were able to leverage in a kind way, and it was important to SIL and BIL that they keep their self- held high regard of themselves and their reputation.  The bottom line is that if H had built a rational case instead of a case at an emotional level (with facts sprinkled in), he would have got zero.  
He started off by telling his story about the result her  actions had on him and our family,  but it was done with a lot of thought and no blame.  Just his truth. It was a victim impact statement.  In the end SIL and BIL did not want to risk their reputation especially with their church.  

Just my belief, but when dealing with an emotional person, one has to adapt strategies.

Furthermore, your H suggesting you put in writing that you will cover medical expenses once her asset’s are exhausted is likely to obtain the opposite of the desired result, because it will confirm her worst fears there will be nothing left for her.  

Your sister’s  behavior  is about your sister’s  needs after all, not your mom.  But optics are of utmost importance for her, so she will find a way to blame it all on you instead.

I would consider if there is a way to shift gears and approach this problem differently.  

[Notwendy]

Furthermore, your H suggesting you put in writing that you will cover medical expenses once her asset’s are exhausted is likely to obtain the opposite of the desired result, because it will confirm her worst fears there will be nothing left for her.  

Your sister’s  behavior  is about your sister’s  needs after all, not your mom.  But optics are of utmost importance for her, so she will find a way to blame it all on you instead.

This is wise advice. What your sister emotionally wants is unacceptable and she knows that. I don't think it's about her not caring about her mother but her being preoccupied with her own needs and looking at this as a solution (rather than deal with the issue in other ways - budgeting, etc). It's Karpman triangle. She's in victim position if she has financial issue. The "rescue" is your mother's money and since you stand between her and that, you are the persecutor in this scenario.

You offering to cover your mother's costs if fund are depleted doesn't solve her issue. She's not liable for this anyway. This doesn't solve the reason your sister wants to conserve your mother's money. So there is no reason for you to state this. Also you need to protect yourself. Saying this tells her "mom doesn't really need the money because I will take care of it" which might make her feel even more resentful of this situation and of you. I would suggest you don't make your intentions on writing to her.




 

[formflier]

Is your sister's signature or approval needed to move Mom to a smaller room?

I kinda doubt it so I can't imagine what good comes from discussing it with her.  I can see a bajillion ways it goes south.

Maybe same thing on the condo.  Before talking to her, get a rental price opinion and also a sales price opinion.

Given the market, I have to imagine that either option will do well for you...although selling it could end up with a big chunk of cash sitting around that she would push for/find things to be reimbursed for///etc etc.

If you keep renting until the estate is ready for a final settlement...it's much more of a "one and done" situation.

The more I think about it...renting it is much much better.

There was also a suggestion somewhere for your hubby to read the emails and "summarize" them for you.  Would he be willing to do that? 

Best,

FF

[livednlearned]

Mommydoc, I admire so much how you are handling this and I'm following your story in hopes of learning what I might expect (though in reverse) as my parents age. I hope you are able to make time for self-care while this plays out even if it's may seem to make only a minimal dent in all that you're shouldering.

I'm curious if you feel your sister is clear on your boundary. The repeated attempts to gain something (without, as others have said, expressly stating what she really wants) means she is working in multiple ways to find a loophole.

Have you said to her, "I will not consent to any decision in which mom is moved elsewhere." Or something equally clear?

Do you feel that expressing that boundary clearly will drive her to more disordered behavior?

[Notwendy]

I am a people pleaser by nature  and my parents always drummed in being a good big sister, so it has taken a lot of unlearning old patterns of behavior to allow her manage her own distress and not fix it.

I think people pleasing is a common characteristic for some people growing up in a dysfunctional family. Families adopt patterns so they can function as a whole. If one member is disordered, the others may over function or take on certain roles to compensate.

Your parents likely knew your sister was vulnerable in some way, even if they didn't understand why. They did what parents would do- become protective. If they sensed a resilience in you then it's probably human nature for them to have put you in protector mode. It wasn't necessarily fair to you do to this, but I think it's how families work.

As children, we learn certain behaviors in our families of origin that served a purpose in that setting, but don't serve us well as adults and may even contribute to dysfunction in our relationships. Caretaking traits aren't necessarily negative, in fact, they make people well suited to the caretaking professions- medicine, teaching, social work. You have had to in a sense, put some of your own needs aside to be able to take care of people. However, the other side of the helping professions is burn out. You have to have boundaries and also take some time to recharge.

Where these caretaking traits cross the line into dysfunction is when we take on tasks that the person can do themselves. We take away their accountability, the learning experience from getting better skills, and also their sense of accomplishment. When you "do too much" for your sister, you feel resentment. She also feels less capable and this plays into how she relates to you.

I have wondered with my BPD mother how much is her own inability and how much is due to her being enabled. I think it's chicken and egg. We also walked on eggshells around her.  I also have been too much of a people pleaser. While this had a sort of stabilizing impact on the family as a unit, being too much of a people pleaser doesn't serve me well in adult relationships.

The good news about learned behaviors is that we can unlearn them, and learn new ones It does take some practice and adjustment though.

