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Since setting "boundaries" for myself, reading many eldercare books, and posting/reading on this forum, I realize that my unhappy & controlling mother in an assisted living facility will never be happy again. She's calling our phones (goes to voicemail), threatening to not take her medications, & wanting her living will to be utilized so she can die (doesn't understand what LW truly is). I hear again ALL the bad things about me & her AL place that she's been saying for 2 years. It's a broken record & I've tried it all! She's asked to go to an Internal Medicine dr, so it's coming up in 3 weeks. Now, she's saying cancel appointments, not taking meds, and requesting to die. These are ALL reactionary stabs at me because she wants out of this assisted living place (nice place) & move out on her own (impossible). She's threatening to get her church involved in this & still threatening to hire a lawyer! This manipulative behavior is her way of gaining control of a life that hasn't been happy, loving, or positive in decades. She's almost 89, hasn't been officially diagnosed with dementia, & is refusing any type of depression/anxiety medication except low dose of Xanax at night. The NP knows she's just uncooperative & says unfortunately, this is all she can do.


I know she needs a psych evaluation. How do I get her this without taking her myself (she'll be kicking & screaming)? Could the AL facility & NP make this happen? My presence as her durable power of attorney would only make this worse for her. She despises me, hits me, curses me, & blames me for all her ills.


Is there an agency I can see for guidance?


You guys have been awesome & gotten me this far. I truly appreciate every piece of advice!

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Have you asked the NP to request a geriatric psychiatrist consult?

I seem to recall that the NP said at one point something like "you can't fix ugly" or something like that...am I recalling that correctly?

If so, it seems like she doesn't see your mother as a suffering soul, which is what somewhat with longstanding mental illness/personality disorder is.

If you mother is threatening suicide, I think that you are within your rights as POA to request that she be taken via ambulance for an involuntary psychiatric admission. You do not have to go along for that ride.

((((hugs))))))
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Marylin Mar 2019
Yes, Barb, your memory is correct. The NP that visits the ALF said that. She has tried to encourage other anxiety meds but mom repeatedly refuses.....I don't want to be "drugged up" to have to stay here or to get along with my family! It's obvious she wants to be in charge of her unhappy & negative life without any suggestions from others.
As for suicide, ALF has not heard her say the suicide words, but they have spoken to her about them. She doesn't deny saying them, but says she wouldn't do anything because her future is in the Lord's hands. She speaks religiously often to them. I have sent several voice messages to ALF admin/nurse with mom referencing suicide..."I just need to take a gun to my head". Once they had a healthcare nurse visit for a few weeks. So, we know & they know but it remains as a dark cloud over us. I requested that the NP get us a neuro vist (taking the "crazy" out for my mom thinking it's for anxiety), but that office hasn't called. NP says they for some reason aren't accepting her. But, now, she's saying cancel all appointments! It's difficult to know if we're on or off. Today I canceled her cardio appointment. as long as we have meds coming in, she can go annually. Who knows if she's taking the meds now or not?
Do I just need to just tell them to come & get her & do a 3-day psych evaluation without a referral? That sounds harsh but may give us answers as to what's going on. We probably already know! What can it change for her if she refuses meds?
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Your Mom is just trying to be manipulative. Stick by ur guns.
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againx100 Mar 2019
Right. I wouldn't fall for it.
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I’m sorry you’re dealing with this. Good advice already given, I’ll just add, delete the voice mails without listening, you don’t need that negativity, likewise refuse to hear the rants. Walk away when they start. You’re doing your best for your mom, don’t add listening to the toxic behavior any more, it just feeds her, brings you down, and changes nothing
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NeedHelpWithMom Mar 2019
Daughterof1930,

Excellent advice to walk away. I could have saved myself many headaches if I had walked away more. I am learning to do it. I slip sometimes but it is certainly more peaceful to go into another room when the mayhem begins. They can't argue with themselves.
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I agree with the three previous answers (Daughterof1930, JoAnn29, BarbBrooklyn).

