A mother load of FOG

[Methuen]

Today I received a text from uBPD mom:  "Miss my family".

I showed it to H, and he just rolled his eyes.

If I showed it to anyone else, they would probably think she is just a sweet mom.  But I know you guys "get it".

We are currently 800 miles away helping our daughter and partner move back to her home town (where we live).  We are thrilled.  She and partner are excited.  She is coming to a great job opportunity, and partner has a great clinical opportunity (still finishing his schooling). This is an 8 day trip for us as we help them move.

Before this trip, we were gone for a 3 day whirlwind trip at daughter's convocation.

Six months ago, I returned to work.  I think "medium chill" is a pretty good way of describing my current relationship with my mom.  Prior to that, I have always been her "person".  I just couldn't be her "person" any more.  It was making me sick, unhappy, frustrated, angry, and feeling caged.

Then today the text: "Missing my family".

My reply:  "The family is working hard packing up a whole house.  We were tired before we got here, and now we are more tired.  Enjoy the sunshiny days, and enjoy a good nights sleep."

I just hate the FOG so much.  It's times like this when I really connect with the term "emotional incest".

The sad truth is I don't miss her or her behaviors at all.  I am so glad to be 800 miles away.  

Meanwhile, over the past few years, she has successfully groomed a new friend to be her "person".  I am speculating that she is a genuinely nice person who doesn't know how to say no, and mom has fully taken advantage of that.  Mom has many "persons".  It takes a whole army of "persons" for her to survive living independently in her own home.  It is remarkable how many "persons" she has groomed to take care of her.  And genuinely good people find it hard to set boundaries with an "old lady living alone".  They've never heard of BPD, and really, how many people are truly "equipped" to manage that kind of behavior?

I realize I am all over the map in this post, but really just trying to process the FOG from the text.

[Methuen]

I should add that “what she misses” is the attention she normally gets by having things done for her by us.  She can’t send us her lists or make demands if we aren’t there.

The distance makes us less accessible- even to send her silly meaningless textx to.  

These are the things she misses.  She misses the control and attention.  

And to her those things are normal, so they are why she misses her family.  

Also she misses the security of having us there in case she falls again or has another stroke.  She is afraid.  

Those are truly the only reasons she misses us.  It’s all about her.  

But I can never have that honest conversation with her because the attacks would be relentless and there is zero chance it would be worth the risk, because she would be hurt, become emotional, and go into irrational rage.

My best defense is boundaries, while I continue to be subjected to FOG.   

Is there a way anyone can think of to stop the FOG short of NC?

[Methuen]

She is afraid of being alone without family.

She says I miss you because it used to work for her.  

In my reply I did not say I missed her too.  She won’t like that.  

She’s using “obligation and guilt “ to have her emotional needs met because she has the old feeling of abandonment since we left town and she is physically without family presently.

Have I got this right?

[Notwendy]

I am so sorry Methuen- I know this gets to you. It does to me too. Ironically, my BPD mother seems to be ignoring me these days. Maybe the less drama doesn't suit her. She also "grooms" people to meet her needs. I think she ignores me when she's got someone to meet her needs. Recently, someone comes to "help" her and I also think this person provides companionship, and since this arrangement, BPD mother seems less interested in talking to me. I am glad for her that someone is meeting her needs.

Congratulations to your daughter and her partner on their next step with jobs. Please enjoy your time with them!

Waif is the hardest, isn't it? It's hard to see our parents physically suffer with ailments. I don't want my mother to feel badly. I know you don't want yours to feel badly either. I think we wish things could be different- for them, for us.

Yes, the "I miss you" reminds me of the "I want us to be a happy family again" email from Dad. It's that my role of enabling and appeasing BPD mother meets a need for her.

[chrystalheart]

I hear you. It feels so familiar... I'm so glad you were able to find a path to a happy, healthy life for yourself and your immediate family. It's difficult dealing with the expectations (often unrealistic) put on us by unhealthy family members. When my hubby and I recently went to CA to  help organize his Dad's estate after his death my Mom tried to invite herself along several times. Distance seems so hard for them.  And, I think you're absolutely right - you can't have that honest conversation without unleashing a beast you don't want to have to deal with. But, you can be honest with yourself and with us and get that validation that you aren't doing anything wrong. Focusing on your immediate family is the right thing for you now. You are meeting your obligations. She is an adult. She can take care of herself, even if she'd rather other people manage life for her. Good luck with the move.

