Angry & stubborn mom in AL, 2nd year. She is refusing meds, is rude to staff, and has banned me. Any advice?

Marylin: You're welcome.

I just thought of something else I did not say before. I know for a fact, because it happened to me when I became disabled and could not walk, it is not pleasant to be in a health care facility be it assisted living or nursing home. Some people do adjust very well but for those who have always been very capable, intelligent and independent, it can be horrible. And the sad fact is that in many cases it is very true (although no one is supposed to believe the residents) that there is insufficient help, needs are not always tended to, the food is awful, and the list goes on. Face it - residents are at the mercy of the staff and of the rules and regulations of the facility - not always the nicest or the best. So she may have some valid points which the outsider will truly never fully understand or know about. Given that fact, accept the fact that this is often the way it is and there is nothing that can be done about it. However, if she personally is and has been abusive and is making your life miserable, you can do something about it. REMOVE YOURSELF FROM HER AT ONCE AND START TAKING CARE OF YOURSELF AND DOING THINGS THAT MAKE YOU HAPPY. Some people have very negative behaviors and personalities and there is absolutely no reason on this earth, regardless of who they are, that would justify you being involved with them and letting them destroy you. Walk away. Make sure her affairs on in order to the best degree you can. Seek help from an attorney and other appropriate people but stay away from this toxic person. She will poison you and you do not deserve that.

I sound like a broken record. I get the feeling this woman was always abusive, controlling, manipulative, nasty and offensive. I don't care if she is God or the devil. If this is how she was and is, she is slowly destroying you with guilt and heartache and problems. WHY ON EARTH ARE YOU ALLOWING THIS? YOU ARE WORTH SO MUCH MORE THAN YOU REALIZE. Do NOT allow her to treat you this way. If you have memories of good times and better days, think on those times.....do NOT allow yourself to be subjected to torment by her. Start thinking of YOU and what is best for YOU. Walk away. Let the professionals handle her - they are getting paid to do that. Don't let her destroy you. Find new outlets and take part in them and be happy - AWAY FROM SUCH A MISERABLE PERSON. You do not deserve to be tossed into the trash. No one, no matter who they are, has the right to be abusive and mean and horrible to those around them. If it can't be stopped, get away from them - now.

Since your mother is in assisted living her basic needs are being provided so I should think you could resign POA, but you might want to consult a lawyer to avoid any possible charges of abuse/neglect and to follow correct procedure. If she is competent she chooses her POA - your father's preferences do not control this. So if she wants to see a lawyer, by all means let her. If incompetent, Adult Protective Services can step in and get a state guardian. Either way, you cannot be forced to be hands-on responsible.  You can resign, block your phone, get new unlisted number etc. If she refuses to follow medical advice, then unless she is declared incompetent, she can make these bad choices. Don't blame yourself.  Sound like she has had personality problems for a long time and you cannot fix that.

I had a mean mthr who abused me & my dogs when I was growing up. Once hubby and I consented to the docs trying antidepressants and other wonderful psych drugs on her when we moved her to memory care, she became a nicer person. It did not take much to make her nicer- but not visiting but every few months helped tremendously.

Please report the next suicide threat as a serious possibility which will get her admitted for 3 days on an involuntary psych hold (and then more to come). If anyone sees her raging at you when she sees the EMTs arrive, they will know there's something seriously wrong. The MDs will find something to make her happier. Mthr was so much better when she was not fighting the world.

The psych diagnosis may help her be proven incompetent, too. You don't have to find an atty to take over if she's incompetent: you can talk to social workers at adult protective services or office of aging and find out about public guardians. They take a fee and report the finances to the court and do what's needed. You are the daughter w no responsibility and no ability to do anything to "help."

