Okay. I have to whine a little! Abusive parent with dementia still lashing out. Any advice!?

I think BrooklynBarb has it right. Do not put up with her abuse, but do consider talking with the Hospice doctor about altering her medication. The combativeness can be very difficult to handle. My mother has dementia and is now in a memory care unit. While I am not an only child, and grateful to have supportive brothers, I am her care giver . When I was young, and into my adult years, she was mentally and emotionally abusive. The dementia brought back some of her worst behaviors. YOU ARE RIGHT for setting firm boundaries. If possible, set the phone to a different ringtone for her, so you'll know whether or not you need to answer it.
Good luck.

i would take the lashing out. Mine went to a lawyer with her best face on and he bought into everything she said. She lives with us. I have been written out of the will. All POAs revoked. The state is now involved. What a frickin’ mess. No other relatives. WTH!

"is it wrong?" IMO, no. Don't put up with abuse. Tell the facility manager you do not want her calling you direct. The Manager may or may not be able to assist but you can block her calls.

If she is combative, the staff will try different strategies, try later or refer to the Doctor (who may or may not tinker with her meds). You can be in the loop on this or not as you choose.

Keep visiting if you feel it helpful - as in, would you regret never going again? Keep any visit short. Try to go at her best time of day. Be prepared to leave if it is a bad day.

It is not unheard of to have to block numbers - if calls are abusive, unsociable hours or cause more confusion.

Sorry for what you have been going through. My mother was very demanding all her life and in dementia it was not much different. There were times when I visited her in the home I literally had to walk fast and when I got to the hall corner I would run to the locked door in order to get out before her legs would catch up with me. Or it would have been a battle at the secured door. As I knew moms life was coming to an end soon, I did visit her everyday, but limited the amount of time.

You do not need to take abuse. I am surprised she has use of a phone to call you. Let some of the calls from her go onto a recorder. I would not argue with her or tell her off. Now is not the time for either of you. I would just by pass any cutting things she says and let it go.

I tried to keep mom calm, especially in the later days. Holding her hand. Soothing music, etc. Which helped both of us. For me, my lasting memories. With this disease additional things can upset them that wouldn’t prior to the disease. There thoughts and worries are real to them. Don’t disagree with her. You don’t have to agree, but I find, even with my husband now with Alzheimers is to say “ok”. So I am not disagreeing with him or agreeing. You can always say “I will check on that”.

Try to stay calm, exit when you need to etc. Take care of yourself.

This resonates deeply with my situation. Most of these answers have been very helpful to me as well.
To the OP, I hope knowing that you are not the only one going through this is as helpful and validating as it is for me. There have been lots of good advice and affirmations to take care of yourself first. I hope that you continue to do so, even when it gets difficult.

Imho, do not engage in convos that are upsetting to you. Prayers sent.

The ALFs reccommend Seraquel. I heard it helps a lot. She is not happy the way she is and you are not happy.
You might have a different outlook on your relationship if she acted like a "normal" loving mother. What do either of you have to lose at this point by trying a medical solution?

I don’t consider this whining...you are asking for love and support from this community. You sound like you have a good head on your shoulders, therapy is a wonderful start. Boundaries. The most important thing I learned from therapy. You have to take care of yourself first, otherwise you won’t have the strength to manage. Hang in there, sending you a virtual hug!

My god, my dear soul - why are you putting up with this. First of all, if she lashes out at you, and it is the dementia but that does not matter to me, get tough and tell her off! It won't fix her but it may make her stop her behavior for the moment. And if it doesn't, why are you going to visit her and set yourself up for what she is doing to you I would never, ever put myself in a position to be near someone like that - never! Stay away. You are doing and have done everything right - but she is acting like a monster. Don't go near her and let the staff and the doctors and medication control her - not you.