I've been my MIL caregiver for 7.5 years. At some point, Hubby and I started calling her bluff. We assured her that she was in charge of her life. MIL also wanted to quit meds, die, move, all at the same time. We told her it was her right to refuse meds and if she was ready "to go"(die), we supported her and understood. We also told her to call her sister and/or her daughter to make arrangements to move from then ALF/now NH. We told her she had our blessing to move. Nothing ever comes of these threats of moving/dying (darn! LOL)

In addition to deleting the voicemails without listening to them as Daughterof1930 suggest, take away her power over you by not reacting when she starts ranting and raving. (It won't be easy.) I bet she never actually follows through and even if she does, the church and attorney would see it for what it is. When she sees she isn't getting a rise out of you, she'll give up--though it could take awhile.

I beg you to take care of yourself. I haven't until recently and regret it. I was a "helicopter caregiver" trying so hard to make her happy and make her world perfect. What a fool I was. It's impossible.

She's safe and well cared for in her ALF. If there is an emergency, they will be calling you. Take a step back and live your life. Nurture yourself today!

Good luck & Hugs.
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This is very common—even when it's not a care situation. If you have someone abusive who is not used to you using boundaries (regardless of your relationship), they are going to act in extremes when you set them.

Has she always been abusive? Well, then let her take on the responsibility of her threats herself. You do not have to put up with it.

Call around. I would contact her doctor, the police, and a social services to let them know she is threatening suicide—because that is essentially what she is doing. If you have it on voicemail, even better. Step away and let the authorities deal with it.

If she's always been this way, you have no reason to continue allowing it or to take *any* responsibility for her abuse. Block her on your cell phone or at least let your spouse listen to the voicemails before you do. If he tells you they are nasty, don't listen to them. Delete them. Same goes with letters or any other form of communication. If you have been dealing with this for life, that's been a lifetime too long. You deserve freedom and sanity.
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This is typical behavior from a narsasist, you enforce boundaries and they throw tantrums.

She is trying to find the button that puts you back in your place.

Once you realize that it is manipulation pure and simple it is easier to deal with.

I play a game with my parents, I enforce boundaries and then I tell my husband what they will do. It never fails, they have to try to be in control and the center of the universe. I can laugh about it but I think I would like to spank them, that's what I would do if they were 3 pulling this crap.

Be strong and expect escalating pressure, contact the law for the suicide threats and learn to look beyond her tantrums. Hugs! It does get easier to deal with when you keep the boundaries enforced but it can be a wild ride to get there.
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Okay, on this one you may have to look into moving her to a NH. If she threatens suicide and tells everyone about how she wants to do it, that's grounds to have her put in the hospital, under 24 hr monitoring by staff, complete with a psych eval. Call her bluff, stand your ground and make it clear you'll not put up with her bad behavior. Unless she wants to be moved to a NH by you, tell her she needs to stop. Then suggest she start looking at some counseling as it sounds like she desperately needs it.
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Your mother is 89 years old. No official diagnosis of dementia, but agitated, resistant to care, etc. I guess my question is what are you trying to accomplish at this point? At this age, is there anything that might make her feel differently? So, there's not much of a chance that will change. I would guess that everyone, but, her knows this too. So, is there any reason that you can't let her make her own decisions about receiving health care, medication, etc. If she has not been deemed incompetent, it's her decision. And at age 89, it would be her choice if she wants to prolong her life. Have you looked into Palliative Care. (Comfort care only.) I might ask for information and see if she's interested in it. Some seniors don't want to continue traveling to doctor's offices for endless tests. My LO's doctor took her off all meds that were not related to her comfort. Prevenative meds were discontinued.

I think that I might just try to keep her as comfortable and content, in the facility, as long as possible. She might settle down if she feels her wishes about her healthcare are being honored. And, if she is still competent, it's her decision.
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My MIL was passive-aggressive. She got her way by sulking or just doing what she wanted and then getting upset when you didn't appreciate what she had done. I would tell her "thank you but no thankyou" and she'd do it anyway. My DH is her favorite or at least the one she depended on. The other two boys lived in different states. After she moved to Fla and FIL died she was after my DH to move there from NJ after we retired. I had my Mom and I was the only child still living in the same town. He would firmly tell her no. After a UTI stint in the hospital and rehab where she wouldn't cooperate, then told she needed to live near a son, she will herself to die. She left this world on her terms.

