Angry & stubborn mom in AL, 2nd year. She is refusing meds, is rude to staff, and has banned me. Any advice?

My first take away, is that your mother is choosing not to be happy and will continue to be a nasty person to you.

Has your mother had a full pysch work up? You say she sees the cardiologist for CHF, but has she had a check up with a geriatric psychologist or psychiatrist? Her behaviour is not 'normal'

What boundaries do you have in place? It sounds like your mother is riding roughshod all over you. Do you leave as soon as she gets abusive? Do you tell her that if she hits you , you will not visit? When she threatens suicide is 911 called? Does your husband hang up on her when she called him to complain?

What would happen if you blocked her calls for a week and did not visit? How would you feel?

Being POA does not mean you have to be at her beck and call, and it never means you have to put up with abusive behaviours.

Your last line is telling, you are putting your mother's feelings ahead of your own.

I think I would talk to the NP about getting her admitted to a geriatric psych facility.

Have you ever talked to an attorney about getting guardianship? Would you want to pursue that, or would rather she become, say, a ward of the State? Sometimes when elders are mentally ill and uncooperative, they will listen to others before they will listen to loved ones.

This must be heartbreaking for you, but there are many folks on this board who are in the same boat. ((((Hugs)))).

I am so sorry that you feel like you need to allow her abusive treatment of you.

She has always been this way, throughout her life, so I am sure you have been conditioned to ask how high when she says jump. This is what narsisistic people do to their children and spouses, if allowed.

Go to www.nefl.com and find a NELA CERTIFIED ELDER LAW ATTORNEY, they will be versed in all aspects of taking over POA and filing for Medicaid when the time comes. If you give DGPOA and HCPOA they will also request she be admitted to psychiatric ward to get her inappropriate behavior under control, however, you seem to be her hot button. She is friendly and loving with others, I was put in this situation with my dad. I told him that he wasn't going to be treating me like crap and if he went certain places with me I would walk away and never look back. This calmed him down enough that I didn't hate him when he left.

Parents seem to think they can do anything to their children and unfortunately children reinforce this behavior by not saying enough is enough. I just wanted to be given the same courtesy that they would give a stranger and if that's not possible, I choose NOT to be their scratching post.

Set boundaries and enforce them, ask your husband to not entertain her bs and seek out a good licensed fudiciary, our CELA attorney is also a licensed fudiciary. Then pass the torch as per her request.

You can't worry about what visitors think they know, you will wear yourself out worrying that they believe her lies. Tell any and all that they are welcome to take over, lock stock and barrel if they truly believe that you are not acting in your mother's best interest. Clarify that once you pass it, your done and will not accept it being passed back.

Boundaries, boundaries, boundaries and enforcement of boundaries are the only way you can survive this nonsense. She can't possibly treat you any worse and you don't have to answer your phone. She is safe and well cared for, that is your obligation and it is fulfilled. Stop being her doormat!

I agree, Mom needs a complete evaluation. Has the AL checked her for a UTI?

I agree with Isthisrealyreal. You are allowing this behaviour. You need to tell her when she respects you, you will be back. Ask her if she wants to die alone. Because that will happen if she doesn't change her ways.

I guess ur siblings don't have anything to do with her? They maybe the smart ones. You are a good daughter but don't need this. It will effect your health.

Got a mom like you.......oh my goodness it was such a stressful time when I started this process. I'm not joking about the mom part, that was even before health issues.
Just know , keep your visit time to your own comfort time, what you can deal with, not mom. When it gets stressful, you bow out. Guilt rides us, when we are children of an abusive parent , but remember your in charge now. On the phone issue, that a tough one.. I was onc told when my mom called , that I needed to stop driving get out of the car and then talk. On her temperament with the staff, same mom, I just kept telling her ,,, you know you treat the staff bad they will drop you in the shower and it will be all over....sounds harsh, but remember your in charge. They hate that ... that's why they are so mad. Ask if she can be tested for also being bipolar, mom had this along with the dementia.sure wish they had found that out when she was raising me versus now, but Once they got her Medes straightened she has a smile on her face, she may not hug me or say she loves me, but she never did.
Just a FYI , through my own experience the nicest of homes don't always have the best care. I went from high class to Medicaid eligible and she's clean, moving, involved and as happy as can be expected.
Fyi , I use to feel so bad for not bringing her home to take care of, but I had to protect my soul from more emotional abuse , I hate saying that but as soon as I realize and accepted that's what it was and why I couldn't bring her home , the more I began the healing process,
Take care , try not to stress too much .

