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Background: Grandmother is 81, lives alone in her own house about 15 minutes from my parents. We have tried for years to have her move closer, move to assisted living, or have a family member move in with her, but she adamantly refuses. She refuses to use any medical alert systems, and threw away the last one my mother bought her. She cannot drive. She broke her hip last year, and is able to walk but only for short distances.
Current situation: Over the past few years, my grandmother has been increasingly nasty to family members. She has destroyed her relationship with one daughter (my aunt). My mother has become her primary care giver, and my grandmother has pushed away every other family member. My mother does all her bills, brings her groceries, literally does everything for my grandmother. Recently, my grandmother has become increasingly belligerent with my mother. She is calling my mother names and making up stories. My grandmother has been diagnosed with severe anxiety and depression, and prescribed medications. However, she continues to go on and off her depression medications, which exacerbates the issue. She has threatened her own life - this past weekend telling my mother “I wish I had the guts to blow my f***ing brains out.”
I am at a loss of what advice to give my mother. She is in turmoil every day, concerned to do too much or too little. She is suffering from extreme guilt. I honestly feel the relationship between them has become severely manipulative and verbally/emotionally abusive. I am curious if anyone has had a similar issue and what steps were taken. At this point, I feel like my mother is sacrificing her mental well-being to placate the toxic nature of my
grandmother. I am deeply concerned for both of them and any advice is appreciated!

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It is called Caregiver PTSD. It includes depression, anxiety, sleeplessness, and can cause physical illness. You feel trapped and the daily anxiety, worry, plus lack of sleep puts you on a very slippery slope.

As someone on another post described it - you are running 24/7 on the hamster wheel and it is never enough. It does not matter what you do, they will not be happy. They will NEVER BE HAPPY.

I will Pray for your Mother and I would advise she take a break. Seek advice from an eldercare attorney and a therapist. She must establish a team of support if she chooses to continue down this long hard road. This is too much for just one person. Firm boundaries are a must!
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Takincare Jul 2019
Spot on.They will never be happy, you can never do enough for them.You run faster and faster doing more and more for them yet it's not going to satisfy them. In my case MIL lives with us, complains to her daughters we haven't been anywhere all week, then I get told xyz says to take me out, it's your JOB to take me out, um no, 1 I don't get paid so it's not a job and 2 the heat index is over 110 F so no one is going anywhere its not good for your heart. I CAN'T fit much more on my plate, have enough to do with her, husband, household chores that need to be done daily. SILs seem to think that I have all the time in the world to cater to MIL every wish and demand. They will not help. All the promises of assistance flew out the window when she moved in with us. Time for op mother to take her life back, if siblings are estranged from mom, they can still help, get house cleaning service to come, find out about at least part time home assistance. Needs to tell her it's either this or its time for other arrangements. Wish I could do so in my situation but it's NOT my mother as I've been told by SILs, THEY are more worried about what small amount of money mom has and how much they can get. (One has been trying to get funds from MIL since moving in with us) If I knew then what I know now there would've been a s*#t ton more parameters in place, required family participation with MIL, and time off for husband and me. They need to nip this situation in the bud now before it gets worse and there is no escape mentally, emotionally, financially, or physically.
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Have you had your grandmother tested for other symptoms? We did and we found out our mother was diagnosed with paranoid schizophrenia and dementia. She would curse at us, tell us we were people in her house to poison her and still her money and house. She would tell visitors not to eat anything we prepared for them. She would hold her lips tightly to avoid taking medicine. It got so bad that she would tell the nurses in rehab that she was going to throw poop at them if they tried to make her exercise. Eventually we kept her at home but, it just got worse. And, she always had somewhere to go but couldn't get out of bed. Covers would be everywhere while she's cursing. She dies just last month, not knowing who I was. Have someone who she recognizes and trust to sit with her and just chat and get them to eventually let her know that you all are there to help her. That was the only thing that worked for us. My daughter and I had the same problems you had. On the bad days, just take a break and walk away. Breathe! It will seem personal but it's not. They just can't control themselves.
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Your mom needs to see a therapist as soon as she can. Someone needs to get through to her that her mother is mentally ill. No matter what she does it will never be enough and she will always be berated and vilified for it. The harder she tries to placate her mother, doing more and more for her, the worse it will get.

