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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 amazon.com, 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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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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Who would look after her if you didn't?
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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 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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FOR ME, I HAVE TO START MY DAY WITH PRAYER AND A SMALL STUDY OF THE SCRIPTURE AND MEDITATE ON THAT VERSE LIKE THIS ONE: FOR IT IS GOD WHO WORKS IN YOU/ME BOTH TO WILL AND DO HIS GOOD PLEASURE. PHILIPPIANS 2:13. THAT IS SO CALMING TO ME. THEN I ASK GOD TO PLEASE GIVE ME WISDOM AND KNOWLEDGE TO FACE MY DAY. TO DISARM THE ANGER, TO CHANGE TGE SUBJECT NOT TO ENGAGE WITH THE ANGER, TO GIVE ME SOMETHING FUNNY TO SAY LAUGH. TRY THAT.
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lealonnie1 May 2020
Better yet, she can try getting her narc mother PLACED in a Nursing Home or ALF and THEN she can say a little prayer every day.
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This is one of our problems these days. We fight to keep them healthy and safe while allowing them to deteriorate further.
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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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Next time she has a doctor's appointment, can you go with her and raise your concerns about her health and safety with the doctor during the appointment?
And if something happens and she has to go to the hospital or ER for any reason, that is your chance to say she can't live alone safely any more and explain why, then deal with the hospital social worker about the options for her upon discharge.
Does your town have any kind of elder care services such as a meals on wheels program or senior center? You could reach out to them, they might have a social worker or program administrator you could speak with who might have some good advice too.
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jacobsonbob May 2020
Even better would be to send a letter to the doctor describing all her observations BEFORE the appointment so it is on record. She might not have time at the appointment to say everything that needs to be said, and with her mother there, she might up having an argument with her mother on the spot. It's also possible that her mother will refuse to allow her to be present.

She should also be certain to keep a copy of the letter for future reference, such as if needed as evidence that her mother needs care in a facility if/when she ends up in a hospital and is about to be released. This will lead right back to contacting the doctor, who can then provide additional support for this decision.
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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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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 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.
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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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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 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.
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Your paragraph starting with "Recently, her short term memory and word recall are just shot" to me means dementia is setting in. Your Mom needs a good physical. There are all kinds of things that could cause her memory problems. UTI will cause Dementia like symptoms. She needs labs done. Write everything down and hand it to the receptionist and ask that the doctor read it before he sees Mom. Then he will be able to ask the correct questions.

I think after 20 years its going to be hard to set boundries now. I would never move in with her and visa versa. I think you have kept your sanity this long because u don't live together. I hope you have POA. Will make your life easier.
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cmdcwc Jun 2020
POA, and Health POA! Our attorney drew it up so that my husband does not have to be in a vegetative state for me to make health decisions for him. he did have to sign the paperwork, but I’m not sure if he was actually aware of what he was signing. every time we go to the hospital, he wants life-saving procedures, which is why I always carry that DNR. I carry the Medical Directive with me anytime we have an appointment in the event I have to make a decision and need the legal proof.//because we had hospice for a bit, I also have his DNR in the car, and on the side of my refrigerator.//The financial POA doesn’t allow her to make health decisions for her mother, which is why I had to get the health power of attorney. of course it depends on the state you live in.
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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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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 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!
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Actually, her mental illness may indicate she is incompetent. She cannot manage her financial affairs and loses important documents. The stories she tells demonstrate she is losing her ability to relate something as it really happened.

If, at this point, the both of you can still have a conversation with her that she understands - try being firm with her about things that MUST happen if she wants to continue living where she is. A person, selected by you, will be coming in X times a week to clean. For initial cleaning, you should be there to sort through junk mail and important documents. As I understand, she is living in an apartment so the landlord owns her residence - not her. They have an expectation of cleanliness for safety of other residents. Blame the deep cleaning on them if you have to.

You can go online and change her bills to come to your address or arrange auto debit payment for most all of them. That will prevent digging through stacks of mail at her house.

