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Sibling has some BPD and NPD history. At this point, there is no physical violence or strong concern about that. However, there is strong concern of harm.


Mom is recovering from a massive stroke. Sibling is obsessively standing over her and doing things like screaming at me and an aide while we try to hydrate mom, etc. She has even gotten on the bed, over mom's body and right by her face to do this while I was giving mom something to drink.


The aide and I are both trying to stay away more, so as to avoid potentially triggering these fits, which hurt everyone. We cannot get the sibling to stay away from the room to just take a break for a while. This also means that mom is not always getting the sleep that she probably should.


The aide, who is a nurse and mom's friend, has heart problems and these encounters might cause her to be unable to continue to help. At that point, it would just be me, the sibling and a weekly Rn visit. I'm not personally sure how much of that I can deal with, alongside helping mom and keeping up my work.


Ideally, I don't want to get in the way of her having this time with mom - I think that mom would want her to be here, if possible. However, it seems like her having this time, in the state she currently is in, is potentially hurting mom's comfort and possible recovery.


(One aspect of this is that mom never got around to changing her POA to be just me, which she had been strongly considering (and I thought had done so last November, but the last update filed was 2011.) So, this has two effects: At this point, every medical decision is joint (It is set up so that I could do it separately, but also so that she could. So, if I start doing that, I think that she would do things without my input, and that could go really badly.) and also this fact is fuel for her crazy fire when she goes into her screaming fits.)


So, overall, I guess I'm just wondering about options if this continues and the need to have her removed from the POA and possibly the house (for some short period only, hopefully) exists.

BPD is such a challenge, to have it combined with NPD, I cannot imagine what you are dealing with. I have fmaily members individually diagnosed with BPD or NPD, but not together.

Unfortunately medications do not help for BPD, only years of intensive therapy.

I am guessing that your sister does not currently have a therapist and perhaps is not capable of accepting therapy at the moment? When she is screaming, what if anything, is she saying? Is she trying to stop you from giving Mum and drink, or does she want to do it herself?

Can you have a conversation with her when she is calm and ask her how you can help her to look after your mother? I know with my BPD family member, addressing issues from her point of view, helps her to feel empowered and allows us to accomplish things together. It is challenging at the best of times and if there is heightened emotion, my family member cannot cope.

Can you ask her what help she thinks the aid could provide to mother? It sounds like this has worked in the past, but now your sister is unable to cope with your mother's illness?

If she is truly out of control and putting your mother at risk, then you need to talk to your local mental health organization about her getting a psychiatric evaluation and perhaps a stay in a unit so doctors can help to get her back on an even keel. If you can arrange for at a minimum an evaluation, if sister is found to not be competent, then it should not be too difficult to have her deemed incompetent to fulfill the role of POA.
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JoRose Mar 21, 2019
I am 49 years old and have had BPD for 28 years. Yes, therapy is helpful but without medications it's pointless. Your moods cannot be regulated by simply talking to someone. BP is a chemical imbalance in your brain, medications ARE needed and DO INDEED work. I am stable and have been for many, many years. My mother made me her power of attorney and health care proxy years ago. I live with and take care of her which my sisters and brother all have decided was the best thing for her. Please do not say that medication does not help people diagnosed with Bipolar Disorder.
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So very sorry you are dealing with this. It makes my sociopathic sister who is trying to get paid for "caring" for our mother (basically watching TV and drinking wine) look like a pleasure cruise. Thank you for sharing your pain. It lessens mine.

As for what you might do I don't have a ton of wisdom here but I do know it pays to document everything. I am documenting everything because I never know when my sister will do something egregious.

And you might also consider using your smart phone to record her meltdowns. Then if you ever need a judge to decide for you, you have evidence.

Sorry I don't have better advice. Honestly I am just hanging on myself. But I am sending you a ton of respect and appreciation for coping so well with something I could not deal with in a million years.
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I hear what you are saying, Leonine, but I'd like to point out that it's not the mental illness that's criminal (or not), it's the behavior. I have a close relative who is bipolar and schizophrenic, and when she is off her meds she can be very scary. The police have been called when that happens. Actually, at least once 911 was called and it was the police who showed up, even though an ambulance was requested. If she could have gotten control of herself and calmed down, they would have gone away and everything would have been fine. But since she stood on the front porch screaming that she was going to kill or shoot somebody, that's a terroristic threat and they had to put her in restraints and take her away. She did not even remember it later.