Natural consequences is a teacher. While surely we'd step in to protect a person from a harmful situation, protecting them from too much keeps them from learning. For instance, if your sister behaves poorly with your mother's medical team, and they respond to this with her- this is the consequence for her behavior. Likewise if she doesn't manage her money well, it's not your responsibility to solve this for her by compromising your mother's care.

[formflier]

Have you said to her, "I will not consent to any decision in which mom is moved elsewhere." Or something equally clear?
 

And also...

How about "Hey Sis, are we addressing your core concern here?"

Perhaps a bit more direct.

"Hey Sis, the records (or whatever) seem to have made whatever you are experiencing worse.  Am I understanding your correctly?"

I mention all of this because it seems she is not really getting the the bottom of it, although to be fair..she may not know herself.

Maybe split into two strategies.

1.  How would you respond if she "knows" but is being manipulative and asking for other..related..things?

2.  How would you respond if she can't really articulate what she wants?

And even better.  If you can craft responses that handle both contingencies.

Best,

FF

[Mommydoc]

She kept bugging the Director yesterday and she just emailed the whole ledger to both of us. I have not looked at it, and don’t intend to engage on it.

I knew/know putting an agreement in writing isn’t going to solve it and appreciate everyone pointing it out. My husband doesn’t fully understand BPD and just wants to fix things. Once she said are you going to cover moms expenses when she runs out of money, and I responded I didn’t think she is going to run out of money, but if she did I would. The next time it was “you say that, but your husband is cheap, I don’t believe you, put it in writing.” I had not considered Saying this tells her "mom doesn't really need the money because I will take care of it" which might make her feel even more resentful of this situation and of you.
This is an amazing insight. Doing what she asks doesn’t solve anything AND it could be another invalidation. What she really wants is to be “My equal”.

Have you said to her, "I will not consent to any decision in which mom is moved elsewhere." Or something equally clear? Yes, I have, many times, but probably not frequently enough. She hears what she wants and distorts everything else. It took years for her to even acknowledge the HC POA. We are 50/50 Financial POA but I am Healthcare POA, but she misrepresented it repeatedly as she was 50% decisionamker. She had to hear it a 100 times from lots of people. The document allows each of us to act “singly” financially which means we can act on behalf of my mom or the trust independently, so I can sign off on the room without her consent. In retrospect, because she wants to be my “Equal” conceding the HC POA was nearly impossible for her. I had to say it over and over, and others (HC team, Social Workers, The facility) all had to do same. They all believed her, until they saw the documents. Last year she asked me to send her the documents to “Prove It” which of course she had been given many times before. Now she acknowledges the HC POA, but says “just because” you are HC POA doesn’t mean you can decide …. Or “you use the HC POA to make financial decisions that should be family decisions”.  I like the idea of having a few simple statements like you are suggesting livednlearned and FF that insert/repeat over and over. I am not going to mention HC POA at all, and just state, I won’t agree.

Previously when I have said it, she doesn’t acknowledge it, but she has heard it, because a few times she has said things like “ I am going to back off on this to preserve our relationship” or “For mom’s sake , if you feel strongly, I will just let it go”. But then of course she doesn’t. I am thinking I should remind her of that prior statement and acknowledge her statement more fully, “meet the emotions” as Methuen suggest of “How important our relationship is and how wonderful she was to agree to let that go and move forward with the other decisions we need to make.

I am  struggling with how to get these “Regular” conversations into a more functional routine cadence. We agreed to talk weekly, and have a list of topics and that each of us could prioritize on alternate meetings. My list (which I sent  3 months ago) even triggered her (“ your list sounds like an amicable divorce”) and so far we have not gotten very far. I told her I was only available for 15 minutes and wanted to talk about the condo. Now in her emails she is describing it as a “Family Meeting” asking if I am ready to discuss “Mom’s Entire Situation” and specifically raising the discussion point of “the facility”. I am going to practice the “I will not consent to any decision in which mom is moved” statement.

My therapist feels every week is too frequent and we should do every other week. Perhaps it is 15 min/week, and if either of us is not available we agree to schedule 30 minutes the following week. If we could talk and agree on the condo, (which I think is easy as I will agree to whatever she prefers) it will set a good tone. The condo is a great topic as she has a real estate license and I can defer to her as “The expert” and express how grateful I am for her expertise . I am hoping for a quick win there.

“Getting to the bottom of it”: I think there is a possibility that she would acknowledge that she wants to reduce mom’s expenses and perhaps we can set a reasonable goal around that. There isn’t much left as we have eliminated a lot of expenses and most of her services are bundled already but the smaller room, canceling her phone/TV would get us about 15%.

The challenge is, she does most of the talking and it is hard to effectively redirect her without invalidating her. I am going to pay attention and make sure that I am gently acknowledging and redirecting concurrently and make sure she knows I have to get off the phone.

Wish me luck, I will check in after the call tomorrow!

[zachira]

Mommydoc,
It can help to remember that less is better. Your sister wants to be in control, and have her way all the time. There is a long list of less of: less contact which your therapist is advocating for, using fewer words when setting boundaries and in all communications, etc., Let us know how the call goes.

[livednlearned]

Have you said to her, "I will not consent to any decision in which mom is moved elsewhere." Or something equally clear? Yes, I have, many times, but probably not frequently enough. She hears what she wants and distorts everything else.