Need to vent send me a email stephaniegoldstein1962@gmail.com

Marylin, the AL is not a good source to determine if mom is ready to be moved. They are making money and they never want anyone to leave unless they are really disruptive or they can't pay.

If they are not a continuing care facility that will accept Medicaid then before she runs out of money a change should be implemented, this way she can stay put when she is broke.

You say dads pension is paying for her care, does that mean she has the proceeds from the sale of her house? This gives her more options if she does have a nest egg.

I read your response about correcting her and how you haven't set boundaries because she is your mom.

You will probably not like what I have to say but I am going to say it anyway. Boundaries are not about making anyone wrong, they are about YOU deciding how you wish to be treated or what you are willing to tolerate and walking away when someone treats you abusively or behaves in a manner that you are not willing to accept.

Boundaries are not a bad thing, we have them everywhere in our lives.

A speed limit is a boundary and we know that if we push past that boundary we are facing a ticket, that includes court, driving school and/or fines. Do people still do it? Yep, but when they get caught they pay the price for disregarding the boundary. It is no different with people, you set these boundaries in your head and heart and you can tell people beforehand or as they bump up against your boundaries.

Example for me, my dad and mom both want to talk crap about each other to me, I don't want to listen to it, so when it starts, I say, we are not going there, I know both of you and I don't want to hear it. When they won't stop, I will again say, we are not going there, if they are feeling special sporty and try again I say I am going to go now, talk to you later, love you bye. I do wait for them to say goodbye but if they try to get 1 last dig I hang up, boundary. Next time I talk to them it never comes up. They know that I will respond the same way every time, doesn't mean they don't want to test it occasionally.

Just because she has the title of mom, it doesn't give her free rein to be abusive. I'm a firm believer that love is what we do, not what we say. Some people beat the crap out of their "loved" one and are always saying sorry and how much they love them, until next time. This is what your mom is doing to you. That's not love, honor her wishes and get an attorney to take over. She will only stop because you aren't there to abuse.

I have a narsasist mom and dad, I understand the depths they go to, to control and manipulate and it is pretty disgusting. I choose not to be their whipping girl until they die, doesn't mean I don't love them and wish things were different, I just know if I didn't take care of me, no one would, especially not my parents. I help them but on my terms and within my boundaries, I would expect them to have boundaries if I was asking them for help.

Truly healthy relationships have boundaries, without them it is complete dysfunction.

I pray you can find a way to take care of you and turn her over to an attorney.

I can recommend two really good books to you also: "Toxic Parents" by Dr. Susan Forward, and "Divorcing a Parent," by Beverly Engel. It's been many years since I read these books, but they were absolutely life-changing and life-SAVING. Like you, I had an abusive mother. She played guilt games on me like they were her bread and butter.
Basically what has happened to us is something called "learned helplessness." We don't know how to escape the guilt cycle. We don't think we CAN escape. We don't think we deserve to. But we CAN. We don't have to let these parasites suck the joy out of our lives. If you read the Bible it says, "love your neighbor AS you love yourself." That means it is not only okay to love yourself, it is really necessary. You have to take care of you BEFORE you can take care of anybody else.
It's okay. Really! I wish you well.

Screw your mom, what about you?!? Her clap trap needs to be shuttered at this point as it's very clear she can't make up her mind. Either she wants you there or she doesn't; she can't have it both ways. The next time she tries to leave a nasty message on your machine you erase it without listening. Then you let her know under no uncertain terms that either she shapes up or your moving out and she won't get to see you again for at least 10 days. If she starts up, walk out and hold your ground.

