This is my first post.

My mom is about to turn 92. She has BPD and NPD and has her entire life. Everything she is now in terms of her narcissism and borderline is a more extreme version of the way she always was when my sister and I were little kids. I am her sole caretaker -- my sister lives 3,000 miles away and hates her guts for good reason. She's paranoid and delusional and extremely tightfisted.

I started taking care of my mom 20 years ago. I didn't think she would live this long. Every year, she gets more difficult to deal with. She's delusional, paranoid, hypercritical and demanding. She's a hoarder living in a two bedroom apartment who is only not buried because she got bedbugs six years ago and had to get rid of everything she owned.

She moved into assisted living four years ago and moved out back to her apartment after seventeen months. Between the fact that the other women there were incredibly cruel to her and the fact that after she broke her hip, I had to go there every single day for six weeks because no one went and saw her except for the people doling out her pills. I thought it would be easier for her to move back to her apartment, three miles away from me in a building with a concierge instead of me driving 12 miles each way. The maid from assisted living was cleaning her apartment weekly until, true to form, my mother fired her at Christmas, despite the woman having found her when she fell in AL and having saved her life.

She has severe osteoporosis, congestive heart failure, a pacemaker. She's colonized with antibiotic resistant E. coli and is incontinent. She cannot and does not clean up after herself but NEVER has. Her apartment is a disaster and she keeps saying she has to "get someone in here" but literally no one will put up with the way she treats people. Six years ago, someone who knew my sister and BIL came her to take care of her full time and be her maid. She was so nasty to him that he would go lock himself in the bedroom and cry and told my husband that people were nicer to him when he was in jail than my mother was, since she verbally abuses anyone and everyone at will. She's completely self-centered and disinterested in anyone else's well-being.

Recently, her short term memory and word recall are just shot. I'm not talking about complex, low frequency words. She couldn't remember my niece's name and calls her "the older one." She couldn't remember, despite ranting about it and Jeff Bezos for years. She forgot my 17 year old daughter's existence. She'll ask me a question and then ask me exactly the same question two minutes later six or ten times in a row. She confabulates like crazy all the time til my eyes are rolling around in my head as she retells stories from my childhood saying they happened to her or that she was there when she was not.

Her affairs are beyond her ability to manage them. She gets mail and never opens it because she's angry at the sender, she loses envelopes with important documents. She has a house she's renting out that she wants to get rid of the tenants in the middle of the pandemic so I can drive her there forty times in the next three months arranging things with tradesmen to repair it because she can't get along with anyone ever. I am her entire social life. She has very high social needs.

I call her daily since April 1, I do her marketing but that's not enough: she's angry that I don't see her 3x/wk, because according to her, I do virtually nothing for her. She has NO friends. Her siblings are all dead. None were on speaking terms w/her for years before they died. She wasn't allowed to go to their funerals or even notified of their deaths until years afterward. I haven't seen or spoken to my cousins since I was in high school because she antagonized her siblings so much.

Advice from those who have been there done that?
How can I sort this mess out before she doesn't know her name anymore? Her mental illness does not make her incompetent.

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I have an answer for you and it is to change your way of dealing with her and put her in someone else’s hands. I have a mother like this and have been her caretaker for 8 yrs. it started off rocky and 5 years into my caretaking career with her, I developed stage 2b non-Hodgkin’s lymphoma. It had been brewing obviously for a few years. When I was diagnosed, a light bulb went off in my head and I said “It’s either me or her - and it wasn’t going to be me!” My mother too has chf, a low battery in her pace maker and a host of other medical problems. (She does not want to get the pace maker replaced). I was able to call in hospice to help out and they’ve been a God-send! She’s been on hospice for over a year now, but she still qualifies because she is declining. (Long decline I guess). Anyway, I told her that I’m unable to care for her anymore the way things were because of my health. I have backed off, and she is managing okay. I still see her almost everyday, but I check on her, stay a bit and then I leave. If she can’t manage like this, the next step is a nursing home and she doesn’t want that. But, me taking a back seat to her care, means she can no longer abuse me or the people trying to help her. I had to flip the ‘script’ so to speak and put myself first. I put my foot down and refused to take her crap anymore. I am her only remaining child. My two sisters are gone and so is my dad. She is 94 yrs old now. I am not her indentured servant any more. It is a day at a time with her. I did chemo for months and am now in remission for my cancer and I will not let her do me in. If I get stressed again, then plans are going to change fast. Please put yourself first and do NOT feel guilty. She needs others to care for her who are trained to do so. Maybe an evaluation for her from hospice can help you too.
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Beatty May 29, 2020
Your reply here is a great example of how to change. 'flip the script' is an excellent way to phrase it too.