Fortunately, you have leverage in the situation because you are legally HC POA.

If and when she feels she's getting nowhere, her intimidation will likely escalate again to talk of legal action.

Has she spoken about taking legal action again?

She seems to be invested in looking good so that may pump the brakes a bit.

Does she use guilt-tripping on you to get her way?

In retrospect, because she wants to be my “Equal” conceding the HC POA was nearly impossible for her.

You mention giving her free reign with the condo because it will make her feel like she's winning -- that may also embolden her to work harder at undermining you on the HC POA.

Being nice, being fair, rolling over -- it sends a signal to disordered people that we are weak and can be manipulated. If you gift her the condo you are giving away leverage that you might need later down the line. It may also give her a second wind with some of these other issues around your mom's care and well-being.

You will have given her x expecting something in y when she is not wired for that logic.

[Riv3rW0lf]

Being nice, being fair, rolling over -- it sends a signal to disordered people that we are weak and can be manipulated.

Very true .

I also find that the more we accept to walk on egg shells around them, the fiercer they are.
 

[zachira]

"Being nice, being fair, rolling over- it sends a message to disordered people that we are weak and can be manipulated." This has been something I am coming to terms with, and I have felt enormously guilty having to do things that didn't feel good, yet I have had to with so my disordered family members and their flying monkeys to mitigate the ongoing escalating abuse of me and others. I have tried to say this so many times in this thread and others, and haven't come up with saying it so perfectly as Livednlearned has. It is so terribly painful to at times to have to be someone we feel we are not, and to do so with our family members. In this case, the medical team is going to tire pretty fast of the sister, and Mommydoc is searching for ways to have low contact with her sister while keeping her sister informed about her mother's medical care. Certainly it does not work to what can seem like enabling bad behaviors that never end just seem to get worse, yet it does not work for us either to do things that go against our most sacred values and our caring hearts. Possibly the solutions lie with setting the best boundaries we can with the disordered persons in our lives, while letting ourselves grieve the losses of having to do this. I am hoping the call went better than expected!

[Methuen]

I 3rd that giving her a "win" on the condo could backfire.  It sounds like you are basing your logic on reciprocity, but do you have faith that she can behave with any degree of reciprocal good will?  This is about power and control, and as you say "needing to be your equal", and, I would add a not so secret desire to "show you up", and "win".

If you gift her a "win" with the condo, it is possible you will be emboldening her.  Hard to say more than that from where we are.  You know her.  Trust your instincts, but also listen to that little voice at the back of your head.  Maybe there is still some way you can validate her "expertise as a realtor" in the condo negotiation?  

I am seeing a pattern, the same one we all experience.  Chaos.  She is the epicenter, and her words and actions create work and emotion for everyone around her.  I have come to the conclusion that one of our jobs is to figure out how not to respond to the chaos, as doing so gives positive reinforcement to create more chaos.

She demands the ledger from the director, who complies. Win for her.

She makes demands to have "discussions" involving care and finances.  You agree to weekly meetings (15 min).  Win for her.  I kind of agree with your T - meeting every week sounds like a big demand.  Ick. This could be set up to fail.  What's going to happen the first time something happens when you have to "excuse yourself and miss"?  Defend and explain to her?  Also, I would not go along with her framing of "family meeting".  This is an obligation where she is in the driver's seat.  "I don't think of it as a family meeting.  It's a talk between two sisters".

She makes demands about the condo.  You agree.  She wins.

She's getting everyone else to do a lot of work...

Pattern?  

Will this embolden her sense of control because she sees you as weak?

Not saying it will, not saying it won't.  Just putting it out there as a possibility.

A few simple statement ("scripts") is excellent.

Have you got any kind of script prepared to "meet her emotions?"  This is where H and I did a lot of work around the financial conflict with his sis.  Rational discussion would not have worked with her when it came to negotiations.  He had to meet her on an emotional level, but always from the point of view of how her actions impacted him.  She made strategic mistakes along the way (over 7 years) that made her look bad.  In the end, meeting her at an emotional level was a successful strategy (facts sprinkled in).

Previously when I have said it [HC POA?], she doesn’t acknowledge it, but she has heard it, because a few times she has said things like “ I am going to back off on this to preserve our relationship” or “For mom’s sake , if you feel strongly, I will just let it go”. But then of course she doesn’t. I am thinking I should remind her of that prior statement and acknowledge her statement more fully, “meet the emotions” of “How important our relationship is and how wonderful she was to agree to let that go and move forward with the other decisions we need to make.

Yes.  The tone of voice used when you remind her of these prior statements will be critical.  Kind and gentle, rather than directive. Lots to work with here, as she is probably experiencing a desperate fear that after mom dies, she will lose you too.  In H's negotiations with his sister, the BIL at one point (after H's story which was his victim impact statement) acknowledged that their actions had damaged the relationship (evidence was damning), and that the parties had reached a fork in the path.  Either the relationship moved forward, or there would probably be no relationship.  Sis didn't want to "lose" her brother, so this was when they started to negotiate on how to partition the inheritance (yes there was a Will - long sordid story not worth mentioning).  H also had leverage because there was some shady stuff done on their part with an insurance claim, and H was talking about calling the adjustor to ask questions.  They didn't want that.  So, can you think of ways to build a narrative on an emotional level, without judgement or blame in your negotiations with her?  Leverage anything?  Including her fear of losing you, but without ever coming out and putting it into words like that?