Like mmcmahons suggestion, cal, her bluff. Tell her if she keeps threatening suicide, she could be put in a lock down unit to be evaluated. I am not for a little threatening with certain personalities.
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NeedHelpWithMom Mar 2019
JoAnn,

You are correct. Sometimes we have no other alternative but to call someone's bluff. Is it something that we like to do? Probably not, it's uncomfortable, but sometimes necessary.
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So many wise people on this forum! Suicide should be taken seriously. Some do it merely to escape pain or mental illness but others clearly do it to manipulate others which is horrible!

My college age daughter's EX boyfriend did this to her. She saved his life but then in order to keep her own sanity and safety, she dumped him! Unfortunately, she had to go through the court system and get a restraining order because he not only stalked her but got physical with any new guy in her life after she broke up with him. She became really concerned when he attempted to buy a gun, murder, then suicide kept running through her mind.

Yes, people can use suicide to manipulate and do. This particular young man was so charming at first. Aren't all manipulators that way? That's how they bait people. When my daughter became acquainted with his family, it was evident that no boundaries were established by his parents. He was given everything that he desired and when my daughter did not bow to all of his wishes, he used suicide as a threat! So for all who preach setting boundaries, please keep preaching it! Follow through on those boundaries or you will become a hostage of chaos.

Do we all slip at times and give in to our parents? I know I have. I have to fight to gain a healthy perspective at times. Also, rely on others for a voice of reason, like from experienced people on this forum. Thanks to all who contribute to making this a wonderful and much needed resource. I am grateful.
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mally1 Mar 2019
My ex husband was exactly like your daughter's ex; gorgeous and so charming, and had been given everything by his folks (we went to counseling and the counselor drew me aside and told me she thought he was so handsome - I said we had nothing to discuss and insisted we leave; what was the point?). It lasted 6 yrs too long, and maybe if I had set more boundaries it would have been better, but maybe not.... They DO work with my mom; sometimes it just takes awhile.
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It's my understanding from the post is that the 89 year old woman, who is competent, wishes to discontinue some of her medications and medical treatments. As long as she's competent, a person has the right to make their own healthcare decisions. The Ombudsman of the facility, might be able to assist in sorting out what rights she has in the facility.
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I requested the psychiatric evaluation in writing, copy to the AL management, and specified that I wanted information specific to concerns about her ability to be in charge of her affairs.
The actual evaluation was done at the AL.
I stewed briefly about thinking this could be unfair to her, but it turned out that it was the best tool to get her the care, management, and treatment she needed.
Thecost of the evaluation was charged to her Medicare and the balancecame from her own funds.
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Marylin Mar 2019
Thanks, Ann!
I needed to respond to an email from her NP. So, since it's Saturday and she's difficult to reach, I included a request for a psych evaluation. I used my heartfelt reasoning and many of your words. I pray she can make this happen for the good of all.
You're a dear for speaking the right motivational words. Cannot thank you enough, Ann.
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If you haven’t already, read the book “Being Mortal, Medicine and what matters in the end” by Atul Gawande
I know she isn’t terminal but at 89 she is near the end.
If you are not a reader just google the five questions and Atuls name. He has several interviews etc online.
Change the dynamics of your relationship with mom. It takes both of you to stay engaged in the power struggles etc. This information elevates the conversation. If she’s nasty when you ask about the perfect day, just tuck it away and move on. Come back to it another day.
It’s a work in progress deciphering the brain and it’s many mysteries.
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I read your post carefully, and I couldn’t find your mother threatening ‘suicide’ as such. Refusing to take medication is a right and can be a sensible choice (eg it’s a common thing to assess in hospice). I don’t think it classes as suicide, and I can’t see that it requires a psychiatric assessment. It would be a good idea to lock up any easy means to suicide (guns, bulk sleeping tablets etc), and wait and see whether this is simply an empty threat intended to upset you. One thing you don’t need to do is agree to help along her requests to die. Try letting her kick and scream all by herself. It probably won’t last long.
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Marylin Mar 2019
When refusing to go to cardiology appointment in order to refill meds, it says suicide plan to me. After disliking the visiting NP at assisted living, repeatedly requesting a new doctor, then telling everyone to cancel it, that says I do not wish to live. After agreeing to go to a neurologist, she says I'm not going.
And, off and on, throughout the years, but especially now, she says. "I just need to put a gun to my head," She had a brother do that after his health failed.
I've jumped hoops to try & get her dr requests made for her to pitch fits & refuse to go. So, at this point, I'll cancel.
Eearlier I removed her sharp knife from her room when she was not looking. The facility had someone come and talk to her a few times. She insists she is not suicidal, but she throws around these ideas, perhaps because she is unhappy with the world?