My god, girl.....your mother sounds like a mean monster. And from what I read above, she was like this for most of her life. So here is my question. Why on earth are YOU concerned about HER if her behavior is so obnoxious and ugly and how she treats you. Once someone acts like that, and I don't care if it is God or the devil, that is it.....I WALK AWAY AND NEVER LOOK BACK. You don't owe someone like this anything at all. It seems you have done your part to help in the past. Now let the professionals handle he. You are not going to change her or make her better - she will only get worse. GET AWAY FROM HER BEFORE SHE DESTROYS Y O U. YOU DO N O T DESERVE THAT.

NAELA - National Academy of Elder Law Attorneys

NELF - National Elder Law Foundation

CELA - Certified Elder Law Attorney


I just saw your question about the terms for elder law attorneys.

NELF is the website I would look for an attorney, they are certified attorneys and have special education and educational requirements to have the certification.

It was started by NAELA Board members as a way to get attorneys specialized and certified. I think they all have the same goal, attorneys that understand and can execute the special needs of seniors and people with special needs. Some go the extra step to become certified, some don't. I personally figure if I have to use a specialist, might as well use one that has done all they can to be the best. (Just my personality)

www.nelf.org can give you a list of attorneys in your state that have this certification. (NAELA gives you elder law attorney lists as well, I don't believe they are the CELA, maybe.) I am sure someone will chime in to clarify)

My husband and I used one of these CELA attorneys and I found their prices to be quite modest in comparison to other estate attorneys. Legal fees are very much based on the area, what is cheap to one is a fortune to another.

If I just added to your questions I do apologize, I hope I helped though.

How is your respite doing? Is mom burning up the phone line? Are you and hubs enjoying each other with out mom spoiling your time?

My mom went through a period where she was verbally abusive to me. She'd threaten me, threaten to hit me, throw me out of the house and complain to my brother about me. While she was in the nursing home she was hateful and rude to staff and they put her on seraquel. She still gets mad about stuff sometimes but not like she was before.

Marylin: Oh, do I know "the independent to a fault" mindset! My mother was ever the actress, "showtiming" to those friends who deemed "nothing is wrong with your mother." Come again?! Not so much.

Just stop going. She won’t change even if the NP thinks she will. Why? Because she isnt rational in her decision making. So staying away will not "teach her a lesson". Anyone who mentioned that doesn’t understand dementia... you really do not owe a person who treats you like that anything.... regardless of who they are.

She is presenting "showtiming" for others. But sadly, oftentimes the elder will be pugnacious to their loved ones. Suggest a visit to her neurologist. I had people say to me "your mother looks fine." Unfortunately, my mother was showtiming and was far from fine.

First know that rising to the occasion and putting on her best act when others go to visit is very normal. Many of us do this in fact whether we realize it or not, I know I spruce up myself and the house more when I'm expecting company, it's the people we feel most comfortable with and are closest to that we let our hair down with are "real" with. Your mom along with many elders differences are just far more extreme, I'm not convinced it's any more conscious for them than it is for us. She isn't deciding to be horrible and mean to you on purpose and nice as pie to them, well not exactly...she is behaving normally (for her at this time) with you and putting on the same airs or show for visitors she doesn't see often the way she would have 50 years ago when you were growing up, yes on purpose because she wants them to see her at her best and maybe even be sure they see she is just fine but it's all part of that same process. It's like going to a job interview, we are on our best behavior. If those cousins really are concerned or questioning great they can help you out, maybe you are too close to things and overly cautious (we know this isn't true) and it would be so helpful to you if someone else could step in be a bit more involved on a regular basis, this means going to see her more regularly and maybe at medication time for instance. Of course it may also just be that they think they are being supportive and encouraging with no real idea how it sounds to you and affects you or supports your mothers abuse.