See if there are any things your mom does for Grandma that can be taken over by someone else, such as a grocery delivery service. They can leave the groceries by the door if grandma won’t let them in. It should be explained to the other family members that Mom is in dire straits and needs their help, even though Grandma is the one they’d be doing it for. What they do they would be doing for Mom, not for toxic grandma.

If at any point Grandma should be hospitalized, she absolutely needs to be evaluated. The staff should be aware that Grandma has severe mental issues and needs help.
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gdaughter Jul 2019
Good points all, and took me back to when mom was in the hospital for an emergency appendectomy. She got nasty when a nurse asked a simple question and mom didn't know the answer. If that nurse had done her job, although it was easy to attribute to the change in setting, trauma of surgery, anesthesia, we might have had an earlier diagnosis of dementia. Instead it was over a year and a half later...
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Your grandmother probably has dementia in addition to mental illness. Dementia, I'm finding out, brings a lot of belligerence along with it. My mother argues something FIERCE and it's become nearly impossible to talk with her. As far as threatening to blow her effin brains out, that's called Emotional Blackmail. In reality, people who want to commit suicide DO it, they don't threaten to do it and hold a loved one hostage with such a threat. My mother used to do it ALL the time before the dementia got bad. She'd threaten to jump out the window, and I'd remind her she lived on the first floor. Better come up with another idea, huh mom?
Hopefully, your mom can get grandma to the ER one of these days for an evaluation and let them know she lives alone & is acting in an unhinged manner. In the meantime, I think it's a great idea for your mom to delegate the errands she runs for her mother to others, at least for awhile. In other words, cut down the exposure to the Energy Vampire. She has to set down some rules & boundaries for HER sake, otherwise, grandma WILL ruin her life and she'll wind up getting sick herself! Your mom should make some hard rules that she will not break, ie: I will go over there on Mondays and bring groceries and stay for 10 minutes or until the verbal abuse begins. I will then say, Mother, I am leaving because you are treating me in an abusive manner that I REFUSE to tolerate, goodbye. That sort of thing.
This stuff is what nightmares are made of. There's no 'easy' way to handle the torture chamber these women put us through. But having some hard rules to follow DOES help; it's helped me deal with my toxic mother without suffering a huge amount of guilt. She brings it on HERSELF, I'm just protecting ME in the process. In reality, 40% of caregivers wind up dying BEFORE the person they're trying to care for!! Terrible, huh? Don't let your mom become a statistic; send her to this website and for therapy as well, if possible.
GOOD LUCK!!!
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StaciA52 Jul 2019
Energy Vampire is a perfect analogy, I have a Sister who is one.
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Next time grannie threatens to kill herself, have mom call the police and report that she is a danger to herself and is threatening to kill herself and she could hurt someone else.

This will get her put in a psychiatric hospital or ward to get some treatment. I would encourage mom to do it everytime immediately.

I hate that type of manipulation and I think that going to a psych ward will help. My mom quit after she found out that you are considered mentally unstable when you say that garbage.

Tell your mom that she matters and does not need to take any more abuse from this person. Of course she feels bad and wants to help, but sometimes family, especially offspring are not the solution for what ails someone. Especially when they are being abused. There is never a justifiable reason to abuse another human being. Giving birth or donating sperm doesn't give anyone the right to abuse another.

Hugs, this is a terrible situation for all.
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MaryKathleen Jul 2019
I have worked in emergency services, if someone threatens suicide or murder you need to call 911. Be sure to follow through and not back off. If she died and it did look like suicide you would have that on your conscience.
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The worst parents create the most guilty feeling children is my experience, especially on this forum. It is though the groom them lifelong to feel inadequate. As to your grandmother wishing she were dead, it is honestly probably exactly how she feels. She has never been happy and is not happy now; there is no upside and she is over it. She is likely suffering from severe depression manifesting as anger and it is unlikely she will accept any help. My fear, in all truth, is for your Mother. She will sacrifice her life to the end of this woman's life, and for what, for she will never hear from her mother the one thing she has working for her entire life, that being "I love you and you are a wonderful daughter".
What you can do is ground your mother in the reality of this situation. There is little you can do with Grandma that will not involve kicking and screaming. If all of you are lucky she will pass away before that is necessary, or before she completely destroys the lives she is working so hard on destroying. Go with your mom to a Licensed Social Worker who deals with end of life and life change problems. Your Mom needs ways to deal. Support her. And tell her "I love you and you are a wonderful Mom".
So sorry, but Grandma has never been any different than she is now. One can only hope that she gets her wish, and is able to exit this life peacefully; she isn't happy to be here.
At the point that Grandma is completely destroying the lives of those around her with her threats, I agree with Isthisrealyreal below. Call and say Grandma is suicidal. She may need placement for her own safety and for the ongoing health of your family in all truth.
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cwinter Jul 2019
You are a kind and compassionate soul well grounded in reality.
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Who is prescribing her meds. If a GP, I would have her evaluated by a neurologist. Also, for a UTI. There maybe more here than anxiety and depression. She could have Dementia.

