It's been a difficult 4+ years since my Dad died and we've been trying to take care of my mom (now 84). She's always been extremely volatile: critical, negative, manipulative. But as her only child (she disowned her other child whom she left with the bio father) her care has been my concern. It's been hard since for a few weeks she'll think we (my husband and I) are terrific, what would she do without us. Then she'll turn on one or both of us, getting very angry. At times she'll say: don't call, don't come over but with no explanation. Then within a few days she'll act like everything is just fine.
Last week was horrid with her making accusations against me to my husband. When he tried to defend me, she blew up. I had a talk with her on Sunday and it was uncomfortable since this is the first time in my life I pushed back a bit, not rude or disrespectful but I did push to discuss the things she had said about me. She seemed OK, we went out to do errands and eat lunch as I do twice a week with her (she doesn't drive).
Today I called (I call her as well 2-3 times a week). She insisted that she "can't do this any more", she's miserable, her life is a mess, she enjoys my company but doesn't want me to ever come over again. We talked for a bit more, I tried to understand what she was trying to say but it didn't make sense. She insisted that I don't come over. I told her I didn't agree but I would respect her wishes since I didn't want to cause her any misery. She said she loved me and hung up.
Although she's been angry before and told us to buzz off, this sounded very final. The first thing I did was call her doctor's office. This is way more than I can handle and felt it was time to involve a professional. The nurse (fantastic woman) called me back and we had a great discussion. She's agreed that she's seen a downward spiral since my Dad died and she will talk with the doctor tomorrow. They will deal with this. She did say I could try calling my mom on Sunday, see if she's cooled down.
Long story actually but I've kept it as brief as I can. Is there anything else I should be doing?
You have my sympathies. I have some specific advice for which I cannot take credit for. It was suggested to me by a psychiatrist who referred me to assist several of his elderly patients. His advice was essentially that elderly people with anger, dementia and paranoia react very differently to personal visits than they do to telephone calls. And even differently to written messages (letters) or e-mails. It may not be possible to visit in person, but information and conversation that is face-to-face is significantly more therapeutic and significant than a call by telephone.
His feelings were that "telephone therapy" is far less effective than person-to-person therapy. I realize that the telephone may be the only practicable means of communication in many instances and it is better than nothing. Nevertheless there is both a qualitative and quantitative difference between telephone contact and in-person contact.
His advice was always to have a person-to-person talk with a patient who exhibits inappropriate behavior or reactions to your attempts to be friendly or make contact on a telephone. He also suggested that when such patients say "never see me again" they are being manipulative and want to observe your reactions. In other words, ignore them. Another comment involves the perception of time. You have no idea how a person who experiences dementia experiences time. All people do not experience the passage of time in the same way. Thus, you may feel you have to stay away for a week after an argument, when in point-of-fact, an hour later the person has changed their mind, regrets what they have said (or may not remeber it), and anticipates your call.
Thank you for the feedback. Yes, she does have trouble with time. Can't tell what day of the week it is, what days I come over, and at times can't tell day from night and she will sit there waiting for daylight to show. Well, if it's 7 at night, that could be awhile.
According to 3 psychologists (2 of them are friends, one is the counselor I met with for coping strategies) my mom has borderline personality disorder. So she can be quite manipulative, has even bragged about the things she does to confuse or upset people. Whew. But she is also very determined to always have her way. She's not afraid to hang up on us (phone) or refuse to answer the door when we come over. And from our last conversation, it sounds like she's ramping up the security on her home so the key I have will no longer work.
I'm thinking of sending her a note, one of those "thinking of you" type cards. It's a chicken's way out. But after a lifetime of hurt from her, I'm not quite ready to put my feelings on the line again, at least not at this moment. I'm feeling better that we have her doctor involved now. But I can send her a note, tell her I'm worried about her, hope she's getting all the things done that she wanted to get done, things like that. No comments on the blow up. I want to keep the door open if she wants us to come back. But I'm just not up for being slammed again.
It's been a difficult 60 years for me but I want her to have the help she needs. I'm just not sure I can provide it all at this stage.
Again, thank you and I'll let you know how things go.
I would also consider applying to the court for a limited Guardianship. There are many types of Guardianships and the judge tries to decide which type would enable the patient to exercise the most freedom consistent with their condition. The trick is to apply for a Guardianship before the patient becomes too confused and demented. Paranoia and accusations against the caregiver are to be expected.
Another thought is to get her a pet. Kittens are in favor, but I have had a lot of experience with small birds. When my mother was eighty her constant companion was a talking African Gray parrot (very expensive but well worth every penny - arguably, the most intelligent of the bird species) and she also enjoyed the company of a ferret. Parakeets are wonderful, but you need to purchase a hand-tamed one (in the U.S. these sell for from $75 to $150), rather than the $4.99 special.
And as a final choice some large fresh-water Goldfish.
The job of feeding the animal every day and the interaction provides meaning to an elder person's life.
Although she has lost the will (she hides things so robbers won't get them) I kept the power of attorney paperwork as well as the old wills before my dad died. The POA is set up that I will have authority to handle her affairs if 2 doctors determine she is unable to do it herself. If she recovers (say it was a stroke) then the power would be returned to her. Not sure how it will all work out.
She does have a dog. The poor thing is filthy but she does remember to feed it. She adores the dog more than me LOL but the dog doesn't ever disagree with her. Funny, when I went over to the house, the dog would grab my pants leg and pull me into the room and roll all around in front of me looking for attention. This has been a recent change in behavior for the dog. I don't do dog mind reading but I do think she is lonely.
I'm thinking I'll send her a "thinking of you" card next week just to keep the door open for contact if she chooses. This way she will have the option of reading the card or tossing it. Control is very important to her. A phone call is intrusive and makes her angry. I'm still thinking this over.
Just a quick update: my mom called me this morning acting as if everything was normal. Asked me where her keys are (as if I would know). I asked about the keys by the front door and she said they are missing. I asked about the set of car keys that have everything on them but she can't find them. All she has is the key to the doggy yard out back. I suggested some places to look, places she's put them before but that was all I could do. She asked about my bleeding kidneys, what has the doctor said. And that was about it.
She has a doctor appt. this Friday, I asked how she wanted to handle that. Never did get an answer; she just rambled. So I dropped it. I did call her doctor back and let them know that she contacted me. I'm really not handling this well.
You are doing a good job under impossible circumstances. I would suggest you keep a log of bizarre behavior, because the situation may be headed towards eventual institutionalization. Such a lot will be useful in that event. One question is whether the nature of the dementia has been identified. There are many different etiologies. Some types of dementia are nutritionally related, some are structural (tumor, for example) while others are due to a degradation in micro-circulation. In other cases the causation is a mystery. In most cases the doctors don't take the time to make a differential diagnosis. It is important for you to have a medical proxy and request copies of her records. Unfortunately a patients psychiatric records are most important and most psychiatrists will not release them except to another psychiatrist. There are exceptions. You can find semi-retired psychiatrists who will do so. They are hard to find. See if you can get her to take cod liver oil every day. The new flavored ones taste quite palatable, and they do improve circulatory function. You have my sympathies.
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