Negotiating to reduce mom's expenses at this point seems reasonable.  She was paying more when she could still benefit and enjoy the extra perks (eg bigger room).  Maybe those things are less important at this stage.

Wishing you well.  All you can do is your best.  You are only half the equation.  

[GaGrl]

I suspect your sister is in some level of financial bind and has been expecting and needing an inheritance, which she sees being reduced now due to the nature of your mother's illness. Yet, she is ashamed to be engaged in this thinking, as it isn't culturally/socially appropriate. So...she brings up other topics that play around the edges of her real concern.

I like the idea of the trust's financial advisor drawing up several scenarios to predict the longevity of the funds. (My husband is a financial advisor, and he often works up these scenarios, sometimes in advance of an estate lawyer actually setting up the trust.) This could very well affect the rent vs. sell decision on the condo.

[Mommydoc]

Thanks GaGrl, I think it would be a good idea for him to do and just send to her.

The call today didn’t go well. It started with her telling me about her friend who had died this week and crying, me offering empathy. I could tell she was  dysregulated before we started.

We talked briefly about the tenant moving out of the condo, she wants to offer it to a friend of hers to move in, and I asked that we assess market rents but if that worked out I was OK with it, and asked her to contact the property manager to advise.

She then brought up the facility. She told me that she had shared all her concerns about the facility and how the decision to increase my mothers level of care was made and she wanted to know my response to her concerns.  I told her my perception of the facility and my version of the story would be different. It was helpful to know how it made her feel. I told her I owned my part of it. I didn’t have a need to do counterpoint or rehash what happened by sharing my perspective. I want to move forward. At that point I shared my talking points. (Which I had written down):

“ I want to be sure we are clear and aligned on goals.  My  goal is to assure mom is comfortable, happy and safe. The goal is not to preserve wealth or assets. The goal is for mom to have enough money between her income and her savings to cover expenses until she passes away.  Dad did a really Good job with that, between SS, his pension, her pension and his retirement savings.  She is not going to run out of money. I am confident of that but want you to be equally confident and to make sure we address your core concern here. I will not agree to a decision to move mom out of the facility.  Mom is comfortable, happy and safe at the facility and she can afford it. It sounds like your core concern is mom’s expenses. You are right that mom’s expenses are high. Let’s work together to look at opportunities to reduce her expenses. Turning off phone, TV, possibly get on a wait list for a smaller room.”

She then started ranting about how off base I was about the reason she wants to move mom, about how it is not meeting her needs, and all of her concerns. She said maybe you don’t care about preserving moms assets but I do (bingo! First time, she admits  it is about money)  She quoted her research on the facility (online negative reviews) and costs being higher than average. She told me how mom’s wellness is being threatened because of the poor care. She wants mom to get  “24 hour compassionate care” (hospice). I conceded that costs are high;  (without explaining why or discussing why she doesn’t qualify for hospice) She kept perseverating about a “demented man” who got in moms room and her bed when she was there. It happened but the irony is the staff  were very upset because she kept going in and  out and leaving the door open which is why it happened. After multiple comments about the staffs poor training, incompetence and that incident, I pointed out that they have a policy to keep, doors locked but she had left the door unlocked, (a mistake on my part) but she was already so angry and out of control that it probably doesn’t matter.  She perceives my mom to be physically disabled and that the unit is not the right place because she needs more cognitive stimulation. The reason I like the place is because of all the activities.  The ranting was really bad this time, she had a whole conspiracy theory about the Director and she must be hiding things, or have done something illegal. She also kept going on that the change in care was  illegal because she is 50% decision maker. I reiterated that I wouldn’t move mom. When we don’t agree, care decisions fall to me as HCPOA. Rage intensifies, more accusations, followed by her making demands for all her tax returns, and “All her records”. I can’t get her to define “all her records” but I know anything she gets won’t be “enough”. I am sticking to letting her “Do it herself”. I didn’t agree to any of her demands  but might ask the accountant to send them to her and/or forward what I get from the facility.

She went back to her goals of honesty, transparency and respect and my goal of harmony. I told her I didn’t think the meeting had been productive and we were failing at those goals. (She corrected me to say that she had been honest, transparent and respectful but  I had not because I “refused’ to address all of her concerns and the “first/only thing” I said is I won’t agree to move mom. (That was least 15 minutes in, ) She ended with
 ‘well I won’t agree to let her stay there and  I am a decision maker. And you will never sell that condo without my agreement so don’t try to do that from under me.”

I am thinking of going to email only contact at this point, advising her that I don’t think the phone meetings are working. Blocking her on my phone and having my husband read her emails. My husband came and listened in as it got heated and he thinks she is going to throw the legal threat in again. She kept talking about things being illegal, but never said she was going to sue. (That has been a frequent threat previously). I am contemplating how I can amass a team to work with her directly, financial advisor of trust, the accountant, new doctor and social worker.

I am also considering  consulting an elder law attorney just to get a consultation, in case, she does go legal. To make sure there are no specific things I should do proactively to protect myself.