Once you find out what the problem is, then Mom can set some boundries.
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What a blessing of a granddaughter, and daughter you are. I don't know how old you are, but can recall being about 17 and concerned about my grandmother (different situation) and my opinion was discounted and carried no weight with the children.
Because grandma is at risk of harming herself or making these statements I would call Adult Protective Services. I believe you might be able to call anonymously. Grandma may need some specialized help because you seem to have identified medications issues do play a role. Psych meds and older adults who metabolize them differently...not that it isn't different for younger people too...need to be monitored and adjusted. Not to mention that it is feasible that some dementia could be developing on top of it. I'd also be looking for a neurologist or psychiatrist with a background in the area, if there is one. Your mom might reject the idea, but she could use some support and guidance of her own to pull back and not be sucked into the drama. Grandma living closer may not be the blessing you wish it to be. It's very hard to accept and learn that we can only (most times) be responsible for our own actions and behavior. Your mom cannot control her mother, nor you yours, but of course we hate to stand by and watch people we love suffer. In the end, it may be your mom that needs more help than Grandma. Guilt is a powerful and manipulative emotion. PS you might be able to file an APS report on line.
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Next time she talks suicide, call her doctor immediately. The doctor Will want to speak to her immediately. If she refuses, the doctor Will direct you to take her to an Emergency Room at the designated hospital that the State has established.
Should she resist, the police will come & take her there. Once there, confined to a room with a bed and table, no bathroom unless she needs one. An employee will be assigned to her to be sure she doesn't do anything life threatening to herself.
They will take all her personal stuff away including jewelry, and lock it safely away.
If she cooperates, she'll be fine. They have mental health specialists there,and the units are guarded by armed security. It's the law in our State since the Affordable Care Act became law.
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I would try to get her on Palliative Care if you have it in your city. This means you do not have to take her to a doctor. The doctor and nurses come several times a week to check her vitals, drugs, etc. If she needs to see a doctor, they call the one that is on staff with the company. They are also experienced in getting her other help if needed. They will know when this reaction is drug related or she could have an infection in her body that is causing this reaction. I dealt with both with my mom. Sometimes the elderly will act out with family members but then be as sweet as can be with others or strangers and medical care. Sometimes Alzheimer patients can be very aggressive. Alzheimer is just one form of dementia. They clearly do not know what they are doing or saying. Your mom needs to remember this is not the person grandma use to be and don't take it personally but this is hard when you are mentally and physically exhausted from caregiving. Grandma may be lonely and lashing out. If you have any other elderly family members or friends, about her age, maybe they can go over and gain a friendship with her. Also, make sure you have checked into Medicare, Medicaid and Veterans Adm. (you can get her on disability if husband was in War and a veteran) to get her help that comes in and takes care of general duties around the house (bathing, cleaning and cooking). I experienced this with mom before she got sick with sepsis. She was living alone and didn't want me interfering or knowing her business. Once sick, she had to come live with me because we had issues with the nursing home we had her in. What you need to do is take care of your mom. Get her out, do small things for her, you buy grandma's groceries and letting her vent will do her good. I always talked and cried to my brother. Find her a caregiver group who she can gain knowledge and hear stories about what others are going thru. I read some of the other advice. Please note: other family members (siblings/grandchildren) will not help financially or with caregiving. Trust me I know I had 5 siblings to deal with and they can cause more problems for you when you are handling business and taking care of grandma. There is always one person in the family that has the patience and caregiving personality to take care of others. This is what happened to me. It is better to get outside help vs. some family members. There will always be those who think they are owed something from grandma and they never do anything but voice their opinion on how you are doing things and place their hand out for money or inheritance and if she has anything of value at the house they may talk her out of it. If they do, just remember this is less you have to clean out when she is gone. Make sure you have all the legal papers you need for your state Ex. Medical Power of Attorney, Executive Power of Attorney, Living Will etc. You may not be able to get it now since grandma will need to sign in front of a notary. Notaries will come out to the house. Grandma may think you are trying to have her sign to be committed. Good Luck and prayers for you and your mom!

