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

In my case I saw those needing assistance but stuck in *family only must help* mode. This kept the illusuon they were independant alive for them.

The proud.. Ask for help? No I don't need help! Yet asking family to do do do.

The tight.. Oh no I'm not going to PAY for that. Expect family labour for free.

The manupulative.. Can you do me a favour? Favour after favour after favour...

The truly unaware.. I just want a ride to.. An all-day-list of chores, tasks, transportation arises.

No matter the reason/s - if family step back this WILL make them choose *non-family*. Eventually.

I'll be the first to agree she needs more than I could ever give. That's her normal. I have been slowly establishing in as objective a way possible, her tolerances for care and lack thereof. Sometimes some things are more important than others to her. What is a permanent feature is her need to control everybody and everything. She has always been that way. I tuned her out until she became very sick 4 years ago. While coming back as an adult child caregiver has its benefits what you don't know until you do it is just how hard it is to be a caregiver at all. It is even harder when your LO is uncooperative or even worse. I will just let her go to LTC if that's the best thing, but as a result of her temper tantrums? I'm thicker skinned than that

BarbBrooklyn is right . Do not step in to help your mother .
When I could not get my mother to go to assisted living, The very wise social worker from the Dept of Aging told me to “ Stop doing for mom, sometimes you have to let them fail .”
Next trip to the ER get your mother placed in a facility appropriate to the level of care she needs.

BTW she has enough funds to hire 2 part time caregivers, one to help clean the house and shop etc, and another to provide home nursing care, showers, etc...in my mind this would be a housekeeper once a week on an ongoing basis and a home health nurse 1 or 2 hours per week to catch what she can't.
A tiny price to pay. Literally $200 for the housekeeper and less than $500 per month for a visiting nurse
I'll bet with her peculiarities Mom could get it down to $600/mo for both
This would alleviate every complaint and gripe she currently has though.
That wouldn't fit her narrative of life being terrible for every reason she could think of
What a misery she has come to

Trials, please take care of yourself, because no one else is going to do that!

Your mother's refusal or inability to get adequate assistance does not equate to you needing to step in.

Sometimes by stepping back, we allow the "system" to work. By continuing to prop up, we prevent them from getting the help they need.

Someone on here likes to say "being stubborn is the quickest way to end up in a Nursing Home".

Thank you all for your considerate replies.
Mom will not be able to go much longer without a part time caregiver.
She absolutely will not see me in a role that she sees as a usurpation of her God given right to dominate and direct me as her progeny.
She just won't allow me to direct her to normal, reasonable outcomes. So mentioning the shower she states I won't supervise her so how can she? Mentioning the dog she just goes silent and sulky. Mentioning her being sick in the morning and waiting until evening to go to ER just makes her say I know nothing about healthcare and that's that. There's no negotiating her perceived right to do whatever she wants.
If I leave she will absolutely be in LTC after her next ER appearance. They have on occasion only released her after confirming someone would be here to assist her and she is in poorer health now than she was then.
I guess if we can agree to a part time caregiver again, we can continue like this.
If we cannot agree to a long term caregiver I guess she will be in LTC sooner. She makes this impossible. Every step is torture

Your mom has reached to point that she cannot tell if she is clean or not and she is not going to do it by herself. So... either you will need to walk her thru the steps of bathing or getting a caretaker to do it for you. I have a friend no matter how much we tell her she needs to bathe she will not do it. One of us need to physically be there to talk her thru it. She can do it but unless we are there then she won't. If she resists a caretaker try introducing that person as a friend and your new friend will help with A-B-C and she may be more open to that. I know my Daddy did not argue about bathing after I got one for him.

trials: Perhaps your mother lacks the capacity for logical thought processes. Her physician appointment and the accompaniment of her dog can no longer remain YOUR responsibility.

it is only going to get worse. talk to dr alone or someone a social worker from dept of aging.

she is not mentally competent. talk to dr alone or dept of aging in your county.

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.

* You are trying to 'talk logic and reason' to a woman who cannot accept or possibly understand. It is an exhausting 'exchange' (war) you will never win. And, what you will end up with is burn-out.

* Get a mussel for the dog. It will then be quiet, at least vocally. Do not ask. Do it.

