Mom has covert narcissism, depression and is scheduled to be released from a nursing home soon. She's difficult at best. Advice?

You've moved out, here's to moving on and better days! Excellent! Best of luck, enjoy the freedom!

Just be very honest w/ her docs & nursing staff and ask for their help. They should be able to assist you w/defining what will come next for your mother. Going home may not be the best solution for anyone.

Since you are POA, make the discharge planner & her doctor aware of her desires & thinking. Tell them that she is unsafe at home and needs placement. Getting her placed while she is there is the easiest way to do it. Once she leaves to go back home, it'll be extremely hard to put her in AL. Make it clear to your mom that since you live so far away & she refuses HH the only safe decision is AL. if you are unable to work effectively with your mom tell her that she needs to find another POA (even need to pay for one) because you will not be responsible if something bad happens to her.

Why is your mother in the Nursing Home? Is this rehab and her time is up? If you have moved her to a NH, how are yhey "releasing" her?

MintJulepCrazy: Imho, make sure that she is NOT released from the NH to YOUR home. Her car should be disabled by any means possible, e.g. removing a key element because IF she does drive, there certainly will be "trouble" in the form of a vehicular accident. If she questions why the auto is no longer working, respond that you haven't a clue as to why or you could say that the auto had "car trouble."

My sons had that issue with their dad. They informed the nursing home that neither of them was equipped to care for him and the NH would be responsible if they discharged him without arrangements. In spite of pretty extreme pressure, the boys stood their ground and refused to take either financial or physical responsibility for him. (PS - This had nothing to do with their feelings for their father - they simply were not in a position to give him the kind of care he needed)

If she is getting released it may be a good time to move her to another facility. While this can be difficult, it can be much harder to get someone out of the house later. It helps if your mother has the finances to start this, then figure out the regular payments later.
You have to be very firm in not letting them talk you into taking her home.
Your mother sounds a lot like my mother was (she has passed). She was the fourth parent my wife and I cared for, and the only narcissist. She only became worse and much more abusive toward the end. E.G. as revenge she reported me as abusing her because I would not bring her home. After that I would not visit her alone so there was always a witness to my visits.
Do not let her permanently destroy your health like my mother did to me. Stress kills. It took me a long time to find out I could only help with her needs, not her happiness or personality.
It is easier if you trigger the POA as far as decisions, but remember the POA does not make you totally responsible for her. It just gives you the power to make health decisions and/or manage finances (depending on the type of POA). It is not an honor.
One of the last things my mother said to me was "I did not really want you, but I kept you because I thought your father did. " That explained a lot.
Good luck. Use this great forum regularly. it helps.

First and foremost, no matter what happens or how she screams FOUL, DO NOT TAKE HER INTO YOUR HOME. It will destroy you and accomplish nothing for her except have someone to beat into submission that much more. With her personality and behaviors, no caretaker would take her on for very long and then what. She MUST be placed where she is cared for and you can live a normal life which you are entitled to. You stand your ground to those who want you to care for her and say NO- you can't and you won't and you can't handle it. DO NOT GIVE IN NO MATTER WHAT. And do you have a Power or Attorney or Health Care Power of Attorney. Get this now.

It’s smart of you to protect yourself, if your mother has narcissistic personality disorder ( different than people who have some narcissistic behavior such as being self absorbed) looking up online only affects 1-6 % of the population and is not something such as depression that can be easily treated- it’s almost impossible to treat. How do you explain this to a prospective caregiver is challenging to figure out — if you choose not to disclose it to the applicant they’ll discover on their own at some point how she is and may be upset feeling it was withheld from them. On the other hand if you do disclose it needs to be the blunt reality of it, and that could discourage an applicant from taking the position. Have you talked with a psychologist or therapist about this? I think that would be the first thing to do to have support for yourself and they can give you guidance on how to navigate what boundaries you want to put, care decisions and taking care of yourself. If you haven’t talked w a therapist and decide to do so I would definitely screen potential candidates over the phone to ensure the person has good amount of experience w family members affected by those w a personality disorder

No real words of advice because I am in the thick of it with my aunt who hates me because I encouraged her to go into assisted living (four weeks later she ended up in skilled), but I empathize with what you are going through. Verbal and mental are real, they are extremely painful, and if you have spent a lifetime being subjected to it, exhausting. I had to walk away from my aunt. No more visits. I am POA so I make sure she is well cared for but for my own mental health, I cannot visit her anymore.

