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My mother is 70 yo and was a lifelong Rx drug abuser and alcoholic. Because of this, she has liver failure and is required to take Lactulose. My mother also has had narcissistic personality disorder her entire life. My parents were married up until my father died in 2005 and 3 months after his death, my mother threw herself down on the ground, claimed she was paralyzed with COMPLETE loss of bowel and bladder functions. She has been this way ever since. Needless to say, she has been in and out of 17 different acute care hospitals, a multitude of skilled nursing facilities and has been examined, scoped, x-rayed, CAT scanned, MRI'd from head to toe....only to be told numerous times that there is absolutely NOTHING WRONG with my mother except for her liver. She demands to have a permanent urostomy and colostomy placed, but no licensed MD will do this as she has no valid reason to have one. She constantly cries she is in pain and demands high volumes of narcotic pain medications and yet after numerous EMGs and other nerve conduction studies, there is no evidence of pain in the areas she claims to have pain. I work close with her MD, who knows her history and her abuse and the only pain med prescribed is Neurontin 300 mg 3x a day. My mother will polish off a 90 day supply in 10 days and when her MD refuses to refill, she calls 911, cries chest pain to have EMS rush her to the hospital. When she gets to the ER, she feigns confusion, cries she is in pain, cries for narcotic pain medication and when all of her demands are refused, she will urinate and defecate right there on the spot. She has been discharged from numerous hospitals, SNFs, nursing homes, etc. for noncompliance and extreme poor hygiene. This behavior is constant and she pulls these stunts about 2-3 times a year. Needless to say, she burns up her insurance benefits for the year very quickly and they will no longer pay until the next year. Just this past Friday, my mother was discharged again from another 45 day stint at another skilled nursing facility. While there, they had her walking, dressing, bathing and using the toilet. However, she refused to take her Lactulose medication the entire time she was there, so they discharged her for noncompliance. When I got her home, she wheeled herself into her house, stood up, and transferred herself into her recliner. Then she proceeded to urinate on herself and then demanded that I clean it up - I refused. I had to leave to go get her groceries and pick up more prescribed medication and when I returned the next morning, my mother had a field day of urinating and defecating all over her house. She urinated and defecated all over the recliner, smeared feces all over the floor in the living room, defecated on the bathroom floor and smear it in there. When I grilled her as to why she did that, she said that she was in pain and needed her pain med. What? Really? So she's basically saying that she cannot hold her bladder/bowels unless she high on drugs. I am at my wits end as this is just 1 of many many horrific scenes my mother has pulled. She lived with me and my family for 4 years doing this exact same behavior. It was on a prior stint that her social worker came to our home and witnessed my mother and her manipulating disgusting behavior. The SW called DCF out of concern for me and my family and they forced us to remove her from my home. My mother 'can' walk but refuses, she rolls around in a wheelchair. She can use the toilet, but prefers to soil in a diaper. But worst is she refuses to change her own diapers. According to her "that's disgusting, YOU clean it." So my question is, where do I go from here. No conventional nursing home will take her because of her hygiene and noncompliance - she's a threat and liability to other patients. No specialty nursing home will take her as she is NOT a para or quadriplegic, she has no reason to warrant a urostomy/colostomy. There are no more state mental institutions. My mother is broke and lives off of a small SSI income. DCF, her doctors and state social workers have all told her that she is going to end up homeless on the street if she does not stop with this disgusting behavior. Her newest diagnosis is now an extreme case of drug and attention seeking behavior. It is quite obvious that my mother trying to manipulate me (and others) - to the point that she will just sit there until someone cleans her up and caters to her ever whim. She constantly screams """I'm not doing nothing for myself, you are MY daughter and its YOUR responsibility to clean and care for me, screw your family, I am your mother and I come first.""" My mother and I did not speak for 20+ years, until she exhausted and destroyed every other family members homes that they shipped her off to me - me and family live 4 states apart. I do not have power of atty over my mother - I tried and she refused. I am only her healthcare proxy. Where do I go from here??????

