Feeling emotionally depleted: Mom near death, Sibling dysregulated

[Mommydoc]

I haven’t posted in a while, but have been thinking of all of you.  Sorry for the long post… a lot has happened since I posted last.

In late November I had  an abnormal screening,  which led to a work up, and recommendation  for laparoscopic surgery, which was scheduled for Dec 9. 

On Dec 8, my mom was diagnosed with pneumonia, started antibiotics and home oxygen. I had my surgery the next morning, and first thing my husband tells me after I wake up from general anesthesia is that my mom had worsened and was requiring more oxygen.   After testing negative 3 times, she tested positive for COVID the next day, and continued to worsen resulting in me taking her to the ED for IV treatment for COVID on my second day post op, Dec 11.

My sister wBPD lives on the other side of the country.  I let her know about mom’s illness and kept her informed as she was worsening.   She was pretty horrible to me, when I told her that her doctor wanted me to take her to the Emergency Room for treatment, initially she told me COVID is just a virus, she forbid me from taking mom for treatment and launched into (even for her) a pretty horrible rage.   I am HC POA and I knew it was the right thing to do, but  I was pretty exhausted from the prior 48 hours of trying to stay on top of and support my mom, without any moment to focus on my own recovery  from my surgery.   I thought my mother was going to die that night, but I declined to let them admit her as she was able to continue to receive the treatment through home health and good care through caregivers.   I knew given her advanced Parkinsons I wouldn’t  agree to any heroic things like putting her on a ventilator.   My mothers doctor talked my sister off the ledge and convinced her the situation was very serious and encouraged her to fly out.   I kept my sister informed through the night.   Mom stabilized and had dramatic improvements after each daily dose of Remdesivir the next few days by which time my sister had arrived.  She had a lot of anxiety and her presence was very stressful for everyone, but we did have a successful family meeting with my mothers doctors about putting my mom in hospice after my mother came out of quarantine.   

Once my sister realized my mom was going to “make it” she changed her flight to go home the next day.   ( she was here less than 72 hours).  Just prior to her departure, my sister called me and told me to “ come right away” ,  mom doesn’t look good.   When I got there, mom looked catatonic, her oxygen levels, blood pressure and heart rate had all plummeted.   I was certain she was going to die, and we decided not to call 911, but worked with nurse to  reposition her and we were able to get her oxygen level up but her BP and heart rate were still dangerously low.  We put her in hospice that afternoon  and prepared for her to pass in the coming hours.  ( my sister delayed her return home by 1 day). For 4 days, she was unarousable and did not eat or drink., but she did not pass away.   She then started to eat and drink a little,  had a couple good days where she was more alert, followed by another 3 days of lethargy and no intake.   This pattern has now repeated itself multiple times.  It has been emotionally exhausting.  My mom has stabilized and is not actively dying right now according to her hospice team, but she is mostly non verbal and sleeps a lot.  It is hard to know what she hears and understands when she is awake.   She is getting out of bed for at least one meal a day, beginning to participate in group activities, eating well but needs to be hand fed, even water.  I spent every waking moment of my sick leave and holiday time off with my mom. My family adjusted and we got some time together.  I missed a planned vacation over NY (friends and husband went without me).   I am now back at work and still visiting daily.   Some times she responds to my voice and seems to know it is me, but she often doesn’t.  She is a shell of her self , it is very hard to witness.  The holidays and the last month  are all a blur. Though my mom has not yet died and isn’t actively dying right now,  she is extremely frail and  it is likely that she will die in coming months.  She and I are very close and on many levels I have already lost her, but I can’t outwardly grieve that loss. People think I should be happy she is “doing better.” 

I am setting boundaries as I return to work, but my job is very stressful, and there were some major crises that occurred while I was away. Healthcare is hard now, with most staff and physicians very burned out, and not enough staffing to handle the crazy winter volumes we are facing.  A huge percentage of the workforce has been out due to COVID and other viral illnesses.  It is really hard to lead through that.  The good news is my successor has been named, we are actively transitioning and I will be retiring in 5 months. 

Fortunately, my sister only stayed a few days,: when she left she expected my mom to pass soon after.   My sister has not handled the ambiguity of the  ups and downs very well, and has been very deregulated.   I tried to keep her updated, included  and be empathetic and sympathetic to her emotions,  while focusing on my mom’s needs as my priority.   She is very demanding , wants constant updates, reassurance and comes unglued when my mom’s  status changes or she  doesn’t  get face timed frequently enough.  I feel I did well, not letting her trigger me.  On Christmas Eve,  while FaceTiming so she could share a lucid moment with my mom, she launched into me, when I told her because mom seemed to be stable, that hospice was encouraging me to go on my trip.   She said some really horrible things about my husband and one of my moms long term care givers,  was all over the place, it was all about her, lots of crazy projections. When she started yelling, I  stepped out of the room, so my mom wouldn’t hear her yelling at me,  but she just kept going on.  I was stunned and said almost nothing, but finally ended the call.  I was done and decided at that point, that  I couldn’t talk to her on face time or by phone and went to text only  updates and communications.  That was over 2 weeks ago. It drove her crazy as she was dependent on me for updates and connecting with my mom.  I asked the  facility director and hospice team to take over the FaceTime and updates, which they did.   I send her pictures, videos, and text updates, but won’t talk to her on the phone.  My sister has been pressuring multiple members of the hospice team to try to get me to do family counseling with her.  They have witnessed  her behaviors, but are working hard to try to support us both.  With out me saying I think she has BPD, they seem to have a pretty good read on her.   

