Mom lashing out with impossible to accommodate behaviors. Best way to say no?

Since you asked... now that my own mother is in care and I’m experiencing some of that 20/20 hindsight...

... it is not your problem to solve.

Example: If her appt is Thursday at 2pm, then you will pick her up at 1:45pm and drive her, no dog, directly to the appt. If she is unkempt and having a meltdown about the dog, let the staff and doctor see it.

I say this because I was unable to convince my mother’s doctor that there was anything wrong with her, she showtimed well plus she was in complete denial of her own decline. Imagine her doctor’s surprise when the assessment report reached his desk, that she didn’t know the year, her age, her town, her grandkids, etc., and had repeatedly tried to escape from the hospital. Only then did he acknowledge what I’d tried to tell him.

The longer you cover for her, the more difficult it will be for you to get help.

It sounds like your mother has some cognitive decline going on. The inability to plan ahead is called "executive functioning" and at least in my mom, it was the first thing to go.

One of the issues I ran into with caregiving (and I knew myself well enough NEVER to offer or do anything other than help with planning) is that I had a lifetime of my mom's critical voice in my head, telling me not to anxious, not to borrow trouble, to be more responsible, to plan ahead better. It made me extremely unsympathetic and prevented me from seeing the fact that she could no longer do this stuff for herself. I, having a mortgage, a family and a retirement to fund, was unable to step in and do this stuff for her.

In your shoes, I would contact mom's doctor and tell her/him about her inability to plan and see consequences and perhaps schedule some cognitive testing (not remember 3 words and tell me the President is.)

Real neuropsych tests will tell the whole story. And allow you to plan realistically.

Sounds like the dog needs his own emotional support dog to help him cope with living with your mother.

Unfortunately there may not be anything you can do until she declines more cognitively. You will have to set clear boundaries and not prop up her facade of independence.

If she won't shower she will go to the doctor dirty. That's it no rescheduling.

It won't be easy but the necessary things never are.

Stop trying to reason with and please your mother, it’s an impossible task. Fully agree with Barb, contact the doctor and tell him/her, in writing if necessary, prior to appointment about the unreasonable behavior you’re seeing along with the inability to make rational decisions and carry out a plan. Don’t worry if mom isn’t bathed for going out, it will show her condition more fully to her medical team, and is not a reflection on you.

I would approach this problem by asking you a question.

Would you tolerate this kind of entitled brat behavior from anyone else?
My guess is no. so, you don't tolerate it from mom either. It's time for you to stop allowing yourself to be treated like a child that mother can command.

Bottom line. Either your mother starts respecting you and the boundaries you set like you will help her shower at a time of your choosing - or you will not help her anymore.

My Aunt had been showing some signs of a Dementia. Her sister was picking her up for an appt which my Aunt was fully aware of. When sister arrived my Aunt was in a stained housecoat and slippers and her hair a mess. No time to get her dressed so sister took her to the doctor that way. My Aunt was meticulous in the way she dressed and had her hair done weekly. When her doctor saw her he said "A this is not you" and sent her for a 72 hr evaluation which found she had ALZ. She did not want to live with her sons so she went to live in an AL. (No memory cares then)

So, like said, better the Dr sees her how she is on a daily basis. You are allowed to tell Mom NO. The tables are turning, ur becoming the parent and her the child. She is no longer able to reason or make informed decisions. If you don't want that dog in your car, then don't take him. You have a right to go have a cup of coffee without worrying about the dog.

This is not particularly an answer to the question, but lately I have been thinking a lot about what happens when someone (like me) dies. Here's what happens: life goes on. Someone else picks up the slack, or they don't, and the PWD dies sooner or later in circumstances that he or she may hate, but that's how it is working in the USA these days. Caretakers are frequently dying from the impossible load they carry. And we are better off than, say, many Ukrainians.

I just helped hubby move to a very nice assisted living place. He couldn't possibly afford it if he (or really I) weren't selling his house. (I live in a very small separate house -- good marital device!). I had to spend many days -- no help from the perfect, loving sons who live at a distance -- packing up things and trying to get him to decide what he could take to a small studio apartment. He wanted to take everything, of course. Then the movers came, I had to supervise, it turned out he had insisted on at least 3 heavy pieces of furniture that absolutely wouldn't fit, movers took them back to the house for $200 more dollars. After that week I was so tired that I worried about having an accident driving home. I slept for 24 hours. It started to occur to me that my health has gone downhill so badly in the 5 months since he had to go to the hospital and the dementia really started, that I truly might die before he does. (He's 93 and I'm 73). So what will happen if I do? That's a question all of us might ask ourselves. The answer I came up with is...things will continue in some way until he dies. Someone will step in. He may not spend his last years in a place or with people he likes, but...tough. I will have literally given my life for him so that he can exist for more years (he's physically very strong) with dementia.