Not all Caregivers are nice and it is hard to have strangers in your home

You should talk to your mom and let her know when you're able to come by and for her to stay at home by herself, she will need to allow help.

Let her decide if she wants a Make or Female Caregiver and decide what would be nice for her to have help with.
Maybe she can get by with just having a companion a few hours a day.
As far as the meds go, most Seniors are on far more meds than necessary.

Tall with her and her Dr and decide which pills are absolutely needed or she will die and let her take just those.
Youtdoor be surprised what meds she canine just fine without.
The least mecs the better. You take this and you need to take this for the side effects then you need to take thst for the sides effect of the other and so forth and so forth.
Devidence what a pill is being taken for and what wojld happen if she didn't take it and if she would have already died before that would happen anyway.
My 97 yr old Dad stopped taking all his meds 4 yrs ago and all his vital signs are good with every check up. All he had to have was a Cathiter because of his enlarged prostate which he took pills for to help him pee but as far as the other dozen med's, looks like he really didn't need them after all.

Talk to the Social Worker.
If she does not want help at home and you can not care for her she can not be discharged to go home.
She needs to be told that it is either accept the help from a caregiver OR she remains where she is.
I could go on and on but the 2 options pretty much limit the conversation, as they should with your mom.

You need to to calmly but firmly tell her that you will not go along with her plan. And that she is not to speak to you in such a manner. And turn around and walk away. Don’t pick up the phone every time she calls. To me, it sounds like some of her behavior is dementia starting to layer on top of her personality disorder. But I’m no doctor! You need to speak to the discharge team and let them know that it is an unsafe discharge and you are not able to care for her. That you work (and need to work) and live at a distance. That there is no one else. That she doesn’t take her medications, refuses caregivers, and has no concept of her current condition. That if she is discharged back home she will be at risk and will end up back at the hospital. The discharge team will be happy to shift the burden on you - but stand your ground.

Your mother sounds exactly like my mother. Unfortunately I had to wait until she declined to a point where she no longer had capacity. I contacted APS to report my concerns so those concerns were on record (they did nothing). My mother was recycled through the hospital, to rehab and back home to rot before any action to keep her safe could be taken.

My advice is to try and take care of yourself and not be sucked into this endless pit of negativity. This could be a long journey and it’s just the beginning. Think hard and long about taking on her POA. Believe me if I had known, I would have taken a look at having a state guardian take over. Get some counseling and set strong boundaries. The stress will make you crazy and take a toll on your physical health. And keep us posted.

I had my mothers probate lawyer meet with her, go over what her doctor recommended, and he had her sign a letter, after finally agreeing to remain in assisted living because she required 2 aides.
Wheelchair and oxygen but she’s going to do all these activities.
Her long term home care insurance would not pay for 2 aides, and she’s more apt to listen to a male attorney, then family, due to her narcissism.
She said the exact same delirious things.
It’s very wearing on the spirit so take time for you-

Yelling at you and "threatening trouble" if she can't drive are just words. Nothing more. Yes, it's unpleasant and hurtful in the moment, but really it's all she has left. Her power has,for the most part, been taken from her. Sorry to say, that what you are feeling is the initial stage of caregiving in which you still "fight " to maintain your freedom. It will be somewhat less angst causing when you realize that for the time being that your life is not really yours but will be that of the person who needs care. Even if she goes to AL or LTC, she will remain a focus. So take it a day, hour, or minute at a time. Good luck.

I am in a similar position. Look after yourself. We have been brought up to believe it's our responsibility to take anything off them. There will lies whatever we do. I am at breaking point. I have been told to walk away and let carers more detached to take over. Good luck

If she is compos mentis then your POA isn't worth the paper it is written on - she gets to decide. If not then you do. But if she isn't then she needs to be in a facility and that is what I would arrange for her. You don't have to do any more than that - either she needs to be in a care environment or she has control of her life and you don't have to get involved. Just plan your couple of weekend a month visits, say nothing and leave her to get on with it - she is an adult. Don't let her historic treatment of you put a guilt burden on your shoulders, and don't play the martyr for her benefit. If she is being manipulative then leave her to it and look after you first.