Today, she texted me,  “ Since mom is stable and seems to have decided to live, I would like for us to establish time to evaluate the trust, present, future and past as is relevant. How do you feel about this suggestion?” On the surface, it seems somewhat reasonable and neutral, but it triggered me.   Any time we had family meetings to discuss “ the trust” it is all about her perception of the past, which is highly distorted and she makes all kinds of unfounded accusations.  Though we could talk about the future, and how we might execute my mom’s estate, funeral, etc, based on the things she says in her recent rants, I expect and anticipate that her focus will be on moving my mom or how she was excluded or mistreated. It is all about money in the end, but she only rarely says things that expose that….as I believe she has shame and can’t admit it to herself. 

I am depleted emotionally and have been putting everyone else’s needs first.  I want to put my mom’s needs first, but I just don’t have the emotional reserve to engage with my sister.  I make up that me “ resetting” the boundary of text only was a huge backwards step in her mind.  She  told me she “ enjoyed” our sister bond, when she was here. She has no self awareness of what happened the night my mom went to the Emergency room or on Christmas Eve.  She thinks I got angry at her when she asked if I would gift her FF miles, which is  laughable and such a huge distortion of what occurred. She hasn’t been successful in getting me to engage with the family counseling idea, so now she goes to the “Co-trustee” obligations that we jointly share.  She knows I take that obligation seriously and I have committed to working with her on it.  At this point, the attorneys have made it clear that there are no actions needed until my mom passes.   It is just a way for her to get me to engage with her.   

Through a lot of self reflection, therapy and prayer, I am in a different place.  I love my sister and do want her to feel included and to support her, while protecting myself.  It was very intentional to ignore her nastiness, so we could support our mother together as she was dying.  We are now in this weird in between place and it is hard to know what and how long we will be here.  My sister can’t live in grey….She needs to say “ Mom is dying” or “ Mom has decided to live and is stable.”   My sister is always consumed with her own needs and can’t see or hear mine.  She never really acknowledged my surgery and need for recovery or respite time.  She doesn’t acknowledge all that I do for my mom as she wants to believe she is mom’s special person and her spiritual guide.   

I need advice and support as I try to claim space for myself and navigate a time of great ambiguity with a sibling who is highly disordered,  dysregulated and trying to pull me into her drama. 

[Notwendy]

Mommydoc- I know this is hard and sending virtual hugs.

I don't know if this helps but as my father's health declined, my mother's BPD behavior went over the top. It makes sense- surely it was difficult for her, it's difficult for you and your sister. But for my BPD mother, it was only her feelings that registered with her and her needs to have everyone's sympathy extended to her predominated.

But on my part, I was emotionally distraught and depleted too. It doesn't matter that you are a physician who has taken care of seriously ill people and have experienced this process with your patients and families. They were not your mother. At the moment, you are a daughter with a very ill mother who is in hospice, and it doesn't matter what you do for a profession as far as your feelings are concerned.

You are used to advising everybody and being on the helping end. I hope you can reach out to your friends, colleagues, and if you have a therapist for support. You have not ever lost a parent before. This is new to you and you are not less deserving of support just because of your experience.

Your sister will be processing this in her own way. IMHO, this is not the time to have any kind of discussion about trusts or expenses. She's not rational. She's probably even more irrational and self absorbed. She not only can't support you, she may even be more emotionally and verbally abusive. My BPD mother was.

You need to take care of you right now. Your mother's needs are being met. The Hospice staff has the skills and ability to meet her needs right now. What happens with her is not anything you can control- let them do their job. Please take care of you. I think at this point it's best to grey rock your sister and not get into emotional exchanges with her.

[zachira]

Thinking of you, and hoping things will get more peaceful as you are with your mother in her last moments. Glad that having the staff facetime and do the updates with your sister, is helping.
The only wisdom I have to offer is that we sometimes get loose with our healthy boundaries with our disordered families when there is a crisis, like a trip to the emergency room, a family member dying, etc., The more time spent with a disordered person, the more our mirror neurons become engaged, and the more we take on the emotions of the disordered person. Considering the possiblity your sister may come back to spend some time with your mother before she goes, can you set some specific time limits on how much you will be around her, when it is time to step away and go where your sister isn't, or have someone else there like your husband whom you feel protected by so you don't take on your sister's projections and negative energies?
Keeping you in my thoughts and prayers!