What I'm getting at is that if any of us removes ourselves from the situation -- by choice or by death -- life will go on. We don't have to kill ourselves so that someone else can continue for years in a nightmare state in which they literally make us die with their bad behavior or their degree of neediness, which can happen to the nicest people that we love very much. If we are gone...things will go on for them, until they don't. This is just a thought I've been having. No one on earth is absolutely essential and maybe it's a good idea to think "What will happen here if I die?" Things will go on. Try to imagine how. Even if you only come up with a story about how totally essential you are...you really aren't, and you don't have to give up your life for that idea.

The best way to say No is out loud.

It sounds like you are taking on too much responsibility for keeping her presentable to the Doctor. If she is independent let her be independent and fail. If she chooses not to shower during the times you are there and available then she goes I showered. If her dog has papers then the dog should be allowed into the appointment (wouldn’t her Dr have filled out the form?) if she gets there and it isn’t then it’s up to her to figure out what to do not you. Hard as it is you need to let her present the way she is, you need to let her try and fail and if she just chooses not to go you need to let her do that too. Eventually the people that need to will see and get the message that she needs more help than they have been allowed to see thus far and presumably that will get you and your mom at least more of the help you need.

I am struck by the idea that you are kept so far away from these appointments that you have to pass the time in a restaurant across the street. I don’t think it would ever occur to me to do that, if I am providing transportation my assumption is I at least go in with her and wait in the waiting room. This way when the doctor needs back up or to make sure her family is clear about what her needs are they can get her to agree to bring you in and do so. If your mom is keeping you that distant from the actual office my suspicion would be that she is hiding some important medical information. Don’t make that so easy for her by allowing her to use you like a personal taxi rather than her helpful, caring daughter/son.

Agree with Burnt Caregiver and several others. Sorry you are dealing with this, hugs.

Setting boundaries that work for you -- such as you will be there between X and Y time to help, and saying NO to the dog coming along. No explaining, NO negotiating; just say this is your offer take it or leave it. Be ready to walk away. Say NO to any other demands she insists on. NO is a complete sentence and needs no further explanation.

If she pitches a fit, try to remain calm and clear! Tell her, "I need you to be respectful in how you speak/engage with me. You either take my offer to help you in the time window that works for me and with my decision to NOT involve the dog, or you will have to make other arrangements. I will not accept any name calling, you interrupting me, no angry outbursts, nor any guilt tripping. You can either accept my offer to help you to do X (shower or name something specific) during the time that works for me and handle that in a respectful way OR I will have to leave. Then be prepared to walk out, walk away. Let things fall back entirely on her. And thereafter, leave it be for a while -- no calls/contact for perhaps a full week. Let her calls go to voice mail, or block her number temporarily so you do not have an intrusions. Let is set in with her that you are changing this toxic dynamic. She may get it or not. That said, this may have to be repeated several times and make the "no contact" period longer, double it each time.

If she is not safe to be alone, her ability to care for herself and to make decisions is compromised and dangerous; consider calling adult protective services (APS) to intervene. Your local area agency on aging, may be able to help get APS or others involved.

Also you may find it helpful to get with a talented therapist to unpack and work towards your own healing. This type of co-dependent and frankly toxic behavior your mother set up with you, likely has been years in the making. She has groomed you for this. It likely will take years to work through. Try not to beat yourself up about this too much. This is not easy to unpack, nor easy to build back healthy ways of interaction w/her and w/clear boundaries and self care strategies for your healing. I am still working through something similar.

I had to go full no contact w/my mother as she was unable to make any adjustments on her end in her behavior towards me. She is 86 and I have not seen or spoke to her in almost 2 years. That started as low contact 2 years ago to the day today, Mother's Day in the US. She told me, "Mother's Day, worst day of my life; having you". I did not speak to her for a full month. The after a low contact period, I went full no contact as the outburst and lashing out were ruining my mental health.

I was able to get her in to one of the best nursing homes in our State, with the help of a talented elder care lawyer following a long hospital stay. She has dementia, cannot walk more than 5 feet and has a host of other medical condition that require 24/7 care. She is getting the care she needs; so I am caring for her. I still handle all the legal and other paperwork for her (taxes, coordination w/Medicaid and the nursing home, am her health agent/POA, have end of life funeral arrangements made for when that time comes).

My uncle (her only living sibling) visits her once a week, and from time to time he and my cousin or another cousin may take her out for lunch. My family has been great with this, no judgment as they understand even without explaining that I need to be out of her toxic soup to recover.

Good luck with this!