Do yourself and your Mom a favor and stop visiting! Have a lawyer take over her entire care and estate and give yourself a break from this constant negative fiasco. It is a shame that elders cannot just take a pill to die when they no longer want to live - it’s also a shame for their caretakers Bc they end up taking the brunt of the unhappiness. At least be grateful that your Mother has given you an “out” by telling you to stop being her caretaker - there are many caretakers on this forum who would wish for the same. It’s not a bad thing to give up when the negativity is so horrendous - for you and your family - just LET IT GO.

Marylin,
Since you say that you know mother is not mentally well, why do you need it confirmed at this point? She's 89 years old. Would she agree to take a medication that's intended to slow the progression of Alzheimers, if that is what she has? Even if she did, would it change her behavior? Does she take meds for depression? That might help her mood. Sometimes, people who have cognitive decline grew increasingly angry, rude, selfish and aggressive. They also suffer with delusions.

Who is her Healthcare POA? Unless, they are able to override her decisions, get the doctor to order meds to treat her symptoms and the staff can get her to take them, then, I'm not sure how she can be helped to change. IT's a shame, since it sounds like she is suffering from mental pain. However, if you don't have the ability to help, then, you just can't. I'd try to take a break for your own mental health. Plus, does she have an Advanced Healthcare directive? Perhaps, she has no intention of prolonging her life at 89, even if she does have a cardiac condition. Some people chose Palliative Care, which is comfort care only.

I only have one little suggestion since the others have covered this very well. As for her "needs" list, I have found that using a grocery shopping service has helped me considerably. I just set up the account and add items to it when my mother asks for items like hearing aid batteries or toothpaste etc. I usually add a few fun things to the order like cookies or chocolate and it all gets delivered to her AL facility without me having to do too much. Hope this helps.

My mom went through a horribly nasty phase in her dementia. She wanted to complain about my sisters and me to anyone who would listen so I suggested that I find her someone to talk to and she surprisingly agreed. It was an opportunity for someone else to listen to this when nobody wanted to. I set her up with a geriatric psychiatrist. Got her the evaluation that she needed and help with some meds. Hope this helps.

marilyn, my mom is so similar, and I’m an only. I totally hear you when you say ‘just think of what she’s going through, too.’ It’s not that you put her in front of yourself, just that you know she’s in pain. This is a great forum, and god books can be so helpful! But I’m a huge fan of adding a counselor for yourself when you’re under pressure like this. Do consider getting one, there’d be only a modest copay if you have insurance (EAP on back of your insurance card). If you don’t, find a support group. I’m moving my mother today into an independent living apartment and it’s going to be a nightmare. :) She’s got this massive persecution complex and she’s the one who picked out the place. Stay strong and enjoy your time ‘away.’ :)

Wow! Great advice here from many. I agree you should let POA go to an attorney as your mom actually requested. No you do not need to be her POA.
Have you ever been to a counselor to see how to cope with her behavior and learn why you allow yourself to be treated like this? Because obviously you may have read the books on boundaries but you are having trouble thinking you are worth implementing them. A good therapist can help you. You’re mom has probably told you all your life bad things about you which has contributed to your low self esteem. You sound like a caring daughter. But just because she gave birth to you doesn’t mean she is a good mother. Sadly she sounds like she has psychological problems. They put my dad on Trazadone at night to help with belligerent behavior. You need a care conference at the facility. Involving the social worker, director and NP.

I am not understanding how you can be banned if you are her POA. Certainly her mental state merits them allowing you there. I would suggest her meds be ground up and mixed in applesauce. Best of Luck.