Still while you should try to remember that she is hardest on you the fact is even if she isn't aware of it or doing it on purpose and it is mainly a function of her disease there is no reason for you to put yourself in a position to be treated that way on a regular basis. There is also only so much you can do to get her to take medications or treat her care attendants properly. As long as you have made sure everything is being checked (UTI or cognitive issues that can be treated to some degree) and she isn't in pain for some reason and you keep in touch with her caregivers making sure things are taken care of behind the scenes there is no reason you should fault yourself or any one else should fault you for staying away. She may or may not mean what she says when telling you to stay away but obviously at least at the moment having you around physically isn't doing either of you any good, just rallying her up and making you miserable so stay away. Visit once a week if you want to, if you choose to but she is in a facility so that she will be safe and has people looking after her, you are already doing your part by arranging that, you are caring for her as best you can. If she get's herself thrown out of that facility or moved into another section (not sure what their set up is) it will only be because that's what she needs not because you did anything wrong or didn't do something. If (and probably when) that happens don't bend over backwards trying to make things better, my guess is it could be hard getting her placed based on her behavior and it doesn't all have to be your problem. Depending on the contract with this facility you may even be able to force their hand a bit in finding a placement for her and the truth is it's probably better a move to some place that is more prepared to care for patients with your mothers emotional tendencies now while she can still private pay (more and better options I think) so she is settled in when her money runs out and you have to file for Medicaid, make sure wherever she goes next will convert to Medicaid when she needs it. This also gives you the chance to go through the application process ahead of time, at the right time and not under the gun like so many do.

Stop exposing yourself to her abuse so much, pull back physically while maintaining close contact with her care givers, maybe a respite will reset the way she treats you, maybe it's a stage, maybe not but you care for you 2

Marilyn, contact your local office of aging in your county. They can give you some advice about social workers and attorneys who can assist you. They can suggest AL facilities that are affordable. Ask to meet with a counselor with their office to guide you toward some peace in your life. Good luck.

Fortunately in the care for my friend, Beth, for whom I was her POA for health and finances, her behavior was never an issue for me. She would not let staff clean her up after she soiled herself in her memory care apartment. The head nurse there told me I should take her to a geri-psych ward at a hospital to find an anti-psychotic drug that would calm her down without doping her up. It took three calls to three different hospitals before I found an opening and brought her and her husband there. I was wondering how we would get them separated because as soon as Beth wasn't with her husband, she was looking for him. When it was time for her to be admitted, a whole group of staff members came into the waiting room and started talking with Beth, distracting her, so the husband and I could slip out. It then took 3 1/2 weeks to find the right medication and right dosage that worked for Beth. From then on she was agreeable and compliant until she passed away and never doped up. I had never heard of such medications or wards before, so it was the staff nurse that was helping me understand what was happening to her. I relied on her great advice to get me through this. Her husband continues to live in the same memory care apartment I had found for them. He is quite sane, but can't remember things. He is mostly agreeable, sees a doctor there once a month to check his blood pressure, etc. and the staff pays attention to his needs. I can't think of what more I would want. And they explained that after 18 months of regular payment, if we ran out of money, they would accept whatever public financing is available, so he never has to leave. They provide the care until they die, with hospice helping at the end. We are way past the 18 months, so I don't have to worry about moving my friend. And we have at least another 12 months of money before we get to the point of applying for his veteran's benefits. He should be down to his last $100,000 before we start the process, I was told. So--the geri-psych ward and anti-psychotic meds might be an answer for you. Good luck on all your efforts. I admire your patience, love and fortitude. These are "tests" for us where a loving heart and great faith can help us along. My friend still misses his wife of 47 years, but we both understand it is only a matter of time before they are together again forever. She's in a much better place now, so wishing her back is not a good thing. And, we can pray for her soul to be moving closer to God, so there is something we can do for our passed loved one. This couple and I have been friends for 40 some years and their having no children or close relatives, I was the one they turned to when her frontal temporal dementia got worse and his memory issues prevented him from grasping what was happening or that anything was happening at all. I am so grateful for the guidance I have been given in taking this on. It seems like the "plan" to have me do this had been in the works for a long time. And with this has come all the answers I have needed to guide me. My prayers are filled with much feelings of thankfulness. I hope you have such support, too!

