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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 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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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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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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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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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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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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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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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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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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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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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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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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