Does a diagnosis matter at this point

[Sneezy]

There has been something "off" with my mom for as long as I can remember. She has suffered from crippling anxiety, paranoia, delusions, and depression. She has lied, exaggerated, and told multiple versions of the same story since I was a young child.  Now that mom is in her eighties, her doctors all say she has dementia. But does she really? Many of the symptoms of dementia, such as making up stories that aren't true, have been things my mom has done her whole life. 

Last summer, mom got really ill and she is now in memory care. It is the perfect place for her.  She is getting her medications regularly, eating, showering, interacting and participating in activities.  And she is still her same old covert NPD self.  I get regular complaints and long lists of things I must do and/or bring her.

So I guess my question is - does it matter exactly what her diagnosis is? I keep dwelling on this, even though I know I will never get an answer.  I truly think my mom has had a personality disorder for most of her life, along with extreme anxiety.  But sometimes I wonder if there was something more going on?  Undiagnosed bipolar disorder or maybe even schizophrenia, based on some of the delusions she had even as a young adult?  There IS some dementia at this point, but I keep thinking there is more to it.

And my other question is - why do I still feel guilty?  Mom called today (yeah, giving someone in memory care their phone was not one of my better ideas).  She left a lengthy message about how she must have her Christmas manger right away and I need to find it and bring it to her.  Well, that manger, along with most of her stuff, was donated when we had to move her out of her apartment and into memory care.  And I feel guilty.  But I had no place to store all her stuff and most of it was junk and I need to conserve her money because memory care is expensive (so no extra money is available for a storage unit).

Any advice on how I can stop overthinking all this and just let it be?  I can't change it, I know.  And mom is safe and well-cared for.

[TimetoHeal]

Hey, Sneezy,

That is such a good question.  One I am grappling with concerning my aging mother as well.  Honestly, I don't know how much a diagnosis really matters at this point.  Usually a diagnosis of any kind at any point in someone's life is most helpful for getting the services and help they need.  We all know that PD's don't think they need any help and don't intend to get any, so...Of course, it helps you to understand why they are the way the are.  But whether it's NPD, BPD, anxiety, depression, bipolar, dementia, or any lovely mix of all of them (so many disorders overlap and have co-moribidity), really makes little difference if she's not actively seeking help for any of them.  And really makes little difference to you.  What matters is how she treats you and how it makes you feel and what you choose to do about it.

You said yourself, she is well taken care of and in the best place she could possibly be.  Could you take a break from the phone calls/messages, either temporarily or permanently?  Or significantly reduce them?  Bringing her a manger is not an emergency or necessity.  Let the staff care for her.  As an aside, that is great that she is socializing and participating in activities!!  Rest and save your energy for when she really needs something, if then.  Guilt is hard, but you have done nothing to deserve it. 

[JR]

number 3 here, my elder mom does most of the same things as yours, makes up stories,lies, etc etc as stated by Sneezy and has never to my knowledge been diagnosised other than depression with out any other disorder, and as been stated by TimetoHeal thinks that there is nothing wrong with her to diagnose its everyone else who need a psychiatrist cause shes fine also it doesnt help matters that her other 2 siblings play along with these delusions and think its funny that i get all twisted up trying to prove most of her perceptions and behaviors are delusional.

[Sneezy]

Usually a diagnosis of any kind at any point in someone's life is most helpful for getting the services and help they need. 

Ugh, of course.  I have been dwelling on satisfying my own curiosity, but the point of a diagnosis would be to help get mom the care she needs.  And she is already getting exactly the care she needs.  So I just have to stop.  Curiosity is turning into unhealthy rumination at this point.

Could you take a break from the phone calls/messages, either temporarily or permanently?

Yep, I did this for a while and felt guilty about it.  But honestly, mom often doesn't remember the long, rambling, frantic messages she leaves me.  I've sometimes rushed over with things she says she needs, only to have her act all confused about why I just brought her something that she doesn't even remember asking me for.  So yeah, time to put my phone on silent for a while.  It's the holidays, right?  Time to rest and renew, not jump every time the phone rings.

[Sneezy]

it doesnt help matters that her other 2 siblings play along with these delusions and think its funny

JR - That is rough.  And totally not cool.  I mean, sometimes you have to laugh, but it should never be mean-spirited.  On Christmas Day, my sibs and I had a good laugh when mom, in all seriousness, proclaimed that she was considering getting herself an iphone 20.  But delusional thinking is not really funny and I'm sorry your siblings don't see it that way.  No matter how angry we get at our parents, and no matter how terrible their behavior, it isn't right to laugh or mock them, or to take joy in their decline.