Dear Marilyn, this is a suggestion to consider that might save your own situation but not make you feel you have abandoned your mother. See her once a month, like you did before. There is a good chance that you will have calmed down from the last lot of problems, and that she will have forgotten them. And follow all the advice about phone calls etc.

Marilyn; I'm so sorry that the NP doesn't think that meds will help.  {{{{{{{{hugs}}}}}}}}

Everyone is different of course but this sounds like my mother last year except for the dementia wasn’t as progressed . She basically took her hostility out on me so after about 6 months I said “enough “ and walked away. I told her why and warned her repeatedly beforehand. In her case, she could control it because she did not do it around others. After a year she fell , broke her hip. I went to see her in the hospital and her attitude is changed. She still rants and raves, mostly due to the meds , dementia and assisted living situation but now she’s an equal opportunity crab, not just at me lol. For what it’s worth ,
I’d limit my visits. If she is incapable of better behavior, maybe have a heart to heart with her drs. to find out, I’d still limit visits and definitely physical abuse is not ok. You deserve less stress , no guilt and definitely no verbal nor physical abuse. If she is incapable of that, she needs to learn to get along without you. Just from what I’ve seen, and lots of study and some therapy due to years of verbal abuse but not really anything scientific, I think their true personality comes out. Unfortunately my mother’s was as a narcissist. Dementia hasn’t changed that for the better. Sometimes facts are just facts and if you can step away from the emotional turmoil, you can see it more clearly. But it’s not selfish to take your needs into consideration.
I think you can get an attorney for a POA. Might be worth it if you can possibly afford it.

Everyone has answered so well. I don't know how true it is, but I am 84 and my primary physician who is a family doctor, told me at my age I cannot take Xanax anymore. She basically said, she could get in trouble for prescribing it to me. So, she put me on Buspirone for my anxiety.

I don't think it will stop meanness. Your mother may not be in mental pain, she just may be mad and hateful because she can't get her way. There is no way in hell you deserve to be anyone's punching bag. Don't see her alone, when you go to see her, get her into a public place and visit there.

There is so much good information here in the responses I've read! My mother is dealing with dementia and we went through a terribly mean, stressed, negative, and verbally unpleasant period of time. This was after moving her into a continuous care facility that she chose (e.g. the facility offers levels of Independent living, AL, memory care, and skilled nursing/nursing home. You move through the levels of care within the same facility as you need them). It's getting better (now 18 months later) in some part because I have learned how to manage her without sacrificing myself as much.

Two pieces of advise that helped me came from the facility Social Worker:
1. SW asked me to describe how our relationship/dynamic was before she needed any help or developed dementia. We spoke about how much time we spent together, how often we talked, etc. Really thinking about that was helpful because the SW response was classic. "Well, you two have been all up in each other's space lately haven't you? Do you think you could take a break, reduce that contact time? She's safe, we've got her". I listened, it helped!
2. Saying "sorry" can work wonders sometimes. Hang on, wait for it. "Sorry....." but don't finish the sentence, just I'm sorry. The rest of that sentence might be "sorry you are so crazy, sorry you can't see or appreciate how much I'm doing or sacrificing, sorry you can't understand how all this is negatively affecting me, sorry you are the harbinger of your own misery, sorry you wish you had your car to drive, your independence, your person that makes all things better, your youth, your health" whatever. Let her fill in the blank, it will be to her liking and she can believe whatever she wants. It's not lying because you are sorry. There's just no need to finish the sentence.

Best to you! This is all so hard!

I think you could use some help navigating the state of mind your mother’s illness has put her in.
My mother’s dr sent me to the Al clinic at the hospital. I am seeing a specialist that is teaching me how to handle conversations with my mother, how to set boundaries and what my options are.
She also conducts a support group one day a week. She is like my life preserver.

