Borderline Mother who won't follow medical advice

[Depression = 72% of members]

Hello.  I have posted before when I was not in contact with my mother for a while.  I had a break and then decided to go back in - given she is elderly and I was finding it stressful for myself, so I really went back in for my peace of mind, not so much for her as we don't have a close relationship.  Since then one of my 2 brothers has gone no contact - and I think he will stay that way.

I was wondering if anyone has some wisdom for this specific issue.  My mother is in a nursing home and constantly demanding to see the doctor.  She calls for out-of-hours doctors too.  She has gone so far without too many medical issues but now she has recently been diagnosed with diabetes and she has a cough and diagnosed with asthma.  But she has a real issue with taking medication.  I think it may be anxiety/fear phobia around taking meds, so I try to be compassionate in myself about that.  She doesn't say that.  She says they give her side-effects, she's cured now so she doesn't need them.  etc. 

Lately she rang me again in a dysregulated state about her cough and not getting medical attention.  I told her to see her doctor when she can.  She rang back that he had said she should be on Serotide (which is a preventer).  She had been on it before and stopped.  My husband has asthma and works for the asthma foundation so I know a bit about managing asthma.  I explained to her it is a preventer and she will need to keep taking it every day even if her symptoms go away.  My husband has to also take a preventer every day. 

Two days later she rings and says she took it for a few days and the RN at the Nursing home came in and cheerfully (in her voice) said 'Oh you look so much better!  I don't think we need to bother with that Seretide anymore.  It's done the job'.  I tried again calmly explaining that's not how it works - it doesn't cure the asthma - it is called a preventer because it prevents the asthma by keeping airways open.  I said she should talk with her doctor about it.

She also stopped taking her diabetes medication after a few days as her bloods had gone down so now it was ok. 

Anyway - my main question I have is how to handle this as she is going to call me again sometime soon saying she has a terrible cough, she's choking to death and the nursing home won't call a doctor. 

I realise today I feel quite angry about it.  When thinking about what I'm really feeling underneath I think is the wish she could be honest about her anxiety and why she stops.  I am pretty sure the story with the RN is made up.  It's not like that hasn't happened many times in the past.  So I guess I also feel disrespected.  That she wants my attention and sympathy but when I give her advice she doesn't take it.

I wondered if I should either:  talk to her about how I've noticed she doesn't like taking medication and perhaps there's an underlying anxiety she could talk to her doctor about.  That's a risky option as her defences may mean she gets angry and it won't go well.

Do I just say every time she comes to me about her terrible pains, sicknesses etc - Sorry to hear that, I'd talk to your doctor (Oh they won't get me one!) Well, I'm sure they will see you sometime so talk to them when you do.  Repeat Repeat Repeat.  And not try advising even though I'm just giving the basic what anyone with asthma etc would know.  I checked on the internet and saw multiple articles saying NEVER stop Serotide without your doctor telling you to etc etc.   Doing so can actual make your breathing worse : (

Or any other suggestions would be appreciated.  I'm going to go out today and try to do something nice for myself as I can feel myself just getting into a worrying loop obsessing about her medical conditions.  {Sigh}.

[Flannelflower]

Hello.  I have posted before when I was not in contact with my mother for a while.  I had a break and then decided to go back in - given she is elderly and I was finding it stressful for myself, so I really went back in for my peace of mind, not so much for her as we don't have a close relationship.  Since then one of my 2 brothers has gone no contact - and I think he will stay that way.

I was wondering if anyone has some wisdom for this specific issue.  My mother is in a nursing home and constantly demanding to see the doctor.  She calls for out-of-hours doctors too.  She has gone so far without too many medical issues but now she has recently been diagnosed with diabetes and she has a cough and diagnosed with asthma.  But she has a real issue with taking medication.  I think it may be anxiety/fear phobia around taking meds, so I try to be compassionate in myself about that.  She doesn't say that.  She says they give her side-effects, she's cured now so she doesn't need them.  etc. 

Lately she rang me again in a dysregulated state about her cough and not getting medical attention.  I told her to see her doctor when she can.  She rang back that he had said she should be on Serotide (which is a preventer).  She had been on it before and stopped.  My husband has asthma and works for the asthma foundation so I know a bit about managing asthma.  I explained to her it is a preventer and she will need to keep taking it every day even if her symptoms go away.  My husband has to also take a preventer every day. 

Two days later she rings and says she took it for a few days and the RN at the Nursing home came in and cheerfully (in her voice) said 'Oh you look so much better!  I don't think we need to bother with that Seretide anymore.  It's done the job'.  I tried again calmly explaining that's not how it works - it doesn't cure the asthma - it is called a preventer because it prevents the asthma by keeping airways open.  I said she should talk with her doctor about it.

She also stopped taking her diabetes medication after a few days as her bloods had gone down so now it was ok. 