[Couscous]

What a trying past few weeks you have had. I’m glad your mother has stabilized.

It’s clear that your sister is unravelling; and I can all but guarantee you that, fundamentally, all of her behavior is an expression of her extreme anxiety about the real issue, which is that your mother nearing the end of her life. By obsessing on the non-issue of the trust she can distract herself and avoid facing her painful feelings and can alleviate her anxiety because she’s taking some kind of “action” (stimulates dopamine which lowers cortisol). It’s even possible that on some level you are colluding with her on this and trying to protect her from experiencing those feelings due to your anxiety about her. As difficult as she is being, she is still your sister after all.

At this point, the attorneys have made it clear that there are no actions needed until my mom passes.

What you could do is tell her that you hear her concerns and that you completely understand how incredibly upsetting this must be for her, but that you have made up your mind and that your decision is final: You will not be taking any action, and then let the chips fall where they may. Wishing you all the best.
 

[Notwendy]

You will not be taking any action, and then let the chips fall where they may. Wishing you all the best.
 

I'd add- you are not in the state of mind to have these discussions or make any decisions. It's too emotional right now. You know well to not make decisions at such an emotional time as you may not feel the same way when you feel calmer.

she is extremely frail and  it is likely that she will die in coming months.  She and I are very close and on many levels I have already lost her, but I can’t outwardly grieve that loss. People think I should be happy she is “doing better.”


Yes, you can grieve. It doesn't matter what anyone else thinks. Grief is a process. Maybe others don't understand that but you are not obligated to go along with their expectations. There isn't a one right way for how you should feel. You experience it in your own way.

Look to those who you can lean on now, your husband, friends, even co-workers.

[GaGrl]

The last 2-3 months of my parents' lives were uneven in the ups and downs of their physical situation. Your description of it being a weird place is so accurate. Both my parents were in home hospice when they died, although my father passed more quickly after being placed in hospice than did my mother. I felt as if I were operating in a "bubble" where I was detached from what was happening, yet able to handle what needed to be done each day.

The days of seeming "better" can be deceiving -- there is no even decline. Some days with my mother, I experienced her utter clarity and emotional balance, while that night she would have vivid aural and visual hallucinations.

As the hospice workers say, "It's part of the process."

Restricting communication to text is good for you right now, so I would advise you retain that and let hospice handle any communications with your sister. As to the trust -- she forewarned you that past and present be included in the discussion, so don't go there. You can tell her exactly what the attorney said -- all is in place with no need to review until your mother's death.

Just love your mom through this.

[Couscous]

I read a few more of your recent posts and have to say that they dynamic between you and your sister sounds so, so similar to the one between my highly manipulative sister and I. I am also the over-responsible older sister who was trained in childhood to look out for her.  

One book that helped me immensely in my dealings with her recently in which she refused to take no for an answer was Emotional Blackmail, so if you have the bandwidth for this I highly recommend it. I would literally copy and paste passages from the book in emails to my sister when she was “negotiating” with me to get me into family therapy with her.

The good news is that by using the non-defensive communication from the book she finally accepted my “no” and managed to survive, but the bad news is that she has ceased all communication with me going on for 8 months now. I am not going to lie — this has been very hard on me, but it has been getting easier and honestly, it has been a blessing disguise because it allowed me to not have to go NC with her and removed a huge source stress from my life. My guilt did not allow me to go NC with her even though it was probably the healthiest thing for me to do, but this is something I will be trying to get to the bottom of in therapy. My thinking is that it’s probably a younger part of me that experiences intense anxiety at the thought of not protecting and looking out for them, and that by going NC I am being mean and abandoning them, and since that part is frozen in time, it doesn’t realize that my siblings are all grown adults and able to take care of themselves.

I found this article about toxic sibling dynamics, and the part about how we can project our shadows onto our sibling was quite thought provoking: https://eggshelltherapy.com/toxic-sibling/

[Riv3rW0lf]

Mommydoc,

I just wanted to extend a virtual hug to you  

This was an awful lot to handle, a surgery, your mother's declining health, and on top of it, your sister's crisis and manipulations. It's a lot. I get the sense though, from what you wrote, that despite it all, you were able to stick to your values, to who you are... It's normal to feel tired and emotionally exhausted... You are going through a rough ride right now.

The thing is, with a stabilisation in your mother's health like that, that you now have to wait for the "next ride", because while your mother is stable right now, she remains near her end. And it's ok... She had a good life, she made it through to old age, with a loving daughter by her side. I think it is ok to grieve now, it is also ok to feel like you are ready to say goodbye. This is healthy.

