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My 82 year old monster in law is driving me nuts. She has Narcissistic Personality Disorder. That has been a life long issue, and because of that, the family is in denial about her needing dementia care. They just think her bad behavior is the same as it's always been.


A year ago, the county senior services paid her a visit. They forced her to take an ambulance ride to the hospital, where she was diagnosed with kidney failure. She has been on dialysis three times a week ever since.


She has fits of rage and crying and text messages and calls my husband at work daily, causing him to get upset. She demands he leave me and come home to her. He is being driven up the wall, but avoids reporting her to anyone and says it's not our business to intervene.


I secretly called the dialysis center SW and she said my MIL is receiving the maximum amount of dialysis, so her behavior can't be due to uremia. She said it has to be dementia, but she can't discuss anything with me due to HIPPA regulations. She suggested I call the county SW, but they tell all details of the report to her, so it identifies who made the report.


In addition to staying on the phones, both cell and landline, she stalks my husband and others on social media. If someone blocks or unfriends her, she makes nasty posts about them and then harasses them for blocking her.


She has also been harassing my husband at work about our car and how we need to have it worked on. She calls mechanics and sets up appointments for our car without our permission, and then won't stop harassing my husband at work until he takes it to the shop. Then she calls the mechanic and wants to know why our car isn't there, and why he didn't he fix our car. She curses out the mechanics and then my husband. She is relentless.


Is this indicative of another mental illness besides dementia, which she very loudly denies she has?


How and where do we get help?

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Ahem. Well I must say that for a person who wishes to keep her medical information secret, your MIL must have some pretty chatty professionals on her team.

Why not look at it this way: your MIL's extraordinary hostility to you does have the advantage that it lets you off the hook. She doesn't want you to know. Believe her. Respect her right to confidentiality.

And your husband says he doesn't have time. Believe him, too. I should give up on trying to help MIL or deal with her behaviour, ignore her - not nastily, just because that is clearly what *she* wants - and concentrate on supporting your husband in however he wants to handle this very difficult phase. It doesn't sound as if it going to last an awful lot longer.
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I would think having dialysis her urine is tested regularly.
My MIL was passive aggressive. She would do something you had already told her not to do then get mad when u didn't appreciate it. She also lied. When she found out at 92 that after a bad UTI she wouldn't be able to go back to her home, she willed herself to die. Like said, let your husband handle her. She will respond to him better. My husband was always able to take care of his Mom. I chose not to be around her unless he was with me. If she is ever hospitalized, you may want to have her evaluated then.
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Your pastor's counseling will help to the degree that he has had to deal with similar situations himself in his own life and has had experience in helping others with this type of situation. I hope if he finds himself in over his head, that they want hesitate to refer you to a trained licensed clinical social worker type therapist. This is not saying anything against clergy, but their training seldom goes into this deep of therapy. Clergy tend to be generalists although there are exceptions.
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My husband is not even being included on knowing any medical information. My MIL is keeping all of her medical information a secret. My husband says he doesn't have time to deal with her. No one will admit to having any POA or other legal or medical rights. In fact, when she does get hospitalized, she sets up passwords with the hospital that only my husband is supposed to know and says I can't visit. She said she hates me being married to her son so bad, that I caused her kidney failure. 😕

Even though the SW cannot "legally" discuss my MIL's information with me, I told her what is going on. I was told the information would be passed to her physicians. I guess no one is listening.

The dialysis center SW said MIL is likely to pass from a heart attack or blood clot before the dialysis stops being effective enough for her to die from the kidney failure.

I have read up on hospice but it sounds like locally, it's not encouraged. The dialysis center tries to get the patients to stick with the treatments as long as possible, even though they say it's their choice.

I am seeking counseling, along with my husband, through a church pastor. The pastor said he would help my husband set some very clear boundaries with his mom. I think he's going to need the pastoral care in place when his mother passes anyhow. I have looked into local Grief Share groups also.

I have been told that when MIL is hospitalized next time, I should be able to contact the hospital chaplain and the chaplain can be a liaison so to speak and relay information to MIL's medical staff without her knowing. I have been unable to get a chaplain to call me back when she gets admitted though.
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The family dynamics sound such as the two of you need some guidance from a counselor who is experienced and trained to deal with such dysfunctional families. I'm convinced that many of our parents are the reason so many of us are in therapy seeking help and support for dealing with them. You are not alone and seeing a counselor does not mean you are weak. You need support and guidance in setting boundaries not in order to change her (which is not going to happen), but in order to protect yourself and your own well being.
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MIL certainly sounds very ill indeed. I agree that you might find hospice a very useful source of advice and guidance, even if nobody wants to broach the topic with MIL.

It must be difficult that you aren't being included in discussions with her care team. The thing is, obviously I don't know about your MIL specifically, but a person can be receiving maximum dialysis but still have uraemia: there's a limit to how effective dialysis can be. And she can be on all the right heart meds, with all the right monitoring, and still have oedema: ditto. The skin on her lower legs is likely to be very fragile and prone to breaking down even if she didn't scratch.

Does your husband have access to more information? Has she appointed him or anyone else as her health care proxy?
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"We constantly hear her say she wants to die". Has anyone brought up the possibility of hospice care?
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It is certainly frustrating. My husband is suffering due to her behavior and it's hard to watch him be on such an emotional roller coaster. He has chronic health issues as well, and doesn't need the stress.

MIL does have other health issues, such as cardiac. I know a physician must be monitoring that aspect because that has to be in check in order to continue the dialysis.