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If she hits you, that is assault....you do NOT have to put up with this behavior!! Walk away and dont look back. You cannot change her behavior only your non-reaction to her tirades....does she hit others as well, or just you? Stay firm on your boundaries!!! Hugs to you!!
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Marylin Mar 2019
Yes, she hit me the last time I was there in January. She's tried before but this time, she succeeded. That's when I found this forum & finally set boundaries.
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I am so sorry for you!  My MIL was a guilt-tripper, but this is just plain mean.  You have nothing to feel guilty about and I'm going to make a suggestion that I truly hope you'll consider.  You say she's threatening to get her church involved (like you are the one in the wrong) - CALL HER MINISTER.  Tell him that she is threatening suicide and ask him to visit with your Mother.  Her church family SHOULD be involved and they can help in ways that you probably wouldn't even think of.  God love you - you are being abused and manipulated and this needs to stop.  💙💙
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mally1 Mar 2019
Good advice, di! My mom's minister helped a great deal when we needed it.
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i hear you loud and clear. Absolutely manipulative behaviour. Turn off voicemail. Do you have a mobile? If so give this to staff and not your mother. If she can’t leave a message she will stop trying. So she won’t take her meds. So what? She’s threatening suicide. So what? The more she tries this on in front of staff the bigger she is digging a hole for herself Don’t take her to any of appointments that are not necessary and scheduled. Do you have to take her? Does she have ambulance cover or access to very cheap transfer services through local NFP agencies? Does she have access to Veterans Affairs. She should if her husband served. Heaps of stuff there. If she needs psych evaluation I am sure staff we organise it when and where.
She’s using you as entertainment I feel you need to stop being responsible for her and stop saying “How high?” when she says jump. I bet there is a girl inside you just busting to say NO!!
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Marylin Mar 2019
Thanks! Yes, my weary mind, body, & soul are saying NO!
Since she has CHF, we visit the hospital a couple times each year. I've already instructed ALF to transport her by ambulance the next time. At first, I thought this isn't Christ-like, but I've had enough. She will be fine, after the embarrassment.
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Ugh. Yes. When my MIL threatened to stop meds and die, I would casually and very matter of factly state, “Well, you are an adult, and you are in charge of you. You can certainly make that decision, and we will support you in whatever you choose.” Stopped the ranting in its tracks! Except one time she backed down to, “Fine! I just won’t get my hair done no more.” Lol!! Like that would hurt me!!
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Marylin Mar 2019
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Giving you big hugs here!
Sorry this is happening. For me, it screams Narcissism. You are allowed to choose to be mentally healthy. You are allowed to disengage, report threats, enlist appropriate resources.
In recent reading on the Hemingway family, I saw many parallels to my own birth family, who I have very little contact with. While my family has been plagued with Narcissism and Flying Monkeys behavior, severe scapegoating targeted at yours truly, there is also the underlying mental illness, bipolar disorder, BPD, depression, afflicting my family. Several relatives were successful suicides. Several more attempted and were unsuccessful. All threats of self harm must be taken seriously. Please put the necessary phone numbers into your phone, to be ready for the next threat. Responders will be able to pull together medical care for suicidal people quickly, once hospitals, doctors, clinics become involved. Let them do what they do. As one whose childhood was constantly upended by nocturnal parental fighting, including murder and suicide attempts, I didn’t know, as a child, that it wasn’t normal for Dad to destroy the family car in a suicide attempt, or mother to go after father with scissors in a murderous rage. It was accepted part of living, for phone calls to Crisis Hot Lines to bring teams to the house, for suicide prevention response. I suggest you be prepared, notify your best option for suicide threat, and back away, to protect you. You don’t deserve the emotional blackmail. There is so much more to life.
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Marylin Mar 2019
Thank you! It is emotional blackmail!
Bless you for ensuring your race. You must be an extremely strong lady. Thanks for sharing.
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This is a terrible situation for anyone to be in. No one should take abuse like you state you are.
I have a question: Why isn't the facility taking the action and calling in a phych to evaluate her. The doctor has the right to do this and i am told that every facility has them on staff. I would request that if they didn't approach this matter than you should. don't talk to the nurses talk directly to the doctor.
Second, i agree with many of the caregivers responses. I would simply tell her she has the right to do what she wishes with her furture. If she choices not to take her medicine, call a lawyer, etc, that is her choice, but when it comes to you, her abuse physically and or mentally is your choice. I would state if you continue to abuse me in these manners i will not come and visit. I will continue to call and speak to the nurses on your health issues and behavior. I will do this because i love and care about you. This is your choice and you need to think it out well. Your family loves you but if you choice to push us away we will have no choice but to stay away. I hope you decide to have a loving healthy relationship with me as i would like with you. than i would say I have to go now , take care of yourself. and leave...............
