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I am the POA and errand runner for my elderly parents (90s) who are still living together in a retirement home. Both are fighting cancer, diabetes and heart issues so there are many medical appointments each week. It is a toss up who is going to pass first. Dad is easy going. He sleeps most of the days away now. Mom has always been on the narcissism scale, difficult and combative and is becoming more so as the days go by. I understand she is terrified, but it is becoming difficult to spend any time with her as she verbally attacks anyone that comes close. She has alienated the other residents and the staff seems to avoid her (who can blame them). She works herself up and doesn't get any sleep. She refuses to take any medication to help with sleep or mood. If it wasn't for my Dad, I would pull away, but I want to see them both to the end with dignity as best as I can. I try not to take her attacks personally but they sting and I feel very sad that her life has come to this. Any advice for me?

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I think that you are doing all that you can at present do. From what you say Mom has a personality that is little changed over time, just more severe as dementia complicates her life. You seem to have a good perspective on this. Try not to pick up the baggage she sets at your feet at every visit. If you need to seek help from a few visits with a Licensed Social Worker who works with life change challenges or with a psychologist, just to learn better coping skills for yourself, do that. But as to Mom, she is unlikely to change a whole lot.
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Gwenivere Nov 2021
Thank you for your reply. I am trying to balance good self care with being useful (not used).
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I don't see where you mention dementia for your mom? I can tell you this; without anti depressants (the max dose of Wellbutrin), my mother is absolutely unmanageable and miserable with her behavior. When my father was approaching the end of his life & the two of them lived together in a small apartment at a local ALF, she was on him like white on rice, 24/7. It was a terrible thing to witness, really. I hated going over there and watching my father get berated for his every movement and his every word, but what could I do about it? Nothing. I avoided my mother as much as possible and spoke to my father on the phone primarily, to see what HE needed and what I could do for HIM. Mom was going down the dementia highway at that time, but she was always a mean and selfish person even before the dementia set in, to be honest.

I truly can't understand it when seniors 'refuse' medication that will help them cope with all the anxiety and fear they have on their plate. Perhaps if your father spoke to her and asked her to consider taking something, do you think that would help? Or if you spoke to her doctor about urging her to take some meds to 'help her sleep'? It seems very selfish for one person to be acting this way and making so many other people miserable due to their behavior, but that's how people like this ARE, it seems to me.

Wishing you the best of luck trying to talk some sense into a stubborn and sickly woman. Godspeed to you with a difficult situation.
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Gwenivere Nov 2021
There has been no diagnosis of dementia for my mom, but I am sure that we are in the early stages. I think she refuses medication because she thinks it would silence her and she thrives on telling everyone how little sleep she got and how bad things are in her world. When I am alone with my father, I do my best for him. He has checked out for the most part. He has his routine and sticks to it. Thanks for your good wishes.
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Mom isn’t changing, except possibly to worsen. So protect yourself. Sticking around and listening to the stream of negativity is bad for the soul so limit your exposure
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Oh God. Im in exact situation. Narc mom who emotionally abuses me and dad is an angel. He just had a heart attack because of her stressing him out. She gets jealous when I pay tender attention to him. At this point I realize im helpless and can do nothing but watch them and let them be. I did get them a condo so they can seperate if need be. Im on eggshells each day thinking of what news I hear from them (the’re out of state). Our happiness is important. Hold onto it tight.
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I am going through the same sort of situation. It is disheartening. I structure visits, stay for lunch time, bringing their favorite foods and always a treat for her [doesn’t matter what, as long as she feels special]. When I control the amount of time that I know I will stay for it is more bearable.
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I am afraid I don't have advice. I just wanted to say I appreciate your post and am in a similar situation. My two siblings and I have found our 92 year-old mother, (borderline personality) has become impossible to interact with without getting criticized, mocked, or otherwise demeaned. We walk away traumatized from most interactions. We all feel sadness that at the end of their lives we are bring pushed away now than ever. It makes sense for a borderline to do that, but it is very very painful for everyone. And my father, 94, wants to see people but is still critical and narcissistic. Sigh. At this point my siblings and I are reducing contact. We almost never see them in person. We will call or Zoom. Sometimes we snail mail which is good for my Dad who can read them better than he can hear on the phone. I will be interested to hear if others have advice.
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Cancer, diabetes, heart issues - what exactly is your mother living with? What are the main symptoms affecting her day to day?
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First of all, you don't have to be anyone's door mat rather they are on death doors step or not. It's not like she has dementia and doesn't know what she's saying.

Have a talk with her and let her know that things have to change..

Go visit and as soon as she starts up her bad behavior, Leave!
Don't have a long discussion about her behavior, just say short and sweet you will be going now and maybe the next visit will be better.