I appreciate all the advice, as I felt very prepared and strong going in. I made some mistakes, but I held on to my boundaries. Her reaction was predictable. ( even so it was  worse than I expected). I wish I could get a divorce and never have to interact with her again.

Happy Mother’s Day to those of you who are mothers. Take care of yourself, we all deserve it!

[GaGrl]

I agree that consulting an elder care attorney and bringing him/her up to speed on the situation is a very good move. It may save time and emotional wear and tear later.

Your sister doesn't understand the hospice care qualification process at all.

And...she is angling to get that condo.

[formflier]

I can't imagine things going well for a "friend" to move in to the condo, yet I also don't think you should say that too her.

If the friend has several months deposit and a massive increase in rent..maybe.

I also like where your head is about phone contact.   It's simply not working for you and your goals. 

What does your husband think of the idea to go email only with him as a "screener"


Best,

FF

[zachira]

I think the friend moving into the condo is likely your sister.

[Notwendy]

I think you see your sister for her motives. There's a conflict of interest here that can not be resolved by any kind of discussion, facts, records, or how nice you are. She wants what she wants and you stand in the way of what she wants. She will twist this and do what she can to get you to back down. While I know you won't back down, discussions with her won't resolve anything and will be problematic.

Compromise doesn't work and neither will making an offer such as a smaller room for your mom. With my mother, any acquiescence only encourages her because emotionally, nothing is enough. You could move your mother to a smaller room, and your sister will find something else she wants you to do.

I agree with the lawyer consultation to protect yourself.

As long as there is a financial connection between the two of you, there will be this conflict.

She went back to her goals of honesty, transparency and respect and my goal of harmony.



I understand you want harmony. We all do, but at some point, realized that harmony with a disordered person is not possible, because they themselves are in an emotional state of disharmony

"honesty and transparency"- keep in mind the idea of projection. You are being honest and transparent. She is not and so assumes the same for you. What they accuse you of says more about them than you.

It's possible that once your mother's estate is settled, your sister may not have much interest in a relationship with you. You may feel the same way.

Rather than have these continuous circular discussions with her, that go nowhere, consider how the financial ties between you can be separated.

The condo. Do not let anyone connected to your sister rent. Anyone who is a friend of hers is not your friend. She's probably triangulated them. They also might not be responsible. If they stop paying rent, then you have the problem of evicting your sister's friend. I stand with GaGirl- this may be some plan for her to get the condo.

It may be better to avoid possible drama with your sister by selling it and splitting any gains from the sale. If she won't agree to sell it, one idea is to have it appraised and buy her out if you can. Then, you rent it or sell it as you wish. ( she might be happy to get the money for it). I would do all this through lawyers so it's completely unquestionable.

With your mother's funds. Your boundary is that you aren't moving her.

Your sister is throwing out all kinds of smokescreens by complaining about the facility. All this is a smokescreen for what she wants. I don't know what she may want, but any assisted living situation has a substantial cost, event the least expensive one isn't inexpensive. First, I'd secure legal coverage so you are protected. Next, I'd consider letting her solve her complaints. Say " while I am not willing to move mother, I understand you are not happy with this situation. How about you look around at options and let me know what you are thinking is better? This way, she puts some work into finding places and seeing how much they cost. Let her contact Hospice and ask- and they themselves will tell her why your mother doesn't qualify. Step out of being the middle person between her and available options and let her look for what she thinks she wants. My guess is that the savings she thinks she could have are larger than the actual ones. Let her find that out herself.

My guess is that your sister's imagined inheritance if only mother was somewhere else is probably not based on reality. I assume you have done the groundwork of finding suitable care for your mother and sis doesn't know much about how this works or how much it costs. I have also looked into assisted living situations, the different payment plans for them and the range of costs. Even the least expensive of them is costly. Just seeing the sum of money- it's a lot. Your sister just sees the numbers and blames you for the cost. Let her find out what all of them cost. Also let her inquire about which of them will even accept a patient in your mother's condition. Not all of them are equipped for her level of care and they the ones that do are not the least expensive.

I think she's shown you what she wants and perhaps she needs a reality check rather than believe you are what is keeping her from an imaginary sum of money.

[Notwendy]

Go Zachira! And sis is not planning on paying rent.

[formflier]

As long as there is a financial connection between the two of you, there will be this conflict.

consider how the financial ties between you can be separated.

So...think back to my "one and done" comment.  Is there any chance that a separation of finances is going to be "harmonious" or "smooth"?  Is it likely to take a small amount of effort and money...or large?

I'm not saying that your consultations with a elder law attorney should NOT happen...I absolutely think all angles should be "considered" and planned for.

However...at the end of the day I will be surprised if there is a plan "separates finances" prior to the estate settlement/probate that would be "worth it".

Related topic:  Please ask the elder law attorney if there is any chance of avoiding probate.  On one account of my Dad's there was not a "beneficiary" or perhaps "pay on death" signature.  That pushed the amount in question up past the threshold of having to open probate.

Why does this matter?    Well...probate is a court proceeding.  Things get argued about.  What are the chances your sister will "contest" things?

Last:  Uggg...I really hope zachira is not correct on the "friend".   Expeditiously renting it seems even more important considering the impact of "discovering" your sis or her friend in the condo.