There is a third scenario, and that is when she can't settle down but doesn't say or do anything overtly threatening or criminal. When that happens, they may indeed call an ambulance and take her to a hospital, to the psych ward, for a 72-hour hold for observation and treatment. Once her meds stabilize her, she's free to go back home.

Thankfully, she's been doing very well for about a year now. Cause for rejoicing. 😊

IMHO, a screaming individual interfering with the administration of meds, on the bed of a helpless elderly individual, is indeed cause for a call to 911. That sounds like endangerment to me. If it was my LO in that position you bet your bottom the police would be called, on the first offence, and I would be filing a restraining order immediately.
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Reply to DesertGrl53
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I'm not trying to attack anyone here, but it breaks my heart how society has criminalized mental illness. It's so sad that everyone's first response is to call the police. Even though there is nothing in your post to indicate your sister has committed a crime, apparently in their minds your sister has a mental illness, and therefore is a criminal, and deserves to be in jail.
Calling the police is the very last thing you should do. Even if you did, and they handcuff her and put her in the back of a police car, drive her down to the police department, strip her clothes off of her, take her mug shots, fingerprint her, and throw her in a jail cell, that solves nothing. In fact it creates a whole new set of problems for your sister and because you obviously care about her, probably for you. Where would your sister live when she's let out of jail in a day or two? She won't be allowed to go anywhere near your mother. And given her condition, she may not understand the consequences of doing so, and would run the risk of being arrested for contempt of court. In addition to having a criminal record, there are financial charges that will have to be paid. Can your sister afford that? Also, having a criminal record might impact her ability to receive benefits in the future. (Food, hoysing, health, etc.) Or be a part of other activities in the community.
You and I both know that as far as having her committed to a psych hospital requires that the person be a danger to themselves or others. And usually it has to be an obvious danger. I realize that at some point it might be necessary to resort to this. If that happens, other people will be involved in making that decision (thank goodness), so the responsibility won't fall totally on you. Otherwise, if you're like me, you might tend to feel guilty about it. And you should not.
So please, keep everything in mind before you call the police. Once it's in their hands, it's out of yours. She will be 100% at their mercy. You won't be able to talk to her or see her or protect her from being treated badly by other inmates and by the guards. It's not a good thing.
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I think having a video record of her outbursts would be wise, you might set up a nanny cam for use when she visits (check the laws in your state)
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I know first-hand about dealing with a loved one who has a mental illness. I know how sad it is, and I know how exhausting it is. I also know that in situations like this, our options are very limited. But please, getting the police involved is the very last thing you should do. (I'll talk more about that in another post.)

Assuming your sister is getting treatment for her illness, I would contact her mental health care provider and seek their help in dealing with this. Because of privacy laws they may not be able to talk to you, but you can talk to them and explain the situation. Ask if a counsellor could discuss it with your sister. If your sister is acting out of fear of losing her mom, a counsellor might be able to help.

You could also ask them for advice on how you can handle it with your sister. The right words to say, or whatever. If your sister isn't currently receiving treatment, you can still try calling the public mental health care provider in your area (where I live, it's the County Behavioral Health Department), and ask for help in dealing with this. Again, the right words to say, or maybe somehow involving your sister more in your mother's care - even in little ways. I don't know, but counsellors might have ideas. Sometimes the answer to changing someone else's behavior is changing our own.
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What on earth do the neighbors think about all the screaming? Is there any hope that one of them might call the police and initiate the treatment your mentally ill sibling seems to desperately need? Could another family member or family friend call the police on behalf of you and aide, or call APS about the abusive treatment a frail elder is on the receiving end from sibling?

I hope other posters might have some experience with this situation. It sounds highly upsetting to all concerned.
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Reply to SnoopyLove
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I think i would be tempted to stage a crazy fit and have someone call the police.

This kind of stress can cause another stroke or heart attack, I would have to try to get crazy put in a psych ward to get her meds regulated.

This behavior when you are administering care is abusive.
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