You're in a tough situation. Do what your conscience bids you to do and feel no guilt if you decide to stop seeing your mother entirely. It's very hard on an adult child whose parent was abusive, cruel, and manipulative all their lives. Even when that parent is old and has dementia it still hurts the same because they've had a lifetime of it. If your mom is in hospice then her time is growing near. My opinion is that you will feel better for yourself after she's gone that you did better for her then she deserved. You don't have to take every phone call from her. You don't have to go running every time she makes up some terrible thing is being done to her either. You must care for her a little bit otherwise you wouldn't be trying to do right by her handling her affairs and seeing her at all. Care on your terms though and let no one, even yourself guilt you into feeling like you're not doing enough.

With dementia-- re-direct--- bring some food for her... bring magazines,,, a glass of red wine in a jar...read to her. leave her with a smile. Don't let the bloody divil win the battle... !!! Tell her about her old friends who have remembered her. Bring her a Teddybear or any kind of doll--- a Dog or a cat doll. No not the ones that purr. Bring flowers if they'll let you.. some places think the patients will eat 'em.
GET a plastic flower wreath for her door and several nice impressionist pictures for here room's walls. Put some kinda essential oil like lavender in the bathroom. Get her some bubble bath. RE-DIRECT ! -- every time you see her and do not wait til she gets on a tangent-- seize the day ! Good luck... oh-- there are nice praise and worship CDs that you can play for her... get a small CD player with earphones. You may have to devise a way to keep the good stuff locked up in a small cupboard or whatever-- there were lots of sticky-finger folks ( patient and-- CNAs...(?)) at my Mom's ALF.

First of all, you are doing the BEST you can! Given her past abuses, it is gracious of you to step in to manage her affairs. Only ignorant people and those with dementia can find any fault! Ignore them.

"But she also seems to know she can try and manipulate the situation. She is making outrageous accusations of the staff and saying her food is poisoned. She is cursing at me and telling me I am not defending her and she wants to leave the facility. And so on."

If you really feel that you must visit, just "listen" (not really) and commiserate with her. This is her reality, topped off with her negativity. "Wow mom. Really, they did/said that? I will speak to someone about it. Only the doctor can give the okay for you to move out. I will call him and see what he says. Is there anything I can get for you right now? No, okay, let me go find someone to discuss your complaints with." And then leave.

If you feel there is no real point in visiting, then don't feel guilty for not going. It doesn't do you any good and it doesn't seem to help her at all, so the fewer times you go, perhaps the less agitated she will get and the more of your sanity you can retain!.

"Since my visit she is calling me and continuing with abusive behavior that is very familiar to me."
If she calls, let most calls go to voicemail. If there was something really important, staff would likely call you. IF you retrieve the messages and they start off with this behavior, delete it without listening to the rest of it. I'm sure you've heard all of these before, many times. No point in putting yourself through it again!

"I have set strong boundaries and consider myself just the manager of her business affairs. I have already spoken with an elder care attorney to insure I am managing everything to the best of my ability."
Again, just stepping up and taking on oversight for her is doing what you best can. Working with staff, doctors, hospice, attorney, all this adds up to you are advocating for her. For someone that abusive, this IS the best you can do. Nothing else will make a difference, so keep doing what you do best and let the rest fall by the wayside.

"I communicate with the staff to insure they understand her anxiety and depression. They have reported she is becoming a little combative. Given her dementia and reports of hallucinations, is it wrong to still be concrete, firm and direct with my responses?"

Advocating and support = good! The only thing I would ask of staff, doctor or hospice is if they think there is any medication that might take the edge off her combative and/or abusive behavior (maybe the hallucinations too?) Even though those who work with dementia patients are more used to it, it's still hard on anyone! Might make your visits, if you go again, a little better too. No real wonder drugs for dementia or personality issues, but if there's anything that can tone it down without doping her, I would give it a try! For responses, see above. With dementia, generally it's recommended to just go along with them, don't argue, don't correct, don't disagree. It's futile and only riles some up. Another suggestion is to try to divert their attention to something else, but it sounds like she's really stuck in a rut! Can't hurt to try - bring up old topics, friends or relatives of the past, ask about them, bring old pictures and ask who they are. If she can't be redirected, then skip all that.