I feel your pain, and also your mother's. It is so difficult and can seem thankless. I am going through a similar situation, but my mother has some good days when she is more loving and accepting of help. On her bad days she is angry, refuses medications and even bites nurses or hospital staff who are trying to take a test and help her. She was on alzheimers medication but at age 95, in consultation with her doctor we decided to stop it. Why prolong the suffering? I have changed the medical directives to specify "no hospitalization." She was angry, upset and uncooperative at the hospital - why put her and hospital staff through that? After her last hospital visit we also decided to change her status to "hospice," which is an approach just to keep her comfortable, but not to try to "fix" things. I don't know if this is appropriate for your mother. When my mother would tell me to "get out" I leave for 5-10 minutes and often I could then go back and it was OK. I never wake her when she is sleeping. If she refuses something, we wait and sometimes it is OK to do it later. Try to keep your mother as comfortable and happy as you reasonably can, even if she is not making good decisions on her own. She's not going to get better. Do not change the POA, unless you just can't take it any more. I've seen and heard of lawyers running through people's assets and giving no better care than a family member - in fact worse care.

A lot of your mother's behavior mirrors what we saw as my father's vascular dementia took hold and destroyed his personality. At first we all saw a worsening of questionable/bad traits; dementia diminishes self governance so the worse personality traits are now free for uninhibited expression.

If dementia is coming into play then you need to realize two things: (1) your mother is not going to happy anywhere regardless of how much you appease her; and (2) a good geriatric psychiatrist can really help stabilize your mother's moods with proper medications.

Any person (friend or family member) who visits and expresses that they “can’t figure out why she is there” is clueless. SMH

You could work through the NP to get someone to come to mom's AL to evaluate her, or you could independently try to find someone to make a "house call."

You are at Stage 1 of the "repair the parent-child relationship," and many will not get beyond that. Some won't need to. I think of Stage 1 as getting Mom or Dad to independent living, assisted living, or a continuing care retirement community (everything on one campus). So she's not dependent on you to meet her every physical need. BUT, you are still connected at the hip, because she expects and demands that you provide, or fix, EVERYTHING that she perceives is missing or wrong with her current situation. And not in a nice way.

Stage 2 is to get out from under that expectation. There were many good suggestions. My sister had to tell our (late) mother that she would visit once a week, and she would not drop everything to bring her something she wanted. "Fine, Mom, I'll add it to the list." Of course she had the ability to get something on her own if she REALLY wanted it urgently enough. They had a shopping service, trips to the stores in the AL's van, she could call someone else, etc. All places have to arrange for Personal Needs Accounts. If my mother-in-law needs something, she makes a list and gets it to the person at her ALF who purchases it for her and debits the amount from her PNA.

So you need to get to Stage 2. She has told you she doesn't want you to hold her POA, manage her finances, see to her personal needs in the AL. She can hire an elder law attorney to do that. Sure it will cost money, but evidently she no longer trusts you so her options are limited. When she complains that she needs money, you will have to say, "Mom, call your financial POA, s/he's in charge now." Practice saying this in front of a mirror. She will argue with you, say you don't care about her, you're cheap (won't spend your own money to buy her Kleenex). And repeat. This can take a long time.

Stage 3 ("nirvana" if you can get there) is when you are no longer responsible for any aspect of her care, either medical or financial. You are just her daughter. You now have a mother-daughter relationship unencumbered by her complaints. Every visit does not have to be about money. You're not there to check on what she needs. But, when you take away a senior's ability to complain about her situation(s), often there is not much left to talk about. You will have to take the lead. When you visit - not that often and not for that long - just give her an update on what you and your family have been doing. Keep it positive. Share photographs. Do most of the talking. Ask directed questions - what was the best thing you did last week? If/when she starts to go negative ("Nothing - and the food is terrible"), try re-directing the conversation. If she persists, get up to leave. DO NOT ENGAGE. Screen her calls. Decide how many times a week/day you can indulge her phone tirades. You need to do this for your own health.

Do check in from time to time.

Marylin, your situation has been on my heart so much.

Next time some interfering friend or relative says they can't understand why she is there, she is doing so well! Tell them "of course it is hard to understand, she is doing very well, BECAUSE SHE HAS A VILLAGE PROPPING HER UP! Who wouldn't look like they've got it all under control when they have a housekeeper, a cook, a nurse and aids. That's why she is here, so she can focus on herself being better and strong."
Then offer to show them the bite marks where she chews on you.

