WWYD? Elderly parents out of state

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I am the person who keeps saying get a geriatric care manager and who curled up on the floor when she called.
The care manager said my mother was a narcissist. I asked why wasn't I one too. She said,"it's because YOU have empathy. Your mother never did and never will."
We cannot change them. We can change how we react. We can change what we do.

Multiple people have suggested a care manager and OP stated she will look into it.

I think it’s a mistake to engage in all this internet diagnosing- and if your mom’s care manager isn’t qualified to make a diagnosis, she shouldn’t be either. OP stated her mom had a personality disorder but I don’t think she stated which one. We provide better help and support when we listen to what’s actually happening and respond to that instead of labeling and projecting.

Are you saying that people with diagnosed personality disorders can change?

That it isn’t what I was saying, but it’s no longer accepted that all personality disorders are untreatable. That’s actually very outdated. That said, an elderly person in declining is not likely to want or comply with treatment for a personality disorder aside from medication. The personality disorders that respond more to medication aren’t the ones that people are typically dealing with here. My point was that internet diagnosis isn’t a great basis for advice. It’s better to listen to the specific issues and respond to those.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I am the person who keeps saying get a geriatric care manager and who curled up on the floor when she called.
The care manager said my mother was a narcissist. I asked why wasn't I one too. She said,"it's because YOU have empathy. Your mother never did and never will."
We cannot change them. We can change how we react. We can change what we do.

Multiple people have suggested a care manager and OP stated she will look into it.

I think it’s a mistake to engage in all this internet diagnosing- and if your mom’s care manager isn’t qualified to make a diagnosis, she shouldn’t be either. OP stated her mom had a personality disorder but I don’t think she stated which one. We provide better help and support when we listen to what’s actually happening and respond to that instead of labeling and projecting.

Are you saying that people with diagnosed personality disorders can change?

That it isn’t what I was saying, but it’s no longer accepted that all personality disorders are untreatable. That’s actually very outdated. That said, an elderly person in declining is not likely to want or comply with treatment for a personality disorder aside from medication. The personality disorders that respond more to medication aren’t the ones that people are typically dealing with here. My point was that internet diagnosis isn’t a great basis for advice. It’s better to listen to the specific issues and respond to those.

If you aren’t OP no need to tell us what OP needs or how to post. I have found the posts here helpful myself. I don’t recall electing you head of the thread.

[Anonymous]

Anonymous wrote:My mother is like this. I learned to detach with therapy. I moved away from phone calls because it took me time to recover from them. I send cards with well wishes and email only where I can keep things polite and ignore jabs.

If she has money, suggest to your sister hiring a geriatric case manager as other person mentioned. If there isn't money, I would offer to look into the options within mom's budget or if you have a lot of money offer to pay for it. Your sister can decline and that's on her.

My mother lives to suck people into her drama with guilt trips and any manipulation she can think of. It got worse with age. It is painful, but I had to detach and outsource to get back my will to live and to be able to focus on my spouse and kids and our own life stressors.

How do you hire these? And manage the case manager? (Not being snarky- genuinely curious).
Does the CM arrange rides to appts at IL? OP said IL has "no staff" so are rides even available?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I am the person who keeps saying get a geriatric care manager and who curled up on the floor when she called.
The care manager said my mother was a narcissist. I asked why wasn't I one too. She said,"it's because YOU have empathy. Your mother never did and never will."
We cannot change them. We can change how we react. We can change what we do.

Multiple people have suggested a care manager and OP stated she will look into it.

I think it’s a mistake to engage in all this internet diagnosing- and if your mom’s care manager isn’t qualified to make a diagnosis, she shouldn’t be either. OP stated her mom had a personality disorder but I don’t think she stated which one. We provide better help and support when we listen to what’s actually happening and respond to that instead of labeling and projecting.

Are you saying that people with diagnosed personality disorders can change?

That it isn’t what I was saying, but it’s no longer accepted that all personality disorders are untreatable. That’s actually very outdated. That said, an elderly person in declining is not likely to want or comply with treatment for a personality disorder aside from medication. The personality disorders that respond more to medication aren’t the ones that people are typically dealing with here. My point was that internet diagnosis isn’t a great basis for advice. It’s better to listen to the specific issues and respond to those.