* Yes, of course, your mother will react to anything she perceives as a 'negative' about / towards her dog. Accept that this behavior will happen. In some respects, 'many of us' feel a dog is our best (and perhaps only) friend and confident. That bond is unbreakable. No surprise if she chooses the dog over you.

* Ultimately, you need to take control of the situation / circumstances and make decisions, regardless of how your mother 'kicks and screams.' Expect this behavior as it will happen and continue to happen, and likely get more intense. If you cannot handle it (which is understandable), DO NOT put yourself in these situations.
- Get a caregiver to take her to appointments.
- And, if she continues to respond as she is, tell her that you will get a caregiver to be with her. She may / may not be able to control herself. However, I believe, and from experience, that people with brain changes (cells are dying) DO hear and DO listen and DO alter their behavior -- when the threat (real and more of a boundary vs a threat) is clarified that she may shift. It depends on 1) her cognitive ability to do so; and 2) her desire to have you / someone familiar in her life vs a caregiver, or 'time outs' / being alone.

Depending on her mental / cognitive abilities, you could explain ONCE using I messages: "I feel ... I need... I am going... or We are going to ... Assert yourself. Do not leave the door open for her to make decisions. And, at all costs, never ever argue with her. This is a set-up / strategy. It will drain all your energy and this is a 'no win' situation.

You state what you / will / will not do / what you both are going to do ... if she doesn't go along or starts to act up, you stop. You either leave her apt / room or if you are driving her somewhere, you turn around and take her home ... and leave immediately. She will either learn that you 'mean business,' and she will 'behave' / change her behavior or not. This is up to her / her ability.

This may feel and be 'tough love, although it is essential if you want to maintain your own well-being and do the best you can for your mom. When she / her behavior changes, you also need to change how you respond / interact with her. It is hard and it is new - it is not easy to do this. However, when you realize you are doing it for her (and honestly, so you can function as normally as possible), you will be more motivated to do it (i.e., set boundaries, take care of yourself.)

Gena / Touch Matters

Please do yourself and her the favor of accompanying her into her PCP ( Primary Care Physician) visit and, have an honest sharing with the physician about her behaviors and, your observations and challenges with her. Will she agree and like you doing this? Sounds like she'll pitch another fit and, lie or disagree etc etc.
Sounds like she may be in denial about some things resulting in her controlling behaviors and demands on you to try and make it alright. It is not alright.
Be sure that you have gotten all POA and Medical POA etc papers in order and signed by her .
Or, you may want to call her Physician and, schedule a time to share your concerns and the situation and, seek their direction.
She may need several types of interventions guided by her PCP.
You need guidance from physician ( medical) and possibly from a geriatric specialist and referral to. Social Worker or other qualified case manager to help you remain sane while navigating the systems and keeping your mother safe .

Practice self care; seek personal emotional and spiritual support for yourself.

Assisted Living and doggie daycare for appointment days.

I completely agree - if you continue to do this - let the doctor see the reality.

We were trying to get FIL's primary to discuss a cognitive assessment - but he seemed to brush us off when we brought it up. We had noticed decline, but when the doctor brushed it off, we chalked it up to what we considered FIL's concurrent (undiagnosed but very obvious) case of Narcissistic Personality Disorder causing him to become much more impulsive and make questionable decisions. His doctor (and everyone else) maintained that he had every right to make poor choices.

Very early last year FIL requested and was given a letter from his primary that stated that he had tremors, to allow him to modify his signature on legal documents. In this document - it also stated -unequivocally - that he had "perfect cognition with no deficits". We were shocked.

Fast forward to now - while there has definitely been more physical decline -the mental decline has not been THAT significant. Meaning - while there is definitely cognitive decline - the change isn't so dramatic in our perspective from what it was a year ago. In other words, give or take a little bit, he's in the same place (from our perspective) he was a year ago. Maybe a little more short term memory loss, but not significantly more. But when he moved to the nursing home 3 weeks ago and he had 24 hour observation by those trained - guess what...he's getting a full geriatric workup. Because THEY see exactly what we have been seeing.

In hindsight, we should have pushed harder. We should have gone out and gotten our own geriatric psych consult. But when a medical professional that has been treating someone for years tells you they are fine, it sort of takes the wind out of your sails.