[zachira]

Glad you are having some well deserved time with your family and are truly out of range for your mother to be able to manipulate you into being there physically. The sad part of being an only child is that your mother is elderly, mentally and physically declining, should be in an assisted living and/or nursing home, and this does not really allow you to completely ignore her texts and cries for help. The challenges that we face when still in contact with disordered family members and the flying monkeys, are how to make it so no matter how badly they treat us, we recover more quickly each time we are subject to FOG. I have seen you make great progress in not allowing your mother's behaviors bother you as much. I am assuming that posting here and feeling understood is a way to move on quickly from the latest round of FOG from your mother. Hopefully you are now back to enjoying your vacation and your family. I admire how you have raised succesful happy children, and have a healthy marriage.

[Riv3rW0lf]

My mother would text me : "I miss my granddaughter." As I am the big bad wolf keeping her from her grandchildren, now that I have children...! I think it is actually easier this way for me to be no contact with a bit less guilt.

Methuen, I am so very happy for you, to hear that your daughter is coming back to live closer to you. I am sure you must be overjoyed with this news. Maybe being able to focus on your own happy and safe family will help you ease out of the FOG faster everytime your mother put you back in it.

I cannot imagine how intense and exhausting it is for you to care for your mother the way you do. I couldn't imagine doing it. I thought I could and would, but, as bad as it sounds, I am glad one of my brothers is a bit of a messed up enmeshed with our mother, because he will take her in and care for her, leaving me my freedom. I admire your strength and ability to keep your boundaries in place the way you do. I really do.

Sending you support, and am very happy for the news regarding your daughter   ... What your mother couldn't do : you did. You are a safe mother, one that can help with no strings attached. Something to feel peaceful about.

[Methuen]

Thank you everyone for your supportive and helpful replies.  Just - thank you.

You give me too much credit for doing well, and finding a path through this.  I am not doing very well presently.

We arrived home last night after helping our daughter and partner move back to her hometown where we also live.

Mother is disregulating again. Her latest text:

Re my drops. Dr _____ said I'm ready to do my own drops. [a lie.] Home care said I'm ready. [Another lie]  It's you holding thiings,,now there coming just to sign the book". [The last part refers to home care documenting the visits in a home health care binder kept at her house.  She believes they are just coming to her house so she has to pay for a service she doesn't want or need i.e. they are coming to take her money].

I ignored this text.

A few hours later, she phoned.  I put it on speaker.  My H and D25 and SO were all in the room.

She viciously attacked me for being the cause of home care still coming to her house.  This is nonsense, because it is her opthalmologist in concert with her home health team who are supporting her to get the drops necessary to retain the vision she has left.  She claimed her opthalmologist said she had 20/20 vision. H calmly asked her in a confused tone why she still needs to wear glasses if she has 20/20 vision.  I left the room.  I suspect H grey rocked her.  D25 and SO were shocked at her tone and accusations with me.  Also ranting racist comments about one of her home health workers whom we have met, and who handled her so calmly and professionally, despite her abuse of him.  

She informed us over the phone that she took the key out of the lock box (she's not capable of this, so her favorite flying monkey who was at her house today must have done it for her) so home care can't come into her house tomorrow (Sunday).  

I'm curious what home care will do with that.

This was my first day home from our trip.  Complete and total chaos.  Again, I wish I could live far far away from her.  Right now an ocean away would be too close.  She's irrational, makes up false accusations, attacks, and messes with everyone's life and happiness.

I feel horrible to say it, but if she just went ahead and had a nervous breakdown, a psych assessment could be done, and that might precipitate some needed changes.

She's suffering so much with this disease, her declining health, her age related cognitive impairment, and not coping with living alone, that the only path to change that I can see is that some catastrophe happens that puts her back in hospital.  Then with medical staff around her, they might finally see what I see.  

[zachira]

Your mother never gives up on trying to inflict her misery on to you. I do think that some kind of breakdown is coming soon in which your mother will be in some kind of care outside her home. Glad you left the room and had your husband to take over the conversation.