We live in a society that fear death immensely and we do everything in our power to keep people alive for a few more months, a few more weeks, a few more days, a few more hours... Death is scary, but what is worst is being stuck in limbo between life and death, to me anyways, and it happens to a lot of elderly people. And so ... Don't feel guilty for being ready to say goodbye. It's a loving goodbye, it's a loving grief, and it's ok.

I get that your sister is putting you through a lot of demands right now, and I wish only for you to find some time, through it all, for  self-care and self-compassion. It sounds like you had to put your whole attention on the outside world since your surgery ... I think it is ok to put it back on yourself now, and process what is happening.

  

[Mommydoc]

Thank you all for the thoughtful and supportive responses. I knew that initiating a family meeting to work on “ the Trust” wasn’t something that was a priority for me, but I was not understanding why it triggered me so much.  I appreciate you all validating the need to grieve and process emotionally and not engaging in the Trust conversation with her.   

I don't know if this helps but as my father's health declined, my mother's BPD behavior went over the top. It makes sense- surely it was difficult for her, it's difficult for you and your sister. But for my BPD mother, it was only her feelings that registered with her and her needs to have everyone's sympathy extended to her predominated.

This helps incredibly NotWendy. When my father died, I was not at all prepared for my sisters behavior, which was exactly like you describe your mother.  I didn’t recognize or know about BPD, and so I was completely unprepared for it.   My therapist has been working to prepare me for it this time.   To expect it and be ready for it.  I think, what I wasn’t prepared for was the emotional exhaustion and feeling so vulnerable as a result.  I am also much better now  at asking for and accepting support.  It’s funny, because my mom is a nurse and a total giver. Before she got sick, I was having conversations with her, about letting go of “giving” to others and becoming a good “ receiver of care from others”. I need to do that too.  I have tremendous support from friends, family, at work, and from my mom’s facility and hospice.  I feel very fortunate in that way.   I just have to give my self the space to be sad, to grieve and to ride through the ups and downs.   Thank you for giving me permission to grieve Couscous and for reminding me of the book Emotional Blackmail. I have read it and have it in my library.  In Sheeps Clothing, is also really good.   I need to pull them both out and read.   The article on Toxic Sibling Dynamics is Excellent!   I think we fall into dynamic #2, but so much of it really resonates.  I am very intrigued by the Deep Shadow work and will talk to my therapist about it.   

The more time spent with a disordered person, the more our mirror neurons become engaged, and the more we take on the emotions of the disordered person

So true Zachira.  When my sister was here, my husband and I kept saying “we can get through this” but her intensity was suffocating.  I appreciate the reminder to put in a strategy for when she returns.  I have a vacation planned for next month and am hoping she will decide to come while I am away.   She has mentioned that possibility to me previously and to the hospice team.  The boundaries will be critical and my therapist has also continued to remind me to stick to them no matter what. 

GaGrl thank you for validating the “ weird place.”

  I felt as if I were operating in a "bubble" where I was detached from what was happening, yet able to handle what needed to be done each day.The days of seeming "better" can be deceiving -- there is no even decline.

My mom had a really good day today, and it truly lifts me up, but the hope and excitement associated with that, makes the “ not so good” day that will come, a little harder, if that makes sense. 

[Mommydoc]

Riv3rWOlf, great to hear from you.  Thank you for the support. I think we posted at the same time.

sounds like you had to put your whole attention on the outside world since your surgery ... I think it is ok to put it back on yourself now, and process what is happening.

Thanks for that.  I needed it.

[GaGrl]

It does make sense, that weird place.

My mom had a 95th birthday party on Monday with her friends from church -- cake, singing, she was happy and animated, had me open cards and read them to her. The next morning, she fell into semi-consciousness and died early Friday morning. I found in those last weeks that I could not let my emotions go up and down with her physical symptoms.

However, I grieved -- much before the end. One night, after Mom was asleep, I finally "lost it" with my husband . I just cried and cried, so helpless at my inability to alleviate all that she was going through and finally admitting my sorrow. I did the same when my 32-year-old sister was in the late stages of Stage IV breast cancer back in 1988. Perhaps many of us just have that "tipping point" where we fall into it and really let go.

I'm holding you in my heart.

[Notwendy]

I began to grieve my father too before he passed. I could tell the direction things were heading and you can see this with your mother as well.

Maybe the grief is proportional to the relationship. You are close to your mother and it seems she is a giving and loving person. I was closest to my father, and thought we had a good relationship. At least from my own point of view, but sometimes question what it meant to him. Regardless, it was difficult to lose him and I felt like an orphan when he was gone.

I also didn't know much about BPD behaviors at the time and BPD mother's emotionally and verbally abusive behavior was over the top. I also was not in a position to deal with it in a calm or rational way. One time, I just yelled at her, screamed at her, something I haven't done before or after that. Had I known about the Karpman triangle, I would not have done it. Her behavior escalated.