Best,

FF

[livednlearned]

Dollars to donuts she is planning legal action. At a minimum, she has considered it altho a hunch tells me she has consulted with an attorney already.

She quoted her research on the facility (online negative reviews) and costs being higher than average. She told me how mom’s wellness is being threatened because of the poor care.

Requesting all of these documents and then not saying much about them, the online research, using the word "threat" in terms of your mom's care -- she might be doing things to get her ducks in a row.

She kept perseverating about a “demented man” who got in moms room and her bed when she was there. It happened but the irony is the staff  were very upset because she kept going in and  out and leaving the door open which is why it happened.

I would ask an attorney what the gold standard is for documentation in a facility like the one your mom is staying in. And then inquire whether the facility has kicked those processes into place -- your sister's behavior has likely tipped them off.

she had a whole conspiracy theory about the Director and she must be hiding things, or have done something illegal.

One reason to move things to email is to have a paper trail of what your sister is saying.

Documentation is gold if there is legal action.  

I didn’t agree to any of her demands  but might ask the accountant to send them to her and/or forward what I get from the facility.

Maybe wait until you talk to an attorney before sending any more documents?

She kept talking about things being illegal, but never said she was going to sue. (That has been a frequent threat previously).

 

Her reaction was predictable. ( even so it was  worse than I expected).

This could be an extinction burst. Sometimes when we set clear, firm boundaries the response is an extra hard shove to test if the boundary is truly firm.

Mommydoc, your sister might be what Bill Eddy (www.highconflictinstitute.com) calls a high-conflict personality (HCP) which he describes as someone who recruits negative advocates, is a persuasive blamer, has a target of blame, and who has BPD.

According to Eddy, not all people with BPD are HCPs, but all HCPs have a personality disorder of some type. HCPs tend to engage the legal system in a very specific way.

People in a constant state of emotional turmoil are difficult people because they outsource boundaries to others. It becomes our job to have boundaries since they are so adamantly disinclined. Several developmental stages are missing yet pwBPD can pass as grown ups with access to all the perks and powers of adult life.

In a protracted legal battle with a disordered HCP, I channeled much of my anxiety into documentation per my lawyer's counsel. While it didn't prevent me from going to court, I was able to have a positive outcome and my pwBPD was a former trial attorney. The "ounce of prevention is worth a pound of cure" approach to legal action can go a long way and thankfully, your sister is kindly letting you know what she's thinking 

[formflier]

Maybe wait until you talk to an attorney before sending any more documents?

Probably a good idea. 

On the one hand attorneys know that the documents can be gotten through discovery and they will likely balance that with "making them work for it" and "go through the process".

Ask the attorney and yourself what is the benefit of continuing to help your sister amass all this data.

Best,

FF

[Mommydoc]

My first text today came from my sister”Happy Mothers Day, I love you sister” with a photo of the two of us.  She does this after she behaves badly.

I think the friend moving into the condo is likely your sister.

. Probably not, as the condo is  far away from where she lives, but I shouldn’t laugh too hard, as she is capable of this. I am going to engage the property manager to do a market assessment for rents and ask her what we should ask for a shorter lease. My feeling is anything less than 6 months (which friend wants),we should increase deposit and monthly rent.  I want the condo to have cash flow but I think keeping the property manager and listing the condo  will be important. (She suggested not using a property manager since she trusts her friend… well I don’t).

Livednlearned, I think you are right that she is a HCP and all that goes with that. You are right about documentation and your story is  encouraging. I have been printing texts/emails to document and create a trail. I had previously consulted with the trust attorney about a year ago and she had suggested I give her records she requested as a show of good faith to include her. She also said that a judge will always side with spending money on the settler of the trust for health care needs. She felt moving any elderly person to a less expensive facility with the purpose of preserving assets for inheritance would be frowned upon. My sister actually helped my case by asking for a medical report that stated the recommendations, so her doctor wrote a very detailed report of the medical reasons behind it. I am not really sure what she would sue for, but I do think there are lawyers who could be persuaded by her that she has a case. I don’t think she does and though I would like to avoid court, I am not afraid of it. If she chooses this path, she will choosing a path
that guarantees our relationship will be dissolved after the estate is settled. That might give her pause.

In terms of probate, I think we are in good shape, as we created the trust in alignment with state laws to avoid probate. The condo is in the trust and beyond that, most of the trust will be easy to liquidate and divide.

Ask the attorney and yourself what is the benefit of continuing to help your sister amass all this data.

It’s exactly why I think it is time to get an attorney. I want to make sure I have minimal liability, that my documentation fully refutes any  allegations and that I can quickly respond to any legal situation. As I think about it having a new doctor to document her assessment of my mother and the facility is a bonus “Second Opinion”, as she will try to discredit the first doctor.

 I am also going to suggest the facility document her behavior when she was there, leaving the door unlocked, the chaos she created, etc.

I did ask the facility to follow their normal protocol and to release whatever they would release to another person in similar circumstances. I think the director wasn’t sure and ended up mailing them to me, but I have not received them. I agree with checking with an attorney before doing anything more.

And in the meantime, LC, which I love!

[formflier]

  My feeling is anything less than 6 months (which friend wants),we should increase deposit and monthly rent.  