Anyway - my main question I have is how to handle this as she is going to call me again sometime soon saying she has a terrible cough, she's choking to death and the nursing home won't call a doctor. 

I realise today I feel quite angry about it.  When thinking about what I'm really feeling underneath I think is the wish she could be honest about her anxiety and why she stops.  I am pretty sure the story with the RN is made up.  It's not like that hasn't happened many times in the past.  So I guess I also feel disrespected.  That she wants my attention and sympathy but when I give her advice she doesn't take it.

I wondered if I should either:  talk to her about how I've noticed she doesn't like taking medication and perhaps there's an underlying anxiety she could talk to her doctor about.  That's a risky option as her defences may mean she gets angry and it won't go well.

Do I just say every time she comes to me about her terrible pains, sicknesses etc - Sorry to hear that, I'd talk to your doctor (Oh they won't get me one!) Well, I'm sure they will see you sometime so talk to them when you do.  Repeat Repeat Repeat.  And not try advising even though I'm just giving the basic what anyone with asthma etc would know.  I checked on the internet and saw multiple articles saying NEVER stop Serotide without your doctor telling you to etc etc.   Doing so can actual make your breathing worse : (

Or any other suggestions would be appreciated.  I'm going to go out today and try to do something nice for myself as I can feel myself just getting into a worrying loop obsessing about her medical conditions.  {Sigh}.

[Notwendy]

I think we might have the same mother!

Actually, there are some of us here who have elderly mothers who are not compliant with their medical care. It's difficult because we wish they would cooperate- but if they are legally competent- they make their own decisions about this.

My mother is also in assisted living and is demanding about medical care- and then doesn't cooperate with the advice given.

She's a behavior problem to the staff there- pushing the alarm button for immediate care when the issue isn't urgent, or calling for the nurses frequently. While the staff there still does their job, her behavior has had an effect on them too- they aren't as likely to want to chat or spend more time with her than they have to. So she feels she isn't getting as much attention.

I will get a call at 8pm "nobody has been in my room to see me and nobody is coming to see me" If I ask questions, she becomes vague with her answer but if I do call the staff- I find out she had dinner at 6 pm and gets her medicine between 8 and 9 and it's been two hours since someone has come to see her, not all day.

The situation with this is that she calls to ask me to call the nurses for her. She can make a phone call herself- she's on the phone with me- so she can call them, but she wants me to do it for her.

Similarly- your mother is in a nursing facility. There's a nurse down the hall- right? If she is calling you to call the doctor- she can call for the nurse or doctor herself! If your mother has a cough- the nurses come to give her her medicine and check on her. They will be aware of it.

One possible reason your mother is calling you to do this is that - with my mother, she calls so much for nothing- she's been asked to not do this and to only call for something if she needs it urgently. If I call- that doesn't "count" as her calling.

The other is that my mother has a need for people to do things for her. It's an emotional need. Calling me to make a phone call for her is an example- if she can call me, she can also call someone else- but she needs for me to do it. She is like this with other people too- they must be in some sort of active service to her.

It's difficult to be completely out of this situation with her as I have power of attorney and medical power of attorney and she's at the point where she needs some assistance with making her payments for bills and also at times, she's been ill and her medical staff has called me to consent. But mostly she's been in the position to make her own decisions and either doesn't cooperate or undoes any plans set up for her.

She's had infections and then refused to take her antibiotics. I called for her to be sent to the hospital to be evaluated and she refused treatment there. If she refuses to take antibiotics, or let physical therapy evaluate her, or keep her bandages on, there wasn't much else that the medical providers could do.  She was then transfered to Hospice/Palliative care and she's actually done better with that as she has more contact with nurses and the care is more comfortable for her. However, she complains about that too.

I understand that you want to be a good daughter and do the right thing for your mother. I do too, but it seems that whatever effort I make, she either finds something wrong with it or doesn't cooperate. For a while, it was a lot of chaos, a lot of phone calls from the facility. My best advice to you is to step back from doing things your mother can do for herself. If your mother is in a care facility- there are nurses there, social workers, and a doctor, PA, or nurse practitioner they can call if needed. You don't need to feel responsible for her medical concerns or for her to take her medicine. Let the medical staff there take note of that. Although your mother may feel you need to do this- you don't have to- she has medical care right there for her.

I had concerns about my father during the time he was ill and called social services to see if I could intervene. I've posted their response to help others too. It was "your father is legally competent to make his own bad decisions". I've asked about this with my mother too and gotten similar answers.

If your mother is legally competent to make her own decisions, she can refuse to take her medicine. By calling you, she puts you in "rescuer" position on the Karpman triangle dynamics. Of course, you take action because you care but also you see there's something about this dynamic that isn't working. It would be one thing if your mother had no access to medical care at all- you'd be trying to get her to medical care (she could still refuse) but she is already in a care facility. She has medical care if she wants it. You don't need to call the doctor for her, or to discuss why she needs to take her medicine.

