uBPD/NPD mom - the next stage

[Depression = 72% of members]

This is my first post under this topic.  I've been over on the Divorce board dealing with divorcing an abusive uBPD husband.  I'm also the daughter of an uBPD/NPD mom and co-dependent dad.  They are quite elderly (mom 85, dad 96) and in relatively decent health.  They still live in their home independently.

As mom has aged, she has become increasingly abusive to my dad and my siblings and I (well, not to one brother who is the "golden child").

This past week there was an incident involving my dad where he became seriously ill, was taken by mom to the ER, sent home with meds that made him have nausea and diarrhea.  After a couple of days of this, he was too weak to get out of bed, fell to the floor trying to get to the bathroom, and mom called paramedics.  They got him up, he "refused" to go to the hospital (according to mom's account), and nothing changed.  This went on for two more days, two more falls, and two more calls to paramedics.  In the meantime, none of us kids knew anything about it (we all live in different cities from our parents).  Early on Saturday morning (the first ER visit was on Monday), mom called my brother and I and asked for someone to come help her because "she just couldn't do this anymore".  There was no sign of any concern that my dad was in critical condition.  My brother got there first, called the paramedics, and sent him to the hospital.  Dad was severely dehydrated and hours away from coma.  While my brother and his wife were cleaning up my dad and waiting for paramedics, my mom became completely dysregulated and verbally abusive to them and my dad.

I arrived a few hours later, took my mom to the hospital (she refused to go with my brother and his wife earlier because she "hadn't had a shower yet"), and the dysregulation continued.  I had to cut the visit short to get her away from my dad.

Since then, he has recovered (amazingly) and came home from the hospital on Wednesday, only to go back to his bedroom and shut himself in again.  He and mom have been in separate rooms for the past 40 years due to relationship issues (she had an affair), and he literally goes nowhere except to the kitchen for food.

My brothers and I have discussed what needs to be done for both their health.  Dad needs to be somewhere else so that he can have social interaction and someone to help him with some basic tasks.  Mom has, for years, isolated him from friends and family and controls his every move (and he lets her) and we already know that she won't consider him going to assisted living.  She certainly won't go herself (she has made that abundantly clear on many occasions).

If you have made it this far, thank you.  We are looking for suggestions on how to deal with this difficult situation without having to have either or both of them declared mentally incompetent.  We can not have a conversation alone with my dad unless we are somehow able to get him out of the house and away from my mom, and even then he is going to be concerned about not leaving my mom.  We are at our wit's end because there doesn't seem to be any good solution.

I guess I'm looking for input on how others have dealt with this, and what to expect.

[InPurgatory]

This is my first post under this topic.  I've been over on the Divorce board dealing with divorcing an abusive uBPD husband.  I'm also the daughter of an uBPD/NPD mom and co-dependent dad.  They are quite elderly (mom 85, dad 96) and in relatively decent health.  They still live in their home independently.

As mom has aged, she has become increasingly abusive to my dad and my siblings and I (well, not to one brother who is the "golden child").

This past week there was an incident involving my dad where he became seriously ill, was taken by mom to the ER, sent home with meds that made him have nausea and diarrhea.  After a couple of days of this, he was too weak to get out of bed, fell to the floor trying to get to the bathroom, and mom called paramedics.  They got him up, he "refused" to go to the hospital (according to mom's account), and nothing changed.  This went on for two more days, two more falls, and two more calls to paramedics.  In the meantime, none of us kids knew anything about it (we all live in different cities from our parents).  Early on Saturday morning (the first ER visit was on Monday), mom called my brother and I and asked for someone to come help her because "she just couldn't do this anymore".  There was no sign of any concern that my dad was in critical condition.  My brother got there first, called the paramedics, and sent him to the hospital.  Dad was severely dehydrated and hours away from coma.  While my brother and his wife were cleaning up my dad and waiting for paramedics, my mom became completely dysregulated and verbally abusive to them and my dad.

I arrived a few hours later, took my mom to the hospital (she refused to go with my brother and his wife earlier because she "hadn't had a shower yet"), and the dysregulation continued.  I had to cut the visit short to get her away from my dad.

Since then, he has recovered (amazingly) and came home from the hospital on Wednesday, only to go back to his bedroom and shut himself in again.  He and mom have been in separate rooms for the past 40 years due to relationship issues (she had an affair), and he literally goes nowhere except to the kitchen for food.

My brothers and I have discussed what needs to be done for both their health.  Dad needs to be somewhere else so that he can have social interaction and someone to help him with some basic tasks.  Mom has, for years, isolated him from friends and family and controls his every move (and he lets her) and we already know that she won't consider him going to assisted living.  She certainly won't go herself (she has made that abundantly clear on many occasions).

If you have made it this far, thank you.  We are looking for suggestions on how to deal with this difficult situation without having to have either or both of them declared mentally incompetent.  We can not have a conversation alone with my dad unless we are somehow able to get him out of the house and away from my mom, and even then he is going to be concerned about not leaving my mom.  We are at our wit's end because there doesn't seem to be any good solution.