[Notwendy]

I am so sorry for this situation for you. I agree, distance is probably the only reason I don't have the exact struggles you do.

I wonder if her home health care workers already see what you see, in part. I haven't spoken to my mother's home health care but a social worker who is involved in coordinating them has told me she's very difficult and manipulative with them, and she has seen my mother's behaviors. Most of them don't stay long with her. She is very demanding and critical. Some I think she has fired. I suspect a lot of them have quit. I did hear that the director of one of the agencies has come over and calls sometimes. I don't know why, but it's probably that employees have raised concerns.

I think it's due to distance that she has to rely on them. You and your H have helped so much, and I think it's a good thing. On one hand, I know my mother is difficult. On the other, I also have enough FOG that I feel badly for her and wish I could do something to help her- but it's a no win situation. I wonder if now that you and your H are doing less, she has to lean more on them, and they will see it.

The issue is the legal definition of incompetence and her right to autonomy. Being difficult and disordered is not illegal. The social worker also confirmed to me that nobody can intervene at the moment unless it's an emergency situation. Her situation is chaotic too, but she's the one directing it.

I think letting her argue with her medical team over her eye drops will reveal a lot. You - on the other hand- stay your course. Don't sign papers for something you know would not be in her best interest. If she were a toddler screaming for chocolate for dinner - you would not give her chocolate- because it's not in her best interest. If home health can't get into her home if she took the key out- well they will call authorities to assist. I actually doubt your mother will do that, as she doesn't want them to get involved. This could possibly be a threat.

I don't want my mother to feel badly either. I also wish she could be more agreeable with others- it would be better for her too.

[GaGrl]

I, too, fear that a serious medical situation will happen that results in your mother being hospitalized and not allowed to return to her home.

Do you think home health would call authorities for a wellness check if they can't get into the house?

[Methuen]

When I had left the room during last night’s phone call, she told H she was getting up at 7 to be ready to see who  comes to the door. 

She may or may not do that as she can’t use an alarm clock.  Typically shes up all night and sleeps a lot during the day.

I’m worried it’s more likely they will call me to go do a check on her.  If they do that, what do I say?

[zachira]

Methuen,
It could be time to consult a lawyer. The question you might want to ask is how can you not legally be responsible for your mother's medical care at all, and how to get the proper authorities to do their job of assessing her appropriately and getting her into a nursing home/assisted living.
My heart hurts for you. I know what is like to be used as a punching bag by a family member.

[Notwendy]

If they do that, what do I say?

That's a tough one, because you do care about her welfare. I walk that line too. I care but don't want to be responsible for her choices. It helps that she doesn't share much with me so I don't really know most of them.

For me, I don't live close enough to be able to check on her quickly. They would need to contact someone else. She doesn't want to have people looking into her welfare further so I don't think she would do something like this. She came very close after not being compliant with her medication. Her doctor raised concern and the issue of assisted living was raised. She does not want assisted living and so, complies at least enough to not have this happen.

For you though, you are able to. This might also be why your mother is less compliant-  because there is an alternative to having people look into her welfare if they call you instead. On the other hand, you have just come back from a trip and may not wish to rock the boat further. It may be that these latest antics are her emotional response to your trip- to feel you have not abandoned her.

One question is- if they had to call you, could this still be reportable and so prompt a professional welfare check on her? Could you even call social services to initiate it. This way, you still feel you can check on her and also have others assess her.

BPD mother did something like this with me. I had just gotten home from visiting my parents. BPD mother called me saying Dad was in trouble and made it sound like he was taking a turn for the worst. I panicked - jumped back in the car to come back. But the issue was already taken care of. The home nurse had come and taken care of the situation. The nurse could handle his health care needs. (better than I can)

I realized that as long as I would jump in the car for an emergency, there'd be a lot of "emergencies". It's not that I didn't want to be there, I did, but I also had responsibilities at home too. So, I didn't do that. I know my father was disappointed in me. I didn't want him to feel that way. But what about my kids? They weren't little but still needed parents at home part of the time. Did my parents consider them? Or me?

Your mother's health care needs can be handled as best as possible by her home health care team. Your mother won't like it if you step away and let them do just that. I know that's hard to do. I do feel for you in this situation.

