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??????