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She is just old no medical conditions besides NARCISSISM. she was never nice and is getting worse.

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Help for nasty mean 90 year old mom, or help for you?!

What sort of care does she need that brings you unavoidably into contact with her?
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What I used to say to my BIL, whose mother - much as I personally adored her - was a piece of work, was that he must try not to feel responsible for anything she said or did. For example, the time when on collecting her from respite care he felt the need to assemble all those members of staff who had been helping her and apologise to them for the ordeal she had put them through. I'm sure the staff appreciated the thoughtfulness, mind; what I took issue with was his accepting that he had any responsibility for her cruel personal remarks, unreasonable demands or slanderous accusations. He just didn't. What you have no authority to control, you cannot be held responsible for.

It is very hard not to cringe and blush for badly-behaved loved ones. But detach, detach, detach. Thank the waiter - better yet, thank him and leave a decent tip. Moderate the conversations with strangers, as far as you reasonably can. But do not accept blame. You are not the slave driver or the intrusive fellow diner.

AND - you say, she requires you to do such and such. Well, she can ask. You can say no. Or can't you?
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Ninety year old seniors often get a pass. I'm impressed that's she able to go out for lunch and order for herself! If her behavior is just too off putting for you, then, explore hiring someone to transport her and take her to lunch. We all know how much we can tolerate. She's not likely to change, so, if I found her conduct too annoying, then, I'd make other arrangements, if there are other options.
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Here is an interesting thought. What if the stress of your mother's demands is causing your acid reflux? The logical thing to do then would be to cut back on them, not feed them, no?

You will find... oh, sooooo many interesting threads about this very topic on the forum, including some encouraging success stories. Dealing with guilt is very hard, but I hope joining AgingCare will be an excellent small step towards it :)
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You don't always have to say "yes" to your mother; that's part of being an adult.

It sounds as though your mother has had a hard life. That is very sad, and not her fault. It's not YOUR fault, either.

Guilt is reserved for doing something bad, with ill-intent. Saving your sanity and your health is "job one" for you. You put on your own oxygen mask before you try to rescue others, right? Do that now.

In most places in the US, there are agencies and services that will provide what an elder needs for pay. If the elder has no resources, there is Medicaid.
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It's tough getting old, and one has to be tough to get through it to advance to a higher age.   And it is sad, as Mom cannot do the things that she use to do ages ago, like get in the car to go shopping on her own.   She probably is having issues with hearing and seeing, which is very common.   Think about it, most of her best friends are gone.   Doesn't make for a cheery quality of life, doesn't it.   I think all of would be grumpy at that stage of life.

So many times I had to put myself in the shoes of my own parents to get a better understanding why they were acting the way they were.   They both become very stubborn, more so my Mom then Dad, as she was in denial that she and my Dad where in their 90's.
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I suppose I'm fortunate, because I don't know any seniors who are mean and nasty, except for those who have dementia. For that reason, when I see it, I suspect that they have some mental decline.

So, to me, caring for them, making them comfortable and not expecting too much is important. Even if someone was a rude person earlier in life, I tend not to hold them to a high standard when they live to such an old age. The advanced senior is dealing with a lot. I'd try to have some compassion. If that's not possible, I'd try to find alternate care for them.
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If finances are available, I might explore a Geriatric Care manager. They go by and assess how the senior is doing and keep tabs on the senior. They can go by once a week, more often or less often. That way you can be assured she's alright and your contact is limited.
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That's good! That's fine. I have no problem whatever with a tough-minded lady asserting herself and getting her needs met. Good for her!

Just so long as we're clear that it isn't always you who has to meet them :)
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She "requires you" -- with a gun to your head? By some criminal activity she knows you have done and she will turn you in? No. By simple guilt. And, my goodness, since she installed the guilt buttons she certainly knows how to push them!

What if she pushed them and instead of saying "yes Mother" you said "I can't do that this week."? What if you arranged her grocery shopping with a senior transportation van? (There is one parked outside of my supermarket a couple times of week.) What if, when she pushed that guilt button you said, "I'm sorry you feel that way, mother. You can take the van or not, your choice. You could also call a cab. But I am no longer going grocery shopping with you"?

This would not be easy, would it? Would seeing a therapist for a while help you over this guilt obstacle?

Why not ask each of your siblings how they manage to not feel guilty about their minimum contact with Mother? Certainly not as though you are criticizing them, but as you would sincerely like to know.  Maybe you could learn something useful from them.

It seems to me that it is your own guilt that is "requiring" you to do things you don't want to do. Learn not to obey the guilt.
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