[Methuen]

It could be time to consult a lawyer. The question you might want to ask is how can you not legally be responsible for your mother's medical care at all, and how to get the proper authorities to do their job of assessing her appropriately and getting her into a nursing home/assisted living. 

This is interesting but I admit to being confused .  Everybody (experts and lay people alike) point out that she is competent to make her own bad decisions, until her doctor deems otherwise. 

So with that in mind, I am confused about how I could be held responsible for her medical care. I’m not disagreeing, I just don’t see how I could be held responsible when her health care team has assessed her to not even meet the benchmarks for assisted living.  That in itself shows what a convincing liar she is.  And the assessor believed everything mom said at face value, and did not ask for any family input to get another perspective depite my having had many conversations with her in the past.

Having said that, I had a very brief conversation with her doctor yesterday, and he said he will get his nurse to call me to make an appointment to discuss mom before we bring her in for her next prolia shot, which is July 13.

I will only have 15 min on the phone.  Any tips on what to include?

[Mommydoc]

Methuen, it sounds like things have really deteriorated. I am so glad you experienced so much joy with your daughters convocation and she and her partners move to be close to you. Your husband is so great with your mother.

You give me too much credit for doing well, and finding a path through this.  I am not doing very well presently.

You are being too hard on yourself. You continue to navigate a really horrible situation with incredible thoughtfulness and self awareness. The problem is the circumstances you are in, not how you are managing the situation.

I remember a similar rough patch, an extinction burst with my sister, that wouldn’t seem to end.  I was totally consumed. I told my therapist at the time, that the situation just wasn’t sustainable for me. One of the very simple things he told me, was this wasn’t going to be forever and that something would happen that would change the situation. When we are in the chaos it often feels like it will never end. 

Your being away triggered abandonment issues for your mother and she became more dysregulated. I have been disappointed with the your mothers healthcare team not addressing your mothers clear needs to be in an assisted living, as I do believe it is becoming increasingly obvious that is the case. By allowing them to see her repeated irrational behavior, it is my hope that they will eventually take action.  There isn’t much more you can do but allow them to see that as you are doing. I am glad your husband, daughter and her partner are there to support you. You have a lot of support here too. Just know we are all learning from and inspired by your clearheadedness, your ability to advocate for your mother while maintaining appropriate boundaries.

The challenges that we face when still in contact with disordered family members and the flying monkeys, are how to make it so no matter how badly they treat us, we recover more quickly each time we are subject to FOG. I have seen you make great progress in not allowing your mother's behaviors bother you as much.

Zachira’s comment is a helpful reminder for all of us. Our personal progress in dealing with a BPD family member has to take into account that the FOG behaviors will continue when NC is not an option. We are human and are going to react, it is more about utilizing the tools we have learned here, having self awareness around our triggers, managing through them and as Zachira said, recovering more quickly.

You are amazing!

[Notwendy]

I am not a lawyer but I don't think you are responsible for her medical care unless you are acting as legal POA and signing on her behalf ( but don't take my word for it)

What I have heard of is family members being held responsible for paying for residential care if they sign on the person's behalf. Be careful about that.

If she were to go to assisted living, she'd have to cooperate with the staff. This seems unlikely. While I think medically, assisted living would be the best support for my mother, I know she would be uncooperative and hostile to deal with. I don't know all the details but there was an elderly person in our community who was so uncooperative they were dismissed from a local assisted living. This is one reason I haven't pushed the "legally incompetent" decision for my BPD mother as I think an assisted living would likely ask her to leave if they can't work with her. She may be difficult for home health to work with, but at least she has a place to stay in her home if they can't work with her. It's not ideal, but it's the lesser of the two possibilities.

Perhaps the conversation with the nurse might be about options for her to continue to stay in her home with care if her being too difficult in assisted living. You could ask about at one point she'd be considered legally incompetent. I still think people have the right to refuse medical care if they are legally competent but also it may be possible to get a court order to override that. It might be good to bring up these scenarios so you know what your options are.