So pleased you saw this path, took it & am in remission now. Best of health to you!
So if you broke your leg or got Covid, who would look after Mother?

Could she buy her own food? Medicines? Pay bills? Keep the heating/cooling on appropriately?

Are the answers are no, no, no & no? If so, then it's time for change.

Look up from all her 'wants'. It's time to arrange the care she NEEDS. Go see her Doctor & ask for help.
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Please get her involuntary hospitalized in a psychiatric facility - hopefully one that cares for geriatric patients. She is unable to care for herself. She needs the hospitalization to help her get a medication regimen and counselling to deal with her issues. After she is stabilized, social services can help you with placing her into a psychiatric long term residential facility where nobody will get burnt out caring for her.
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cmdcwc Jun 3, 2020
Everything you said is helpful, but to get her placed in a nursing home, if she can’t self-pay means going the Medicaid route.// I spent 30,000 of my own money last year funding a qualified income trust to qualify for Medicaid because my husband‘s pension is too much for us to qualify for help, but not enough to put him somewhere where I can self-pay. 4-applications, nine-months, over 50-hours on the phone, and $30,000 out of my IRA. once he was placed in the Medicaid nursing home, they were taking his entire monthly pension, leaving me with 0, which meant I had to go back to work full-time (after just having my knee replaced.) I ended up pulling him out after 35-days (I’m kicking myself for that,) but there was a CNA who was emotionally abusing him. Caring for him now is just too much, but I can’t spend another 30,000 getting him qualified, and yes I went through an elder affairs attorney - they are very expensive.
Not exactly on topic, but I have experience with a mom sort of like yours. She is now 95. She has been and always was concerned about herself, first and foremost. She fashioned a life as a dependent yet also felt entitled to yell at us for hours if we did not do her bidding. Point is she is 95. My MIL was a lovely, sweet woman who is long dead. My dad, a kind man, is now dead.
Working theory: Narcissists, by virtue of their personalities, live longer lives. They may not have close families or friends and they outlive everyone but they don’t care — they are, after all, still alive and still needy.
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lealonnie1 May 28, 2020
That is SO TRUE: these types of women live to 100!!! My theory is, they are pampered and catered to their WHOLE entire lives while hounding and torturing OTHERS the whole while. So those of us unfortunate enough to be dealing with them wind up gray haired at 30 and dying young, while they live forever.
Do you have POA or will she allow that? I’d make having it a condition of being involved at all. Foremost, others have backed off for their own mental health, so please consider yours and take care of yourself before your mother, always. Decide your level of involvement and stick to it, don’t respond to any demands. The book Boundaries by Cloud and Townsend has been a big help to many here. If you decide it’s within your boundaries with her, have her mail forwarded to your home and take over paying her bills with her money. Decide how many phone calls you’ll take and don’t answer the rest. Don’t listen to conversations that make you feel sad or any endlessly negative loops, tell her you have to go, no explanations needed. Decide how many times you’ll take her anywhere, and don’t bend. Remember you’re the competent adult here, it’s not about her wants, it’s about keeping you sane and healthy. She doesn’t care about that, for either you or herself. It’s good advice to visit an elder care lawyer for advice, as well as a good social worker. If you decide you can’t be involved, no one could fault you, contact APS and tell them of the situation. And if no one has told you, your mother is blessed that you care, even if she can’t see it
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She's likely suffering a molotov cocktail of mental illness AND dementia/Alzheimer's along with a personality disorder and OCD (hoarding) which makes for the ugliest possible situation for all concerned. Her memory issues and repeating herself incessantly is a hallmark symptom of dementia......I 93 y/o mother does the exact same thing (she is especially bad with people's names & what day of the week it is) and she was diagnosed in 2016 with progressive dementia. AND she has a passive-aggressive covert narcissistic personality disorder. So I made the decision long long ago that I would NEVER live with her in my home or her home, no way Jose. I had both of my parents placed in Assisted Living back in 2014 after my dad (the sweetest man on earth) fell and broke his hip. Mommy Dearest is still alive and now in the Memory Care annex of the place, takin a lickin and still keepin on tickin. As these women ALL seem to do, regardless of HOW many diseases and issues and ailments they suffer from. How many issues have they given US as a result of decades of dealing with them? That's the question.