If she is beyond living alone, and you have no plans to take her to your house, then it may be time for assisted living where people are paid to help her out. They will stop the hoarding, for same reason an apt manage would. They would be on call to help her. They have activities if she wants to participate. It may be time to make the hard decision.
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cmdcwc Jun 2020
Your points are all well taken but I know for a fact that even a patient with dementia and hallucinating can refuse treatment and meds, can refuse to follow directions, and can refuse placement.
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Why, wny on earth are you putting up with this? This is horrible. You have gone above and beyond and now her mentality and behavior are going to destroy you. Enough is enough. IMMEDIATELY start the process of placing her somewhere away from you - that is your only hope. Caretakers won't stay or put up with this and you'll be back where you started. She is gone - it cannot be allowed. Be tough and get her into a place where she is "controlled" and taken care of. Please do NOT wait. She is mentally not there, nothing is going to fix that and even if it did, do you really want her around you? I would hope not. Get help now and move her as fast as you can and just tell her off if she starts in on you - sometimes that works better than distraction or kindness to make them stop.
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cmdcwc Jun 2020
Although I agree with your answer, assisted-living facilities, nursing homes, memory care facilities - even when you’re paying top dollar, they don’t have to keep a patient if the patient is a “bad player.” I have a friend whose mother was kicked out of five different facilities at the age of 90. she was so hard to deal with (biting doctors and nurses, but no dementia. Just mean.) so that could be an issue in this particular case. When my husband was going through rehab (after ankle surgery) at a nursing home, his behavior was bad enough that he’s not allowed back in that nursing home. I can’t afford to self pay, meaning place him somewhere permanently, even if I were to go back to work full-time. but if he needed rehab again, I’m limited because there are two facilities that won’t take him. That may be the case with her mom. it’s such a “Catch-22.”//if she has the wherewithal (she’s passing the mini mental status tests,) all she has to do is make a complaint to family services about elder abuse, even if it’s verbal. then her daughter has a whole ‘nother issue to deal with. My husband has used that tactic on me, including once when he asked me to get a gallon of milk (which I don’t drink.) in the 30-minutes that I was gone, he forgot and called 911 and said that he was elderly (66,) had Parkinson’s, and that his wife had abandoned him. that’s all it took to start an elder abuse complaint. he even admitted remembering that he had sent me out for milk. so for the last four-years, I can’t leave him for even five-minutes. I have pictures of all the bruises where I have been knocked to the ground, punched, choked - no one cares about that. all they have to know is that he’s got dementia and Parkinson’s; I don’t stand a chance. The fact that he’s having hallucinations would be my only saving grace - someone might think he’s confused, because he is confused. It’s a no-win situation when the patient is also manipulative.
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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 know.........my 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 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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What keeps you tied to her? Are you dependent on her for any reason? It might be a case of backing off and letting things take their course.
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Kat819 May 2020
What keeps me tied to her is that I keep thinking she's about to die. She's outlived her parents and all of her siblings by substantial margins. I am an idiot because the idea of breaking with her permanently when I've put up with all this abuse for the last twenty years means giving up when it's almost over.

She almost died four years ago. She had pneumonia and LBBB. Her heart was 30 bpm. I took her to the hospital and dealt with everything for her to get a pacemaker and go to rehab. Then I thought she would go live in assisted living at a CCF and I would be done. But she fell and broke her pelvis in AL twice, which was a total nightmare. Then the doctors told me the chances of her dying within one year were staggeringly high. Wrong.

She moved out and that was three years ago this summer.

I just want make nice with her until she dies or ceases to have any idea who I am.

The problem is that she's too compos mentis to be put in a nursing home against her will. In many ways, she's sharp as a tack when it comes to the news. She can pass the Mini Mental Status Exam with a score of 24. Obviously, she's going to get worse eventually.
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Imho, 20 years is FAR too long to be taking care of your LO. You need respite badly. Prayers sent to you.
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I think it might work for you to get an assistant who is hearing impaired for your mother, since her verbal abusiveness is such a problem.
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I like the term GAinPA used *backing off*.

It's not abandoning. It's still being in touch, calls, visits etc. But as a daughter - not a servant.

Have you said no to some of her requests in the past? What happened?
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By the way, the 'denial of decline' you mentioned is a thing: search *Anosognosia*

https://www.agingcare.com/articles/anosognosia-dementia-patients-cant-recognize-impairment-210090.htm

https://www.agingcare.com/articles/anosognosia-and-caregiving-suffering-from-a-lack-of-insight-196699.htm