That's another reason for self care. If you are stressed and grieving, you are more likely to react to your sister's behavior. Even if it's understandable - a reaction to her behavior- she won't see it that way. If anyone gets upset or angry at my mother, her reaction is that they are just attacking her for no reason. It doesn't lead to any good.

[Couscous]

So did you and your sister get along well in the past so that your parents felt confident that naming you as co-trustees was a wise idea?

Because if not, I really wonder how they could not have seen this coming. But maybe it was more important for them not to look like the “bad guy” than to do what was best to keep peace in the family.

https://www.estateplanning.com/should-i-name-all-of-my-children-as-my-successor-trustees

As much as you love your children and would like to think they will be caring and unselfish when you’re not there to referee, this is the time to be realistic. If they really don’t get along, or if there could be jealousies, you and your family will be much better off with a professional as your successor trustee. The fee they charge is a small price to pay if it keeps peace in your family.

[Mommydoc]

Couscous, it’s a great question, and one I have frequently reflected on.  ( My lawyer asks it out of frustration!).   

They were very aware of my sisters jealousy, resentment and feeling of being “ less than”.   As the article you posted described, she is the Puer/Eternal Child who never learned boundaries, is charming and dynamic, but in life has “underperformed” (me: overperforming  more serious responsible first child).   I think they thought by naming me as HC POA and us jointly as Co-Trustees, I would take care of things, but granting her the title would make her feel like my equal.   It was wishful thinking, and may also just have been to avoid conflict.   In fairness, at the time, I was still  trying to people please my parents, by walking on eggshells with my sister.   In addition, my fathers death was a triggering event for her, and her BPD behaviors became more obvious. In fairness, I don’t think anyone saw all of this.  I used to think if I could just appease her more, or validate her more, things would be better.   I am stuck with this role, but when my mother dies, after a period of likely high conflict, I will finally free of the Co-Trustee role. 

She repeated her request, this time specifically asking to meet on Saturday.  I responded to her last message asking for more specifics about what she wanted to talk about.  She responded
“ I’m surprised by your response. I was hopeful that, given a new chapter (mom’s life, new year, etc) that you would be more conscientious of working with me as a co- trustee. We need to be able to communicate beyond an email and text here and/ there. I propose we move forward by having communication. How do you feel about that? If you are against a meeting, how do you propose moving forward.

I am not even unwilling to talk with her, but it needs to be structured around something specific, and I don’t feel safe talking with her alone.   ( that was the problem with prior family meetings on the trust).   Beyond that, the trust is updated, fully funded and there aren’t any major decisions.  If she would commit to “ I want to talk about the rental property” or something, so the conversation is productive, I could do it. 

I know she wants to paint me as “ uncooperative” and refusing to engage and partner with her on the Trust.   I need help in responding. 

What I want to say, is I am exhausted and don’t want to be attacked again…. What I am thinking about saying, is “ The Trust is fully funded and up to date, I am unclear what about the trust you want to discuss.   Can we focus on mom’s recovery and comfort right now?”

I am too tired to work on a BIFF response and yet don’t want to further trigger her.   

[kells76]

Hi Mommydoc, it's always nice to see you here -- and first of all,   

If I'm tracking with you, there is 0 work to do with the trust until your mom passes -- correct?

It sounds like your sister is coming up with arbitrary "reasons" to "talk about the trust" -- I mean... "it's a new year"... really?

Let's find you a way to have even fewer "doors open to discussion" with her right now.

If we tweak this a little:

What I am thinking about saying, is “ The Trust is fully funded and up to date, I am unclear what about the trust you want to discuss.   Can we focus on mom’s recovery and comfort right now?”

maybe we can close some doors and get you some safety right now.

It could look like, instead:

Thanks for checking, the Trust is fully funded and up to date.

I'd be concerned that

I am unclear what about the trust you want to discuss.

opens a big door for her to intrude into your life -- too open ended.

And here,

Can we focus on mom’s recovery and comfort right now?

well, if only she would! You can think about, if you want to, including it as a statement about what you will do, like:

I am focused on mom’s recovery right now.

though for some pwBPD, even that is too much "explanation".

I want to send you strength to go "less than BIFF" if you need to -- it could even look like:

The Trust is fully funded and up to date.

Your energy is better spent on you and your mom. There's so much going on in your life in the next few months. It's OK to keep it <BIFF with your sister, because you KNOW you're doing what a trustee should do -- you aren't shortchanging anyone.

Here for you, and hopefully our brainstorming can help you save your mental energy. Let us know how else we can help;

kells76

[Couscous]

I know she wants to paint me as “ uncooperative” and refusing to engage and partner with her on the Trust.

Is there any danger that if she succeeds in doing this that this will give her grounds to attempt to remove you as co-trustee?