"I haven’t returned for a visit. I am still upset."
Wait until you feel you are up to it, if ever. Not visiting doesn't reflect back on you at all given the circumstances! If you do go, let whatever she says fall on deaf ears.

I understand., She is not going to change - she cannot change. Good for you that you have her in a place where she is taken care of. They can provide her with more medication if needed. I doubt she will get sweeter - don't we all hope for that?

Agree that dementia patients can be abusive verbally and physically. It's part of the illness. I have to try to separate the "spouse" from the "caregiver" which is what I am 95% of the time. Learn patience, walk away and take some deep breaths. My husband's dr. gives him meds that help (Seroquel - check with your dr.) plus we've also lowered his Parkinson's meds (over time they contribute to, or worsen dementia). I'd suggest you get connected with a Alzheimer/dementia support group in your area. They've helped me a lot and I get a lot of information.

You keep doing everything you are doing. When she launches into her song and dance of abusiveness, you say, “Call you later,” and walk out.
Let the phone ring without an answer.

It took me YEARS to realize that’s what’s coming out of their mouths - abusive, yes, but only words. Doesn’t mean it doesn’t hurt, dont get me wrong. But they are words. And you yourself have words. Like, “goodbye,” “Call you later,” and ultimately, “Have the staff call me if there’s an emergency.”

It’s tough, I know, believe me. My mother gets combative and she is of sound mind 100%. A few, “Hey I’m not going to tolerate thats” and she stopped, for good.

Good luck.

If your mother wishes to have a relationship with you she MUST repent. Repent means to admit what you did, admit it was wrong, apologize for it ask for forgiveness and stop doing the offence.
If it is not important enough to her to nurture a loving relationship with you then it is not important enough to you.
If you must have contact with have it on a formal basis with internet mail. If there is any abusive emails all contact will be severed.
Please Father bless mom to see and understand how much she has hurt me. Convict her and bring her unto repentance. Please bless us with reconciliation. Help me to be a good care giver to her even though she does not appreciate it. Help me to stay focused on the fact that I am serving You by being her care giver and that You appreciate the hard work and suffering this vocation causes me. Please bless me with wisdom, strength and self control to be a good care giver. In the name of He who suffered much for me, Jesus Christ, I humbly pray. Amen Joseph a son of Jehovah
I depend upon You, Holy Spirit to help me set Godly boundaries in my relationships. I depend upon You to guide me in the proper use of these skills to nurture loving relationships while purging myself of toxic folks who only bring unnecessary drama and chaos to my life.  Joseph a son of Jehovah
You have excelled at doing your part now it is her turn to do hers.

You should get a therapist for yourself to help you cope with your mother's dementia and demands. There is no reason for you to feel like a child again. A therapist can help you set boundaries that work for you, while you do your best to make sound decisions for your mother.

Hi!
Emotionally it was hard for me to take the verbal accusations every time we talked on the phone. I chose to phone block her calls Friday-Monday. It was my FOUR peace-of-mind days. So from Tuesday-Thursday I was available. If she was nasty, calls were short. I also hired a friend to take her to doctor appts or phone skype with her. She is very nice to my friend/helper but I am a trigger as her dementia symptoms decline. I am much happier and I know she is being cared for. My contact is with my helper for feedback, the director of ALF and coordinating her financial affairs and such. Educate yourself with the 7 stages of dementia so you have more understanding of her behavior. It is easier to accept that it isn’t necessary a personal attack. Find your peace.