At a minimum. 

Are you open to the idea of the friend moving in? 

Lots of pitfalls here.

Best,

FF

[Notwendy]

Yes, the "I am good now" switch to being nice 

When my kids have rented apartments ( off campus housing, etc ) they have had to have a credit check, background check and proof of income. We parents have had to co sign leases when they didn't have sufficient income of their own.

Your sister's friend can also do the same if she's interested in renting. And you can approve or not approve the application. I suggest you do this for any potential renters. If your sister is trying to rent "between friends" without this information, beware.

[missing NC]

If your sister pursues legal channels to move your mom, which is admittedly self-serving and clearly not in your mom's interest, you can end your relationship with her well before the estate settles by petitioning to have her removed as co-trustee. 

If you do end up sending her financial documents, you may wish to include a summary of your conversation, including her priority of preserving the estate versus spending money on high quality care for your mom... But of course, the attorney can speak to all of that.  Given that your attorney's fees will be coming out of the estate, your sister is already reducing the amount that will be left. 

I had the same reaction as others when you mentioned your sister's friend staying in the condo.  Ugh.  Sorry you are going through this but glad for you that you evidently have a good handle on things. 

[livednlearned]

I am not really sure what she would sue for, but I do think there are lawyers who could be persuaded by her that she has a case. I don’t think she does and though I would like to avoid court, I am not afraid of it. If she chooses this path, she will choosing a path that guarantees our relationship will be dissolved after the estate is settled. That might give her pause.

You have the best attitude  and it's a good sign that your sister may be motivated to preserve your relationship.

She may be looking at legal stuff as a way to manage intense anxiety or emotion that has no real outlet. I do think there are HCPs who seek legal recourse almost like it's a drum set. Lots of noise. If you aren't rattled by it, she may begin to think it's not quite so effective at getting the response she wants. And a good way to not get rattled is to gather information like you're doing.

I want to make sure I have minimal liability, that my documentation fully refutes any  allegations and that I can quickly respond to any legal situation.

It's hard to know the degree to which your sister is driven by delusion or paranoia or intent or a combination of all three. If she genuinely believes there is misconduct, that's one thing. If she is trying to stir up a case to get control of the situation, that's another.

And in the meantime, LC, which I love!

 

[formflier]

It's hard to know the degree to which your sister is driven by delusion or paranoia or intent or a combination of all three. If she genuinely believes there is misconduct, that's one thing. If she is trying to stir up a case to get control of the situation, that's another.

I've been trying to organize this in my head and this comment sort of showed me the way to lay out the possibilities.

She can think all she wants..believe what she wants, but in any legal action the court is going to look at "evidence". 

So...perhaps one tactic to take with your sister is to send documents and ask (in writing) for her to point out which documents show "misconduct" or whatever she is alleging.

Has your sister written down her accusations or only spewed them verbally during conversation. 

If she is on record saying "x" is happening to Mom and we need to change that, then any court is going to want see evidence of "x".  So...to evaluate your sisters "case", it would be important to know exactly which documents she thinks show "x" happening.

Switching gears

There are lawsuits that essentially say because of neglect (or things NOT happening to/for Mom that need to be happening) she needs to be moved or have a different care team.

As long as you can show the court a history of good care for Mom and show a plan for that to continue, I think you should easily prevail.

So even if there is documentation of someone getting into Mom's room once or twice...or a door being left unlocked or whatever...  Well...that's just what happens from time to time with elderly people (many with dementia). 

They will walk into the wrong room. Once staff realizes what a person seems to be doing now, then they can "interdict" that behavior in the future.

I think you are "fine" here (in a good position) and I also think staying ahead of this by checking in with your attorney is important

Best,

FF

[Notwendy]

It's hard to know the degree to which your sister is driven by delusion or paranoia or intent or a combination of all three.


I'd be careful as there's no way of knowing how vindictive they can get if they feel like victims.

Although we have been concerned about my BPD mother's mismanaging of her funds, we are grateful we have had nothing to do with it or her care. Recently, she's been accusing her caregivers of "elder abuse". There's been no physical abuse but she considers "upsetting her" as fitting the definition. Home helpers don't stay with her for long. If anyone is being abusive, it's her. The only way to "not upset her" is to be submissive while she does that.

She's said that if anyone upsets her, she's going to call the police to have them arrested. I don't know if she would go through with this, but I don't trust her not to. At this point, I won't go near her.

Then on Mother's Day she tells me how wonderful her kids are. 

Document everything.

[Turkish]

Agree with Notwendy. Document everything. My mom did that to me, accusing me of several types of elder abuse and calling cops on me. 

[Notwendy]

Gosh Turkish,
I am so sorry she did that.

[Mommydoc]

I'd be careful as there's no way of knowing how vindictive they can get if they feel like victims.

Like you, Not Wendy, I just  want to stay out of her way. Your advice is well taken. I can’t think like her to predict what she will do. My sister is pretty disorganized in her thoughts. One minute talking about “wrongs” from many years ago, the next minute “the best sister”, then attacking me, then the care team and now her target is the facility and facility director . It can and will change with her emotions of the moment. And of course the “love you sister,  Mother’s Day message” right after raging at me.