[zachira]

Mommydoc,
You are a kind and caring person. It seems you want to treat your sister in the ways you would like to be treated or how you would treat a normal person. The more you explain, the more doors you open for your sister to escalate her abuse of you. Would it be possible to have all communications with your sister go through the hospice staff and lawyers? The only time you may have to communicate with your sister, could be when she is physically present, and then it is probably a question of determining when it is time to exit the conversation as it becomes more unproductive and emotionally overwhelming. With my sister with NPD, we have only communicated through our lawyers in the last few years, and my lawyer gets it that mediation just wastes time and money with someone as narcissistic as my sister. I can't tell you how many times, my sister tried to get me to interact with her through correspondance sent to me from her lawyer to mine or how many times, the  flying monkeys tried to get me involved with my sister and the disordered family members again. It feels awful to have to treat close family members with such distance and low contact, and it is what it is.

[Couscous]

It was wishful thinking, and may also just have been to avoid conflict.   In fairness, at the time, I was still  trying to people please my parents,

Or was it a deliberate move on your parents’ part to assuage their guilt and atone for having played favorites, plus avoiding conflict with your sister, all the while sticking you with the job? Aim addition, this would give them the added benefit of being able to give the appearance of being the the “good guys”, and allow them to to play Rescuer by sympathizing with you while at the same time covertly shaming you for not having better boundaries with your sister.

[GaGrl]

kells76's suggestions for an answer were exactly what I was thinking. Just don't even give her an opening to start something.

[Mommydoc]

Kells76, that was perfect.  I pasted your suggestions right in, and then blocked my phone a couple hours.  Her response was not bad “We should focus on her recovery together. It will benefit her the most! Let me know your intentions on a plan for moving forward.” It really was never about the trust.   I am going to give it a day, and send her an update on my mom via text tomorrow which I have been doing on the days hospice is not there.  No meeting.  Boundary held for now.

Or was it a deliberate move on your parents’ part to assuage their guilt and atone for having played favorites, plus avoiding conflict with your sister, all the while sticking you with the job? Aim addition, this would give them the added benefit of being able to give the appearance of being the the “good guys”

Great points, which I have spent a lot of time in therapy on. My parents felt a huge amount of guilt for playing favorites ( individually at different times they shared that they had difficulty relating to her, her friends and though they loved us both, they also had challenges dealing with her).  They also walked on eggshells with her, but I don’t think either ever figured out she had BPD or went deep enough to develop good boundaries with her. So, yes they definitely did it to avoid conflict.  Do I wish they had made a different decision and have some resentment towards them for my current situation, yes.   Have I forgiven them, yes.  There were definitely decisions THEY made, that she still blames me for, because they never really asserted them with her. Making themselves the good guys.   My sister and my dad had a challenging relationship, but 7 years after he died, she now talks about him,  like he is a God.   And all her unresolved issues and anger with him get projected towards me.   Not fair at all.   I blame my sister for her distortions and  projections, not my dad.   

Is there any danger that if she succeeds in doing this that this will give her grounds to attempt to remove you as co-trustee?

I totally need to hear that… pretty obvious there is no danger there, so who cares how she paints me!  thank you!

You are a kind and caring person. It seems you want to treat your sister in the ways you would like to be treated or how you would treat a normal person. The more you explain, the more doors you open for your sister to escalate her abuse of you. Would it be possible to have all communications with your sister go through the hospice staff and lawyers?

Zahira, this gives me pause. You are right, I am trying to respect the situation, the circumstances, her grief and her disease.  I also want to be authentic to my self and my values.  My T and I have talked about my values/ authenticity versus self protection, boundaries and safety.  Creating a balance that preserves both  ( for me not for her).

One of my colleagues ( also a doctor), shared that he just started “ thinking” of his difficult family member, as one of his patients difficult family member.  It depersonalized it for him. We are all used to dealing with difficult family members, you might get frustrated and it can be draining, but don’t take it personally, you just do it, and you stick with facts, and don’t get sucked into the emotion.   Maybe that is grey rocking.   

I agree that the only way to come out of this with my sanity, is through strong boundaries.  I am really glad my sister finally got an attorney, as I do think letting all the trust/ estate stuff flow through there will be the best thing…. But right now there really isn’t anything to do with the trust.   We did some year end gifting to the beneficiaries ( which the attorneys recommended and agreed to), and I make up she may want to raise that again for 2023….because it is about the money but she can’t say that. 

Hospice in partnership with the facility is doing a great job with communicating her….I am actually working with them to make sure they also set boundaries!

Today, when I visited my mom, she was really tired and so it was mostly holding hands, hugs and kisses. I talked a lot to her and she listened but couldn’t respond. I cried a lot afterwards, but when I left she summoned her energy to blow me a kiss…. So special.   Holding these moments in my heart and also to give me strength for the journey ahead.   

[zachira]

Mommydoc,
It warms my heart to hear how you are spending special time with your mother.

[Couscous]

Are you familiar with the term, the identified patient? Understanding this phenomenon went a long way towards helping me to better understand why my BPD brother developed BPD in the first place.

https://www.psychologytoday.com/intl/blog/making-the-whole-beautiful/202202/how-does-someone-become-familys-identified-patient

[Methuen]

I am late to this thread, but just...wow.  

