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My mother is 76 with some physical, but mainly psychological issues. Currently she lives alone and is able to bathe, dress, and feed herself. However, she is an extreme hypochondriac - goes from doctor to doctor, although in reality her only real diagnoses (besides psychological issues, anxiety and bi-polar, for which she on meds) is arthritis, osteoporosis, some GI issues. She does have a bit of weakness in her legs - uses a walker although she doesn't necessarily need it, just convinced herself that she does. She is a difficult person - in need of constant attention - calls doctors, help centers, case workers, and others multiple times during the course of the day to the point of harassment. She eventually alienates everyone she comes in contact with because of her neediness, which leads to anger, and her eventually lashing out because (in her mind) no one is doing enough to help her, or they have "mistreated" her in some way. At this point she has convinced herself that she has major health issues and that she needs someone to prepare all her meals and to take care of her, says she doesn't feel safe where she is, and she believes that assisted living will be the answer to all her problems. In short, my brother and I have been looking into small assisted living centers. However, she is very low income and has little assets, which means my brother and I will be picking up much of the tab. (She has been on the Medicaid Waiver list for many years but nothing has come through - and even if it does, no guarantee she will qualify medically. So we can expect to be out of pocket for perhaps quite a while.) We finally found what seems to be a decent assisted living in our lower price range, which has proven difficult. However, given my mother's behavioral issues and history in her interactions with people, my brother and I are 90% certain she will get kicked out. There is a 30-day clause in the contract, which will not allow us much time to find another place, especially a decent one in our price range. I am not sure what to do - do we put her in there anyway and take our chances? Eventually we will have to sell her house because even that small amount of equity will help to pay for some of this. This will mean she will not have anywhere to return to if she gets kicked out, and neither my brother nor I are willing to take her in. She is just too difficult and demanding. Any advice is welcome.... ?????

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Molly, first off, what does your Mom think of moving from her home into Assisted Living? Moving from a house or apartment into a small studio apartment can be difficult... that is a lot of downsizing. It might be better to move first into Independent Living, which is less expensive where Mom would have a nice size apartment with full kitchen. Lot of places have once a week housekeeping and linen service. Places in my area are around $5k per month.

Moving might be a positive things for your Mom, she would be around people closer to the age group. She could make new friends, and eventually forget about her medical conditions. Being extreme hypochondriac is very tough on a person, I had that for decades. With the right meds to calm Mom down, she might get into the "whatever" attitude about doctors :)
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She wants to move into an assisted living, or so she thinks. She believes it will be the answer to all her problems, both real and perceived. I am not saying that it will NOT help her to be around other people. Just saying that she is a very difficult person and she eventually alienates all those she comes in contact with due to her high expectations of others, followed by their perceived wrongdoings, her angriness and her lashing out. The hypochrondria is only a small part of the problem, unfortunately.
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She has more than bipolar and anxiety that needs mediciating. Has anyone told her psych about these other problems?
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molly - I understand. My mother would think that if only "whatever" her problems would be solved. When "whatever" happened she found fault with it as she did with everything else. She also alienated people who tried to help her. Mother was diagnosed with Borderline Personality Disorder. Eventually, when things really started falling apart, she was admitted to a geriatric psych hospital and evaluated and also found to have vascular dementia. After some months there she agreed to be medicated and has been since, She is in an ALF for people with mental illness, soon to be moved to an NH as the vascular dementia has progressed.

I agree with cmag that your mum needs to be medicated. Can you get her to a thorough neuropsych evaluation? Good luck, I know how difficult this is.
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Thank you. She has been under the care of a psychiatrist for many years and her psychiatrist is aware of all these issues.  She has been off and on a variety of pscyhiatric meds - right now she is taking meds for bipolar and anxiety. She has also had several psychiatric inpatient stays in the past, though none recently. Several years ago she was admitted to a geriatric psych hospital to be evaluated, but they found nothing seriously wrong and she was released with some tweaks in her meds. Each time she is released she returns home, and of course the cycle starts again. (*I did not know they had ALFs specifically for people with mental illnesses, although she has never been diagnosed with anything other than the bipolar and anxiety.) I highly suspect this assisted living facility is not going to want to deal with her - the other residents seem calm and reasonable, and she is anything but.

p.s., I just looked up Borderline Personality Disorder.  A LOT of the description seems to apply to her, although as far as I know she has never been formerly diagnosed nor treated for it.  That is very interesting.
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(((((Molly))))) She sounds like a BPD. Maybe you need a second opinion/evaluation. Can you write up your mother's problematic behaviours and submit them to her psych? I am in Canada so the system is likely different. They may not have ALF's for people with mental illness in the US. Due to home help, Mother had a caseworker who was well aware of her problems as were the staff at her regular ALF. I was in constant communication with them as she got worse and worse. Finally at age 100 she tried to fly east without proper ID and the sensible staff at the airport took her to the hospital where they assessed her as BPD. 5 years before she had been assessed that too during a stay in hospital. She was released, but put in a list to be visited by a psych nurse and community psychiatrist. She pulled the wool over the eyes of the psych nurse (she could be very charming when she wanted to be), but not the psychiatrist and the rest of us knew. Then, as the vascular dementia progressed, she started getting paranoid and having delusions and eventually was suicidal. She refused to take the prescribed meds and everyone who dealt with her were having troubles. The community psych decided it was time for admission to the geripsych hospital, involuntarily if necessary, but mother agreed to go and stayed there nearly a year before she agreed to take medication. There was another fiasco in the middle of this with my sis (I am POA health and finances) trying to move her to an inferior ALF as mother was unhappy where she was (what's new)! It was a 5 ring circus for a number of years and only settled down once she was on an antipsychotic and an antidepressant. She still isn't happy but she is happier and manageable. My heart goes out to you. dealing with this kind of thing is so stressful.
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BTW - there is not much treatment for BPD. I was told that she had had it too long for therapy/counselling and would have had to agree to it anyway. The only help was medication.
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Borderlines are masters at wearing masks when needed.
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Bipolar is often boderline misdiagnosed.
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I suspect that is the case here, cmag.
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golden23,
That's amazing. How old is your Mother now?
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She is 105 and has no comorbidities (heart, lungs, kidneys, liver, blood sugar, blood pressure etc all good) so I expect she will last another few years. I just turned 80 and it is no picnic I can tell you. I am hoping I will be done with care giving by the time I am 85 or 90.
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Oh Golden, you scare me to death! My mom is only 84 and becoming more and more difficult, while I am becoming less able to cope. The good news is that my husband is helping when he needs to, but encouraging me to leave her more and more in the hands of her social worker - whom she does listen to - seldom listens to me about anything important. He says I have enough stress now, and that to add more stress about her will do me in... when I think about so many more years - only God could have helped you manage all these years - and manage such a tough mom! Kudos, kiddo....
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mally - you need to leave her more and more in the hands of the professionals. The stress will only increase and you have to protect yourself. Yes, God has helped me - no doubt about that. We will soon have to move mother for the 5th time in 8 years. She will go to an NH and that should be the last move. I expect her to be quite unhappy about it and will have to stay out of the line of fire, as she tends to blame her unhappiness on me. I am sure you understand. I am thinking (not very seriously) of writing a book titled, "I am an 80 Year Old Caregiver." According to the lady assessing mother for the move, I am not alone. Take care! Prayers appreciated.
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