There are hotlines to call:

Family Caregiver Alliance (FCA) 1-800-445-8106. Services for Family Caregivers – lots of hotlines! Veterans Affairs (VA) – National Caregiver Support 1-855-260-3274. Alzheirmer’s Foundation of America 1-866-232-8484. Alzheimer’s Association 1-800-272-3900.
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Next time she says anything about killing herself call 911 and tell the dispatcher that it is a suicide threat. She will be transported to the hospital and probably be admitted on a suicide watch.
At that point you/ your mom can say that she is not safe in her house alone.
She will not be released to her home unless there is someone there or she would be released to a facility where she can be monitored and kept safe.
This is going to be difficult for your mom and she will feel terrible for doing this but it is for her safety as well as your grandma's. By safety I am talking about personal/physical safety as well as mental. As with all things it might get worse before it gets better.
Hang in there, give your Mom a hug..and giving her a hug you will get one back and you deserve a hug.
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If she threatens to kill herself again call 911 as she is threatening to commit sucide. She will be under watch, then because of her many issues and lives alone, she is not safe living by herself, and there is no one to stay with her, 24/7, she will be placed in a home. Who has the POA? Is she on Medicaid? Your mother sounds to be codependent on her mother, there is no reason for any guilt. This is a bad situation and someone must step in and handle it. Getting her into AL is the only option, keeping her at home is no longer one.
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TouchMatters Jul 2019
Guilt isn't about reasoning or logic. It is about emotional and psychological relationships (over years or decades). It is about fear. These relationships may be in place for decades until something happens - requiring one to look at it with fearless honesty, often with a professional therapist.
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Fear translates to anger. She is very afraid, as would anyone be no, doubt. Some geripsych for her, family counseling for the family, and eventually addressing the heart of the issue would probably help with her anger. She wants to be listened to and sympathized with, which is pretty impossible when she pushes people away and is belligerent with those still in her circle. Professional assistance would be my uneducated suggestion, but as always, what might work for one won't always work for others. Best of luck to you and your family. Tough situation.
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The way into a psych eval is to call her on the suicide threats.

They will take her and hold her against her will and hopefully if you can make the powers that be believe you, they will hopefully find some med or something that can calm her.

My mother used the suicide threat CONSTANTLY all my life. It's a cruddy way to raise kids....blame...shame...I'll kill myself and THEN you'll feel bad. I heard that weekly for 25 years, I kid you not. Finally at age 30(!) I called her on it. Said "Please, please, please DO kill yourself and let's quit playing this sick game. Don't leave a mess, though".

For some reason this tactic only 'worked' on my YYB and me. The other 4 kids just ignored her.

At 81...don't hold out too great hopes that an antidepressant can help--more likely something to calm her down and some better anger management tactics.

