Advice for adult children of mentally-not-all-there parents?

Get a copy of http://www.amazon.com/exec/obidos/ASIN/1455521159/metafilter-20/ref=nosim/. It's more about Alzheimer's related dementia, but can be super helpful. The best thing I learned from the book was DARE (Don't Argue, Reason or Explain). It's not worth your time or energy and actually doesn't help your mom. Good luck and take good care of yourself.

over the last 5 years or so, she's started saying meaner and meaner things, and then later denies ever saying any such thing, and I think she actually believes that she didn't say it. It may very well be that she actually does believe she didn't say it. In reading your question, I was reminded of http://www.slate.com/blogs/quora/2013/02/27/what_is_it_like_when_one_of_your_parents_gets_alzheimer_s.html that was on Slate recently, about caring for a parent with dementia. Because of your family history, everything is more difficult, but personality changes, and, in particular, this kind of mis-remembering of conversations, is a very, very common part of a dementia diagnosis. How do you let mean comments not affect you? You really can't. It's human nature to feel something when a person who looks and talks like your mother says hurtful things to you. In a family with a different history, it might be easier to rationalize it as "it's just not her any more" but with your history I think it will be harder to do. Talk very openly with your therapist about this. Do try to hold on to the idea that it is really the illness talking, and not her. If you are able to access a support group for other children caring for parents with dementia, you'll quickly find that there are strong commonalities between what other adults with dementia say and what your mother says. Unfortunately, it will get worse, not better. Be very open with your therapist about it, and talk through the pain. If they doesn't want you there, but no one else is nearby, what are your responsibilities? This is up to you. Some folks in your situation would just walk away. If you choose to stay, then you and your sibling need to work together to start to take on the load of making decisions about both finances and care. In-home care can be tricky at the best of times, and I think you'll find that, fairly soon, it won't be safe to have your mom living alone in her home any longer. With your sibling but (at first) without your mom you need to sit down with an attorney who specializes in elder law and talk very, very frankly about what her available resources are and what the options are for assisted living (and probably, eventually, nursing home care). For some families (like the one in the article I linked) in-home care is the best option for everyone, but I have a strong feeling from your question that it's probably not the best thing for your family. So, you'll need to sort out things like: what is the house worth if sold? What are her assets? Is your dad paying alimony? Is there a pension? What social security and other benefits is she entitled to that she may or may not be using? Only once you have educated yourself about the options available should you open the conversation with her about taking over part of her financial and/or medical decision making. Because only you know your mom, it's up to you as to which part to tackle first. In some families, it is easier for the children to get more involved in the medical care part of it, and then handling the finances flows naturally from there. In other families, taking over the finances eases a burden on the parents, and then talking about things like assisted living becomes more of a financial conversation than a medical one. The reason you get yourself educated first is so that you can use the voice of authority in the conversation. But, at the same time, you can't come in and just make the decision -- "Mom, here is what we have decided is best for you." Encourage her to be part of the process. At all times emphasize that you are doing this to make her life easier and more comfortable. Which sort of leads into your last question. For me, it is all about demonstrating respect for anyone through actions, and letting them be as autonomous as they can be. While your past with your mother has been difficult, the choice ahead of you is not, ultimately, about her at all. If you make the choice to continue to be involved, then everything going forward is really about treating her with as much kindness and compassion as you can, not because she is your mother but because she is a human being in pain and all people are basically deserving of our respect and compassion. Best wishes to you. You have a long road ahead. You are correct that it would probably be easier to lose her quickly, or to something that does physical (vs. intellectual) damage to the victim. To a large extent your impulse is correct - she is not just acting like a freaked out five year old. Her mental capacity is very close to that of a five year old. And it will get worse. You note that your mother often sees herself as a victim; in this case she really is; she's in the middle of the worst process imaginable ... the process of being unmade, while you're aware of it. She will need all the love you can summon for her, because, in many ways, she will soon be your dependent child.

