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My Mom 83 fell and fractured her hip and had surgery about 12 days ago. Prior to the fall, my mom would have self diagnosed panic episodes, and rarely left the house unless she absolutely had to. She is also a raging narcissist. The panic episodes are typically her being cruel and verbally abusive to others so more like narc rage imo.


While Mom was in the hospital, my sister stayed with her the entire time, day and night. She said she did this so Mom would stay at the hospital and not be panicked by being outside her home, and also to prevent Mom from verbally abusing the nurses and staff.


Mom came home a few days after surgery without rehab. Since coming home she has been bed bound and has been refusing to participate in her recovery.


I came to help my sister for a few days and it was hell. Mom doesn't like me as much as my sister. Mom calls me nurse ratchet if I attempt to help her with bathing or her bedpan. She even throws things at me that are readily available within her reach. Everytime I helped Mom, she got angry and said I was doing it wrong. I was doing my best, but it was not good enough for her. She has always raged at me more than my Sister anyway.


Eventually after a few days of this, I left to take care of my family and my mental health. Now my Sister is basically living with Mom, attending to her every need including bedpan duties in the middle of the night. I know she is sleep deprived. She just put her whole life on hold for the forseeable future to care for mom.


I said we need a nurse or an aid to help if this is going to be long term, as this is not sustainable, but my Sister doesn't want to because mom would be too difficult and mean to homecare staff. Mom freaked out when I hinted at it to her and basically told me to leave since I didn't really want to help. *sigh*


Currently, mom is not trying to do the exercises for recovery or trying to get out of bed. She wants to use a bedpan, but no diaper. I know mom is capable of more activity but she refuses. Maybe she thinks she doesn't need to try with my sister around. Maybe she is depressed, maybe she likes all the attention, maybe it just hurts too much. I don't know, but I have even seen mom reposition herself in bed without help.


My sister has children and a husband and a work from home job. Currently she is working between mom's needs. She basically sacrificing her welfare and family to care for mom.


I don't know what to do. I want to help my sister, but this whole situation feels so toxic. I am going to help her for another couple days next week, but part of me thinks I should stay away so they will agree to some outside assistance. An occupational therapist will be coming to mom's house soon. Maybe my Sister and mom will listen to them?


I just am worried for my Ssister's health and wellbeing. Mom will suck her soul dry and ask for more without boundaries.

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You haven’t said that mother has dementia, and it sounds as though she is legally competent – even if unpleasant. That means that both you and sister can only control your own choices, not hers.

Suggestions:
1) Go to the meeting with the OT. See what is recommended. If it's reasonable, decide that you will only help (at all) if mother follows the recommendations.
2) Suggest that sister does the same. It’s in mother’s best interests, as well as hers and her family’s. That’s why you aren’t willing to help her with care if mother doesn’t help herself.
3) Send a note to your BIL to explain in writing what you have decided and why. You are concerned that it will impact on all of you. Suggest that he considers the best way to handle the situation, and that he also sees the OT if he has doubts.

Good luck!
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Re the narcisstic label:
I sometimes wonder if becoming self-centered when ill/injured/disabled is a survival instinct?

I mean, it's no-one's fault really - but the one in need can sort of take over. Their needs just swamp the caregiver's. That's where I see your sister right now: at the bottom of the swamp.

Was Mom diagnosed with any dementia/Alzheimer's or any other condition with cognitive decline BEFORE the hip fracture?

Has there been a long standing pattern of pleasing Mom to avoid tantrums? Many non-confrontional , softer-hearted folk can fall into that rather than setting boundaries as you have done.

The longer the pattern is held, maybe harder to break. But change IS possible.
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MyaMama Aug 2022
Mom has been that way her whole life. I wish this was new behavior perhaps there would be another explanation for how volatile she is. My Sister and I have walked on eggshells our whole lives. That being said Mom wouldn't explode towards my Sister as much as she would with me. My Sister has always been my Mom's favorite. I keep advocating for some outside help, but to no avail so far.
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I agree, you are setting boundries. The only person who can help sister is sister. She too needs to set boundries. Maybe you can help her there.

I would talk to the discharge planner and ask if Mom was offered Rehab. I will bet she was and refused it saying her daughters would be there to help. 12 days without a physical therapist coming out seems a long time. My Mom had a small procedure for a fractured vertebrae and in home care was calling me that afternoon when we got home wanting to start the next day. OT I would think should have been out before now too. I would also ask the planner about that too.

There is a window where Mom can still go to rehab after a hospital stay. Thats were she needs to be. Let the OT evaluate but for every 1 day in bed, it takes 3 days of therapy. After 12 days, it maybe recommend she go into Rehab. I would tell Mom if she does not do the therapy and get where she can do most things on her own, she will need to go to an AL and if she can't afford that, LTC on Medicaid. That your sister and you have husbands and families that are your priorities. That you and Sis refused to be her caregivers for the rest of her life. Of course, you have to get your sister on the same page and the husbands need to speak up. May have a family meeting. Let her scream and holler, she needs you more than you need her. She needs to realize if she doesn't work to become independent, she will be placed. If she refuses, then you call APS, tell them there is vulnerable person that your refuse to continue to care for and she is refusing rehab or to be placed.

If you can, get her back to Rehab. Explain to her if she does not get to where she can be independent in her own home with little help from an aide (not u or ur sister)she cannot return to that home. She will transition to LTC or an AL but she will not be able to return home because her daughters are not doing the caregiving. You make the SW aware of this too. Tell them that it would be an "unsafe" discharge to release her to home. That you and your sister will not care for her. And I am sure after a few days the staff will know where ur coming from.

Your mother is playing you. I know a 93 yr old woman who had hip surgery and was able to remain in her home with no one living with her. Just family checking in. The longer Mom remains in that bed, the worse she will get. I bet the OT will be livid when she/he finds out Mom has been in bed all this time.
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Are you in communication at all with your sister’s husband or children? I wonder what they are making of this situation. Maybe together you all might have more luck changing this dysfunctional dynamic your poor sister seems sadly eager to participate in.
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Be there for the OT meeting, if at all possible. This will be a good chance for you to have your say - that caring for mom is too much for your sister. Maybe, hopefully, the OT will agree with you and put in an order for more care or placement.
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Call the hospital and tell them that mom needs to go to rehab. Have her transferred there.
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I feel really bad for your sister that she is going to sacrifice her physical and mental well being for your mentally ill and abusive mother. I wish there was a way you could get her to stop this insanity and place mom in a home and wash her hands of this woman.
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😓😓😓
Oh I get this..
(((hugs)))
Be back later after a little think.
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Did your mother qualify for inpatient rehab?

You have a much better sense of boundaries than your sister does. I applaud you for wanting to help your sister. What will be the biggest help to her will be if she will stop letting your mother basically abuse her.
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MyaMama Aug 2022
I think she said she would get care at home. She met all the requirements to go home at discharge according to my Sister. The Occupational therapist will be there on Monday. I hope they listen to them because they don't listen to me.
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