She also has anxiety issues that she is being medicated for, with Ativan or Xanax.

The dialysis center SW confirmed she has a diagnosis of dementia.

As for her skin, a combination of the kidney failure and dialysis makes her body itch non stop. She thought it would get better with dialysis and instead it got worse. I know she's miserable.

Though we're not certain, maybe her legs that are being treated at wound care is where she's scratched them open.

We constantly hear her say she's dying and she wants to die.
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I have been married for 40 and have a strong willed MIL too. I learned early on to let my husband deal with her as he sees fit. Take a step back and allow him to deal with it. Help only when you are asked to.

A couple of questions, does MIL actually have any diagnosis (other than Kidney Failure) from a doctor? If not you may want to suggest to your husband and his siblings that at her age a complete physical might be helpful. I agree with freqflyer, check for UTI. But basically you will just need to let her children decide what to do.
Sorry as I know how frustrating it can be.
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MIL has dialysis three days a week and have been told her blood is tested before and after each treatment, as well as other vitals, such as temperature, watching for fever due to infection etc. I'm not sure about urine testing for a UTI. I know those can cause mental issues if not treated. However, I have read some patients stop producing urine when on dialysis. I don't know what the case may be here.
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She appears to be deteriorating fast physically, such as alot of weight loss from the strict dialysis diet. The skin on her legs is breaking down, though we're not completely sure what from. Information has been passed to us that she has been going to wound care for that. It just seems to me doctors would stop sending her home at this point, and draw up orders for a nursing home or at least admit her to a dialysis unit. I pray every day over this situation.
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Jag, when was the last time Mom-in-law was tested for an Urinary Tract Infection [UTI], as those type of infections can turn an elderly person into a monster. The test is easy and quick, and urgent care facilities can do them if Mom's primary doctor is busy. The treatment is antibiotics.
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I hope you don't feel were attacking you.

Getting care for someone who is resisting that care is almost impossible until they are hospitalized and it becomes clear that they can't be safely released.

It's sad, I know.
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She is ill in more ways than one, unfortunately. A restraining order that leads to her arrest is not an option. This is my husband's mother, and I am trying very hard to get her help, in a loving way. Trust me, it is extremely difficult to be forgiving toward someone who hates me that much, no matter how toxic she is.

My husband and I do not have a POA for her. As far as we know, no one does. She keeps all of her medical information private so no one can know anything.

She lives with her 82 year old husband and a 60 year old daughter. The husband hasn't been to a physician in 30 years, and yes, he shows signs of Dementia also. However, there is no one to force him to get help either. The 60 year old daughter is living there to be taken care of, not help care of the parents. The daughter is like a zombie, I assume from the years of narcissistic abuse by the mother. The entire home situation is dysfunctional at best. The husband and daughter take turns dropping her off for dialysis but are uninvolved in her care. The husband shouldn't be driving at all.

Like I stated, my husband is not the type of son to do hands on care. The family is very much into avoidance and denial because everyone suffers from her abusive ways.

I know it varies by state on getting someone committed, but we are in MS and the PD will not get involved. An ambulance has to be called and we have to meet with a psychiatric nurse at the hospital and sign legal papers agreeing to testify in court against her. This will turn the rest of the family against us, as they think getting her care is being mean. I know, it doesn't make sense.

I am not here to be attacked or put down by anyone else.
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It sounds like the woman is taking way too much power for herself. The only thing I know to do is take back some of that power for yourself. It doesn't matter if she talks bad about you online. That happens to people all the time. It doesn't matter if she is mad and calling around. If your husband doesn't need to take his car in, he could just say no. I don't understand this at all. Why would he take his car in because his mother told him to? Just say no and keep saying no. The only way to handle a narcissist is putting up physical and emotional barriers.
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The main difficulty seems to be that your husband is being constantly interrupted at work.

If she is calling his office landline, it should be possible to block her number - ask whoever's in charge of the telephony system.

If she's calling his cellphone, then he must just turn it off during office hours; and, if he needs to use a cellphone a lot, get another one and for God's sake don't give MIL the number.

I sympathise with your efforts to get MIL's healthcare team to pay attention. But about making a formal report: suppose your MIL did know you'd called social services in. What then? And?

She can spout and rant on social media, she can howl her head off, she can do what she likes. But everyone who knows her (and you) must know what she's like; so why does it matter what she says? Surely every insulting and offensive comment will only confirm publicly what a piece of work she is when she puts her mind to it?

I do also have room for some sympathy for her. Even people with, er, "challenging" personalities do feel ill, do get old and do have reason to be angry and afraid. The way she copes with it is, obviously, unpleasant and unhelpful; but all the same - don't forget to look at life from her point of view, too. Dialysis three times a week can't be much fun.
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So, she has preexisting NPD, renal failure and dementia. Does she live alone? How is she getting to and from dialysis?

This is your husband's mother; what does HE want to do?

If she's stalking you on social media, the block her. Contact all your FB contacts and write "sadly, MIL has been diagnosed with dementia". Just leave it there.

Call the mechanic and tell him not to accept any appointments from her. Tell him not to argue, just don't write them down. Tell him just to hang up if she becomes abusive.

You can usually get an involuntary 72 psychiatric hold on someone who is behaving in a way that is a danger to themselves or others.
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Wow...I would get a restraining order.

Seriously, you need to get her out of your life. This person is toxic.

You obviously do not have POA, or DPOA for medical. So, you have no legal,obligation to continue this. Change your number and drop social media.

Wow. Stop being a doormat.
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