I think you are correct that what your mother is doing is due to her anxiety. This is similar with my mother. You also see that these frantic calls are according to what she is feeling, not what is actually happening. You also see that when you step in to try to solve the situation for her, it doesn't work because her anxiety is her feelings and you can't control her feelings or solve them for her. For me, the only "solution" is to step back and not try to advise or fix the issue for her. It's not effective anyway. You aren't neglecting her by stepping back because she has medical help right there in the facility. You may feel you need to assist due to the dynamics but you don't. Medical providers are there if she needs them even if she feels they aren't.

[EyesUp]

You two might be my sisters from other misters...

My relationship with my mother didn't bring me here, and I don't think she has BPD, however she is immune to advice and generally goes with whatever she hears last or feels will be easiest/least costly - which is often a shortcut and not really effective.

This applies to healthcare decisions, financial decisions, you name it.

Here's what I've learned:

Much like anyone with BPD, I cannot make all my mother's decisions for her, I'm not truly responsible for her (although I do feel some obligation...), and she has the right to make her own decisions - which, like anyone else, may or may not align with decisions I would make or prefer her to make.

Her late husband, my stepfather, had diabetes and was the same way:  utterly indifferent to doctor's orders.  He would gleefully drink sugary soda and eat sugary snacks and declare that as long as his levels were ok, he'd be fine.  When pushed, he would admit that he'd prefer to enjoy food and have a shorter life. He got his wish.

Unless you are your mother's healthcare proxy or have power of atty, you need to try to separate your emotional motivations and compassion for your mother from her right to make her own decisions, however impulsive or poorly informed they may be.

$0.02

[Flannelflower]

Hello NotWendy & EyesUp,

Thank you both for your thoughts.  Very many similarities NW - my mother does the same with constantly ringing the buzzer, no one takes me out etc.  A couple of the staff there have actually resigned and left the NH as they couldn't cope with the abuse etc.  I do feel for them too.

That's true EyesUp - there is a lot of medical non-compliance around which is not related to BPD. 

I think the advice you have both given me to step back and allow her to make her own decisions is helpful.  I cannot control what she does and regardless of my opinions she is going to do what she wants to anyway so what can I do....

I was thinking yesterday what I find hardest is I wish she was like your step-father in that regard - that she was making informed decisions and deciding she knows the risks but prefers to do what she wants.  And if she told me - I know what you're saying but you know what - I don't care and I'll do what I want.  I think I would find that easier to accept.  But I think she is making decisions based on faulty reasoning and fear etc. which makes it harder to accept she gets what she is doing and the decision is hers. 

But at the end of the day whatever the reason it still comes back to the same point you both made - that I can't control her choices and why ever she makes them doesn't change that. 

The comment you shared NotWendy "your father is legally competent to make his own bad decisions" is a good one for me to remember and tell myself. 

I think growing up we were pretty well trained by our dad to always "look after mum", stand up for her to anyone, agree with whatever she thought that its hard to shake that inbuilt programming.  He's not here anymore so she doesn't have that person fighting her battles.  But I will have to continue to resist that urge to feel responsible for making her happy and making sure she does the right thing. 

[Notwendy]

Hello NotWendy & EyesUp,



I think the advice you have both given me to step back and allow her to make her own decisions is helpful.  I cannot control what she does and regardless of my opinions she is going to do what she wants to anyway so what can I do....

I was thinking yesterday what I find hardest is I wish she was like your step-father in that regard - that she was making informed decisions and deciding she knows the risks but prefers to do what she wants.  And if she told me - I know what you're saying but you know what - I don't care and I'll do what I want.  I think I would find that easier to accept.  But I think she is making decisions based on faulty reasoning and fear etc. which makes it harder to accept she gets what she is doing and the decision is hers. 

But at the end of the day whatever the reason it still comes back to the same point you both made - that I can't control her choices and why ever she makes them doesn't change that. 

The comment you shared NotWendy "your father is legally competent to make his own bad decisions" is a good one for me to remember and tell myself. 

I think growing up we were pretty well trained by our dad to always "look after mum", stand up for her to anyone, agree with whatever she thought that its hard to shake that inbuilt programming.  He's not here anymore so she doesn't have that person fighting her battles.  But I will have to continue to resist that urge to feel responsible for making her happy and making sure she does the right thing. 

This last paragraph- this is the hardest, because I think we were trained to look after our mothers.

After my father passed, my BPD mother did well on her own for a while. I was concerned about her mismanaging finances and asked my father to allow me to assist with that. She refused and kept us kids out of any information. Her doctor didn't even have a consent to speak to me. She wrote me out of her papers/will but then "reowned me" later. So we didn't know anything about her decisions for a while.