Hi MintJulepCrazy,
I'm in the exact same boat! I feel your pain, stress, misery, and aggravation. I've been taking care of my dad for very many years and notice the decline in his cognitive abilities. He was in AL for 2 1/2 weeks from a fall, UTI and sepsis.
The home said he was fine and able to go home alone as well and of course, drive! My estranged brother and the home seem to think my dad is sharp as a tac! Yeah, right! I brought him home on Tuesday. Have been super cleaning his home and no where near finished. But it's uncluttered and easy for him to use a walker now. The first thing he said: No napkins, Rose what do you do with all the napkins? I never seen napkins in my lifetime. I needed the chuckle. But he is the same way. Won't take his meds, won't shower or take a bath and won't drink a drop of water. He has his car keys and I'm sure he'll be out and about first thing on Thursday. My hands are tied as well. I'm in the process of getting him evaluated. My dad does handle his own bills but not much else. Date/time/year as well. We live a little under an hour away and yesterday we went from home to his house 3 times. It's very difficult. It does seem like we're the crazy ones, eh? I just wonder if dementia can get better now they're at home.
I do hope things get better for you.

Please get her evaluated by a couple of doctors. Her family doctor is a start. He/She may make a referral to a neurologist to evaluate and treat dementia. Make sure she gets a referral to a geriatric psychiatrist to evaluate and treat her mental health issues.

I suggest you talk with a lawyer that deals with elder law about using your POA since your mom will do things that are not in her best interests. She may need to be placed into a facility to keep her healthy and safe. Start looking for places that take dementia patients with mental health issues - they aren't many.

You mentioned dad - do they live together? What is his condition? Can he provide any care for her or is he in need?

As long as no one has deemed her incompetent, there's not a lot you can do. Even the POA wouldn't be active, as you noted (per the bank.) That includes using it to hire people (if they are being paid from her funds - you shouldn't be using your own!)

You can't "place" her, you can't stop her from being discharged (she can discharge herself.) You CAN refuse to do anything that she needs done, including providing a ride home. Let her or the NH arrange that - you aren't available, period!

I wouldn't recommend revoking the POA yet. At some point you may need it and it will be legit, but if she's not competent, she wouldn't be able to assign it at that point.

So, let her go home. Let her make stupid mistakes. Let her get rid of all her "help." None of these are considered being "incompetent." Plenty of people ruin their own lives making stupid mistakes. In the meantime, stop going there. We can't force another person to do what we would prefer and there's no point to making yourself miserable along with her. If she needs food/supplies, she can hire a taxi or equivalent or have it delivered.

Until/unless she's deemed incompetent, your hands are tied. Even with dementia we can't force them to do what we want, like moving to facility (per our EC atty.) I would stay away. At the most, I might, if she tones it down, help with the food/supply delivery, and maybe a ride to medical appts now and then, but it might take some time before I'd commit to that! My mother (early dementia) wouldn't let the aides in (only 1hr/day to check on her and meds, nothing else!) She could get nasty when she wanted, but generally she appreciated me helping (we took the car away, that didn't go well!) I live 1.5 hrs from where she was, so I know how taxing it is to make multiple trips! I REALLY burned out dealing with the condo after she moved to MC (2.75 YEARS of multiple trips/week!)

God help you if you allow her to come home. Look at how she is behaving now and when you stop her from doing certain things, it will be hell for you. Have her placed immediately and do NOT allow her to come home. You will be very sorry if you don't listen and take her in.

You have received some great advice here. This is abuse. You cannot continue to be abused. Talk to the nursing home social worker. Tell her you cannot continue with her behaviors. Let the social worker know it’s affecting your physical and mental health. Make it clear you can no longer be the primary caregiver. Resign your POA. This is no way to
live your life during this season of life.

Don’t discharge your mother from nursing home. Tell Social Worker you would like to leave her there long term. Home care isn’t going to work & you can’t be there every day to supervise. I’m guessing your mother won’t even let any help in the house. Does she walk? If so, she might be able to go to assisted living…& they usually have memory care within their building too. ..her abuse is a red flag that she could have dementia. Has she seen a neurologist? She needs medication to control the agitation or else she’s going to hurt herself & any caregiver. Hugs 🤗

So sorry for the situation you were and are in. Please set boundaries for your mother, if she starts being abusive leave or end the phone call. Do not have the car fixed and do not find the car keys. If she is physically abusive call 911 and press charges. Do not have the car fixed and do not find the keys.