I guess I'm looking for input on how others have dealt with this, and what to expect.

[alterK]

Wow, Purg, this is a tough situation! Do you see how many have read your post, but haven't been able to offer an answer?

Probably your parents have lived this way for such a long time that, miserable as they are, they fear any change, just like an animal that's lived all its life in a cage and fears to come out when freedom is offered. To quote an old psychologist friend of mine, "People prefer familiar problems to unfamiliar solutions."

It is clear both of them are so involved in their awful way of living that getting them to give up the things that have become the pillars of their lives cannot be anything but a very slow and laborious process. Like 2 PPD smokers, they may really be willing to die rather than change. It's possible that there may be nothing you can do to solve the problem, and that the most important thing you can do is learn to accept it. And sometimes acceptance, rather than a head-on attack, can be helpful.

You really are in a difficult spot. I wish I could offer you a nice key that would fit that gigantic lock, but I do sympathize with you, as I'm sure the others who have read your post do.

[GaGrl]

My 95 year old mother died last month after a health journey that included a fall/911 call, orthopedic surgery, pneumonia (six week hospital stay), rehab (six weeks), home health care, then hospice care.

The hospital social worker, in cooperation with your dad's doctor, can provide the best assessment of what your dad needs. The social worker has probably dealt with hundreds of situations in which assisted living is rejected. However, there is home health care and eventually hospice, if that is the journey. Home Health includes physical therapy and some personal care.

Believe me...no one single person can handle the needs of an elderly patient who is prone to falls and who may eventually be bedridden. Carrying is required, and your mother needs to be two-time about the finances available for what Medicare and private insurance does not pay.

Also, home health and hospice RNs keep a close eye on the family situation and can call in their own social workers for difficult care situations.

My mom came home with a paid (by us) caregiver five mornings a week, and another caregiver all day on Saturday to allow my husband and I to do errends, shop, even just have lunch out somewhere. All the other care I did until two weeks before her death, when her caregiver came over every evening to get mom ready for nightime. It was almost too much physically -- I am 68 and am just feeling that my back is recovering.

[zachira]

I have/had some similar situations to yours in my multigenerational highly dysfunctional immediate and extended family. My heart goes out to you. Many members on PSI, have found that consulting with a geriatric case worker to be extremely helpful, as to figure out what they can do now, and how to plan for the future. Keep in mind, that the professionals can't help you if they do not know what is going on, and people like your parents tend to be secretive and put on a good face for outsiders which is so frustrating. In my own experience and in learning from others on PSI, there are many health care professionals who work with geriatric patients who are extremely aware of situations like yours and can be incredible resources if you reach out and consult them. We are here to listen and support you. Post as much as needed and any time.

[Notwendy]

I am so sorry you are going through this. This situation is similar to what I experienced with my parents when my father's health declined. BPD mother's behavior increased, most likely due to the stress of the situation- and as you mentioned, my father's enabling behavior was impacted by his inability to do the things he usually did to meet her needs. In my situation, and probably yours, his role was to do things for her, not the other way around, and when he couldn't, she got angry and abusive.

The Karpman triangle helped me to understand the dynamics and also why my attempts to help ("rescue")my father were so difficult. Still, it's not something you can observe without trying to help- for your own sake- so you know you did try- that's important for you to know. I even called adult social services but their reply was that as long as my father was mentally competent, and was making his own choices, there was little I could to to intervene. I've posted their reply to me before after hearing my concerns- "your father is legally competent to make his own bad decisions". However, just because I didn't think something was a good decision, didn't mean he felt the same way.

I too felt it was better for my parents to be in a community for the elderly where he could get help if he needed it, social interactions, and mom would also have these needs met. I suggested some, and you can too, but my parents refused this.

I agree with other suggestions to look into home health, adult social services. My father did accept some home health nurses to come and check in on him, but sometimes my parents would not like them. He did have someone come in to help him with some daily tasks. However, one aspect of my parents' relationship was to act as if my mother is normal and to protect her from too much observation. I think this is one reason for refusing the elder community living idea. The other one that I think might happen is that with my mother's behavior, they may have not been able to manage this.

Dad is deceased now. I didn't know as much about BPD relationship dynamics when I stepped in to try to help. If I had known, I think I would have responded to their behavior differently and not taken it as personally. Trying to ''rescue" Dad resulted in me being the "persecutor" to BPD mom "victim" and she got angry- Dad would step in to "rescue" her from me. Although my intentions were to help, their reaction and my mother's abusive behaviors towards me were difficult to deal with.

Please know that all you can do is your best to try to help, but that their reaction and their choices are up to them. Please also take care of yourself as it's hard to go through this yourself and know that the dynamics between your parents are what they are- somehow they balance each other,

[InPurgatory]

I just posted an update and realized that there were responses to my original post about a month after posting, so I didn't see them.  Thank you to all who took the time to offer support.  As you can see from my current post, the situation has gotten worse over the past year.  Many of your suggestions for getting them help have been tried and failed.  Now we are reaching the point where my Dad really doesn't have a lot of time left.  After that, I dread dealing with my mom.