During a visit, we kids found in her papers that she had taken out a home equity loan and didn't tell anyone. Although I don't know how much money my father left, I know it was enough for her needs if it was managed. This indicated to us she was having financial isssues. We asked for information. She refused, and we didn't ask further.

Eventually, her extended family asked about what was going on and I told them. I also told them that she didn't listen to any advice for me and there was nothing I could do. (Although I had POA - as long as she is legally competent, so is the legally competent to make bad financial decisions). So they offered to try to advise her and she rejected their advice too.

Eventually we had to move her to assisted living. She needed assistance at that time and had spent most of the equity in her house and if she continued, the bank might have repossesed it.  We sold the house and put the money in her account. She's spent most of that now too. Her version is that we "forced" her out of her house. There was no way she'd be able to move or sell the house on her own- we helped her do it.

I consulted an elder care attorney to see if there was some way to protect her money for her needs. I'd have had to have her certified legally incompetent and take her to court and I would surely lose as she can hold it together for a mental status test. Same for medical decisions. So long as she is legally competent, she can do what she wants with her money and her medical care.

I think it's been possible to step back from trying to "advise" her as I know the limits of what I can do. I also saw that when her extended family tried- it didn't work either- and they too feel they have done all they can do. As long as someone is legally competent- they can make their own decisions. My BPD mother insists on being in control of her own decisions.

[Methuen]

Two days later she rings and says she took it for a few days and the RN at the Nursing home came in and cheerfully (in her voice) said 'Oh you look so much better!  I don't think we need to bother with that Seretide anymore.  It's done the job'.

It just seems highly unlikely that a health care worker would say this against doctors orders (a prescription).  More likely, your mom heard what she wanted to hear. pwBPD do that.
If you know the day and time your mom claims the RN said this to her, you could speak to her case manager or person in charge at the nursing home and share your concern.  See where that goes.  

I think refusing medication must be part of the disease.  There have been so many similar stories shared on this board with my mom being one of them.  The best part?  My mom was trained as a nurse in the 1950's.    Mom was diagnosed with Parkinson's disease a few years ago.  I was with her at the appointments where the specialist took her history and did the tests.  The Parkinson's is obvious even to a lay person, so the diagnosis wasn't a surprise.  Mom's response?  (Keep in mind she was a trained nurse...) She self-diagnosed as "essential tremor", and refused the medication saying "it was going to kill her".  A year and a half later, a best lifelong friend of hers had her husband diagnosed with Parkinson's and told mom "how much the medication was helping him".  Low and behold mom decided she did have Parkinson's and told her Dr she wanted to start the levadopa.  Then she said how much the medication was helping.  That's how it goes with this disease.  There's no rational thinking.

Trying to reason with them is a waste of both time and energy.  In my experience, trying to have a rational conversation just escalates their emotions because they don't feel validated.   The only way they will start taking medication is if they come to decide it will benefit them.  A doctor telling them that is dismissed.  They have to figure it out on their own.  It always comes back to control.

[Flannelflower]

Wow - what a lot to go through with your mum's finances as well NotWendy.  I'm fortunate in one way that my mum doesn't have any assets.  She gets assisted living through the government because of that.  But the same sort of things have happened with her telling one of my brothers that my other brother and I were plotting to get Power of Attorney over her (totally not true) and just the suspicion and things sounds similar where they are suspicious and can't accept you might be trying to do something to help them.  I can understand it would have felt easier after your other relatives tried and failed to help.  It really shows the difficulty lies with them and not you or anything you can do. 

Thanks Methuen.  I totally agree that its very unlikely the health care worker would have gone against the doctors prescription for her.  I think you are right it is what she wanted to hear.  I had thought of ringing the NH to check on it.  Last time I did that I found out she was lying about something else and everything went pear-shaped so in some ways I'm reluctant to find out!  My brother is the main contact so I'm thinking they will call him to discuss her medication refusal if they need to as well.

It is strange how this seems to be part of the disease.  It's not something included in the symptoms but seems to be common.  It's good your mum finally got to the Parkinson's medication though it took a while.  I agree control is a big thing for my mum too. 

I actually feel a bit annoyed with myself for falling into the trying to reason when I should know better by now.  I really hope that I can resist trying to convince her of doing as she has been told by her doctor again as it just makes me feel frustrated.  A 'I don't know - better talk to your doctor' about any medical stuff is what I hope I can do from now on : )

[Notwendy]

I understand feeling annoyed with yourself but please consider that we are trained to take on this role - and it’s uncomfortable to not be trying to help. It did help to see that my mothers relatives were not successful. I was concerned they might be judging me for not helping enough. For my mother - I don’t think she feels what anyone does is enough.


I also reply « -ask your doctor or nurse «  to any medical related questions and I refuse to discuss money management. It doesn’t do any good so it seems pointless to try.