[Mommydoc]

It’s great you have an appointment with her doctor. I would share with doctor your continued concerns that she needs to be in an assisted living, and give the many examples. Explain why you believe the other assessments might have been flawed. Ask the doctor to document the examples and your concerns in her medical record.  You may want to ask  her doctor if they feel she is competent and what additional information or assessments would help them make an objective evaluation of her competency. I am hoping the doctor is beginning to see what you see, but help them in painting the picture and be direct in your requests. Lastly, ask for their recommendations on how to manage the situation. This forces them to offer a solution. If that solution fails, then perhaps, you are step closer to where you need to be.

I don’t think you are at any risk of liability. In fact, you have plenty of proof that you have been an advocate for your mothers well being. The only benefit I could see of engaging an elder law attorney is to provide objective advice on how to work with the medical team to demonstrate your mothers needs. It might be a consideration but I think the upcoming conversation with the doctor might be a more fruitful next step.

Good luck!

[Notwendy]

I don't know about your mother but the idea of assisted living was enough to keep my BPD mother moderately compliant with home health because she absolutely does not want to go to assisted living.

Maybe the idea to your mother - if she refuses to comply with home health- then the only option left is assisted living will motivate her to cooperate.

See what her doctor says and what her choices are. Home care is costly- but it's what my mother has chosen to do with her saving and assets. It's her decision.

[zachira]

As far as being at risk for liability, it really depends on the laws where you live and how the authorities interpret and enforce them. My cousin was horrified when her husband died in the ambulance after suddenly getting very ill at home and was told that his death would be investigated unless a certain doctor signed off on it. He was elderly, morbidily obese, had diabetes, and numerous well documented serious health conditions. I suggested you might see a qualified lawyer. My thinking behind consulting a lawyer includes the possiblity of the lawyer writing some letters to the health care providers for their negligence, including assessing your mother as capable of living on her own and no longer qualifying for assisted living. It can be quite effective to have a lawyer involved, though I would not file a law suit, just pay for her/his time and services. A lawyer might also tell you how to protect yourself from any accusations of elder abuse even though there is none. Because you have been directly overseeing your mother's care even though she is supposedly competent to make her own decisions and has given you no legal rights to manage her health care, you still might want to address this with a lawyer. A question you might ask is how to make it clear you have no authority over what she is doing, and could you if you choose to not be further involved in any of her care. It seems to be me that the situation with your mother has gotten way too out of hand, and perhaps there is a way to make some of these agencies that oversee the health care of senior citizens more directly responsible for overseeing that your mother gets the right kind of care and regular assessments to determine her fitness to make her own decisions. Too many people seem to be passing onto you decisions that you do not have the power to make or enforce.

[Notwendy]

Zachira makes a good point. Lately my mother has latched on to the term "elder abuse". Apparently someone made sure she was informed of that possibility so she feels she can use it to protect herself. Unfortunately though, from her perspective, anyone who upsets her is a perpetrator of elder abuse.

Upsetting her could mean anything such as having a boundary with her or accidentally picking up the wrong item for her at the store. Or saying something to her that she didn't like.

I am considering not visiting her alone due to this. I don't put it past her to make such an accusation if she were to get angry at me.

You could need to protect yourself from any accusations.

[GaGrl]

I thought of these two situations (Methuen and Not Wendy) yesterday afternoon. We have had a neighbor (B) across the street -- retired, successful executive -- whom we have not seen for the entire seven years we have owned this house. She once put a note in my mailbox asking who did my yardwork, and I replied with the info and my phone number. She had regular complaints about her next-door neighbor (P), who nonetheless kept an eye on her. Apparently, the woman had conflicts with her daughter and did not see her anymore.

Yesterday afternoon, my husband said there were two police cars at P's house, and he wondered if there had been a car theft -- we've had unlocked cars gone through a few times with guns stolen. A few hours later, he took the garbage can to the street and said there was an ambulance loading a covered body at B's house -- no siren when it arrived, no lights, no urgency.

B died alone in her house with only P to feel that something was amiss. It is sad, yet our group of neighbors knew she would not answer the phone or door, no matter what. I doubt anyone could have moved her to assisted living without a crowbar.

[Notwendy]

Wow, how sad for that woman.

I don't ever question when adult children aren't around. I think people assume they are neglectful people, but I don't do that.

There was an elderly woman in our community who people liked and visited frequently. Yet, I didn't meet her children who lived a distance away. I understood that she could be pleasant to us but treat them entirely differently.