I think oftentimes people respond by recognizing the behavior as the one they've seen before. I for example don't know if my mom has ever been diagnosed with anything as she has never said anything and we don't have a type of relationship where we talk about these things, but she has had issues with her behavior her whole life (and lots of destroyed relationships to show for it, including her family-of-origin, all DILs, no friends left). A personality disordered behavior obviously fits a certain pattern: this is how these things are diagnosed. People who participate in these threads often have decades-long experiences with their own parents, have seen certain behavior over and over and also have tried one and the other thing. Usually what happens is that an adult child tries to accommodate a personality disordered person's demands and outbursts, often for decades, but at some point those demands and accusations become so outrageous, irrational and harmful that the adult child has to escape in order to save themselves. It becomes a matter of survival. At the end of the day, it doesn't matter what the exact diagnosis is or isn't. What matters is the message we try to convey that the adult child will never be able to satisfy their personality disordered parent's demands, no matter what they do, and instead of killing themselves in the process (which at some point will manifest in actual symptoms) they need to let go. The problem is not a parent "out of state", the problem is a parent who has a personality disorder and behaves accordingly, who happens to live out of state.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I am the person who keeps saying get a geriatric care manager and who curled up on the floor when she called.
The care manager said my mother was a narcissist. I asked why wasn't I one too. She said,"it's because YOU have empathy. Your mother never did and never will."
We cannot change them. We can change how we react. We can change what we do.

Multiple people have suggested a care manager and OP stated she will look into it.

I think it’s a mistake to engage in all this internet diagnosing- and if your mom’s care manager isn’t qualified to make a diagnosis, she shouldn’t be either. OP stated her mom had a personality disorder but I don’t think she stated which one. We provide better help and support when we listen to what’s actually happening and respond to that instead of labeling and projecting.

Are you saying that people with diagnosed personality disorders can change?

That it isn’t what I was saying, but it’s no longer accepted that all personality disorders are untreatable. That’s actually very outdated. That said, an elderly person in declining is not likely to want or comply with treatment for a personality disorder aside from medication. The personality disorders that respond more to medication aren’t the ones that people are typically dealing with here. My point was that internet diagnosis isn’t a great basis for advice. It’s better to listen to the specific issues and respond to those.

I think oftentimes people respond by recognizing the behavior as the one they've seen before. I for example don't know if my mom has ever been diagnosed with anything as she has never said anything and we don't have a type of relationship where we talk about these things, but she has had issues with her behavior her whole life (and lots of destroyed relationships to show for it, including her family-of-origin, all DILs, no friends left). A personality disordered behavior obviously fits a certain pattern: this is how these things are diagnosed. People who participate in these threads often have decades-long experiences with their own parents, have seen certain behavior over and over and also have tried one and the other thing. Usually what happens is that an adult child tries to accommodate a personality disordered person's demands and outbursts, often for decades, but at some point those demands and accusations become so outrageous, irrational and harmful that the adult child has to escape in order to save themselves. It becomes a matter of survival. At the end of the day, it doesn't matter what the exact diagnosis is or isn't. What matters is the message we try to convey that the adult child will never be able to satisfy their personality disordered parent's demands, no matter what they do, and instead of killing themselves in the process (which at some point will manifest in actual symptoms) they need to let go. The problem is not a parent "out of state", the problem is a parent who has a personality disorder and behaves accordingly, who happens to live out of state.

I understand what you are saying, but the OP didn’t ask and hasn’t indicated that they want to estrange. They asked for advice about navigating this situation with a difficult mother and challenging circumstances with the sister. Some of the details that emerged changed the picture a bit wrt sister, and most people landed in the same place, which was try to involve a care manager if you can, see if you can improve communication with sister, and you don’t have to listen to the tirades.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I am the person who keeps saying get a geriatric care manager and who curled up on the floor when she called.
The care manager said my mother was a narcissist. I asked why wasn't I one too. She said,"it's because YOU have empathy. Your mother never did and never will."
We cannot change them. We can change how we react. We can change what we do.

Multiple people have suggested a care manager and OP stated she will look into it.

I think it’s a mistake to engage in all this internet diagnosing- and if your mom’s care manager isn’t qualified to make a diagnosis, she shouldn’t be either. OP stated her mom had a personality disorder but I don’t think she stated which one. We provide better help and support when we listen to what’s actually happening and respond to that instead of labeling and projecting.

Are you saying that people with diagnosed personality disorders can change?