My oldest son had a lot of memory issues when he was little. We learned how to deal with him. When I am my two sons lived with relatives for a year while I was going through a divorce, we had no trouble dealing with my elderly father with Alzheimer's. So, some general ideas for dealing with people who aren't all there: Emotion and routine are two forms of "memory" that get relied on more heavily when other cognitive functions deteriorate. Those are pathways you can use to more effectively engage your mother. For example: My dad sat at the same place at the kitchen table. He had a lot of dietary restrictions and food had become a battle. He had a lot of negative feelings and distrust towards the people around him. He was also extremely defensive if we offered him food and he didn't want it. One of the things we started doing was just leaving food at his place at the table. He would eventually wander in, see the food, realize it was for him and he could decide for himself if he wanted to eat it. It removed the dynamic of other people arguing with him and trying to control everything he did. It restored some sense of personal choice and control. My mother began doing the same thing. It allowed her to argue with him less. With less arguing, he had fewer negative feelings towards her and stopped being so difficult. So, if you can, try to make use of your mother's routines as a means to engage her in a manner that is comfortable for her. If nothing else, try to not interrupt her routines. She needs them to function at all. Try really hard to be consistently pleasant and not fight with her. It will eventually pay off in improved relations. But it does take time. Try to offer information in a supportive way rather than a controlling way. It looks to me like she resists all suggestions from others because she doesn't want other people controlling her life. So if you research what her options are, try extremely hard to present that information as just that: information about available options. Try very hard to avoid saying anything that sounds judgemental or controlling, like she "should" move (or whatever). You are more likely to get cooperation if she feels you will really listen and are not just trying to run her life. My mother grew up in Germany during WWII and its aftermath. She can be pretty unpleasant and difficult at times but is also an extremely generous, heart of gold kind of person. As a child, I found her really hard to take. But as an adult, it was much easier to basically say "that's her childhood talking" and just ignore it. My mother made sure I had food on the table growing up and there were no bombs falling in my backyard. I can't imagine what she went through. I won't judge her. You have indicated your mother had a worse childhood than you had. So it might help you to be more forgiving and tolerant to realize she did make an effort to make your childhood suck less than hers and she just didn't know how to get to someplace genuinely pleasant and secure. If I am "better" than my mother, it is partly her acheivement, perhaps more hers than mine. I just try to be respectful and understanding and try to back out diplomatically when she has some spaz attack about something. I try to be glad that whatever hardships I have endured have cut less deep than what she has endured. Best of luck.

I'm so sorry you are going through this. You actually have two related concerns: 1. How do you deal with the increasing abusiveness of a declining parent who wasn't always there for you before they declined, and; 2. How do you deal with the caretaking of a physically and mentally declining parent? Number 1. is something your therapist and support groups can help you with, more than anything. There are groups specifically for caretakers of loved ones with dementia, and many books. As someone who has seen grandparents and my mother decline, I can tell you that it helps to keep the person they are now separate from who they were then. Imagine how you might act and what you might say if your filter was gone...it would probably not be your best self that would show through. But it's also ok to be angry. No one likes being insulted! And you already have some issues with her. Try to find channels for your anger and let it blow through you and leave. And try to keep anger at things she says now separate from whatever things you are still angry about from your childhood. Don't worry about whether you love her "enough." There is no such thing as enough. Whether you love her or just feel compassion for her as a suffering human being, that is sufficient. It's what you do that matters, more than how you feel. And you have the right to set boundaries in what you will do, as well. And your friends are well-meaning, but watching a parent go through dementia is not lucky in any sense of the word. Number 2. is something you don't mention, and that is a concern. Your mother is not going to get better, and she will not be able to take care of herself much longer. What is your plan? Is your sibling on board with it? What about power of attorney to secure her assets/prevent bad financial decisions? Is your dad still involved? Resolving some of those issues (if they can be resolved) is not pleasant, but will allow you to feel more control over the situation. Those are also issues which caretaker support groups can assist you with. If you know there is a plan for what to do as your mom declines, that might release some of your anxiety and allow you to deal with the day to day stuff better.