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Get a restraining order? I was glad to hear that DCF is aware of the situation. That helps protect you against any legal shenanigans she might get up to.
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What Jessie said....call a damn exorcist! And I thought my mom was whacked!

Honestly, were I in your position, I'd change my phone number and for all intents and purposes literally disappear off the face of the earth as far as she is concerned. Let the state deal with this woman. I wouldn't take over anything concerning her, not for one minute of one more day.
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In reply to sb23508...yes, there are witnesses - numerous local healthcare providers, i.e. homehealth nurses, SNF nurse, etc. My mother's medical record at her MDs office is as thick as a 3 inch phone book.....and she's only been here in Florida with me for 4 years.

But I want to thank you all for your replies. I truly needed the uplift and support. I also wanted confirmation for myself that what I am doing is right. Again, thank you all for your advice and support. Best wishes to everyone!
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Emjo is absolutely spot on! The only thing I would add is to try to get a 3rd party (one of your mother's friends, neighbors, etc... ) to witness and document the behavior. Failing that, use the video/audio feature of your cell phone to discreetly capture the behavior.
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(((((((((((((hugs|)))))))))) I was thinking the same thing, though very tough call to make. And thank God for the DCF.
You are the first point of contact. There was a gal on here a while ago who had a similar situation though not quite as bad, but her mother was obviously very mentally ill. She ended up refusing to have much contact with her mum or to be involved in any decision making. The system dealt with her mum and the gal has achieved a good degree of freedom from the stress.
Your mum is on a path of self destruction, and I doubt anyone can "save" her.
I surely understand that you are sick and tired of this. My mother is mentally ill too, though she looks after herself well physically, but I have been dealing with her crises for about 70 years. I am 76 and I am heartily tired of it, Re the lawyer I wasn't concerned about your power over her, but her power over you in terms of the threats. However the lawyer has assured you that you are not responsible.
It is very unfortunate, but the FL state social worker has made a recommendation and I have to agree with it. It does sound awful, but I think it is the best thing. I am so sorry you are in this horrible situation.
It still can't be easy for you facing that .
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Again, my mother lives in her own home - She is not permitted to be under my roof or DCF will remove MY children from my home. The state deemed her a health hazard around my kids. Yes, I have consulted a lawyer - I do not have power of atty over her, so I am not legally or financially responsible for her. But because no other family member will deal with her, I am the first point of contact every time she pulls one of her tantrums. Why me? Because I am related to her? I am so sick and tired of having to repeat the same story over and over and over again each time she pulls this. The only reasonable choice I have left - per FL State social worker - is when her ammonia level gets high enough, she will fall into a coma and from there, I can take over as healthcare proxy. But after 4 years of this, I can guarantee you that I will refuse any heroic measures and will immediately place her in hospice. As awful as it sounds, every healthcare provider involved in her care with me has stated this would be the best thing for her.
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No I don't blame them. My mother, though not in the same ball park as yours, refuses to take meds that would deal with her paranoia, which makes life harder for everybody.
I hear your fear that she will report you. Is there not a big enough paper trail by now that you are doing all you can. She knows about elder abuse. Would it be an idea to consult a lawyer for your own protection and knowledge as to what your responsibilities are? She is obviously an excellent manipulator. Find out if you have to keep her clean and get her groceries when doctors have declared her able to do so. Maybe I am up a tree here, but it seems to me that she is calling the shots, and the table needs to be turned if that can be accomplished. For example, is it considered abuse legally if you do not change the diaper of a woman who is capable of using the toilet? If it is not abuse I would be inclined to let her sit in her sh*t till she decided to do something about it. Her problem - not yours. I may be right out to lunch here - all I can think of.
((((((((((((hugs)))))))))))))) to you , It is a horrible situation, Truthfully not many could or would do it.
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Sorry for the obvious question - have you consulted a lawyer?