On Christmas Eve,  while FaceTiming so she could share a lucid moment with my mom, she launched into me, when I told her because mom seemed to be stable, that hospice was encouraging me to go on my trip.   She said some really horrible things about my husband and one of my moms long term care givers,  was all over the place, it was all about her, lots of crazy projections. When she started yelling, I  stepped out of the room, so my mom wouldn’t hear her yelling at me,  but she just kept going on.  I was stunned and said almost nothing, but finally ended the call.

Ending the call was the right thing to do.  The only thing I would say is that perhaps you should have done so sooner, whilst she was saying horrible things about your husband.  That should be a boundary...and would be the time to end it.  The message?  If she is talking to you, she can't cross certain boundaries.  Yelling would be another one of those boundaries...so "I've gotta go.  We can talk more when you are feeling better.  Good bye." Click.  Don't give her a chance to keep going on like that...

I had to learn this.  Our brains are wired to care about people, to hear them out, to try to solve the problem through reason.  It didn't feel natural to me to "end the conversation" with my own mother when she was treating me like this.  I always want to calm her down, to find reason and resolution.  I imagine it's the same for you with your sister.  The thing is, it takes two.  One cannot play that game with any success.

One time I was at my mom's (in the past) she was spewing her toxic bile on me.  I was already at the front door.  As she was screaming I picked up my shoes, and exited out the front door.  I didn't even take the time to put my shoes on.  She opened the door and kept yelling some more at me but by then I was getting in my car, and drove away.  When they are doing this, like it sounds your sister was, there is no way we should enable their behavior by sticking around to receive more of it.  

I'm a big believer in natural consequences, thus the need to leave the situation.  We also have to learn to be ok with our own discomfort of ending conversations with family members who hurt us, regardless of the title of the relationship (sibling, parent).

I support all the great suggestions you have already received here.  

Especially this:

Thanks for checking, the Trust is fully funded and up to date.

Perfect.

She was pretty horrible to me, when I told her that her doctor wanted me to take her to the Emergency Room for treatment, initially she told me COVID is just a virus, she forbid me from taking mom for treatment and launched into (even for her) a pretty horrible rage.

Forbid you?  This is the kind of thing that drives me crazy. My H got similar treatment from his sister over the care of their father.  My mom has behaved in similar ways over her life.  These are power plays. My take is that inside they are "out of control". So to feel in control, they say these things and behave these ways to feel in control and "better".  Except it doesn't work.  She isn't in a place to "forbid" you as HC POA to do anything.  How ironic that it happens to be a "doc" she is talking to, whilst implying that she is the better decision maker by "forbidding you".  Good grief...

I hear you on the emotional toll Covid has had on the HC system, and your ability to manage in your position at the hospital.  To have to deal with your mom's health care crisis (and apparent impending passing) the day after your surgery... the ups and downs of your mom's cycles between living and passing, and through it all a sister engulfed by her own unhelpful thinking and her own needs, my goodness Mommydoc. Any one of those would be enough, but all of them strung together...just too much.

If I remember things accurately, a swimming pool is one of your happy places, or am I misremembering that?  I hope you are finding the space to practice self-compassion and self-care.

It's awesome that you have people to lean on including T.  Before your post, I was thinking of you because I am currently reading a book for reading club titled "We are all perfectly fine" - by Jillian Horton.  It's a novel written by an internist, who turned down an opportunity for a full scholarship to Oxford for a PhD in English to become a medical doctor.  It's full of humour, and for a non-doc reader like myself, the most meaningful and insightful book I have read on the real experience of being a doctor, and practicing self-compassion.  For doc readers, I'm speculating the read would be wildly relatable to many. 

You sound happy and relieved that a replacement has been recruited for you, and you will retire in 5 months.  Huge congratulations.

My advice is to not inform your sister.  You don't want to become more "available" to her.  If you find her texts and emails intrusive now, it could get worse once you are retired.  Both your work and physical distance give you a nice safe boundary from her.  Hang onto that if you can. I am currently working through my own problem of wanting to retire (for the second time), but am sticking with the job for now because it gives me a safe boundary from my 86 yr old waif mom who lives in my small town.  My T keeps advising me to either reduce my hours or retire, but just not inform my mom.  This is hard to do in a small town where everybody knows everybody.  But it may work in your situation.  

Safety first.

 

[Notwendy]

I agree with not discussing retirement plans (both of you). We also keep pertinent information from my BPD mother for different reasons, but one is for privacy and to have some space. BPD mother seems to crave "information"- both positive and if anyone is having difficulties and she can get intrusive with questions.

Her extended family tells each other everything. That's fine if it works for them and they seem to be supportive to each other. BPD mother wants to appear "in the know" but also doesn't respect privacy.