I went through this with my dad. People telling him, he didn't need help, to the point he moved out of AL. Now I wait for the phone call, because he can't care for himself, he lives with people that don't care for him and it was all because he was doing so well from all the care.

Pulling our parents off the edge is a double edged sword. So sick to so well and no one else can see why! Just frustrating.

Take care of you and enjoy your husband.

I am my Aunt primary caregiver since 2012. I am not her POA. We went through the same thing she didn't need me, I wasn't her neice, verbally abusive towards me, she has slapped, hit, punched, scratched, kicked me. All the while day after day I showed up. She is well taken care of in a Nursing Home long term. So when we have displays of this behavior I get my purse and say to her I Love You I'll come see you on a day that is better for you where your not so upset with what I say or do turn around and leave. I stay away anywhere from a 1-2 weeks with no contact I tell the Nursing Home hey I'm taking a break if anything arises call me but we need this time away from each other. When she realized I wasn't accepting this behavior from her she is much pleasant now she still complains about the facility but its tolerable.

Marylin, I just saw your response, continuing care facilities are facilities that have a layer of care.

Independent living
Assisted living
Nursing home/skilled nursing
Memory care

All of these levels are at the same facility, where I live the IL is usually apartments that are right next door to the facility that has the others. Some are different wings and others are different floors.

They serve to keep from having to do a move, it's kinda like changing hotel rooms, as it were. All of the activities are the same, dining room, courtyards etc. Mom just gets moved to the level of care she needs. It is less change for them, they learn a new room number verses an entire facility.

I hope this clarifies that.

I wasn't trying to be offensive, so forgive me if I was.

It is so difficult because our parents know every single button we have, they created them. Learning to walk away is difficult when we feel like our reputations are being ruined but anyone that matters will seek out the truth and the rest just don't matter.

Let mom think they are her allies, then maybe she'll need you less. Just a thought.

Has your mother been assessed by an older age psychiatrist or a neurologist? Because of the congestive heart failure I'd be wondering about vascular dementia - there is an angry, negative phase which is hard and painful going; and you are right to be concerned about how desperate your mother must feel behind her lashing out.

It will pass, but not in a way I expect you would want to wait around for. Do you have access to specialist psychology services for her?

Meanwhile, you do not have to tolerate being hit, not in any circumstances. Your mother is well cared for, so that objectively speaking she does not need you to be there, and if you think that your presence is doing her no real good either, it is *fine* to take a break. You can manage her care perfectly well without direct contact, at least for the time being.

It may even be that a skilled psychologist or mental health nurse will be better able than you could be to get her to accept help and treatment. These professionals have two huge advantages: one, expertise; and two, your mother's behaviours don't hurt them.

Let the people over there handle Mom with Care...You stay out of it, Unless they are Mistreating her. She has a debilitating condition, She won't Listen to Anyone, Not even you now, hun.
Let that go for now, Your visits that she refuses to Include you with in her life. Give it some time and when she may have cooled Down, Find out if she wants you Around.

Ah, the "kooky" mom (as someone else here put it). I read about it all the time here and I have that myself. Really good comments, and nothing really insightful to add other than reinforcing the boundaries argument.

I too struggled with the boundaries idea on my own mom, while though a kook her whole life, did also do a lot of good and sacrifice for me growing up, sports, vacations, scouting, etc. Its hard to do that when you know the other person is just not outright evil.

But I ended up having to, including one blank check day a week (one day a week for me to "use" her as she will, with the idea she schedules all of her stuff then) and up to another day a week if a dr. appt. or funeral of a friend comes up or something. I do know some of her friends think I am being mean to her, but other friends know how she is and they feel sorry for me.