I think there are probably adult children who don't care but I believe that most of them have been driven away and are sadly caring at a distance.

Fortunately, my mother accepts home care help- but has issues with them and often engages in drama with them too. Still, it's her choice.

[Methuen]

Thank you everyone for your feedback and your stories.  It is all helpful, and plays a big role in keeping me going.  Like others, I echo the sadness in GaGrl's story.  There are undoubtedly many more layers to that story.

Late yesterday I had the appointment with my mom's family doctor.  Mommydoc, I used your advice as a template.  At the end of the conversation he mused about getting the geriatric team to assess her.  What a great idea!  I asked if she would have to give consent.  He said yes, to which I noted that mom was unlikely to cooperate with that.  He noted that would be documented.  It is still a step forward.

This morning I got a call from the home care supervisor.  Mom has removed the key from the lock box so they cannot enter her house.  But she waits at the door to see which person is coming, and then lets them in.  One lovely gentleman triggered her simply because he was male (we met him and he is a genuine carer), so the supervisor advised me he has been removed from the caregiver list.  We had a fairly lengthy conversation about mom's deterioration.  She is now dishevelled.  More paranoid.  Denying her Parkinson's.  Insisting she's getting the drops in her eyes completely by herself when the workers are still assisting her (by telling her where to put her hand).  Sometimes the drops run down the side of her nose but she still insists they went in.  Self-sabatoging.  How?  She wants to remain in her own home.  But by insisting she doesn't need help from home care to get the drops prescribed to manage her remaining vision, she is showing that she isn't making good decisions about her own health. The supervisor said there was a scheduled care meeting for tomorrow and he was going to bring up mom's situation to the team.  By the end of the conversation I was in tears, begging him to ensure mom never learns about my communication with home care.  He assured me they would take care of her and I should try to enjoy the weekend with my company (daughter's partner's mother is visiting).  He said he would call me Monday regarding mom.

I brought her presents this morning (from our recent trip).  I'm no mental health expert, but I know my mom and I would say she is in a serious downward spiral.  I was on my way to work, so it was a short visit, but really distressing to see her like this.  Dishevelled.  Waiting inside her door for home care (because she took the key out of the lock box).

Crazy making.

[Notwendy]

Methuen, I am glad you got to speak to your mother's doctor. Now, your concerns are documented and they can observe what you have told them about her behavior.

I do think it's about control. While my mother likes to have help, she also needs to have control and choose who she has to help her. It's interesting to see her carry on similar dynamics with them. I recall if I did something minor, that would be it for her. So if someone for instance asks a question the wrong way ( to her ) she probably won't have them back.

There's no way she would go to assisted living. I think your mother feels the same way. I think the lesser control in that situation would be unacceptable to them. I know it must be hard to see your mother in cognitive decline.

[Mommydoc]

Methuen, what a challenging moment in your mothers journey. It is heartbreaking that she can’t see how much you care about her and how you advocate for her well being. Unfortunately, this downward spiral was predictable. You saw this coming before her home care team.  Something will need to change, and it is doubtful it will be your mother.  It is encouraging that both the doctor and home care supervisor are beginning to see and share your concerns. Let us know what the team recommends.

Aging and end of life are so hard. Your mothers BPD certainly makes this situation  harder. I recall how resistant my paternal grandmother was to leaving her home and going to assisted living. My father, her friends and neighbors all knew that living alone was no longer working but it took multiple injuries and hospitalizations before my father with recommendations from her medical team, made the decision for her. She fought it, and he agonized over it. I was very involved and recall my father saying to me, that he would never put me through what she was putting him through. But the situation stabilized and she had a few really great years in assisted living very close to my parents home. Fast forward only 10 years, and we were in the same situation. Like his mother, he wanted his independence until he died, but at a certain point, my mother, a home care giver, and my entire family couldn’t safely provide the level of care he needed. The doctor told us either 24/7 in home caregivers or assisted living were the only options.  My father chose assisted living in the end because he realized my mother needed respite and she also needed care. It was agonizing, and yet once they moved, things stabilized. When I reflect on what I want as I age, the truth is I don’t really want to be in assisted living either. But I have a much stronger feeling of not wanting to put my kids through what your mother is putting you through Methuen, what my PGM put my father through and what he put me through. This is all so difficult without BPD. I think what makes it even harder in your situation, is how effectively your mother was able to “cover” and play others. I am very hopeful that her spiral might, at least in time, activate the team to make stronger recommendations. Both you and your mother will benefit from a more stable caregiving situation. I am hopeful you are getting closer to that.