You don't have to be a saint. Give yourself credit for being there, even when your mom is mean. I think it would be wise to speak to an attorney who is skilled in elder concerns to discuss conservitorship and other issues pertaining to your mom's increasining inability to deal with her money appropriately. Her house may indeed be too big for her, or too much for her to manage. It may be wise for her to put it on the market. Not just because it's more space than she needs, but because the upkeep is expensive and/or she's not physically up to dealing with it any more. People on fixed incomes can't afford to fix the A/C when it dies, or put a new roof on the house, or even keep the front yard mowed. If the house is old, she may be paying out the ass for utilities because of insulation issues. (My MIL paid $400 a month in electric in her old house!) A small apartment might be more appropriate at this point in her life. Your mom may need to be brought around to accepting your help and to substituting your judgement for her own, especially if she has a brain issue that impairs her decision-making ability. You can try to broach this with her, perhaps with the lawyer or her doctor as an intermediatry, "Mom, I'm growing concerned about you. We both know that you have health issues that are making your house more of a curse than a blessing. I agree with you that moving might be a good decision and I want to help you with that. Additionally, I'm worried about some of your spending decisions. With your illness comes some compromised decision-making, and I don't want you to fall victim to someone who doesn't have your interests at heart. Dr. Smith, and Mr. Jones here agree that having someone in your life who loves you and wants what's best for you should be helping you with your finances. I'll be happy to do that for you." It's probably not going to go over big, but it's better now, than when she becomes more frail and more scattered. If she can afford it, assisted living may be the way to go. If not, perhaps you can get her involved in Meals on Wheels, and other elder care services in your community. I'm 50 and my parents are aging as well. Most of their stuff is physical, but we talk about things like this openly, all the time, and it comforts me that my sister is there on a day-to-day basis to monitor the situation. If things get skiwampi, we have each other's back. Perhaps you can enlist other family members to help. As for the hurtful stuff, there's not much you can do about it. Try to remember that she's not in her right mind, that she loves you, no matter how harsh or mean she can get. One thing you can do is nip it in the bud, in the moment. If you're on the phone with your mom and she says something mean, say, "Mom, that's really hurtful. Do you mean to hurt me with your words like that?" Either she'll stop and apologize or she'll blow it off, if she doesn't acknowledge that she's hurt you, you can say, "Mom, I love you, but I'm not going to let you say mean things to me. I'm hanging up now." Then hang up. I'm there, I hear you, you're not alone. But this situation is not going to get better, so have a plan and start moving toward executing it.

I just popped in to say i went through this exact sort of thing w my dad the past 5 years leading up to his death and am going through it with my mom now. Even down to the irritating friends who dont understand what having parents like ours is like. What i want to say is that they dont get any nicer as they get older. And you are going to always walk that line between what is your duty as a daughter, human, christian (if you happen to be one) vs your instinct to pull back and protect yourself. And then its the strangest thing....when they're dead, you're suddenly not mad anymore. All the horrible stuff they did just seems to float away and you just love them and wish they weren't dead (even tho before you felt bad for looking foreward to being free of them when they die). And then the guilt starts-i wish i could have been more loving. I wished i could have turned the other cheek. I wish i had what it takes to actively love such a difficult and hurtful person. My mother is no better than my father but i am working hard against to be loving and kind to her and ignore her insults. I do this truthfully more for myself than for her or even god. I can't bear to face that aching guilt of wishing id been more of a comfort to a parent in their last months, even tho they didn't deserve any mercy. Also get a power of atty in place for her health and finances.