Often I find there is a two fold goal in boundaries. One is to help induce change in the other person, and the second is protect yourself. e.g if a friend takes advantage of you in some way, you set a boundary, and maybe it makes them change. With people our moms age, they are not going to change. I found that realization somewhat liberating as I thought if I reasoned with her enough, explained logic to her enough, she would see my point and change .She didn't, then I got doubly frustrated. So now I realize she is who she is, she will not change, she will not understand reason. So I still suffer from her abuse, but do so in a limited fashion due to the boundaries, but also don't get frustrated when she doesn't change.

Order dvd's of Teepa Snow, she is expert in her field of challenging behaviours and her training videos look just like you described your mom and my mom. She is funny and uses audience for examples. Great to learn by.

I think you could use some help navigating the state of mind your mother’s illness has put her in.
My mother’s dr sent me to the Al clinic at the hospital. I am seeing a specialist that is teaching me how to handle conversations with my mother, how to set boundaries and what my options are.
She also conducts a support group one day a week. She is like my life preserver.

There is so much good information here in the responses I've read! My mother is dealing with dementia and we went through a terribly mean, stressed, negative, and verbally unpleasant period of time. This was after moving her into a continuous care facility that she chose (e.g. the facility offers levels of Independent living, AL, memory care, and skilled nursing/nursing home. You move through the levels of care within the same facility as you need them). It's getting better (now 18 months later) in some part because I have learned how to manage her without sacrificing myself as much.

Two pieces of advise that helped me came from the facility Social Worker:
1. SW asked me to describe how our relationship/dynamic was before she needed any help or developed dementia. We spoke about how much time we spent together, how often we talked, etc. Really thinking about that was helpful because the SW response was classic. "Well, you two have been all up in each other's space lately haven't you? Do you think you could take a break, reduce that contact time? She's safe, we've got her". I listened, it helped!
2. Saying "sorry" can work wonders sometimes. Hang on, wait for it. "Sorry....." but don't finish the sentence, just I'm sorry. The rest of that sentence might be "sorry you are so crazy, sorry you can't see or appreciate how much I'm doing or sacrificing, sorry you can't understand how all this is negatively affecting me, sorry you are the harbinger of your own misery, sorry you wish you had your car to drive, your independence, your person that makes all things better, your youth, your health" whatever. Let her fill in the blank, it will be to her liking and she can believe whatever she wants. It's not lying because you are sorry. There's just no need to finish the sentence.

Best to you! This is all so hard!

Everyone has answered so well. I don't know how true it is, but I am 84 and my primary physician who is a family doctor, told me at my age I cannot take Xanax anymore. She basically said, she could get in trouble for prescribing it to me. So, she put me on Buspirone for my anxiety.

I don't think it will stop meanness. Your mother may not be in mental pain, she just may be mad and hateful because she can't get her way. There is no way in hell you deserve to be anyone's punching bag. Don't see her alone, when you go to see her, get her into a public place and visit there.

Everyone is different of course but this sounds like my mother last year except for the dementia wasn’t as progressed . She basically took her hostility out on me so after about 6 months I said “enough “ and walked away. I told her why and warned her repeatedly beforehand. In her case, she could control it because she did not do it around others. After a year she fell , broke her hip. I went to see her in the hospital and her attitude is changed. She still rants and raves, mostly due to the meds , dementia and assisted living situation but now she’s an equal opportunity crab, not just at me lol. For what it’s worth ,
I’d limit my visits. If she is incapable of better behavior, maybe have a heart to heart with her drs. to find out, I’d still limit visits and definitely physical abuse is not ok. You deserve less stress , no guilt and definitely no verbal nor physical abuse. If she is incapable of that, she needs to learn to get along without you. Just from what I’ve seen, and lots of study and some therapy due to years of verbal abuse but not really anything scientific, I think their true personality comes out. Unfortunately my mother’s was as a narcissist. Dementia hasn’t changed that for the better. Sometimes facts are just facts and if you can step away from the emotional turmoil, you can see it more clearly. But it’s not selfish to take your needs into consideration.
I think you can get an attorney for a POA. Might be worth it if you can possibly afford it.