I am not sure whether this is available in your area, but some of my friends have utilized adult day care for elderly parents. It is kind of like a cross between an assisted living and preschool. They get dropped off in the morning, do activities through the day, get their medications and lunch there and then go home for dinner and spend the night in their own home. They provide a lot of cognitive stimulation and social support. It seems like your mom is very isolated and she might even improve with more structured social support. The assisted living my mother lives in, allows people to do “day care” for a limited time, to “try out” the place while waiting for a room to open up or before making a more permanent decision. It is likely just as expensive but could be a compromise that your mother might agree to as an intermediate step. It might not be an available option, but might be worth looking into.

Looking forward to your update. Hugs! 

[GaGrl]

Methuen, is there someone in your area who does home visits for hair and nails? My mom was very particular about her hair, and her personal hairdresser (retired) was wonderful -- came every Friday to wash and style Mom's hair. Mom's caregiver or I took her to nail appointments until her fall and hospitalization, but once she was home in home health care, her nail tech came to our house several times.

Your mom might accept that, as it would be "pampering."

[zachira]

I am wondering what the differences are between qualifying for assisted living versus a higher level of care such as a nursing home. My aunt who could not keep any of her hired caretakers and tried to force her children who were senior citizens themselves to be her round the clock caretakers, went to a nursing home. From my visit there at lunchtime, I observed my aunt to be the most able bodied person there, fully able to walk to where she needed to go, and the most mentally fit, able to carry on a normal conversation. I think she could have been in assisted living if she weren't so difficult. The nursing home told my cousins that their mother was the most difficult person in there. My question is: What is the appropriate level of care for an elderly person who needs assistance with their medical care and clearly does not have the maturity to be cooperative enough to be in assisted living?

Methuen
Keeping you in my thoughts and hope you get a situation soon that is better for both yours and your mother's wellbeing.

[Notwendy]

GaGirl- I love the idea of a hair and nails at home!

Zachira- it's level of care and how independent a person is with their own self care- dressing, bathing, using the bathroom, and how much supervision they need. Someone in assisted living is relatively independent but needs support such as meals, transportation.

One other big difference is finances. Both are expensive but if someone has few resources, Medicaid will only pay for nursing home care. One also doesn't have a lot of choice. Some nursing homes may designate a few beds for Medicaid. One has to go to the one where there's a bed available.

It may be that your aunt needed to rely on Medicaid assistance and in that case, the choice is a nursing home.

I agree with Mommydoc- I don't want to be in assisted living either but I see it as a logical choice if the need arises. The problem with staying in one's home  until some catastrophic situation happens is that, then, it's an emergency situation and one needs to find a bed in a nursing home available. If one chooses assisted living when they are relatively independent, and if they have the resources to cover the costs, they have more choices.

[zachira]

Notwendy,
My aunt's nursing home was paid for out of her funds. Those who are in the business of elder care are usually very aware of how problematic elderly people with personality disorders can be, though they may not know the terminology, though fully able to describe the disordered behaviors. I am sure that there are probably some unique ways for dealing with this type of person, and it would be helpful to know more about what are some of the ways institutions and health care workers deal with incapacitated elderly people with a personality disorder. It certainly is not one size fits all, despite the laws, rules, and protocols on paper. On a lighter note, there was an elderly woman who lived on a cruise ship, who every night at dinner would steal all the silverware. Every once in awhile, a crew member would go to her cabin, and retrieve the silverware when she was not there. I am not suggesting that we put Methuen's mother on a cruise ship. I am saying that there is a lot of out of the box thinking and unique solutions happening when dealing with an elderly person with a personality disorder who refuses to go to assisted living despite no longer being capable of living on their own or having the capacity to accept caretakers coming to their home. Hopefully Methuen will soon experience some relief as alternatives come available that get her mother a better level of care which fully take into consideration how impaired her mother is due to her BPD.