Order dvd's of Teepa Snow, she is expert in her field of challenging behaviours and her training videos look just like you described your mom and my mom. She is funny and uses audience for examples. Great to learn by.

Ah, the "kooky" mom (as someone else here put it). I read about it all the time here and I have that myself. Really good comments, and nothing really insightful to add other than reinforcing the boundaries argument.

I too struggled with the boundaries idea on my own mom, while though a kook her whole life, did also do a lot of good and sacrifice for me growing up, sports, vacations, scouting, etc. Its hard to do that when you know the other person is just not outright evil.

But I ended up having to, including one blank check day a week (one day a week for me to "use" her as she will, with the idea she schedules all of her stuff then) and up to another day a week if a dr. appt. or funeral of a friend comes up or something. I do know some of her friends think I am being mean to her, but other friends know how she is and they feel sorry for me.

Often I find there is a two fold goal in boundaries. One is to help induce change in the other person, and the second is protect yourself. e.g if a friend takes advantage of you in some way, you set a boundary, and maybe it makes them change. With people our moms age, they are not going to change. I found that realization somewhat liberating as I thought if I reasoned with her enough, explained logic to her enough, she would see my point and change .She didn't, then I got doubly frustrated. So now I realize she is who she is, she will not change, she will not understand reason. So I still suffer from her abuse, but do so in a limited fashion due to the boundaries, but also don't get frustrated when she doesn't change.

Let the people over there handle Mom with Care...You stay out of it, Unless they are Mistreating her. She has a debilitating condition, She won't Listen to Anyone, Not even you now, hun.
Let that go for now, Your visits that she refuses to Include you with in her life. Give it some time and when she may have cooled Down, Find out if she wants you Around.

Has your mother been assessed by an older age psychiatrist or a neurologist? Because of the congestive heart failure I'd be wondering about vascular dementia - there is an angry, negative phase which is hard and painful going; and you are right to be concerned about how desperate your mother must feel behind her lashing out.

It will pass, but not in a way I expect you would want to wait around for. Do you have access to specialist psychology services for her?

Meanwhile, you do not have to tolerate being hit, not in any circumstances. Your mother is well cared for, so that objectively speaking she does not need you to be there, and if you think that your presence is doing her no real good either, it is *fine* to take a break. You can manage her care perfectly well without direct contact, at least for the time being.

It may even be that a skilled psychologist or mental health nurse will be better able than you could be to get her to accept help and treatment. These professionals have two huge advantages: one, expertise; and two, your mother's behaviours don't hurt them.

Marylin, I just saw your response, continuing care facilities are facilities that have a layer of care.

Independent living
Assisted living
Nursing home/skilled nursing
Memory care

All of these levels are at the same facility, where I live the IL is usually apartments that are right next door to the facility that has the others. Some are different wings and others are different floors.

They serve to keep from having to do a move, it's kinda like changing hotel rooms, as it were. All of the activities are the same, dining room, courtyards etc. Mom just gets moved to the level of care she needs. It is less change for them, they learn a new room number verses an entire facility.

I hope this clarifies that.

I wasn't trying to be offensive, so forgive me if I was.

It is so difficult because our parents know every single button we have, they created them. Learning to walk away is difficult when we feel like our reputations are being ruined but anyone that matters will seek out the truth and the rest just don't matter.

Let mom think they are her allies, then maybe she'll need you less. Just a thought.

I am my Aunt primary caregiver since 2012. I am not her POA. We went through the same thing she didn't need me, I wasn't her neice, verbally abusive towards me, she has slapped, hit, punched, scratched, kicked me. All the while day after day I showed up. She is well taken care of in a Nursing Home long term. So when we have displays of this behavior I get my purse and say to her I Love You I'll come see you on a day that is better for you where your not so upset with what I say or do turn around and leave. I stay away anywhere from a 1-2 weeks with no contact I tell the Nursing Home hey I'm taking a break if anything arises call me but we need this time away from each other. When she realized I wasn't accepting this behavior from her she is much pleasant now she still complains about the facility but its tolerable.