Can YOU evict her for non-compliance? If she ends up in a shelter and acts like this I bet they'll find someplace to put her!
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Your mother is not an elder yet, so don't worry about that one. She sounds like she is pretty able to take care of herself when it comes to spunk. Reading about her, it sounds more like you need an exorcist. Sorry for being cheeky, but this is a nightmare. There has to be a way to get her into some type care facility.
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This is FLORIDA....we no longer have state funded psych facilities and because my mother is coherent and appears rational and sane in front of healthcare providers- she adamantly vocalizes that she will not take her lactulose or any other medication and here in Florida, that warrants discharge for noncompliance. These facilities and providers do not want responsibility for her because she refuses to follow their instructions. Can you blame them?
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As I read it mpeak's mother lives in her own home at present not in mpeak's home.
It is untenable for you to continue like this.
I don't understand her dr. and state social workers saying she will end up on the street as she is clearly very ill. Are there no psychiatric facilities in your state. You say there are no state mental hospitals but surely there must be some facilities that can deal with non compliant psychiatric patients.
Personally, I think your main role with her should be as advocate for obtaining a suitable placement even if you have to go out of state.
My heart goes out to you, This is an impossible situation and yet you have been dealing with it for some time. Prayers for both of you. let us know how you are doing,
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Yes, she's seen a psychiatrist and was prescribed meds, but again, she refuses to take it. Unless its narcotic, she will not take it. I've tried to have her Baker Acted (72 hr psych hold) but because she's not a threat to herself or others, they will not take her. I've tried numerous agencies, but all cost money and I will not give another penny to assist my mother. I've supported her enough and she's cost me thousands of dollars in repairs to my home. As noted above, we did not speak for over 20 years. It was my dad's death that forced us to communicate again. As to how did I get stuck with my mother??....After dad passed, she went to live with my sister. She destroyed my sister's home the same way. She then went from family member to family member and you would think that she would behave considering that they were being generous to let her live with them. But no, she purposefully disrespected them and urinated and defecated all over their homes. Now these are not accidents - she rips off her diaper and will release right there in front of people. Then very RUDELY demand that someone else clean it. Believe me, the entire family hates her. They dodge me and avoid my calls for fear that I may send her back. My husband and I both have careers with school age children. I'm asking for advise because my mother is very smart and knows the legal laws about elderly abuse. She threatens me that she will lie on me and destroy my life unless I do what she demands - dead serious. Thank the lord for my kids and their cellphones - they video taped hours upon hours of her behavior and threats. I showed these to her primary MD, but all I am told is unless she falls into a coma or becomes unconscious, I cannot make any decisions for her. Oh how I really wish an anvil would fall out of the sky and clunk her on the head - just like Wile E. Coyote. :o(
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BTW, if you think you may end up calling 911, check to make sure which hospitals have psych units. At her age, she may just need a regular psych unit, instead of geriatric. That way if she goes to the ER, they will be able to transfer her to the psych unit without arranging for a transfer. Much luck to you.
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Your mother is clearly mentally ill and needs to be placed in a psychiatric facility. Talk to her doctor about committing her. You can't tolerate this behavior, even if it is from a family member. Once she is committed, don't let her come back to your house. If her doctor won't commit her, call 911 when she has one of her extreme fits and have her taken in for geri-psych evaluation. Then make your home off-limits to her. It is apparent that you mother does not have the capability of respecting you enough to let you take care of her. Big super hugs to you. You have gone beyond the call of duty. It is time to let the professionals handle it.
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id get her some frigging opiate narcotics. a drug dependancy should be a non issue with an elder in failing health. if it comforts and stabilizes them i dont see the harm. bipolar, for example, is almost always linked with substance abuse but science to this day are unsure if the substances cause the disorder or if the substances were used to self medicate an existing mental discrepancy. opiates dont get you high. they just give you a comfortable and peaceful glow as tho an electric blanket were tossed over your shoulders. i dont care for them but i do understand the shroud of calm and contentment that they provide. im a tobacco addict. if i run out of tobacco youd better duck cause ill be at least slinging turds.
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Turf to Psychiatry?

Your mother's behaviour is very extreme, surely. Could any drug addiction agencies provide help and advice?

(And what on earth possessed you to allow her over the threshold..? But it's a bit late to ask, of course.)

Your situation is horrific. I wish I had more useful ideas to offer. xxx
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