Sadly, in my case, I have had to walk away from my mother almost completely. Not proud of it, and sorry it went this way, but I have passed all care of her off to my other 4 sibs. 63 years of her dramas have done enough damage. Your poor mom--she needs a break.
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Get your PCP for your GM to write an order to have her evaluated at a Geriatric Psych Hospital and see what the issues are.  Sounds like she needs to be placed on some medication that will help calm her, and in turn, calm the waters with your family.  Then, things might start going in the right direction.  My mom's meds have been tweaked several times and currently, she is on a medication on "off label use" that is working well for her.
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Call in to authorities the suicide threats. This situation CANNOT NOR SHOULD NOT continue. Then Gma can be admitted to psych ward of hospital and mom says that Gma can no longer remain at home.
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My mom did the same as your grand mother. She constantly threatened to kill herself. All the guns (she had been an avid hunter) were removed from the house by my brothers since she tried shooting the neighbors and a health care worker sent by her doctor to check on her.
She also fell multiple times each week. I would have to get up and go get her out of the yard or off of the floor in the late house of the night. She too tossed her safety necklace. She burned it with her trash. Her doctor told her constantly to stop making the suicide threats and to quit wandering around outside at night. She tried to get her to go to an assisted living area. She fell everyday for a week and the dr said one more threat or one more fall and you will be turned over to the state to place you in a NH. Well, she fell again about 2 days later just before Christmas. I got a call from her while sitting at a red light after doing the grocery shopping for Christmas dinner. She wanted me there right then. I asked if she was still outside (she had a cell phone). No, she had come into the house, cleaned up and changed but thought her shoulder was broke again. I said I would call an ambulance and got a good cursing. NO AMBULANCE!! Okay. I figured I could run by my house and put the fridge items away. I left grocery sacks all over the kitchen and when I got to her house about 30 min later, I got her "you don't care enough to drop everything and come take care of me" speech. I notified her doctor while she was in the er. The doctor was given the info that she had pulled her shoulder out of joint and everytime they put it back and tried to put a sling on her, she pulled it back out again and was threatening to go home and kill herself. She never got to go back home. They kept her in the hospital and the dr had her transferred to a NY on Christmas eve. She blamed me and my niece who was her POA over medical and financial. My niece left me in charge of financial since I had been doing it all along.
I got the guilt trips constantly from her at every visit. A 50 mile round trip for me and I went 2 to 3 times a week. I still picked her up and took her to dr appts but, she didn't like it and wanted to go home since I had to pass her house on the way to and from Dr. I started taking a much longer route to miss her house. She was in the NH 3 years and went downhill after more falls and a mild stroke. She still made me the bad person. You can't please a stubborn person as mom was. Your mom needs help, rest and definitely a shoulder to lean on.
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My mom did the same as your grandmother. She constantly threatened to kill herself. All the guns (she had been an avid hunter) were removed from the house by my brothers since she tried shooting the neighbors and a health care worker sent by her doctor to check on her.
She also fell multiple times each week. I would have to get up and go get her out of the yard or off of the floor in the late hours of the night. She too tossed her safety necklace. She burned it with her trash. Her doctor told her constantly to stop making the suicide threats and to quit wandering around outside at night. She tried to get her to go to an assisted living area. She fell everyday for a week and the dr said one more threat or one more fall and you will be turned over to the state to place you in a NH. Well, she fell again about 2 days later just before Christmas. I got a call from her while sitting at a red light after doing the grocery shopping for Christmas dinner. She wanted me there right then. I asked if she was still outside (she had a cell phone). No, she had come into the house, cleaned up and changed but thought her shoulder was broke again. I said I would call an ambulance and got a good cursing. NO AMBULANCE!! Okay. I figured I could run by my house and put the fridge items away. I left grocery sacks all over the kitchen and when I got to her house (6 miles away) about 30 min later, I got her "you don't care enough to drop everything and come take care of me" speech. I notified her doctor while she was in the er. The doctor was given the info that she had pulled her shoulder out of joint and everytime they put it back and tried to put a sling on her, she pulled it back out again and was threatening to go home and kill herself. She never got to go back home. They kept her in the hospital and the dr had her transferred to a NH on Christmas eve. She blamed me and my niece who was her POA over medical and financial. My niece left me in charge of financial since I had been doing it all along.
I got the guilt trips constantly from her at every visit. A 50 mile round trip for me and I went 2 to 3 times a week. I still picked her up and took her to dr appts but, she didn't like it and wanted to go home since I had to pass her house on the way to and from Dr. I started taking a much longer route to miss her house. She was in the NH 3 years and went downhill after more falls and a mild stroke. She still made me the bad person. You can't please a stubborn person as my mom was. Your mom needs help, rest and definitely a shoulder to lean on.
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Make sure you tell her Dr.s of this behavior and THEY PUT IT IN HER RECORDS. That way if you would , God forbid, have to defend yourself the situation dosen't get turned around on you. Even you blocking a swing can cause a black and blue mark on them. Dr's and nurses tend to believe the elderly over the care giver and then there you are having to defend yourself to a caseworker. One time I was trying to keep my mom from backing off a step( she was having a temper tantrom). I grabbed at her clothes and she swong at me. The contact caused a bruse on her wrist. I was able to keep her from falling. Her CNA was there and witnessed it all. But then she was affraid to deal with my mom. Sorry I have no advice on how to prevent it. You have to protect yourself in every way. Sorry for spelling errors
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Your poor mother - she does not deserve and MUST NOT ALLOW HER GRANDMOTHER'S ABUSE. I don't care what is wrong with the grandmother. If medications and other help procedures are not helping and she won't cooperate, your grandmother is digging her own grave. Your mother is INNOCENT. She has done what she can but the grandmother will not work with her. Face the fact that the grandmother is destroying what is left of your mother and YOU must not let that happen. If you can't stop the negative behavior, then that person MUST be removed from the environment before the rest of the family is destroyed. No one must allow that from anyone. Please find a way to get your grandmother into a facility and spare your mother from further harm. That woman is not worth it now.
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* Grandma needs more care and supervised care.
* Who is the POA?
* I know all about belligerent. (Although with a client, not a family member. Still.)
While it may not be easy to let the belligerent-ness just go, it is important for everyone to realize these are emotions and words of a person very frightened, losing their independence (or has already), fear of the unknown, or fear of dying.
* Do what is necessary to do. have a live-in or someone there 24/7 (if she has the $ to hire people). Realize she will be belligerent no matter what transpires.
Someone(s) need to take charge and not be ... phased by her reactions. Although this isn't easy, it isn't easy now, either.