Thank you Turkish, FF and NotWendy.

Document everything.

, seems like a clear message. As mentioned, she has threatened a legal action and lawyer previously and never followed through. It always unnerved me, but I believe it was her way of trying to get me to do what she wants. This time she never mentioned it, but for the first time, I believe she is getting ready for legal action. So, I am preparing.

Yesterday, I decided to start my work day late, and made a number of productive calls. I spoke with our property manager, the trust attorney, the director of the Facility, the  facility Ombudsman, and the trust account financial advisor. Even though the situation is unpleasant, each of these individuals in their own way, were very helpful, supportive and validating. I feel like I got great advice from people who are objective and clear advocates for my mom.

Property Manager: advised against shorter lease to “friend”, said rental market is hot and we can easily increase rent and get a 12 mo tenant. If we went with friend, advised higher rent, prepayment and required application and credit/criminal check. She agreed to a market assessment and set of recommendations. I made her aware my sister will want to let property management go, but I will insist on continuing use of their services.

Facility Director: She was angry about my sister’s allegations but said she wasn’t worried. Been through it before and feels we have “10X the documentation” most families have to document my mothers care recommendations and the excellent care. She advised connecting with ombudsman to be a neutral advocate for my mom. She agreed to pull some documents for my records and to arrange for another cognitive evaluation this week to document my mothers impairments ( sister doesn’t believe my mom has dementia or cognitive impairment despite serial assessments documenting her slow decline)

Ombudsman: She is going to visit my mom, and ask her if she has concerns with her care. She can’t document anything, but the director will document she came by and so will I, and it establishes her relationship. She shared with me that of all facilities she works with, she almost never gets complaints and that when she does the Director is very responsive and easy to work with. If my sister does go down this path, she can be an independent person to investigate my sisters concerns and be an advocate for my mother.

Financial Advisor: he is going to prepare a trust assessment and project assets until age 100, and objective recommendations.

Trust Attorney: I have consulted her frequently over the years and she has been a great source of information. We talked for over 30 minutes and she agreed that at this point I needed to engage an elder law attorney to protect myself and gave me two referrals. She deals with families and trusts everyday and she had trouble wrapping her head around my sister’s insistence that she was decision maker, until we discussed her personal financial problems and desire for an inheritance. She represents my mom, but gave me sound advice on how to protect my mom in this situation.

All in all, it felt good to “take action” to prepare for what may be inevitable. I am on solid ground. My sister’s comments frequently make me doubt myself and look for my contribution to the situation we are in. Talking with objective professionals, whose job it is to be neutral and my mothers advocate was validating for me. I spend so much time trying to validate her, that I don’t think I was aware of the level of self doubt I had allowed myself to have.

We are entering a different phase. This  post is getting too long, so I will probably start a new one for my next update. I appreciate the support, advice and validation I get here. Now I have to figure out how to transition to LC again while moving forward with the decisions we need to make. It will be tricky…

[GaGrl]

The most difficult part of the next phase for you might be maintaining LC while your sister deals with each of these experts on her own.

You've got this!

[formflier]

All in all, it felt good to “take action” to prepare 

Something to consider.  What is the difference to you when you say the above quote and when you say it just the way you wrote it (for what may be inevitable).

The smaller quote above is you doing some extra because you value is you will be a great caregiver for Mom. 

The longer one might be related to "I'm doing this because my sister might..."

Basically...the more you organize your thoughts to be about you..the better.

Best,

FF

[Mommydoc]

Yes FF, there is a subtle difference in the mindset. The trust attorney asked me what my goal was, and I told her it was to make sure I was fulfilling my responsibilities as HC and financial POA and  being a good caregiver by making decisions that are aligned with my mothers needs. I have never previously  felt my sister was a threat to my moms well being, but I might have underestimated her. She might be.    I appreciate the reminder to be driven by values and not take action in “reaction”, so much more empowering!

[formflier]

I have never previously  felt my sister was a threat to my moms well being, but I might have underestimated her. 

Yes..much more empowering to do it because of you.

I would also encourage you to shift to "my sister's lack of emotional regulation" is making care for my Mom so much more difficult.

It's hard for me to imagine a scenario where she is granted actual power and can actually make decisions about Mom's care.

So "threat to well being" (maybe a bit much)..."makes a difficult situation almost unbearable"  (yep...)

Best,

FF

[zachira]

You are not alone in underestimating what a disordered family member is capable of. We just don't think like them.

[Notwendy]

You are not alone in underestimating what a disordered family member is capable of. We just don't think like them.

Yes, I agree. I think our consciences won't allow us to. It's not that they also don't have a conscience but I think, in victim mode, they feel justified in their actions in the moment.

I have never previously  felt my sister was a threat to my moms well being, but I might have underestimated her.

I don't think she's thinking she's a threat to your mother, but more like she has a financial need/want, sees there are funds- and in "victim mode" feels she deserves them somehow. It is possibly a combination of a true financial need with an emotional need. She is probably driven by this feeling, not your feelings or your mother- and so her actions can impact you but she's possibly not considering that.

I don't think the two goals- make sure your mother gets good care and protect yourself through documenting and legal protection if necessary are mutually exclusive. You can remain focused on your values and also be careful about protecting yourself.