I'm so sorry: this is a very difficult situation, and it's hard to know where to start. Your mother has dementia (Alz or another type); I suggest you read up on the illness so you can understand what it's doing to your mother's brain and perceptions. One thing to keep in mind is that any mental health or emotional issues your mother had before the dementia are still there, and are aggravated by the disease, because she is losing the ability to cope. Some part of her brain knows there is something wrong, and that makes her anxious, upset, and likely to lash out--especially at family members. It's not you, and in some ways, it's not even her. I second what people have said upthread: try as best you can to disengage your emotional responses, because reacting to it won't do you any good, and in fact will simply create more upset for both of you. Also, the way the brain works, it defends itself by rerouting around problems--as a result, the person with dementia does not usually know they have it! At least, not until the situation is quite far along. On a practical note, there are some questions you need to get answers to: 1. Does your mother have any legal documents like a Medical Power of Attorney, an Advanced Directive, or something like that? Does she own the house in her own name? Can you get copies of them, if she does? (I would be surprised if she has an Adv Directive, but she might.) 2. Do you have the names/numbers of her physicians? Gather that information, along with any evidence you have of her increasing incapacity. Call her GP and ask them to evaluate her at her next appointment for mental capacity. Ask for a written letter signed by the doctor stating what the doctor thinks is her ability to perform daily functions and manage her own legal and financial affairs. DO NOT tell your mother about this: she will consider it a betrayal. Remember, she doesn't know she has dementia. 3. Find a reputable attorney who specializes in elder law (check with the local Alzheimer's Association chapter for referrals), and ask them what you can do to set up a legal structure to protect your mother from herself. You need to protect her financial resources so she doesn't irreparably harm her ability to provide for herself. You might end up having to have her declared incompetent. (I did so, through a provision in my parents' living trust--happily, we didn't have to go before a judge, and my mother hasn't noticed it happened.) Make sure you keep your sibling involved, so nobody feels like you're trying to take advantage of your mother. 4. Maybe you can task your sibling with the medical side of things. You need to find a neurologist who specializes in dementia/geriatric issues, and have your mother evaluated. Probably the best way is to have her GP make the referral, and tell her you're just helping out with that. If you can, go to the appointment with her, where they will give her a series of tests. If she won't let you in the room, call the neurologist before and after the appointment: they may not be willing to give information to you, but you can explain to them what the situation is and your concerns about her behavior and her safety. 5. The neurologist might subscribe medication. IME, meds intended to help with the memory loss made no difference at all, but my father's life was immeasurably improved when we got my mother on anti-anxiety medications (until that point, she'd been having screaming rages at least twice a day, and was psychologically/emotionally quite abusive to my poor father). Some people feel that behavior-modification through medication is inappropriate for dementia patients, and they would be helped better through exercise, diet, and sunshine (see the stories at The Alzheimer's Reading Room for evidence of this), but my mother, at least, is so non-compliant that none of that would have helped, and the medications did. Anyway, studies are ongoing w/rt direct treatment for dementia, but there is no cure, nor is there any way to absolutely halt the progression of the disease. By the time you see the evidence of it, the damage has long been done. 6. After all that, you need to find a place for your mother to live. I recommend assisted living in a facility that includes memory care, so you won't have to move her more than once. Times have changed: these are not the horrible old nursing homes of the 1960s and 70s; many of them are lovely, sunny and bright, with lots of activities. There are consultants who will evaluate your/her resources and needs, and help identify some options. I suggest leaning on her doctors to support the move--they will be willing to say that a place with more support will be better and safer for her, and the sale of the house might help fund her placement. Wow, that's a lot. I am so sorry you're going through this! It's very hard. But if you choose to take on this responsibility (and I know that must be a difficult decision, given your history), I hope your sibling will step up and help. I am the primary person managing my parents' affairs, but my siblings have been great about helping out in whichever ways they can. I cannot imagine doing this as an only child. Some ridiculous percentage of the American population will suffer from dementia in the coming century, and the resources are there to help you out, once you begin looking. Good luck, and know that you're not alone.

You need to stop respecting her wishes when her wishes are clearly against her greater well being. Just do what needs to be done, over her objections if necessary. For example, you're saying she won't let you research places - how on Earth is she going to stop you? Do the research with your sister, get brochures, check out the places, and once you've narrowed it down to 3 or so that accept cats, find a way to present them to her as options. Leave the brochures on the kitchen table? Mail them to her in an official looking envelope? Take her out to lunch and then on a tour? This part will probably take some trial and error, but you'll figure out how to present things to her in a way that doesn't trigger negative emotions. As for the house, call a roofer and get the roof fixed for her. Just do it and tell her you're helping her prepare the house for sale. Show up one Saturday and help her clean. She's never going to tell you she wants help and she might even be a jerk about it, but if you just show up and help the things that need to happen will happen and you can move forward getting her out of there and into a space that's better for her.

I really feel for you. Having had these kinds of issues with my father and with his wife, one thing I can say is that it seemed a lot better once there were legal protections in place. My father agreed that he wasn't up to managing his finances, etc., and my sister took over. So at least there wasn't the feeling that some horrible practical/financial problems were about to arise because of crazy decisions like you describe. Granted, this was an incredible amount of work for my sister and it can be very difficult to persuade someone whose mind is failing to hand over the reins of responsibility. But if you can do it, then you can start seeing the interpersonal issues in less of an emergency context. If you make the effort and it fails (If they doesn't want you there, but no one else is nearby, what are your responsibilities? ) then maybe see a lawyer about your liabilities. As far as dealing with and talking to your mother, don't demand too much of yourself. Another person's diminished mental capacity does not mean you have to give up your own boundaries. Don't expect mean comments not to affect you; you're human. Don't be afraid to ask for help or even join a support group.