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81, Narcissist, COPD, vicious attacks. No helper will stay. I want my life back.

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I'm not sure from your profile page, do you live with your mother? I think that your mom can get away with being nasty because she knows you will come along to sweep up the pieces, perhaps if you stop that she will have to accept the help she is given, even if she is bitter and ungrateful about it.
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Keepingup, I thought my SIL and her husband were going to have exactly this problem. My MIL went through a string of paid "companions", at least two home help agencies terminated contracts - I couldn't think where they were going to turn next. And I honestly couldn't blame the companions: there isn't enough money in the world would persuade me to spend a week in MIL's house risking her insane, vicious, hair-trigger verbal abuse.

Oddly, my SIL's close friend had the same problem with an entirely different sort of mother in that she thought she would never get anyone to stay. She's solved it, too.

You have to persist, it seems, with agencies until - just keep praying - you find your personal Godsend Caregiver(s). MIL's has now stuck with her for well over a year, and friend's mother has bonded with someone who sounds absolutely terrifying (could carry a washing machine on her head, I'm told) but whom for whatever reason she just trusts.

Do you have a list of agencies? Any you haven't tried yet?
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My mother will never leave her lifetime home. I have had people she trusts suggest it gently - she throws them out. I almost think it would be better if I just left, but who would come in for basic needs,etc. I feel so so much guilt wishing she would just go, but those thoughts creep in.
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keepingup, have your Mom tested for an Urinary Tract Infection.

In older people, an UTI will make an elder be out of control regarding temperament, and other unwanted behaviors. Mom's primary doctor or an urgent care can easily run a test. If it does turn out to be an UTI then antibiotics will help clear the infection. And you can get your life back, and the cat would be happier [per your screen name photo].
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I'd say the family and friends are on to something. I agree with Katiekate.
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Look to find a memory care unit and admit her.
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Alzheimer's/dementia is tough to deal with. I would suggest you watch some Teepa Snow videos and read about validation by Naomi Feil. Are you getting helpers who are trained in dealing with PWD? I found it was very important to read everything I could about Alzheimer's and how to deal with the behaviors associated with it. Visit the Alzheimer's association website too.

I understand your frustrations... It is the toughest job you or I will ever have. Have you discussed her behaviors with her doctor? Does she seem neurologist our geriatric psychiatrist who specializes in dementia?

My mom was diagnosed in 2009. We started 24/7 care for her about 5 years ago. We did about 8-10 hours a day before that with my step dad covering after dinner and bedtime. Caregiving consumes your life, and mine.
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