[Methuen]

I have gone back and re-read your original post.  It seems to me you are kind of where I was 4-5 years ago, which is a very very different place than I am now (read dozens of books, years on this forum, and years of therapy).  Our mom's seem painfully similar.  So I'm going to try to be what I hope is helpful, and share my experience, and put my spin on some of what you are reporting, so that hopefully you can see another perspective, and not suffer as much unnecessarily for so long, with an impossible mother.

My mother is in a nursing home and constantly demanding to see the doctor.  She calls for out-of-hours doctors too.  She has gone so far without too many medical issues but now she has recently been diagnosed with diabetes and she has a cough and diagnosed with asthma.  But she has a real issue with taking medication.  I think it may be anxiety/fear phobia around taking meds, so I try to be compassionate in myself about that.  She doesn't say that.  She says they give her side-effects, she's cured now so she doesn't need them.  etc....
Lately she rang me again in a dysregulated state about her cough and not getting medical attention.  I told her to see her doctor when she can.  She rang back that he had said she should be on Serotide (which is a preventer).  She had been on it before and stopped.  My husband has asthma and works for the asthma foundation so I know a bit about managing asthma.  I explained to her it is a preventer and she will need to keep taking it every day even if her symptoms go away.  My husband has to also take a preventer every day. 

Two days later she rings and says she took it for a few days and the RN at the Nursing home came in and cheerfully (in her voice) said 'Oh you look so much better!  I don't think we need to bother with that Seretide anymore.  It's done the job'.  I tried again calmly explaining that's not how it works - it doesn't cure the asthma - it is called a preventer because it prevents the asthma by keeping airways open.  I said she should talk with her doctor about it.

She also stopped taking her diabetes medication after a few days as her bloods had gone down so now it was ok. 

Anyway - my main question I have is how to handle this as she is going to call me again sometime soon saying she has a terrible cough, she's choking to death and the nursing home won't call a doctor. 

I realise today I feel quite angry about it.  When thinking about what I'm really feeling underneath I think is the wish she could be honest about her anxiety and why she stops.  I am pretty sure the story with the RN is made up.  It's not like that hasn't happened many times in the past.  So I guess I also feel disrespected.  That she wants my attention and sympathy but when I give her advice she doesn't take it.

This.

Are you familiar with the term "parentification"?  Because when I read this again, and observe it from where I am, you are clearly trying to take care of her. This is reasonable in the context of normal aging with mentally healthy parents, but where BPD is involved it's more complicated because they have groomed us from our childhood (when we are vulnerable with undeveloped brains that don't yet think critically) to take care of them, physically, emotionally etc.  Does that make sense?  For example, for me, I have memories back to the age of 5 where I was taking care of my mom "not feeling well", and running as fast as I could to do it.  These are not happy memories.  She was demanding.  I was her nurse.  I was not a "child". But over my life, I never realized that wasn't normal, because it's the way I grew up.  I thought everybody did that kind of stuff for their mom.  What I see in your story, is that you may have been trained to take care of your mom too.  This is a typical pattern in pwBPD.  They need this attention, and servitude. I know the asthma cough you are talking about because my son has it.  He developed it as an adult, and saw a Dr when he was staying with us for a few weeks. He follows his doctor's orders.  Then he feels better.  My H also has allergies and develops all kinds of symptoms this time of year, for which he also has to take medications.

Reasonable people who want to feel better will follow Dr orders.  If your mom is stopping her meds (Serotoide), or otherwise not following instructions, then maybe it's not really bothering her as much as she claims.  She is an adult and has the right to make her own bad decisions.  The ONLY way she will learn, is if she experiences the natural consequences of her decisions. I suspect most pwBPD are also a bit narcissistic, so the only way they will change course is if THEY decide it is best for them because they are never wrong! Or, perhaps if her best friend (golden person) happens to tell her the Serotide works for her or her husband she will start taking it as prescribed (this is how my mom started taking her Parkinson medication after almost 3 years of not taking it).   

As for often calling the doctor, and then claiming she is not getting help, then not following instructions when she does get help (exactly like my mother), another perspective to this is to recognize 1st of all that she wants to live.  Accept that and suddenly everything changes.  Notice who she is reporting all this to.  You.  She is causing chaos, and expecting you to "fix it".  That is what they (BPD's) do. Enter "parentification".  From childhood, we have been groomed to recognize their moods and also take care of all their physical and emotional needs.  I now suspect the fact that we carry this from childhood into adulthood is a kind of "procedural learning" - kind of like riding a bike or getting dressed.  We just do it without thinking about what we are doing.  Thus we become the parent.  They are the child.  This is what they want.  But it's really messed up and it messes us up, because as we eventually figure out after years of struggle and emotional pain/trauma, they don't want our help, they don't accept our suggestions or advice (even when it is to protect their health or life), and conflict inevitably ensues in the relationship.  We can never be the daughters they want us to be because what they want isn't reasonable, sometimes not rational, and sometimes not even safe or healthy (emotionally, financially, physically....etc).