Her FOO is in the know about who their grandchildren are romantically involved with, or their jobs and schools but they are OK with this. It upsets BPD mother when I don't discuss my kids' romantic interests or their plans or their jobs or even their disappointments as she wants to be able to share this information with her FOO. It's not hers to share. I don't discuss anything work related with her. If I did retire, I would not tell her as I also wish for my time and privacy to be respected.

[Mommydoc]

It’s a great point.  My sister makes snide comments about my job and my life all the time and so I share almost nothing with her at this point.  It just makes her resentful and she always needs to one up me.  I announced my retirement 7 months ago, but have not mentioned it to her.  During the pandemic, she wanted to know details about how impacted our hospital was.  She was very distressed about my mom being in lock down (as was I).  It was a huge mistake to share anything because it turned into, “you are overwhelmed, it is not safe there for mom, we need to move her close to me. I can take care of her. ”  Lesson learned. I tell her nothing about myself or work now.  I like the boundary, of “ I am working”.  Methuen, I like the idea of you cutting back and NOT telling your mother. 

Ending the call was the right thing to do….. Our brains are wired to care about people, to hear them out, to try to solve the problem through reason.  It didn't feel natural to me to "end the conversation" with my own mother when she was treating me like this.  I always want to calm her down, to find reason and resolution.  I imagine it's the same for you with your sister.  The thing is, it takes two.  One cannot play that game with any success.

This is something I am continuing to work on.   I think you are right, it does feel unnatural and I may not be doing it quickly enough.   I have made huge progress however.  One thing I notice, is that even though in all conversations, she dominates, talks over me, and when she starts yelling or saying inappropriate things, I say the same thing, “ I need to end this call, it’s not working for me”….that is very triggering for her…. She interprets it as me being angry at her… even though I am very calm when I say it.  On Christmas Eve, I was way too vulnerable and not prepared, so I let it go on too long, but when I did say that, she said, “ that’s what you always say when I want to talk, it never works for you”  I could be more casual about it, but I worry she would just call back or want to talk later the same day.  When she does this, I want her to get that I really am ending the conversation, not pausing it to be resumed later.

While  my mom was very sick and not expected to make it more than a couple days, I did talk on the phone with her frequently which was appropriate, but now that mom is stable, it is clear she wants to go back to “ moving forward and collaborating as Co-Trustees”.  She is determined to not do that via text and email. Her attorney has been out of the country, and at present there is nothing actionable, so I am trying to kick any discussion of the trust down the road.  Hospice Team, PCP and Facility are giving regular updates, so we really can go back to LC.  Unfortunately, she got a taste of what she calls “our sister bond” and wants it again. 

I am feeling a lot better today.  I haven’t texted or emailed her in a couple days and we averted the family meeting. I am visiting my mom daily, and she and I are almost hitting a cadence with her finally getting a more predictable schedule and me knowing how to balance it with work.  The visits are a big reality check for me, and I am moving into a greater awareness of my grief (because I finally have space!)….it’s painful, but it also feels good.  On Thursday a colleague of mine lost her 11 yr old in a tragic accident on the playground.  It puts it all in perspective.  My mom has had an amazing life, and when she can express herself, she expresses love and joy.   I am just trying to soak up every little ounce of her that I can. 

Hospice is encouraging me to tell my sister about my next planed vacation… its 5 weeks away.  Even though she knew about my vacation over New Years, she claimed I was abandoning mom if I went and demanded I not go. She also claimed I gave her no notice, also not true, she knew at least 6 weeks before hand, before my mom got really sick.  I ended up not going because even though my mom was improving and seemed stable, the prior weeks had been so up and down, that I didn’t feel confident.  I don’t want her permission to go in Feb and definitely don’t want  to be told “you can’t go “ again.  I don’t think she needs to come, but  I also would be OK if she came while I was away.  I am even OK at this point, with the trust paying for it, but that is what the 2022 gifting was for.   

I would appreciate advice on what to do with this.  If my mom suddenly worsened again, I can get home fairly quickly. But I think it would be bad if my mom found out from the facility or hospice that I wasn’t there.  I think her desire to come if I am away is reasonable, I just don’t want to be dependent on her coming or “ in debt to her” .   

[zachira]

Mommydoc,
I have some questions about telling your sister about your vacation:
How far away does your sister live and how far in advance would you need to tell her?
I am thinking that the later you do it, if you decide to do so, the less havoc your sister can create.
How long are you thinking of being away for?

[Mommydoc]

I will be a 2 hour flight away while on vacation.  My sister lives on the other side of the country , so more like a 6 hour flight.   My tickets are for 10 days, but I am considering shortening the trip for a few reasons. 

Hospice team feels I should tell her sooner rather than later, as they think she might plan a trip and it would be easier for her to plan if she had notice, which seems reasonable  ( she has been sharing with them why she was upset about my other trip, even though she is not being truthful about when she found out)