Guilt is a huge one. Encourage your mom to get into therapy immediately. Your mom needs to deal with her feelings/guilt in order to move through and forward. This is a family issue - not just your mother. Therapists will work with families. Everyone needs support in these situations.
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Does your Grandmother show signs of dementia? This behavior can be related to dementia. Your Grandma may not be in total control of these emotions. Speak to her doctor, there are medications. My Mom has COPD and the beginnings of dementia & will "freak out" exactly like you described. Her doctor said a low dose of Xanax when she can't calm herself down would help but to be careful due to the COPD.
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Must she wait until next time Granny makes such threats? Would the police or paramedics respond to a call about something that occurred recently? If they will, perhaps Mom (or Pokebex) could call 911 today.

(@Pokebex I hope there aren't any weapons in your grandmother's house.)

... and I agree with others upthread. Your mother is blessed to have you.
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Your grandmother actually did the opposite of threaten her own life. She made a statement that amounts to a reassurance that she will not take her own life - she doesn't have those guts.

But it doesn't matter - the poor lady is absolutely miserable, and ill, and she's sucking your mother down with her. This has got to change.

So your grandmother "adamantly refuses" all options put to her, does she, and will accept only your mother's increasingly desperate efforts? Well, two can play at that game. Your mother can start adamantly refusing to prop up arrangements that she no longer believes are in her mother's best interests.

You mention on your profile that in addition to her severe mental ill health your grandmother has heart disease, and she has also suffered a broken hip. The reason it's important to look at her world from her point of view is that it explains what she's got to be so angry and unpleasant about. Her target - your poor mother - is very definitely the wrong target, but your grandmother's attitude and current personality make a lot of sense. Which of us would be Sunny Jemima in her place?

I appreciate that by this point you yourself are probably running out of patience and sympathy with her; but don't forget that just as her toxic side has been emerging for years, so have her chronic illnesses and painful conditions. I agree that she has managed to make it all worse! - but that isn't the point. This is still a woman who needs the right kind of help and deserves to have her feelings respected.

You have two cans of worms on your hands:

#1 Grandmother's care plan;
#2 Protecting your mother by helping her construct better boundaries.

#1 You don't need anyone's permission to research possible options. What alternative accommodation is available and affordable for your grandmother? Start by narrowing down what you'd ideally aim for until you've got something like a concrete proposal to make. I know grandmother is refusing, but the time will come when either she will think again or she'll be in no position to refuse, and it's good to have a plan. It also avoids generalised complaints and refusals if she has to come up with real rather than assumed objections.

#2 As a first exercise, get your mother to list what she does for her mother in a typical week - day, activity, time taken. Add what more should ideally be done to improve grandmother's overall quality of life that is simply impossible in current circumstances. Then she should LOOK at it, and see whether anyone on this planet would think it reasonable to continue. Appreciating just how far someone has encroached on your life can be a good first step towards setting more manageable limits.

I don't suppose your mother would want to join us, would she? She'd be very welcome!
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