My advice is to stop acting as her "responsible caregiver" i.e. parent.  I am not suggesting you don't see her or support her.  I still visit my mom.  Bring her "treats", and talk about things I'm comfortable talking about with her. In a way this works well for her.  She gets my time and attention when I choose to give it. But I have boundaries.  So for example, when she starts gossiping (which I ABHOR) I change the subject, and if she comes back to it, I more overtly say I'm not comfortable hearing those things about someone else without them being present, and then if she doesn't stop, I simply look at my watch and say I have to go.  Every visit I have with her triggers me.  100% of the time.  The contact distresses me.  Although I hide it and don't let her see it because I am not a fool. In this way, I still feel I am doing my "duty", which fits my values.  But, while it works for her, it's truly not working for me.  I am not in a mentally healthy place right now.  And this has resulted in all kinds of physical manifestations.  I am 62.  She has harmed my well being.

At least your  mom is in a place where she has access to care.  If she chooses not to receive it or follow Dr orders (take her prescriptions), well, she's an adult and it's NOT YOUR JOB to try to change her mind.  That's the parentification (role reversal) taking over, and in my experience, it will NEVER END THE WAY YOU HOPE IT WILL because of the underlying disease.  And that is not yours to fix.  Counsellors and even psychiatrists are unsuccessful treating these people, so how can we reasonably think we can make a difference and help them see reason? Our love makes us have hope we can make a difference, but sometimes love is not enough.

But she has a real issue with taking medication.  I think it may be anxiety/fear phobia around taking meds, so I try to be compassionate in myself about that. 

You are making excuses for her.  Even if this is true, let it be up to the medical staff to address that.  They are the professionals.  Understand that you cannot fix this.  I could not "fix" my mom.  I was so kind and loving and forgiving and compassionate, and attending to her needs all my life.  I burned out.  What I failed to do until recently was "ACCEPT" her and her disease. 

This is where I am coming from when I say to let her make her own decisions.  She does want to live.  When her cough (or her diabetes) gets bad enough, she's in a place where they have the resources to help her or save her life if it comes to that.

My mom chose blindness in one eye over having home care come in 2X a day to dispense the necessary drops.  She hated having people "she didn't choose" come into her home to dispense medication.  She wanted me to do it for her.  I was working.  "But if I loved her I would do it".  That's emotional abuse.  It's all about control.  Now she complains all the time that she can't see out of that eye.  I ignore it and change the topic.  Once I told her that she still might have that vision if she had kept her home care.  She changed the topic.

That says it all.

So.  My advice?  Save yourself.  Live YOUR life (not hers).  Don't try to be her caretaker because their disease destines this to be a failure.  Anything you do will never be right, or good enough.  And another thing I learned?  The harder you try, and the more you do, the more they mistreat you.

So.  Just ACCEPT it is what it is.  Let her do it her way.  She needs to figure it out her way. 

she is going to call me again sometime soon saying she has a terrible cough, she's choking to death and the nursing home won't call a doctor. 

So if you step back and look at this objectively (pretend it is someone else's mother) based on everything you have shared, can you see how crazy this behavior is?  First of all, she's not choking to death - they exaggerate and dramatize everything X100 or X1000.  If she was choking to death, she would call for help because nobody wants to die that way.  She's manipulating you to fix her problem which she's created.  This is crazy. She just has to take her medication, right? I had to learn to step away from that role (of "fixer"), and I will admit it was hard and painful.  One of the things I am working through now with my therapist is that I was NOT a failure as a daughter, despite what my mother makes me feel.  I was an amazing daughter with a lifetime of stories to support that with so much loving evidence, but while my mind knows this to be true, my psyche and heart are ripped to pieces.  I feel broken.

Celebrate that she is at least in assisted living.  At least you don't have to mow her lawns, fix her dishwasher and leaky faucets, bath her, fix her hair etc because those services are available there (probably for a fee). My mom has refused assisted living, and relies on me, H, and a few enabling friends to "meet her myriad" of needs for her "independent living" which trust me, is not independent.  This is her way of controlling us.  She is as dependent as an 8 year old, and for example, relies on the kindness of others to bring her meals because she doesn't cook for herself. But she lies to home care on her RAI assessments and tells them she does her own cooking, and they just accept that as fact.  She has been determined to be competent.  I used to bring her meals 3-4 times a week.  Now I might bring her something once or twice a month.  Otherwise, it's just enabling.  And as you can probably tell, my H and I resent that her right to live in her own home and not accept any home care services, has left us and a few of her friends indentured to meet her needs.  Any time we leave to go on a holiday she screams that "we don't love her" because she feels abandoned.  She is not appreciative.  She is not grateful.  She is negative. She is hostile.  She is mean.  But to everyone else she is charming.  She is an impossible burden.  But she has chosen to live alone in her home.  That is on her.  I have done everything humanly possible for 6 decades, and am now burned out.