That it isn’t what I was saying, but it’s no longer accepted that all personality disorders are untreatable. That’s actually very outdated. That said, an elderly person in declining is not likely to want or comply with treatment for a personality disorder aside from medication. The personality disorders that respond more to medication aren’t the ones that people are typically dealing with here. My point was that internet diagnosis isn’t a great basis for advice. It’s better to listen to the specific issues and respond to those.

I think oftentimes people respond by recognizing the behavior as the one they've seen before. I for example don't know if my mom has ever been diagnosed with anything as she has never said anything and we don't have a type of relationship where we talk about these things, but she has had issues with her behavior her whole life (and lots of destroyed relationships to show for it, including her family-of-origin, all DILs, no friends left). A personality disordered behavior obviously fits a certain pattern: this is how these things are diagnosed. People who participate in these threads often have decades-long experiences with their own parents, have seen certain behavior over and over and also have tried one and the other thing. Usually what happens is that an adult child tries to accommodate a personality disordered person's demands and outbursts, often for decades, but at some point those demands and accusations become so outrageous, irrational and harmful that the adult child has to escape in order to save themselves. It becomes a matter of survival. At the end of the day, it doesn't matter what the exact diagnosis is or isn't. What matters is the message we try to convey that the adult child will never be able to satisfy their personality disordered parent's demands, no matter what they do, and instead of killing themselves in the process (which at some point will manifest in actual symptoms) they need to let go. The problem is not a parent "out of state", the problem is a parent who has a personality disorder and behaves accordingly, who happens to live out of state.

I understand what you are saying, but the OP didn’t ask and hasn’t indicated that they want to estrange. They asked for advice about navigating this situation with a difficult mother and challenging circumstances with the sister. Some of the details that emerged changed the picture a bit wrt sister, and most people landed in the same place, which was try to involve a care manager if you can, see if you can improve communication with sister, and you don’t have to listen to the tirades.

The OP said this in her first post: "I've been told by plenty of people over the years to just go no contact, but I've tried to do my best to continue a relationship and put some boundaries in place with how I will allow myself to be treated." This is the crux of the matter. The personality disordered mom is escalating her behavior because she's at the end of her life. It's very common. "But, getting verbally attacked and insulted weekly now because I don't live there is taking a toll." -- the OP still has an impression that she's getting attacked because she doesn't live there. No, she's getting attacked because that's what a personality disordered person does, and this behavior is ramping up because like a drowning person, she's grasping at the straws.

[Anonymous]

I am the OP who had a geriatric care manager for my narcissist mother in FL while I lived in VA.
I looked in a directory of them in her area, talked to a couple on the phone. Picked one. She was a licensed NP as well. She arranged home help (a challenge because mother kept firing them), rides to appointments, etc. Visited her at home weekly. I wasn't too invested. The point was to keep me out of the loop.

The care manager had dealt with hundreds or thousands of elders. I think she was capable of recognizing behaviors. But if not so effing what? The point was mumsie wasn't going to change, it was not my fault she was a cruel and vicious and self centered person and nothing I did was ever going to make her happy enough for long enough. Even if I was "TOP DOG."

If you hire one mumsie cannot fire them. Lol

Look for professional associations and regional directories

This seems to be one now
https://www.aginglifecare.org/ALCAWEB/ALCAWEB/Default.aspx

[Anonymous]

If you really want to help you tell sister you are coming up for two weeks and give her two weeks off of caregiving and a true vacation.

Ask sister what weeks would work for her.

You go up there for 2 weeks, cover things, and let sister get a much needed break or vacation.

I say that has someone who cared for Mom. We had the caregivers but my duties were endless: meds, supplies, doctors, house repairs, meals, groceries, dental, finances, getting house ready for resale etc.

Sister did nothing for 6 years and never visited once.

It would have meant a lot if I'd a 1 or 2 week break/vacation.

[Anonymous]

Just a short video of dying narcissist's behavior:
https://www.youtube.com/watch?v=abiwDvsUrGQ
It's by Danish Bashir.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My mother is like this. I learned to detach with therapy. I moved away from phone calls because it took me time to recover from them. I send cards with well wishes and email only where I can keep things polite and ignore jabs.

If she has money, suggest to your sister hiring a geriatric case manager as other person mentioned. If there isn't money, I would offer to look into the options within mom's budget or if you have a lot of money offer to pay for it. Your sister can decline and that's on her.

