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She has a horrible habit of badmouthing any person that’s out of the room, or ear shot.

Here’s an example: I brought my mother to get a blood test at a walk-in clinic, it was the third stop we did on all day outing that included two doctor visits, a trip to the bank, and some grocery shopping. She’s 90, no longer drives, but is able to get around without much assistance.

I stayed in the waiting room. Little did my mother know, the soundproofing there was nonexistent, and I could hear everything that was being said. As I sat there I heard her say to the lab technician, who was Chinese and spoke very little English, that her children didn’t care about her, and never help her.

On average I take off one day a month from work to bring her to her numerous appointments and errands. I usually sit in on all the doctor appointments, as I am her health care proxy.

I got kind of fed up and told her that I wouldn’t be able to take her to the following month’s appointments and that she would have to make other arrangements.

Should I have confronted her on it after we left the office? Or is it better just to let things roll of our backs?

Thanks for listening.

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Either let it roll off your back OR confront her. Don't kinda do both. If you are not taking her to next month's appointments and haven't explained why, what has she learned from that? That you don't care and don't want to help, confirming her paranoid fear. Don't punish her without even telling her why, and how she can change that.

Is this lack of gratitude a relatively new behavior for your mother? Has she shown some paranoia since her stroke (or coronary event -- can't tell from your profile)? Does she have any signs of dementia?

Or is this horrible habit one that she has been practicing for decades? Have you ever brought it to her attention before?
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Ruggles if she's always been a narcissist, as my mother has, she'll never change. After I sold my house, quit my career and moved 200km to care for her (4 years of living hell) I discovered she'd been telling people that I lost my job and she "saved me". I was absolutely horrified. She has Parkinsons and has had increasing dementia for years. She's in a NH now and lord knows what stories/lies she's telling.

Since a stroke a few months ago her speech is slurred such that you can't understand her much and she decided she didn't need her phone any more.. No-one else calls and I've been visiting 2 or 3 times a week, running her errands and so on but it's becoming increasingly difficult and downright depressing. Occasionally she'll call from a hallway phone to find out what I'm doing and/or to pick a fight.

Last visit she'd dropped the tv remote the night before and staff couldn't find it and her radio wasn't working well so take it back to the store. The remote was found (I suspect she hid it just to see everyone run around searching for it) and no, I don't have the receipt, it's a cheapie and I'm not driving for an hour to take the radio back, chuck it out.

I may take a nap but, if I do, I'll have to take the phone with me in case she calls. Depending on the mood, if I don't answer she may try to call the cops and cause even more chaos. Although I don't live too far away, I've never given her my address, just the name of a nearby village, though of course the NH has my address for billing purposes. I may have to eventually change my phone number and make it unlisted. It's all crazy making.
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Teaching a 90 yr old manners is futile. The elderly are scared and vulnerable, some become very self centered, forgive, ignore, keep loving. Hopefully it will be paid forward when you are elderly.
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We experience the same with my MIL, so I try to redirect the line of thought. I will ask a question "Who called today?" and remind her if she has forgotten "Sue called, it's so nice of her to call you isn't it?" If I over hear a complaint, I won't address it directly, but in a roundabout way. I will ask about the person, how is she doing now? Oh that is good! when I hear a positive statement and redirect on a negative. Often they don't even remember saying something bad, but if you keep repeating the positives and discard the negatives, the patient starts to follow the pathway of thought. Even if I think the person is deserving of a negative assessment, I redirect mom to a positive thought like " You know her mother was a lovely person" and move on.
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Thanks for all the terrific responses, I learned something different from each one. Jeannegibbs, you’re totally right, a passive-aggressive solution is pointless. She’s been totally narcissistic as long as I can remember. lsmiami, thanks for reminding me that the elderly are "scared and vulnerable” - And pstegman, your tactic of "keep repeating the positives and discard the negatives” is something I’m going to work on. Thanks everyone.
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Ruggles, my mother does the same thing and she is healthy with no dementia. No strokes to blame it on, nothing. She has been this way my entire life. But when her complaining started including me and came along with a nice side order of lies, well that was too much. I confronted my mother. And I can tell you, It did absolutely nothing except to make her angry and complain/ lie more.

So, I guess you have to gauge if she is narcissistic or just getting old to decided what to do. In my case it only made my mother more hostile to me because she holds grudges and never lets anything go. So tread softly.
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Oh, and as usual, people are still stealing her stuff, especially clothes and chocolates. I think in some corner of her mind she imagines she still has huge walk in closets stuffed with clothes and shoes.
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I am so grateful that my mother doesn’t have dementia.
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