You have to make yourself feel right. Don't listen to the abusive words. Just stay calm at all times. She is in Hospice so this is her final days. For yourself, try to remember the good days. I know it is hard but ........

sorry for going thru so much by yourself.  Dementia patients do go thru combative episodes and other type things (my father did also) and that was while he was still home with mom, until the last fall he had and mom said no more, she couldn't handle it (she is diabetic and was affecting her physically/mentally as well).  I wonder if she has a UTI going on as that will also affect an elder persons mental state as far as confusion.  When your phone rings IF you know it is your mother calling, don't answer.  I know most places have a phone in the room of the resident, not sure if you can ask them to disconnect her phone so that she can't call you.  And NO it is not wrong to be firm and direct with your responses, she has to know that she cannot manipulate you, but then again how much of it is dementia that has crept into her normal speaking.  I was going to suggest that when she starts getting nasty, either hang up the phone without any warning (when she asks later, say you don't know but the line must have gotten disconnected), I did that only a couple times with my dad.  Its definitely hard for the "loved ones" at the one end while I am sure your parent is also confused in another aspect of her mind too. kinda being locked in a cage, you know how to get out but just can't.  Wishing you luck.

Continue with how you are handling this situation. It sounds like you have good boundaries. I'm surprised she is now calling you daily. You need to block her calls and do not answer. If there is anything significant to share, the staff will call you.I would not allow my dad to have a phone once he was in the NH as I knew from past experience he would call me with constant complaints and crazy talk.
I am not surprised she laid into you when you went to see her as you have probably always been a target for her. And of course you did that out of a sense of obligation and concern and then when we are talked ugly to, we recoil. The very last words my dad said to me before he was on hospice was "I almost hate you". I was so sad he felt he needed to say that, but I knew it was his unhappiness at his situation. He was isolated because of Covid and I hadn't seen him for 3 months. He was in hospice two weeks later. When they thought he was Imminent but he was still aware they told me I could visit, however, I would not see him as I was afraid of hearing ugly things, so I waited until he was in a coma to see him 48 hours before he died. You have to protect yourself and that is perfectly OK.

It is NEVER wrong to keep boundaries to protect yourself! Taking care of your mother's affairs and leaving the day-to-day care to the ALF is perfectly acceptable. No one should be expected to accept abusive behavior.

That said, is there a way you can set mental boundaries? I learned a long time ago that I cannot always avoid the abusive person in my life, so I set mental boundaries and completely ignore the abuse. I know the truth and that is good enough for me. It is not easy, and it took work with a good therapist to set the mental boundaries. Maybe a therapist can help you not let her push your buttons.

Keep those strong boundaries in place. She is lashing out emotionally and knows you best - so you are her focus. Keep communication lines open with the staff and her primary care doctor. Since she is now combative, it would be wise for her primary care doctor to add an anti-anxiety or sedative medication to help her calm down and cooperate with staff's efforts to care for her.

Please consider weekly visits and time your visit for her most "cooperative" time of the day - usually after breakfast and before lunch. Make sure she is clean, dressed, and well-cared for. You do not have to accept any of her verbal abuse or efforts to manipulate you. You are just doing health and safety checks. Make sure to check in weekly with her usual caretaker(s) about mom's week and any needs that must be addressed.

Sometimes chemical imbalances and infections can exacerbate problem behavior. So, please check with her primary care doctor to make sure a UTI or other problem is not the reason for her change in behavior.

It doesn't sound like your mom was a very nice person when she was healthy. She certainly is not going to change now. Care for her from a distance. If she calls, place the phone down and let her rant, then say you have to go. It takes two to argue and her brain is not healthy so decide not to argue or try to explain things to her. My mom is very similar and I keep my visits and calls short. If she begins to get abusive I leave or get off the phone. You do not have to accept this for yourself. All of this emotional turmoil will only make you sick. God help you.

Your the Adult now and eith her mental state. she is the Child and you should go visit her and explain everything that is going on and remember where she is and know that some of her accusations are probably true.
You can also be up front and honest with her that there aren't any other choices fir her since she isn't able to stay by herself or live with you.
You should continue to visit once a week and be nice and let her know that you will continue visits as long as she is being nice.

But don't get to picky about your moms niceness to you, people don't change overnight and Im sure she is scared, bored and depressed.