When logic & reason fails face to face, you have to work behind the scenes instead.
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Yes, I’m going through it with my almost 96 year old mother. My mother is a gambling addict and a hoarder. I live 15 minutes away from her. She lives alone in her house. I refuse to live with her. I have backed off seeing her and calling her. I go over once or twice a week. My son goes to help her twice a week. She left me a nasty note the other day. My mother took call a bus to go to the grocery store and my husband and I went to her house when she was gone to put in her air conditioner. She knew we were coming over because my son told her the day before. She left me a note that said”DONT TOUCH MY BAGS. I was up all night clean up YOUR mess!!! Stay away!!! You make me sick!!!” These are nasty notes that she use to leave my father all through my childhood. Now she is writing nasty notes to me!!! She is verbally abusive to me so I back off seeing her!! You are right, just because she has mental illness doesn’t mean she’s incompetent. My mother is very competent.,Takes her own meds, pays her own bills, takes call a bus to the grocery store. This was the first time she has been out since the beginning of the corona virus march 15th.
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Ohlas1 Sep 2020
Wow, I got the nasty grams (that’s what I called them) too for aslong as I can remember.

one of favorite repeat ones was “clean the house, don’t throw anything away.”

the funny part was she would put them in my clean non hoarded room on the mirror, she was in the house.
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I am a caregiver also - Parkinson’s and Lewy Body Dementia. I have such anger because of his treatment toward me early in our marriage, his lies, AND the fact that he didn’t disclose his Parkinson’s (which he had for 12-years before we got married.) I found his meds three-months after we were married, and even then I had no idea that I would end up having to dress, bathe, toilet him. It’s like taking care of an 18-month-old.//With that said, as I read your post, my heart breaks for you. Unfortunately I have no answers, but I just wanted to let you know that even though I thought my situation was bad (I am so unhappy,) you are really taking a beating, both physically and emotionally. Try to make time for self-care, if possible. You might call the elder affairs office in your county to see if they can offer you some solutions. I’m sure someone on this site will post better options. I pray things get better for you. I am guessing that you are exhausted, and that you feel like you have no life. I hope someone gives you good resources to look into.♥️
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One avenue that might help you is by calling a local hospice and asking them to evaluate your mother for palliative care due to her heart issue. mention her dementia, but do not mention the nastiness. there’s hospice when someone is dying, and there is palliative care hospice. I’ve had them twice for my husband; in both cases he was dropped Because he was not dying in the six-month period. they knew that when they took him on; they did remind me that if I needed them again, that they offer palliative care. my husband has Parkinson’s, Lewy Body Dementia, and mild congestive heart failure. he’s only 70. your mom is in worse condition; they may very well give you services. A nurse would come in once a week, they would provide her meds which Medicare would pay for, they might provide someone to bathe her three times a week. We were asked if we wanted a DNR. I said, “yes;” my husband was sitting there and didn’t say, “no,” so I have a DNR and you’d have to rip it out of my hands!// when one hospice dropped him because he wasn’t dying, I then called another hospice and we got services from them. it will cost you nothing for them to come out and evaluate your mom. again, don’t bring up the nastiness. Whenever hospice came, my husband spent his time complaining about me not letting him leave the house (we had 4-silver alerts last year;) me not letting him in the refrigerator or the kitchen (he started a fire on the stove top.) there was so much drama, I think that’s why the 2nd hospice dropped us. So don’t bring up anything negative between your mother and yourself. they might see it once they come in and start working with you; don’t point it out to them.//don’t ask your mom‘s permission. An hour before they are due to arrive, tell her that a nurse is coming to check on her. or don’t say anything until they show up. my husband’s dementia is such that it didn’t click with him that hospice could indicate dying (although he’s not dying.) your mother may balk if you ask her. Once they’re in her home, quickly mention that they are there to see if they can help you take care of her (which might help you get past having to use the “hospice” word.) I do hope you have a POA, and you really need the health POA, so that you can make financial and medical decisions for her.
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My mom is a narcissist too but a little younger and just at the beginning of health issues. I appreciate all the post on this website and I’m setting up strong boundaries now. No offense to those with good mothers who reach very old age but seems like the mean ones live the longest. Good luck to the OP.
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You’ve made some comments that need to be read together. “I started taking care of my mom 20 years ago. I didn't think she would live this long.” “What keeps me tied to her is that I keep thinking she's about to die.” “I just want make nice with her until she dies or ceases to have any idea who I am”. “People with narcissistic personality disorder live longer than normal people.”

She’s 92, she could live for another 10 years. Seriously! She may be ‘about to die’, but don’t count on it. Stop the stuff about ‘want to make nice’. Just walk out. If and when she dies, so what? Acknowledge to yourself that it’s what you always wanted, what she always deserved, and what is inevitable anyway. That’s the brutal truth - at least look at it!
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