I would keep in touch with the facility daily but stay away until you hear positive news from the nurses.
This puts the ball in her park now . Maybe staying away and being alone will clear her head, but if it doesn't i wouldn't step in her room until she grows up...............
good luck.....
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Marylin Mar 2019
THanks. Your advice is in progress.
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My situation was not quite this bad, but close. I used my mother's love of her physician to get her to a Neurologist. I told her the doctor scheduled the appointment and requested it, so she went along. She failed her dementia exam big time, so my suggestion is to get your mother in for an evaluation. After that she had a springboard POA so that all we needed were 2 physicians signatures to obtain the POA. This was helpful when placing her in MC.
It may be that she needs more social stemulation. My mother's MC has been excellent at making sure she stays engaged socially and mentally with a variety of activities. As she put it, "I have to go to bed early because if I don't get up for breakfast with the girls, I don't eat." I can see that if she had been placed in AL, she would have been very isolated and without routine in her daily life this would have exasperated her condition. MC makes sure she has daily routine, meds, and social experiences. Also, although she was still able to cook and personally care for herself, we were unaware at how stressed out she was by having to take care of her house, dog and personal self.. all of which had gone downhill in the past year. Just by not having the stress of it all, her mood and personality improved significantly.
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Marylin Mar 2019
Her assisted living facility has a multitude of activities. I can name on one hand the times that she's participated in 2 years. Pretty much a loner & stay-at-home mom has been her choice in life. She says these activities do not interest her, that it depressing her to be out there even for the 2 meals she goes to the dining room for. It's depressing to be around these people!
Her favorite introduction when she calls is It's your mother. You better get over here. These people don't know what they're doing! YOU stuck me over here. I'm not going to stand for it. I'm glad YOUR daddy is not having to see how YOU'RE handling this and spending all his hard-earned money! Then, she proceeds with all my sins that she's twisted. I rarely recognize where these stories come from. According to her, I've always been a problem & we've never gotten along....really???
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If she is intent on dying ask your minister to do a service of healing for her. In this particular case healing would relate to her passing on based on God's will for her.
Then you are out of the picture and it now is between her and God!
By the way, a service of healing can take on many different aspects of a persons spiritual life.
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Marylin Mar 2019
Thank you.
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As a Christian, I believe we are obligated to be sure our parents are taken care of in their old age. However, that does not extend to allowing them to abuse us. If she is well-cared for, then you do not even have to have contact with your mother. You do not have to continue to visit or talk to someone who hurts you. You can monitor how she is doing by keeping in close contact with the AL facility. Laura Schlessinger has some excellent books on dealing with toxic relationships. I'm sorry you are in this situation and will pray for you and her.
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Marylin Mar 2019
I remember Laura! Will do.
It's an eye-opener to say I'm in a toxic relationship. I am a highly educated person but have let this take over so many facets of my life. Keep praying for me. I truly appreciate it!
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Marlin
Just wanted to thank you for posting about this issue. There were so many helpful answers given. Hope things do smooth out for you. Please keep us posted.
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Marylin Mar 2019
I am so blessed to have found everyone on this forum. Often times, I say "no, I can't" but then "she's my mom" pops up. It's refreshing to hear everyone put such common sense into this situation. I respect all comments and am reading them daily. Thanks so much!
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I have some questions and some suggestions. At 83 I understand that I am nearer to the end than the beginning. I am a care giver for a disabled daughter who sometimes drives me to the movies. (Literally). I realize that we are limited in the amount of control we actually have. I ask her why she doesn't want to take the meds and then just tell her she gets to make that decision. There is a group of doctors, across the country called "Doctors who make house calls". You might check and see if they are in your area and arrange for one of them to come to her, not have her go to them. DO NOT LET HER CONTINUE TO ABUSE YOU. You may also think about communicating with her by mail. Get a bunch of cute cards at the dollar store and send one to her each week with a short note, a memory of something from your child hood that makes you smile and say, Sorry I couldn't come by this week but was thinking of you. I may make you feel better.
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Marylin Mar 2019
Thank you. You've endured hard times. I appreciate your advice.
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Marylin