Save yourself my friend.

NW always says being in assisted living doesn't change anything.  This is true, because the underlying disease is still present. The behavior patterns will stay the same - just in a new environment. But at least you can go away and know that someone is watching over her, and not feel responsible for whatever terrible thing happens while you are away.  That is no way to truly be able to "enjoy" a holiday.  Remember, that as "parentified children", we have been groomed to feel responsible for their wellbeing, and after a lifetime, that feeling doesn't just "go away".  Even if we understand cognitively we have the right to a holiday, the " terrible feeling" of "what if she's lying on the floor for 3 days without being found" is there the whole time.  What if  a fire burns through and the area has to be evacuated?  She will burn alive unless someone finds her.  Yet she refuses to have home care "safety checks" while we are away. She refuses to give us that because she thinks we should never go on holidays and "leave her".  So I am happy for you that she's in assisted living.  That's something. 

I wondered if I should either:  talk to her about how I've noticed she doesn't like taking medication and perhaps there's an underlying anxiety she could talk to her doctor about.  That's a risky option as her defences may mean she gets angry and it won't go well.

Do I just say every time she comes to me about her terrible pains, sicknesses etc - Sorry to hear that, I'd talk to your doctor (Oh they won't get me one!) Well, I'm sure they will see you sometime so talk to them when you do.  Repeat Repeat Repeat.And not try advising

  You're parenting her again.  Don't advise.  She doesn't want your advice.  She wants attention.  And if she's like my mom, she thrives on "being bad" and causing chaos. This chaos seems to be what feeds them and gives them energy.  The more you parent her, the more resistant she will become.

But if she ever tells you she took her Serotide, be sure to give her attention for that.  Look for opportunities to give "positive reinforcement".  Avoid giving her attention for bad behavior, because that just reinforces the bad behavior.

I've learned it all the hard way.  I hope you don't have to.  Just stop being her parent because it's destined to fail, and will only wreck you.  Save yourself.  Let her be her.

[Notwendy]

I agree with Methuen- while it's more "normal" to be in a caring and parenting position to an elderly parent- this is a position we were trained to be in at a younger age. It feels almost automatic to step in to it. Conversations with my mother are about what is bothering her- and so we then advise.

I learned something interesting-but useful- that advising my mother also feels invalidations. It's as if we are trying to help- but to her- she perceives it as invalidating. I realized this when sharing an experience. I had some construction work on my house and forgot to cover a shelf- and I then had to clean the dust off everything. My mother was also having some work done and I - without thinking-  mentioned "better cover that bookshelf nearby".

She blew up- I didn't expect that reaction. It was only a suggestion. And it is her indignation at being expected to do something. She reacted as if I expected her to climb up a large bookshelf. Of course not- she could ask the workmen to do that. "How dare you expect me to climb that bookshelf" and then the "I know what to do" and how dare you assume I don't know that.

She's often replied to suggestions that "I know what to do, don't assume I don't" and with indignation when asked to do something.

My BPD mother also has NPD traits and a sense of entitlement. It's expected that people do things for her. You don't dare ask her to do anything.

I think some aspects of being in assisted living is better than if my mother were in her own home. I also don't live near her so she doesn't call me for everyday tasks and there are nurses and people to help them. However, it's still frequent issues as she still has BPD. I am in a sort of parental position in that I am the "next of kin" who is called but it's also because I chose that- she doesn't really have anyone else who would be called. I do what I can but I don't make decisions for her. There have been times when she was ill and unable to do that and the medical staff has called me,  but when she recovers, she has undone them.

There was a time she was in skilled nursing care and the staff thought she should stay there for the higher level of care. They called me and I agreed (I think she needs it actually). We had a family meeting with the staff and she blurted out that "her family was trying to force her into a nursing home" and had enlisted some of the staff to defend her. None of this was true. So she's in assisted living care at a lower level of care. I don't blame her- being in skilled nursing has drawbacks but the way she went about it and accusing us- I won't get involved in such decisions now.

I don't try to advise her with her money. She asked me the other day for my advice and I said no, I'm not going to do that. I don't trust her to not somehow perceive advice into something else or to make a false accusation.

[Flannelflower]

I have gone back and re-read your original post.  It seems to me you are kind of where I was 4-5 years ago, which is a very very different place than I am now (read dozens of books, years on this forum, and years of therapy).  Our mom's seem painfully similar.  So I'm going to try to be what I hope is helpful, and share my experience, and put my spin on some of what you are reporting, so that hopefully you can see another perspective, and not suffer as much unnecessarily for so long, with an impossible mother. This.