BUT, doctors only see them for a few minutes. And they can showtime for that amount of time. Especially if they are clean, showered, in good spirits, calm, prepared, happy, not stressed, had plenty of time to get ready, on time, etc.

BUT - if they are stressed and running behind, and didn't get to shower and are disheveled and unprepared and you take them in there just as they are and they have to present - un-propped up - THAT is who the doctor needs to see.

When my FIL was seen for who he is unguarded and real...that's when the truth came out.

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.

I found as my mom got older and it become apparent to her she wasn't able to do as many things for herself she would hang on to certain things so she still felt in control. It's hard to parent a parent, but it's something we have to do. I did a couple of things... I worked with my Mom to pick a couple of set days for her to shower. I would try to make appointments on a particular day of the week. And I made it clear that if I am taking time to do these things she was too. We struggle some days, but I don't give up and I don't take the anger personally. Also in regards to the dog...just be strong and say the dog stays home.

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!

Tell your Mother to Knock it off or she can go to assisted living . People with dementia often times don’t like showering . Seems to be a issue she maybe afraid of falling . As far as the Dog goes make a boundary that you are not a Dog sitter - and the dog stays at home .

Say “no”.

The best way to say No is out loud.

I am sure that your mom is attached to her dog but the dog doesn’t need to be shlepped all around town.

This creates a problem for you because not only do you have your mom to contend with, now you have her barking dog as well.

Is there a valid reason why the dog can’t stay home until she gets back from the doctor? Does he have separation anxiety? Have you suggested a pet sitter if she doesn’t want the dog to be home alone?

I wouldn’t be concerned about her ‘cleaning up’ though. Allow her doctor to see her in her truthful manner. Let him assess the situation for what it is and go on from there.

You don’t mention dementia in your profile but I wouldn’t rule it out. Sometimes, we think a person is being contrary but in reality they are struggling with trying to cope.

Best wishes to you and your mom.

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.

You are right to use the word *responsobility*

It's Mom's Dr appointment but YOU were left holding all the responsobility for it, for the time management & travel. And not forgetting the dog!

All that stress wears a person out!

My LO was just like this. I was getting very stressed arriving to be transport for regular appointments. Same... not washed, not dressed, maybe not even had breakfast. Acted like the day was 36 hours long.. a ha! No time management skills.. short term memory issues?. (Dr later explained the executive functioning deficits).

I suspected some behaviour was on purpose, aimed at me for not doing what LO wanted 🙄 I didn't know much about 'passive aggression' & had never understood the term 'acting out'. Then a councelor enlightened me. When retelling my tales she saw the pattern, labelled it & then I saw it! The behaviours are the anger.

"I need to at least attempt to explain to her that she MUST take some responsibility to get to her dr office and to stay clean enough that she can be comfortable going."

Try ACTIONS rather than words too.

(It has only been through actions & physical discomforts that my LO has taken on some responsobility).

If Mom wants it her way, she will need be accountable for the result.

Give her some simple choices, she decides, consequences are hers.

Eg Mom doesn't shower in time before you arrive.
No time for a shower now Mom, so you can choose between a quick face splash or go unwashed.

Alternatively if you take over, it should be on your terms..

Eg I said I cannot take the dog today. If you want to bring the dog, it will have to be another day.
You can choose between me taking you today (no dog) or cancel & go another day (with dog).

This does take practice. Took me several weeks but then..ahh.. MY stress was much less.

I was so up close & swept up in the little details. Of *Fixing*.

When I zoomed out.. saw the wider angle. Like others said, what will happenn if Mom arrives at the Dr a little late or unwashed? The Dr will see the true situation is what. Which is a GOOD thing.

The next level of a wider view is looking at all of Mom's ADLs & seeing how indpeendant she is / is no longer. One step at a time though!

Impossible behaviors = wacko. This is putting it bluntly.

You can turn yourself inside out figuring it out over and over and bearing her explosions about the dog and the bath and on and on. You can beg for extensive testing and walk Fido for hours outside the neuropsychologist’s office while they create a report that will tell you in medical language that she’s, well, wacko. Next they’ll point out options that will get her on the road to assisted living or memory care.

Prepare yourself and start looking for facilities that will allow her to take her “emotional support” animal. Just be glad it’s not a miniature horse.

I’m very sorry you’re having to deal with this.

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.

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.

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.

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.

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.