[JR]

it doesnt help matters that her other 2 siblings play along with these delusions and think its funny

JR - That is rough.  And totally not cool.  I mean, sometimes you have to laugh, but it should never be mean-spirited.  On Christmas Day, my sibs and I had a good laugh when mom, in all seriousness, proclaimed that she was considering getting herself an iphone 20.  But delusional thinking is not really funny and I'm sorry your siblings don't see it that way.  No matter how angry we get at our parents, and no matter how terrible their behavior, it isn't right to laugh or mock them, or to take joy in their decline.

Sneezy they think its funny that she shows me in particular bad behavior, and treats them totally different, so they are happy about that and for some disturbing reasoning think i deserve it, these are the sick dynamics of a narcissistic family where all the children aren't treated equally, so they are golden children and i was since very young assigned the scapegoat, so therefore i get what i deserve for being the bad one, and they help it along when they can thinking its the norm, all the way deep into old age. its a sick mentality towards any adult person regardless.

[TimetoHeal]

On Christmas Day, my sibs and I had a good laugh when mom, in all seriousness, proclaimed that she was considering getting herself an iphone 20.

Forgive me, sneezy, but I had to have a hearty chuckle at this.  Isn't it amazing, even in her state of mental decline, that she knows what the latest iPhone is?    Makes me think about how my mom knows the latest things going on in the news and with celebrities and such, but claims she can't manage to pay a bill online. 
Also, good for you for silencing your phone for the holidays!  Silent night, and all that, right?   

[Tribe16]

Mom called today (yeah, giving someone in memory care their phone was not one of my better ideas).  She left a lengthy message about how she must have her Christmas manger right away and I need to find it and bring it to her.  Well, that manger, along with most of her stuff, was donated when we had to move her out of her apartment and into memory care.  And I feel guilty.  But I had no place to store all her stuff and most of it was junk and I need to conserve her money because memory care is expensive (so no extra money is available for a storage unit).

Sneezy, please don't feel guilty - when I worked as a receptionist for an adult day care, the nurses talked often about "therapeutic lying" - basically saying something like "Mom, I'll have to go "into storage" to find it and I'll bring it when I find it" in order to keep the individual calm. Hopefully she will forget about it (hopefully!). Desperate times call for desperate measures! 

[moglow]

Last summer, mom got really ill and she is now in memory care. It is the perfect place for her.  She is getting her medications regularly, eating, showering, interacting and participating in activities. And she is still her same old covert NPD self.  I get regular complaints and long lists of things I must do and/or bring her....

Any advice on how I can stop overthinking all this and just let it be?  I can't change it, I know.  And mom is safe and well-cared for.

Hey Sneezy, I swear we share a parental unit. Mine is still insistent on being at home but I know full well it's not good for her. She cant reasonably take care of herself and hasn't for quite some time. That we've not had another incident since last summer is a wonder ... but I refuse to step in there and manage any of it. She's made it clear where I stand and that's well outside her purview. I'm working on acceptance with that and putting aside any "responsibility" for her. But that's my stuff.

I italicized the above to emphasize for you, she IS better where she is. She's getting the care she needs even if she chooses to not see it. You truly can't change or fix any of this for her, and I suspect if you managed to do part of it she'd still focus on the parts you can't. Would it help if you see having an additional diagnosis as just another word for something that isn't yours to fix? I'm not a fan of labels as a general rule [particularly of a mental health variety] because so many other things come into play. Me being my heartless self, that she chose to not address the things she very possibly could have changed speaks volumes.

[Sneezy]

I swear we share a parental unit

They all sing out of the same songbook, don't they?  I think it is especially tough when they don't trust us and don't listen to anything we say.  And then they make terrible decisions and expect us to rescue them.

Would it help if you see having an additional diagnosis as just another word for something that isn't yours to fix?

Yes, I think that is a good way to look at it.  I don't need a further diagnosis.  What I need, or at least what I would like, is a justification to let things be.  The situation is not ideal.  I wish I could spend more time with my mom, but I know if I do I won't sleep at night.  I wish I could make her happy, but that is impossible.  So I need to let things be what they are.  I don't have to justify my decisions.  Mom is in the right place and I'm doing what I can do.  She got herself kicked out of independent living, and rightly so.  She had to go somewhere safe where she could get care.  And I had to empty her hoarder-apartment and figure out what to do with all her stuff.  I may have jumped the gun on getting rid of so much of her stuff, but I hate clutter and couldn't stomach the thought of storing all her crap at my house.  I will keep up the "therapeutic lying" as Tribe16 mentions, as I think it is the kindest thing to do.  I hate lying, but I don't want to make mom more upset.

Happy New Year, Mo - let's hope 2025 is a peaceful year!

[moglow]

I think Practical is the one who introduced me to the concept of *notlügen* years ago: "a harmless or trivial lie, especially one told to avoid hurting someone's feelings." SO appropriate for this situation! Would it hurt anyone to lie in your position? Nope! Would truth help? Not.at.all. So - Notlügen it is.