My mother lives to suck people into her drama with guilt trips and any manipulation she can think of. It got worse with age. It is painful, but I had to detach and outsource to get back my will to live and to be able to focus on my spouse and kids and our own life stressors.

How do you hire these? And manage the case manager? (Not being snarky- genuinely curious).
Does the CM arrange rides to appts at IL? OP said IL has "no staff" so are rides even available?

There are more and more of these places. Yes, a good one can not only hire aides, a traveling doctor, traveling PT/OT/ST, delivery of a hospital bed, wheelchair, etc as needed, but they can also arrange a meal delivery service, driver and even medical transport from the hospital and they can advocate at AL and Memory care when the time comes. The case manager management can be tricky. It is her relationship and she has to sign a release for the CM to speak with you. The best way to get recommendations is to see what eldercare services the doctor's office recommends. The independent living may have some names as well. Word of mouth works well.

[Anonymous]

Anonymous wrote:Just a short video of dying narcissist's behavior:
https://www.youtube.com/watch?v=abiwDvsUrGQ
It's by Danish Bashir.

I think he must know my mother! Thanks for posting.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Be prepared to accept that your sister will always resent you for not being there. Even if it's not rational. The other PP is correct about distance. The only thing your sister gets out her immense labor is (the childcare, of course, but she's already forgotten that) the perverse satisfaction of being able to say, for the rest of her life, that she was the primary caregiver for her mother and that her sibling stayed far away and "refused to help". That's how she's spinning it. You've read such posts on DCUM, from overworked children who care for their parents and whose siblings are far away...

I am sorry but I am not understanding when you write that that is how the sister is "spinning it". OP's sister IS the primary caregiver and OP is far away. There is nothing to spin.

The spin is that OP is refusing to do more, which is a lie. She wants to do more and has suggested many options. What the parent and sister want is for OP to actually uproot her life and be there on the daily, which is not a reasonable ask. So the spin is the usual "poor me, I'm all alone taking care of my parent while my sibling lives her life", which does not tell the whole story.

Maybe, maybe not. My sister swore up and down that she wanted to help and I didn't believe her. When I asked, she did one quick visit. I then asked her to take a meeting by phone for 15 minutes over her lunch break and she refused saying she was "busy." Then, I stopped asking. Because it was performative.

Parents have been divorced our entire lives. After the one I cared for died (and I was on opposite coasts) I told her she could be the executor and deal with other parent. I am done. Don't care about $$, just want out. Done caring for everyone. Some people just rely on everyone else to handle to be jugglers, and it sounds like OP has done that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Just a short video of dying narcissist's behavior:
https://www.youtube.com/watch?v=abiwDvsUrGQ
It's by Danish Bashir.

I think he must know my mother! Thanks for posting.

You're very welcome! He has short to the point videos. I think it's important to emphasize that once you're out of the fog, you can predict what will happen next and how these personality disordered people behave. They follow the same manual. And aren't we lucky that people like case managers and aides exist nowadays and that one can hire such help?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I want to look at OP's situation a bit differently. While many of the PPs are focusing on OP and OP placing possible boundary issues with her mother and sister, I am going to argue that the bigger issue is a bit more black and white. OP's mom is quickly declining as elderly people ultimately do. OP's sister is currently the primary caretaker and doing the far vast amount of support. And OP is being blamed by both that she is "not there" and then dismissed.

All feelings and family baggage aside and we all have plenty of history to sort through when it comes with our families, the fact is that OP is.not.there. She just is not. OP is not physically able to physically support her mother in a significant and needed way. Regardless of why OP is not there, regardless of physical miles between them, regardless of past hurts and wrongs, regardless of whether OP's mom deserves the help or not, regardless of whether OP's sister had mom's support prior with childcare, regardless, regardless, regardless -- the fact remains that OP is not there. When her mother and sister claim this they are 100% correct. If you take all the emotion and all the complex history out of it the fact is that OP is not in a physical position to do much for her mother. And it is what it is. That is how distance works whether it is an elderly parent, a sibling, an old friend or a new friend. If you are not in close physical proximity you are not there and thus you are not able to provide what they may need. And with most elderly at the end stage of their lives what they need - really need - are hardly the phone calls and checking in but instead the day-to-day physical support. Sure, a quick weekend visit to mom is "great" but it is absolutely surface and not what an elderly person of quickly declining health really needs. That is the truth and reality and anyone who says otherwise is fooling themselves.