She'll either change or your visits will be short.
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Mo mom lived with us for 5 years, when she had Alzheimer's, until she passed away (at 94).We had gotten along great my whole life, until Alzheimer's-induced insults came a'calling. I learned to curse the disease, not the person, and tried to find humor where I could. To that end, I wrote a book: "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale." (I thought of the title when I was driving home from work one day, and I realized that this slightly broad "broad's" once broad life was reduced to the pressing health concerns of my mom and dog.) This included, as you know, many doctor visits. I learned, over time, that trying to reason with this once bright, caring woman was useless. Just take it day by day.
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Talk to the head doctor. I’m sure they have concerns as well. Ask if there are alternatives for administering her medicine. Maybe she will require a port if she won’t swallow. I’m sure the doctor will agree that medicating her is paramount to her quality of life, and (I hope!) they will do whatever they can to create a Plan B (and C if necessary).
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Your 90+ mom is suffering with 3 major health issues plus not sleeping - who wouldn't be on edge? Have her doctor prescribe her a low dose of Xanax to take the edge off. She doesn't need to know what it is, it can go in her food or given with her regular meds. The staff should not be avoiding her - they surely are trained for this behavior and have seen it in others. Perhaps you can write Mom a letter telling her how much you love her and wish her well and that it hurts you when she lashes out. Reading it while she is alone will give it time to sink in. It's worth a shot. Kudos to you for all your patience and all your loving care taking for your parents.
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These insults hurt and they build up over time. She's hostile and defensive because she is terrified. Other than responding back to her, develop the thickest skin you can. It's really your only option. I have a feeling she might be saying the horrible things to you because causing misery is the only thing she has left. Children often act out to get negative attention because they aren't getting the attention they want. By deflecting these attacks you take away her attempt to make you feel bad.
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If she won't take meds its going to be uphill but I recommend cannabis. She can eat gummies or take gel tabs like those made by "care by design". Since she has heart condition please have her INR tested until she's on steady dosage schedule. Start with high CBD low THC until you find balance that mellows her out without getting her stoned. My mom became very combative but cannabis enabled us to keep her at home and her moods improved greatly.
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One out of left field – get industrial strength ear plugs for yourself, and put them in before you get there. You can take them out if you are alone with Dad, although he may be happy with you just being there. They don’t cut out hearing speech completely, but they dull down the impact. You can say they were prescribed if it annoys her. It may even stop her if she knows she isn’t being heard!

My DH was an engineer, used these professionally, so we have always had them around. They improve all sorts of things for me, including letting me sleep through the most spectacular thunderstorm in 20 years on Tuesday night this week. Three inches of rain overnight in the central Australian desert!
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This woman is angry and afraid but that does NOT excuse her behavior and it must NOT be allowed. She has to be told she has to behave and must take proper medication and not attack you. If at all possible, see your father but totally stay away from her and do not see her - she does not deserve the privilege of seeing you. You have to get tough and set boundaries and be ready to enforce them no matter how nasty she gets.
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She truly needs anti-anxiety medications to help her relax and not react to her fear with over-controlling and anger. Realize that her world seems scary and confusing. Some react with crying and moaning and other with fighting. She's a fighter. Without these meds, the best approach is to be calm, patient, and explain everything simply. She needs an extremely consistent routine and non-varying environment.
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Gwenivere: Imho, your mother requires sleep, else her health declines even further. Perhaps the staff can give her melatonin.
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Wow! Your mom sounds just like mine. My mom does have dementia though, and she takes her pills really well, but she doesn't have a clue what they are for. My mom takes Buspirone, and I call it her happy pill because a day without it and she's a bear, like she used to be. Too bad you can't get her on something and tell her it will help her feel better.
I hate to be the bearer of bad news, but it sure does seem like the nasty ones outlive the others. My dad, step mom, step dad are all gone, and the difficult one is probably going to outlive me. She is almost 89 years old and none of the other 3 lived to be that age.
At least you know you are doing your best, and you have the understanding and support of a lot of people here.
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Dementia, of any type, changes the personality and behavior of the affected person. Besides, it starts many years before a diagnosis. This has no been mentioned in the answers to your request for advice. Please disregard any recommendations of "tranquilizers" and medicines unless they come from a physician (preferable a geriatrician). Somebody suggest an intelligent approach: short visits that you finish when the situation is too hard to deal with it. And always remember: Your mother, when behaving as you describe, even if she seems to do it on purpose, is not trying to get you. She is not doing it to you: Is her brain doing this to her.
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I went through this with my mother also. For 6 years I was her caregiver after my father died. She passed away nearly 6 years ago. All these years later, as I think back about it, I realize that the main reason she was acting this way is because she was lonely. She even faked TIA's for attention. Would not take her insulin for attention. Stopped taking all her medications, and bragging about it to the other residents at her Assisted Living place for attention. She even tried to break my husband and I up! I probably could have done more, but I don't know what.
Maybe put some notes around her home reminding her that you love her. A note in the fridge. Maybe in her pocket. A candy here or there. Just a reminder that she is special, or that you are thinking about her. Maybe a HUGE banner with my favorite saying, "IT IS BETTER TO BE KIND THAN TO BE RIGHT" across her bathroom mirror.
Good luck, and try to remember that there is probably nothing you can do to make her be more pleasant. In 6 months, you'll look back on these as being 'The Good Old Days' !
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Try to do what you can to limit your exposure, realistically and thoughtfully, without feeling guilty. Try to find serenity in feeling like you are doing the best you can with the resources you have. Try to embrace your sense of humour about whatever you can, about your situation. Just not consciously at anyone's expense, or in a hurtful way. I have experienced many of the same things as you have relative to my own family, and many were the days that a sense of humour was the only thing that kept me sane. That, a true companion animal who gives unconditional love, and whatever your favorite music to listen to is. The genre and style doesn't matter all that much, just that it provides a sense of 'soul food' when it's felt to be needed. I would suggest James Brown, but I realize he's not for everyone. Best wishes to you.
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