You are within your rights to just step away and send the occasional card. That would be an acknowledgement on your part that you can't make your mom happy. She's safe and cared for in AL; as far as I understand, you've fulfilled your responsibility as a dutiful daughter of a mother with lifelong mental illness.

See, she's competent. She is an adult with choices and agency- e.g., she is allowed to exercise her own powers of decision-making to say Yes, I will not take meds even if it endangers my life".

Uunless she's NOT competent. That really can only get determined through a thorough psych eval. How do you get That? You really need to talk to the NP about that.
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Marylin Mar 2019
Thank you! It's in progress. Waiting to her from her next week. I pray she can make evaluation possible instead of saying again "no pill can fix ugly". I pray I won't be asked to take her.
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Marylin;

If you are "asked" to take her, you say "No, I can't possibly do that; she's violent towards me."

If she needs to be transported in an ambulance, all the better.

If they threaten that "the state will take over her care" you say "yes, thank you, that would be a relief".
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Marylin Mar 2019
I'm convinced...no transport from me. I do see how dangerous it could become! I have my sister's blessings on this, too (she has RA & isn't involved in this). I just need everyone kin to be on board when/if this happens.
Thank you!!
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The elderly do bring the drama.
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mally1 Mar 2019
Ain't it the truth!
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My mother, (who also had mental illness) talked about suicide and I told her case worker and a psychiatrist she had seen. It was enough for them to hospitalize her (involuntarily if necessary,) She went and spent almost a year there being assessed as having dementia and eventually treated. She refused meds for months. I had made it clear to her all my life that I would never take her into my home. She would have ruined my life. She tried to guilt me about that but I held firm.

Stick to what Barb wrote. If they ask you to take your mother the answer is "No". She is violent towards me. I cannot endanger myself, nor provide adequate care for her."

It is your mother's choice to take her meds or not . There is nothing you can do about that. Don't let her use it to manipulate you.

((((Hugs))))) I know it is hard but you can do it, and need to
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Marylin Mar 2019
Thank you! Bless you for your endurance.
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marylin; Read what Golden23 wrote!

She has walked this path; I have not.
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Marylin Mar 2019
Yes! I'm learning from her experience.
All of you are a blessing to me.
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