Do a search in her area for AL facilities make the trip and note the 2 you like the best and tuck them in your pocket for when the time comes - which may be sooner than later. You don't have to let mom know you are in the area. She will still be a distance away and you can caregive from a distance without ever seeing her again, if that is your wish. You can advocate so that she gets what she needs.

When the last caregiver has thrown in the towel contact APS for a wellness check or the Council on Aging or whatever they call it where mom lives to see if they can do a needs assessment - of course mom may kick out the social worker.

If worse comes to worse call the social workers in your area and tell them your mother needs assistance but you can no longer act as her POA.

Even though she is your mother - she is not allowed to abuse you and you don't have to put up with it. Take care of yourself because you are worth being cared for. I wish you all the best in the world.

She's just started having issues that are either she made a stupid choice and quit taking her meds or she might have the start of dementia. Or is that the fact she can't hear? It's very hard to pin down what it is.
The nursing home says she's okay to go home and live alone. They also saw the mean targeted at specific people. Since she's okay to be there alone, that means that if she starts lashing out, all of her caregivers can leave. I've spoken to everyone who's getting paid and made it clear that they should leave if she gets mean and not to reward any tantrums.

She can still manage her finances. I spoke to the bank and until she's diagnosed and declared incompetent, i don't have poa for either parent because Dad has a contingency poa. But she thinks I do in terms of living at home and medical care. The car won't start. I failed to maintain it while she was away. Not so much by design but because I just had so much going on. We've also misplaced the keys for now. I don't have the authority to sell it, but I'm skilled in making cars not run.
My gut is she won't make it at home. It means cooperating with too many people. I can do the poa stuff from afar with her in a nursing home. And if she's okay to be at home, I can keep my distance, too

A few things. Having POA paperwork in place is different from the POA being active/usable. Many POAs do not become effective unless the person is permanently or temporarily incompetent, as judged by one or more doctors. If that is your case, until the POA is invoked you can't make her do anything. This is extremely frustrating, at least it is for me with my personality disordered mother, but it also kind of sets you free. You can't legally make a competent adult do something they don't want to, even if they're making dumb decisions that threaten their own health and safety.

The good side of this is she can't make you do anything either. Cut your visits down to what is manageable for you. I went from visiting weekly to not having seen her in person for years. She's still chugging along, firing any caregivers well meaning family hires, and just being a generally whiny person who won't listen to reason. When she neglects herself to the point that she needs a trip to the hospital that's when you can step in and try to get some better care in place. Until then you can work on your own boundaries. Decide what's best for you, balancing your desire to be a "good person" with caring for yourself too.

Call the Social Worker at the Nursing Home and inform them that you do NOT live with mom and that you are resigning your POA due to her abuse.

Ask that they facilitate emergency guardianship by the state, or, if they deem her competent to run her own affairs, that you will not be involved in any way.

There will be NO solution as long as others think YOU are the solution (quoting Beatty)

I’m not clear on who’s making decisions on her care, other than you? If there’s a car she owns, use your POA to sell it immediately. Provide no defense or attempted justification for doing so, or for any other decisions you make in her best interests. There are a number of caregivers here that provide care from a distance that’s safe for their own health, a wise choice for you. Please decide now not to take another minute of abuse. The minute is starts leave, or get off the phone. Make your own choices about what you will and won’t do, sounds like you’re off to a good start with the decision to limit visits. She will need more help, and you not trying to be all the answers will ultimately show her that she needs more help other than you. And know that calling APS is an option if she becomes in a dangerous position. I wish you calm and peace

What people are making decisions for her care? Do you mean people you as POA hired? It isn't up to them to know your background or question. That's not their job.
As to being POA for your Mom, I would not serve this function for an uncooperative woman who abused me. I did this for my beloved brother. It was a job! And he was the best guy ever.
I would talk to an elder law attorney about hiring a fiduciary to handle bills and finances. They get paid out of her funds. I would not continue as POA unless Mom was in care. If she is incapable you can report her as an elder in need to APS after resigning as her POA. Many people do not have children. They are on their own in these things. Eventually the state takes guardianship. As far as I am concerned that should be the result of abusing children, as well. They are simply not "there" when finally needed.
That's my own opinion and many will disagree. I feel no obligations by blood, only by love and caring.
I wish you the best. I think that if your Mother has any competence left at all you might consider sitting with her and telling her her options where your own "services" to her are concerned. But that's just me. Whatever your choices for your own life I do so wish you good luck.