So accept that OP. Accept that you can only do what you can but also accept that your mother and sister are completely justified in how they feel as well. What are your other options? It doesn't sound like you are going to be moving closer to your mother and sister. It doesn't sound like your mother is going to move closer to you. OP can bang her head against the proverbial wall all she wants but the facts remain: she is not there. And if OP has guilt from that and/or feels defensive about that (and she does seem to have all of those feelings) than she needs to lean into figuring out what she can do to help herself with understanding those feelings better.

Physical distance makes a difference in all relationships. Always has and always will. And that is okay OP.

All of this. Even taking the mother out of the equation, the sister is doing pretty much everything. And it is the day-to-day work that is overwhelming and soul crushing when taking care of an elderly person at the end of life without help. So OP has to accept that. The only way I've seen it work (somewhat) is if the not hands-on sibling pays for care to come in and take some of the burden off the sibling.

That said, most people can't afford to do that, because they have to provide for their own families and their own retirement so that their kids aren't having to foot the bill of their elder care. Basically, solve the problems that their parent's generation rarely gave thought to.

Many of the elderly now had parents who died before they ever needed significant care. Or as soon as care was needed they died soon after. But with medical advances, people are living longer and many of that generation are simply not prepared monetarily. So the care falls to the kids.

I feel for you, OP.

Thank you.

And just two points of clarification in my situation.

1. My Mom has a lot of money and pays for all her care out of her own accounts. My sister and I don't need to contribute.

2. My Mom has 24/7 home health aides and lives in a nice independent living apartment community. Groceries are delivered by Instacart. My sister doesn't provide care to my Mom in the sense you may be thinking. There hasn't been day to say work in an ongoing way. There have been bursts of needs like we're in currently. She absolutely does do a lot and lives in the same town.

OMG OP you are SO clueless. No wonder your sister is pissed at you.

So, first of all - "groceries are delivered by Instacart"? Who figures out what food to order? Your sister, I bet. Who figures out meal planning? Who order those groceries? Your sister, I bet. Who calls the aide and says "Hi, the groceries were delivered, please bring them in a put them in and put them away." Your sister, I bet.

If your sister is doing this, you could take over. You will have to communicate with the caregivers about meals, what is going bad, what is not, make sure they bring in the groceries promptly. And you can't trust most caregivers to throw out bad food, so your sister likely still needs to go over and toss the old food.

And just because she has aides does NOT mean she doesn't need day to day care. These aides are often not that great and they need oversight and instruction. Otherwise your mom may wind up dehydrated because they aren't giving her enough fluids. Or with bed sores because she is sitting or lying in one position too much. Or with a UTI because they don't change her diaper enough or take her to the bathroom enough.

God. You are clueless. Just keep telling yourself that there isn't day to day care.

I'm the last pp and 100% this! I wrote instruction booklets for caregivers, helped with doctor appointments, dealt with his jury duty to get him permanently released, called doctors to clarify instructions, sat in by phone with doctors, helped facilitate contractors, talked him down about endless things, sent food, talked to social workers, and on and on and on...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My mother is like this. I learned to detach with therapy. I moved away from phone calls because it took me time to recover from them. I send cards with well wishes and email only where I can keep things polite and ignore jabs.

If she has money, suggest to your sister hiring a geriatric case manager as other person mentioned. If there isn't money, I would offer to look into the options within mom's budget or if you have a lot of money offer to pay for it. Your sister can decline and that's on her.

My mother lives to suck people into her drama with guilt trips and any manipulation she can think of. It got worse with age. It is painful, but I had to detach and outsource to get back my will to live and to be able to focus on my spouse and kids and our own life stressors.

+1
Ask for referrals from your most trusted providers. Nurses, OTs etc often have better insight than doctors when it comes to recommending a care manager.

How do you hire these? And manage the case manager? (Not being snarky- genuinely curious).
Does the CM arrange rides to appts at IL? OP said IL has "no staff" so are rides even available?

There are more and more of these places. Yes, a good one can not only hire aides, a traveling doctor, traveling PT/OT/ST, delivery of a hospital bed, wheelchair, etc as needed, but they can also arrange a meal delivery service, driver and even medical transport from the hospital and they can advocate at AL and Memory care when the time comes. The case manager management can be tricky. It is her relationship and she has to sign a release for the CM to speak with you. The best way to get recommendations is to see what eldercare services the doctor's office recommends. The independent living may have some names as well. Word of mouth works well.