We're talking about next steps for mommie dearest. Not one chance we'll live with her or bring her in. I can easily see her losing her shit in a facility. I don't know what other options there might be - or how long she may need them. AND somebody has to pay for it, guarantee she's nowhere prepared for that either. Rock and a hard place.

Wishing you and yours a happy and blessed new year!

[Sneezy]

I think Practical is the one who introduced me to the concept of *notlügen* years ago: "a harmless or trivial lie, especially one told to avoid hurting someone's feelings." SO appropriate for this situation! Would it hurt anyone to lie in your position? Nope! Would truth help? Not.at.all. So - Notlügen it is.

I like this - I will make it one of my intentions for 2025!

We're talking about next steps for mommie dearest.

Good luck - I hope you can figure out a solution that works.  You are very smart to realize that your mom should not move in with any of you.  I am very lucky that my mom managed to contribute to a small retirement account.  And she and her husband moved to a warm area where housing prices went up over the years.  So between her small IRA and selling her house, she has enough to afford a few years of memory care.  After that, I don't know.  We don't do a good job here in the US of taking care of elderly, especially those with major physical and mental needs.

In other news, no good deed goes unpunished.  I have been trying to stop by and see mom at least once a week and have been answering her phone calls a little more often.  And it's been awful.  She blames me for everything.  It is my fault that she can't travel, because I won't make reservations for her or drive her to the airport (of course I won't, because it wouldn't be safe at all for her to travel alone).  And it's also my fault that she has chin hairs.  Sorry, but I'm not plucking her chin hairs.  She's going to have to ask an aide or just let it go.  But I have to draw the line somewhere 

[SonofThunder]

Hi Sneezy,

Im reading this thread with interest in your story, as my parents are both in their 80's and still living at their home. My PDf will be a terribly demanding memory care resident if he ends up in one, and my mother just the opposite.

One of the things that strikes me in your words is that imo you are doing everything wisely in practicing caregiving as best possible for a PD parent, but also being very intelligent and loving in your decisions for yourself.  Well done! 

My nature/nurture traits align with HSP (Dr. Elaine Aron's work on High-Sensitivity) and I'm also a INTJ on the Myers Briggs.  So i'm a high-radar, high-feels, overthinking-the-details kind of guy who can be very hard on myself.  Thankfully I've learned not to be a caretaker (Fjelstads book) any longer but I believe care-providing well suits my traits. 

As much as I enjoy care-giving in love of family, friends, neighbors and so forth, doing so opens up so many extra interactions for me to over-analyze and be hard on myself.  For the longest time, I have desired to change some of my traits, but in recent times, I have concluded it's just who I am, and I will accept the side of my traits in which I wrestle with myself. Yes, I still wrestle, but its just what I do, and I love myself and who I am!

Some consider HSP traits to be a kind of 'superpower' but there is always a flip-side to superpowers. Just think if you had xray vision like Superman and all the good you could do with that power.  But then think of all the things you just couldn't unsee.  What if you were Wonder-Woman with her powers of superhuman strength, reflexes and speed (not to mention the sick invisible jet!). You would have a heck of a time blending into normal society when you weren't out saving everybody and the world and that would be frustrating.  Wonder-woman probably gets home from her day of protecting humanity and is hard on herself for what she believed she could have done better.  Being wonder-woman though is truly enough!  You Sneezy are truly enough!

Keep up the good balanced work of self-protection and care-providing love. 

SoT

[Sneezy]

SoT - Thank you for your kind words.  I hear you when it comes to overthinking.  I think it's just how we are.  But also we have had to think and think and think in order to manage our PD-parents.  The more we can plan, anticipate, and think ahead, the better we can manage their never-ending moods and needs.  Which is what they expect from us, right?

I also agree about not being a caretaker.  I like to think that I am mom's care-manager.  Although she would certainly like me to be her servant, therapist, chauffeur, personal shopper, etc.  Just managing her care is enough!!!

My PDf will be a terribly demanding memory care resident if he ends up in one, and my mother just the opposite.

I truly hope your parents do not end up in memory care, but if they do, just remember to keep being the manager, not the caretaker.  That's what the staff gets paid for (and they are better at it than we are, most of the time).  Everyone's journey through dementia is unique.  Some people who have been difficult for most of their lives become sweet (and vice versa).  But I think most people keep their core personality intact, so if they were difficult, they get even more difficult.  It's hard to predict.

I sure wish I had a superpower.  Can I pick "medium chill" as my super power? 

[SonofThunder]

Sneezy, thanks for your insights about memory care. As you said, surely hoping my parents avoid. MC is a great superpower choice and hope you find yours increasing!

SoT

[Poison Ivy]

"But also we have had to think and think and think in order to manage our PD-parents.  The more we can plan, anticipate, and think ahead, the better we can manage their never-ending moods and needs.  Which is what they expect from us, right?" They might expect this, but that expectation is unreasonable. We have no obligation (and limited ability) to manage our parents' (or other people's) moods and needs.