How to deal with older sister in late third stage COPD with diabetes who is stubborn and has a hair trigger bad temper?

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She is on many many medications for asthma, COPD, diabetes, blood pressure, and is very overweight and her mobility is growing more limited, though she lives alone and gets around and does for herself with the help of a housekeeper who comes in once a week or so. She lives in another city. We talk on the phone twice a week as I find it is too much for me to handle her anger every day. I visit once a month. Over time she has become a rager. Asking her to tone it down is more incitement to anger. Most conversations are walking on eggshells, she is not interested in more help at home or assisted living or support groups, but is constantly angry and vents and escalates to rage at any frustration. Being around her is similar to being in a car with a road rager, and she will not accept my asking that she not yell at me about things that are not my fault, for even asking a question about something she is complaining about, trying to understand what is going on. I have anxiety depression and panic attacks and migraines due to stress and though working hard on these things and getting treatment have not found a way to deal with her attacks when trying to set some reasonable boundaries as to the verbal abuse and raging, that doesn't trigger my own issues. I understand she is upset that she is dying, of course. It would be a lot easier to help her and be there for her if she wasn't so angry at me all the time and insisting that nothing helps. I know that there are some practical things that do help but she has fears of spending money to make whats left of her own life more comfortable though she could afford it and is relatively secure. Is it common for people in later stages of COPD to become ragers? I have another older sister who has had the same problems with this sister's rage/anger but she is even further away and does call every day, but she says it is affecting her own health. Has anyone found a way to help the problem if it is caused by the later stage of COPD? I wish she would use her oxygen but she does not. I have suggested she might talk to her doctors about some of these frustrations and lack of interest in anything she used to care about, if she is depressed but that triggers more of a rage. We are not and have never been really close, I am much younger and even with all the above issues in much better health (she would not accept that psychological issues are real ones) but I feel obligation to her and grateful for the ways she helped me in our dysfunctional family situation during my childhood.I would appreciate any suggestions.

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"Somehow she got the idea that releasing anger and frustration is better than holding it in, and since it gives an adrenaline rush" Wow! I think you summarized the situation in a nutshell. At some point you have to think of yourself, your emotional stability and your own health first.
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Thanks Give a Hug. I have been working on my restraining myself for awhile now, as I know by now it only leads to blow ups. Somehow she got the idea that releasing anger and frustration is better than holding it in, and since it gives an adrenaline rush I don't think she will change much. Walking away, as you say seems to be the only thing that works, for at least a little while. I know I can't change her, my only choice is to handle it differently within myself. I must work harder on detachment because it does upset me a lot, ruins many phone conversations and visits.
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I remember reading a comment that the "I can't control myself" excuse given by wife-beaters was a bunch of BS, since they could always manage to control themselves around someone who was strong enough to beat them to a bloody pulp.
I think your sister's "uncontrollable" raging may be in the same category. She probably COULD control it if she had to, but it's more enjoyable for her to rage than to not rage. All I can say is maybe next visit, tell her you really can't handle her complaints since you can't fix them, and when she starts, ask her to stop, since it's not anything you can do anything about, and change the subject, and if she persists then leave.
Come armed with some PLEASANT topics of discussion, and a reason to leave at a particular time (so you don't run out of "good" topics).
BTW, this one visit don't tell her what to do about ANYTHING. Not her Ox, not exercise, not ANYTHING. Maybe this would be a good visit to go out to a coffee shop, or anywhere out of the house - anything to break the bad behavior rut.
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Thanks GardenArtist, I have spoken to my other sister and she is saying the same thing. I am thinking that she might get used to the idea of more help over time even if it's only additional visits from the housekeeper for now. She is independently living in her own two story house, not in a facility. I also called some local home service agencies and explained the situation, and they agreed that she seems depressed and would benefit by more attention from professionals but it might be that it will take another acute emergency episode for her to be more open to help, someone outside the family who gently encourages her to use the oxygen more as a maintenance rather than just in emergencies.
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Your sister has made some decisions which aren't helping her situation, but they are her decisions, right or wrong. I can understand that you want to help your sister, but from your explanations, she's essentially pushing everyone away with her anger.

I don't think that late stage COPD engenders rage. From your description, it seems this is a personality and self care problem. You state that she has become a "rager" over time, and has other co-morbidity problems. Apparently she hasn't taken care of herself, is now facing some very serious health care issues, and is angry.

If your sister refuses to cooperate with you or even with medical recommendations, such as using oxygen, I honestly don't know if there's anything you can do.

Your profile states you're caring for someone in independent living. If this is your sister, perhaps you could talk to the Admins and ask if they could arrange for a social worker to visit, although I imagine she would meet with the same anger as others.

It's a sad situation for you and your family. Perhaps others will have some suggestions, but it doesn't seem as though your sister will cooperate.
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