Are you familiar with the term "parentification"?  Because when I read this again, and observe it from where I am, you are clearly trying to take care of her.

Hello Methuen.  I want to thank you very much for taking the time to think more about my situation.  What you have written was actually very impactful for me.  I had quite a few "aha" moments when reading your post.  I am going to take some time to really think about what you have said as I think you have hit on quite a few things that I wasn't seeing so clearly.

I have heard of 'parentification' in the course of my reading and a while ago when I had some therapy.  But interestingly I have only ever applied it to what happened to me as a child.  That as a child I was 'parentified' by my mother (and my father too in a different way). 

But I have never thought of it as something that is still happening now.  That I am continuing in that pattern of being trained to take care of her still.  But seeing the things you highlighted and the comments you made I saw for the first time that is exactly what is happening.  And when I think about how I feel around her it is very much me trying to take care of her. 

I have thought about and am getting the importance of 'detaching' - not feeling responsible for her decisions and what she is and isn't doing that she should do.  But I've never really thought about the fact I've been trained to be in the parent role and how that plays into it.  I'm really going to think about that more.

So much else you said was helpful - the not trying to fix things, remembering she is in a place where there are professionals to take care of what she is and isn't doing with her meds.  That I'm making excuses for her around that....and the times you could see I am coming from a place of parenting her.

I'm not sure if that all makes sense but I do feel like what you said has caused a lightbulb to go off - and I need to work more into that area in pulling out of that parenting role. 

I can see what you mean about the benefits of her being in a care home.  Both my parents went into a care home when my dad got cancer as my mum didn't help look after him as he had spent his whole life looking after her.  She expected him to keep on doing that and it got to the point he couldn't keep going so moved them both into care.  But I'm very fortunate about that as the thought of her being on her own and us having to do the sorts of things you are dealing with now would be so hard. 

So I just wanted to thank you for giving me the benefit of your hard-won learning and growing where you are now in a different place.  It does all sound very draining for you - I can understand what you mean about when you visit your mum.  I feel the same - I go with my brother and we both steel ourselves for an hour and a half or so of constant negativity , complaining, and guilt-tripping.  The last thing we are always told before leaving is "just remember....I get very, very, very lonely in here".  And I feel like saying - but know it is pointless - I understand, it would be good if you would interact with the people, activities etc.  She never goes to anything - just stays in her room.  But then expects us to fix all her loneliness.  That one I just try to let wash over me now as we're leaving. 

I do hope that you are able to take a break at times too. 


   

[Flannelflower]

Hi Methuen. 
I haven't got the hang of the clipping of a quote yet!  I tried clipping some of your post and commenting but it just turned into the whole thing looking like an excerpt.  Hope it makes sense.

[Flannelflower]

I also reply « -ask your doctor or nurse «  to any medical related questions and I refuse to discuss money management. It doesn’t do any good so it seems pointless to try.

Thanks Notwendy.  It's good to see that is what you do too with the medical issues.  I think that is a good way to go.

[Flannelflower]

She's often replied to suggestions that "I know what to do, don't assume I don't" and with indignation when asked to do something.

My BPD mother also has NPD traits and a sense of entitlement. It's expected that people do things for her. You don't dare ask her to do anything.

These both are true of my mum too Notwendy.  Sometimes she asks advice and doesn't take it. - but unwanted advice makes her very cross.  And yes, NPD traits and sense of entitlement also apply. 

[Notwendy]

After moving to assisted living, BPD mother made some very odd financial decisions  to protect her from financial abuse, her relatives tried to step in and help her with the finances. I told them I had tried and had no success. They didn't either. It was then that I remembered my name might be on one of her checking accounts as Dad put me on one during the time he was ill in case my parents needed me to use it for their bills. I never accessed it as BPD mother didn't want me to. I was able to call the bank and gain access. It's been helpful as I can see if there are suspicious expenses and also set up some electronic payments for her from that account as she has difficulty writing checks. I am careful to discuss any expense with her and keep careful accounting. 

I don't offer any financial advise- it does no good and she does what she wants anyway. She's done away with her savings on her own. The only thing that has slowed down her spending is that she's unable to spend what she doesn't have.

But also being on her account makes me "in service" to her. She will call me to go over her bank statement several times. I might go over it and an hour later she wants to do it again. She has the information- it's the service, the interaction she wants. Me being in service to her is the basis of our relationship. If I tell her we are planning a visit- her first response is good- I want you to do _________for me.

Your mother knows she can call the doctor or nurses for medical advice but she asks you. You aren't her medical provider. Consider her asking you is a basis for the relationship- your being in caretaker/rescuer role.

My mother will call and say she "has a question" but what she's calling about isn't the actual question. Or she will say it's for one question but the reason is another one. The "question" call is an opening for the "service".