Long long ago I realized something about my mother: she was never, ever, under any circumstances going to be happy or satisfied or content. So why was I jumping through fiery hoops to make something IMPOSSIBLE happen? Because I was trained to do so. From an early age, as an only child, with nobody to back me up or tell me Mommy Dearest was a freaking lunatic. So I am now almost 63 and STILL dealing with this crapola on a daily basis. But at least it's on MY terms, nobody else's.

What are YOU going to do to get your mother placed? Or to get in home help to her so that lets YOU off the hook? You can probably get her deemed incompetent, from the sound of what's going on.........check with an Elder Care attorney to see what your options are. But get OUT of the dreadful scenario you've been in for too long now or YOU will be the one to die young. Again, these women live forever, it is their children who die young.

Don't be a statistic.
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Kat819 May 28, 2020
I don't know what I can do to get her placed. She adamantly does not want that. She was there, she paid a $10,000 "community fee" to move in and stayed 17 months. Until she's so mentally gone that she has no say over it, I don't see how I have the option to put her in a nursing home. I'm not paying for it -- I couldn't if I wanted to.

There are actual academic papers that show that people with narcissistic personality disorder live longer than normal people.
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Such a loving daughter to do all you have been doing for your mom. But sounds like it is time to step back and find help. Try contacting your county’s Department of Aging and explain her situation and that she doesn’t have care - be clear that you can’t do it. Tell her doctor as well what is going on.
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Often, experts and/or the courts are the ones who determine competence. I wonder what about her behavior spells competence. I’d likely consult with an attorney to explore your options and what evidence you need to intervene. With her condition and age, she may not have much time left. It’s hard to manage the care of people who have cognitive decline. Getting legal control may help, but it’ll still be challenging. An attorney and/or a senior care manager may be able to assist or give you support.
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Have you had your mother evaluated for competence? I have a mother very similar to yours, and she is 93 years old. Not as severe as your mother, but I have had to develop very strict boundaries with her and will not be a part of her demands for attention or get involved with any of her "schemes."
You have to decide what is "enough" for you, and stick to it. The best way is to do this gradually. Also, explain to her that if she needs more help, she has options like a cleaning lady, etc.
Our elderly loved ones who have these tendencies can be a danger to themselves. We have to be the voice of reason because we want to keep them safe and healthy, but we also can't allow them to consume us.
Get sound advice on her conditions, mental and physical, through your mother's doctor(s), senior social workers, support groups, etc., in order to make the best decision for your mother and you. Do not allow her to tell you what you can do for her, because some of it doesn't appear as if it is rational, reasonable, or even sensible to expect you to do.
I wish you and others facing these situations the best. It is not an easy road, but you have to consider your health and well being, too.
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ButterCuP7 May 28, 2020
I agree with you, set boundaries for yourself. Get resprite, get a massage, sit outside , enjoy nature. Please get some you time, dont feel guilty.
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Will you only be satisfied with a "fairy tale ending" ? These are the difficult times. She will never be satisfied with a decision that is made by another person. You know what the ultimate outcome will be.
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