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I have a historically parental relationship with my mom. By that I mean that I have been the parent for the majority of my life and she has been the child. This started in my teen years and has slowly but surely transformed into a tough love situation where I am not willing to bail her out of situations or hold her hand anymore (for at least the last 10 years). Now, within the last month, her health which was already not great has gotten worse and so I need to be more caring. However she is still the same person she was so I find it difficult at times to come to a balance between the tough love that is still necessary so she does not take advantage of me (her medical conditions are not affecting her mental state) and yet give her extra care and support that she needs right now. I do not live near her and so any care/support I provide in person involves at least 3 hours of driving and a lot of logistical changes for my family which includes a younger child. This is additionally why I still need to keep my guard up as I am looking out not only for myself and my mother, but also caring for my family in my home. Any advice?

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The responses here are excellent and should help some. Make changes slowly, involve other people in your mother's care such as in-home caregivers, set boundaries to protect yourself and your family, and take care of yourself. Finding the correct balance is difficult for any of us and it's different for all of us.

Daugher52 said it well when she said she had to "mother" her mother but did it in such a way as to not make her feel less than a person. It sounds to me that your mother may have had some mental illness or personality issues that made it necessary for you to be the caregiver way to early. Now you're faced with other issues too. We are with you in spirit. Please keep us posted.
Carol
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Tough love and care giving are not incompatible. You do it with your children, correct? Same thing.
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One good thing is that you don't live near here. That's a built-in buffer right there.

My advice would be to create boundaries. Over the years your mom has become dependent upon you and now that dependence is shifting into someone altogether different than what you've been used to. There are many books about creating boundaries and maybe someone here will have a title of a few that have to do with elderly parents but those books are out there and can help you figure out how to create boundaries. One boundary you can build right now is, because you're a mom with a family, you won't jump in the car the minute your mom calls on you. Assess the situation first. First determine if you even need to be there or is this something that can be handled over the phone with calm tones, support, and reassurance. Some elderly folks love their "emergencies".

Keep your guard up but let it down a little as you do some of the more hands-on care for your mom. With boundaries in place you'll know when your mom is trying to prey upon your good nature and willingness to help.
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My personal experience is that I sometimes have unrealistic expectations of my 90 y/o mother who lives at home with my heavily medicated, mentally disabled sister. I like what looloo wrote: "Something I remind myself to try to get better at, is that you can't prevent any/all accidents, you're doing your best.” I’ve actually found that I had to back off a bit, as I was getting too much into my mother’s business, and it was really pissing her off.

Do as much as you can to make sure everything is in place from a legal standpoint, get others involved. I actually called her states adult protective services and had them come in and do a living situation evaluation. The assigned social worker now makes surprise visits to my mother, and gives me a call afterwards.

I grapple with the fear of letting go, and acknowledging that she’s getting closer to the end, she’s going to eventually die, whether it’s in a nursing home, or from an accident at home, or a stroke/heart attack.

There’s only so much one can do on their own. Boundaries are important, but setting up a network of help is equally important. Don’t try and do it all by yourself.
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Yes, build boundaries.

Also, consider other ways for Mom to get the care she needs. Some things you can do best. Many other things can be done equally well (or better) by others. If her health is beginning to fail, she should have a cleaning service if she doesn't already. Perhaps she should have meals on wheels. Does she need a periodic visit from a nurse? Would her doctor order that?

Mom may sincerely need more help now than she used to. Help her arrange for that help, but set boundaries around what you will do yourself.

Does Mom have a medical alert system? Would that be a good idea now? You cannot handle emergencies from that far away. She needs to call 911 or use an alert service. After she's done that she can call you and you can help keep her calm until help arrives. If appropriate you can meet them at a hospital.

Mom should know you are there for her, that you will not abandon her, and that you continue to love her. Keep the boundaries, too.
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Is her dependency at a level where assisted living might be the best choice? Perhaps at a facility closer to your residence?

Clearly she's not going to respect boundaries, so you have to do it yourself and FOR yourself and your family.

As long as love is in the equation, you'll make the best choices. Good luck and God bless.
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My mother (92) is BPD, bi-polar, and Narcisisst. Independently living nearby in her own apt, finally this year she befriended someone who lead her to a great agency who helps elders. When I tried to get her help I was the enemy with an insult. When a stranger makes a suggestion, it is like it was sent from Heaven. She is always critical, over-reactive, demanding and the well, you all know the list!

Today at lunch as she rants and rabbles on and on and on about nothing: I closed my eyes for a moment to enjoy the food. All upset she snaps at me,
"Don't give me that bored look!"
"Excuse me? I am enjoying this food for a moment. How do you know what I am thinking or not?"
Mom: ignores me and looks like an offended queen, turning up her nose, snorts,
HUMPH, and than continues to rattle. Meanwhile, I am thinking: bored? now why would I be bored with this 100% self indulgent and insulting human being who happens to be my mother?

I just put up with what needs to get done, take time off when I can. I come back to my empty apartment so happy to be alone.

Tough love is about boundaries. Care giving is about obligations, choices, and maybe, if there is any left after dysfunctional mental illness that is NOT dementia or Alz, maybe there is a shred of love. I think I love the person that was: a few years of a few good times. I am grateful for what she has done for me and I see my job as learning boundaries, being a firm but kind person, learning how to be flexible and able to back off and let it be.

Trying to find possible opportunities for good times together, certainly seems like mission impossible but today I found something to try. I am used to situations rapidly degenerating into my mother making me into a villain, but today it was fun to see her smile. A friend of mine needed a mural to be finished. I tried to paint the figures yesterday and found it very tough so I invited my mom to come and try it. I introduced her to my friend, showed him her portrait work, and I acted as her assistant while she struggled with the mural. She was thrilled! So far, so good. I was happy that I was able to find something that we could both do and that she could be proud of.

There were times my friend and I weren't sure she could pull it off, but we quietly got out of her way, trusted her, gave her breaks, fresh juice drinks and I kept cleaning her brushes, water, and dealing with the paints and so on. It was fun and we all were very happy. It ain't done yet but I think it may turn out to be good experience.
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That's true, that the distance has pros as well as cons. Getting comfortable with setting different boundaries is really important, knowing that you're free to adjust them as you see fit. Something I remind myself to try to get better at, is that you can't prevent any/all accidents, you're doing your best. It's never been a two-way street w/you and your mom, so you can only do what you can do.
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You do it a moment at a time....It is difficult to advise you when so much more history is needed. Forgive, I am in the medical profession. God bless & care for you first.
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This is a tough one. I have noticed the change in my behavior as I moved from the daughter role to 'mother' of my mother. I think it is inevitable. I manage every aspect of her care so it is easy to slip into the opposite role. I think the key is to do it respectfully without making her feel less a person.
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