Tgen when she dies, you will know that you did what you could and not have any wish I would haves regarding your mom.

I had a similar situation -- and life experience -- with my mother. Now her dementia and decline make her, believe it or not, an easier person to be around and I like her more than I've ever liked her in my life! Before this last major decline she was nasty and difficult. She would do anything to hurt my feelings...and she did. Sometimes I would leave the facility in tears. The nurse said, "Stay away. She doesn't care if you see her or not. So don't see her. Take care of yourself." It was the best advice I received.

Always consider yourself in this arrangement. Don't guilt yourself. Do what you can do emotionally and physically.

For your MOTHER'S sake, don't visit. You are apparently a trigger for her.

Talk to Hospice nurse about her agitation and stay away. Let the hospice nurse know that you would like to know when she is at the absolute end, medicated to the point of no anxiety IF you really feel like you need to visit again.

I find that so many folks think that there is going to be a "revelation" of love and kindness at the end of life. With a narc parent, it nevers happens. I had a friend, just this past week, go to visit his dad in hospice, hoping for an "I love you, you've been a wonderful son". It didn't happen.

When my mom (who was not by any means a narcissistic) lay dying on hospice and was comfortably medicated with morphine so that she was not anxious, my SIL asked the nurse, "why is mom not responding to us?". The nurse sighed and sad kindly "she's travelling now".

Truer words were never spoken. Mom was no longer with us, but she wasn't yet in Heaven.

You and your Mom reassumed your normal positions while you visited. If you want more of it, then visit again. To be honest, she is just another flawed human being, and more flawed than many. There is no reason now to visit. To be frank it upsets her as much as it upsets you, because she is still able to click into trying to manipulate you. You always knew what you had as a Mom and her limitations.
The limitations of my own partner's Mom were so severe that he was only relieved when she died. His Sundays were now free from the always miserable phone call, which was all they had left after a lifetime of a relationship that was a torment. He never looked back. It was what it was, not what he would have chosen.
I am so sorry, but I am also relieved to see that you are as sensible and giving a human being as you are, after all that. She will soon come to peace. And peace is all I can wish you. I hope you don't put either of your through this again. They will medicate her as needed hopefully, and perhaps hospice should now be considered. I am so sorry for all you went through in your life, and for what you must go through now. And for your Mom as well, for her life gave her only suffering without peace. It is where this inevitably leads.

YOU went “back to feeling like a helpless 10 year old” but your mom was just being her old self.

If she has been diagnosed as having dementia, all of the words she says are just.... words. They are not about you. They just aren’t.

When she sees you, your image evokes from her damaged brain a reflexive succession of.........words. Not thoughts. Not insults. JUST words.

Her brain doesn’t function as an organizer, filter, expressive tool, because it is now irreparably DAMAGED. Whoever she was in your childhood is no longer here, talking to you.

You are doing for her what a loving, supportive, objective thinking person does to provide SAFE, ongoing care by professionally trained caregivers.

Your job is not to be a target. In EVERY DEALING GOING FORWARD, consider that you are honoring her with good care, AND honoring YOURSELF by ACCEPTING the fact that you are choosing to do what she needs and choosing NOT to allow her behavior to cause you discomfort.

Be good to yourself. You deserve good care too!

You do what is right for you physically and mentally.
If caring for her "from a distance" is the healthiest way for you to manage her and your feelings then that is the way you have to do it.
You do not have to make excuses for how you feel and please do not let the Guilt word enter into your mind about how you cope.
As long as you are doing the best that you can that is all anyone can ask or expect.

JoAnn29 had not posted her reply when I answered but I had to edit my reply when I read her comment....I agree that Hospice should be trying to manage the aggression. You should talk to them about that. (Or is it possible that she only acts out when you are there? If she has done this always with you it might be the way she "gets to you" and it is ingrained in her to act that way with you) In any case discuss with Hospice medication to help with anxiety or aggression.