Marylin, your situation has been on my heart so much.

Next time some interfering friend or relative says they can't understand why she is there, she is doing so well! Tell them "of course it is hard to understand, she is doing very well, BECAUSE SHE HAS A VILLAGE PROPPING HER UP! Who wouldn't look like they've got it all under control when they have a housekeeper, a cook, a nurse and aids. That's why she is here, so she can focus on herself being better and strong."
Then offer to show them the bite marks where she chews on you.

I went through this with my dad. People telling him, he didn't need help, to the point he moved out of AL. Now I wait for the phone call, because he can't care for himself, he lives with people that don't care for him and it was all because he was doing so well from all the care.

Pulling our parents off the edge is a double edged sword. So sick to so well and no one else can see why! Just frustrating.

Take care of you and enjoy your husband.

You could work through the NP to get someone to come to mom's AL to evaluate her, or you could independently try to find someone to make a "house call."

You are at Stage 1 of the "repair the parent-child relationship," and many will not get beyond that. Some won't need to. I think of Stage 1 as getting Mom or Dad to independent living, assisted living, or a continuing care retirement community (everything on one campus). So she's not dependent on you to meet her every physical need. BUT, you are still connected at the hip, because she expects and demands that you provide, or fix, EVERYTHING that she perceives is missing or wrong with her current situation. And not in a nice way.

Stage 2 is to get out from under that expectation. There were many good suggestions. My sister had to tell our (late) mother that she would visit once a week, and she would not drop everything to bring her something she wanted. "Fine, Mom, I'll add it to the list." Of course she had the ability to get something on her own if she REALLY wanted it urgently enough. They had a shopping service, trips to the stores in the AL's van, she could call someone else, etc. All places have to arrange for Personal Needs Accounts. If my mother-in-law needs something, she makes a list and gets it to the person at her ALF who purchases it for her and debits the amount from her PNA.

So you need to get to Stage 2. She has told you she doesn't want you to hold her POA, manage her finances, see to her personal needs in the AL. She can hire an elder law attorney to do that. Sure it will cost money, but evidently she no longer trusts you so her options are limited. When she complains that she needs money, you will have to say, "Mom, call your financial POA, s/he's in charge now." Practice saying this in front of a mirror. She will argue with you, say you don't care about her, you're cheap (won't spend your own money to buy her Kleenex). And repeat. This can take a long time.

Stage 3 ("nirvana" if you can get there) is when you are no longer responsible for any aspect of her care, either medical or financial. You are just her daughter. You now have a mother-daughter relationship unencumbered by her complaints. Every visit does not have to be about money. You're not there to check on what she needs. But, when you take away a senior's ability to complain about her situation(s), often there is not much left to talk about. You will have to take the lead. When you visit - not that often and not for that long - just give her an update on what you and your family have been doing. Keep it positive. Share photographs. Do most of the talking. Ask directed questions - what was the best thing you did last week? If/when she starts to go negative ("Nothing - and the food is terrible"), try re-directing the conversation. If she persists, get up to leave. DO NOT ENGAGE. Screen her calls. Decide how many times a week/day you can indulge her phone tirades. You need to do this for your own health.

Do check in from time to time.

Any person (friend or family member) who visits and expresses that they “can’t figure out why she is there” is clueless. SMH

A lot of your mother's behavior mirrors what we saw as my father's vascular dementia took hold and destroyed his personality. At first we all saw a worsening of questionable/bad traits; dementia diminishes self governance so the worse personality traits are now free for uninhibited expression.

If dementia is coming into play then you need to realize two things: (1) your mother is not going to happy anywhere regardless of how much you appease her; and (2) a good geriatric psychiatrist can really help stabilize your mother's moods with proper medications.