She is 94, and in addition to severe dementia (presumed to be Alzheimer's), she also has a lifelong underlying mental illness that we believe to be Narcissistic Personality Disorder. It has become exacerbated with age. I have some disabilities, but I've been her sole caregiver for several years. She is usually fairly clearheaded for a few hours in the mornings, but by late afternoon, she becomes completely delusional, unable to perceive logic or recognize reality. And whatever delusional idea she gets, she is adamantly committed to it, to the point of trying to leave the house, and violently attacking me when I have to stop her.

Tonight, she swung her walker at me (she's very strong when she's angry) and I grabbed it in mid-swing to keep from being hit -- and she lost her balance. I caught her and eased her down to the floor (I am no longer strong enough to hold her up), but she did scrape her elbow. Now she claims I knocked her down, and she's going to have me arrested. (She will almost certainly remember none of this in the morning, thank goodness.)

This is the first time she's gotten hurt during an attack, and I'm worried that I may no longer be able to keep her safe. I'm also worried that the crushing pressure and anxiety and desperation of all this is going to end me. At what point do you give up and do what your mother has told you all your life you must NEVER do, "Don't you EVER put me in a home, I'll kill myself," ever since I was about eight years old. I'm trying so hard to fulfill the promise I made, because I think her few lucid hours a day would probably be lost if she were among strangers. But I don't know how long I can continue before I break, physically or mentally or both. How do you know when it's time to give up? I don't want to be selfish. I want to do the right thing for her.

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You are participating in a co-dependent dance, do you realize that?

You can no longer keep your mother safe and it sounds as though YOU may well die before she does if you keep up the caregiving.

You need a plan to get her into care. Call her doctor and the local Area Agency on Aging and ask for help.

If there is another attack on you, call 911 and have her transported to the hospital. Have you considered the posibility that she may have a uti?

This must be terribly, terribly hard for you. ((((((Hugs)))))). Please come back and tell us how things are.
Helpful Answer (37)

Well. Happily, your mother has already sorted this dilemma out for you.

The basis of her refusal to consider "a home" - we'll come to the meaning of the word home in a minute - is that it would be the end of her. But she has, surely, reached and passed the point where living at your home is going to be the end not only of her but of her daughter too. She is a danger to herself. She is a danger to you. This not only has to come to an end - it actually has already come to an end.

Be clear in your own mind and conscience that her fall and her graze were caused not by your actions but by hers. Suppose that instead of blocking her you had stepped back and away. She might well have hit her head - let's not even think about that. In trying to *prevent* injury to her, you are being bamboozled into anxiety that you caused it. You didn't.

The fact that you want to keep the promise that your mother extracted from you does not in itself make you capable of doing so. There is only one of you: she needs a team of people. Her challenging behaviours require skilled handling by professionally qualified people: you are an untrained family member, who has the further disadvantage of being emotionally involved and vulnerable. You CANNOT supply her needs, any more than if you were dead. How can continuing in this way possibly be the right thing *for her*?

Moving on to what constitutes "a home." A faceless institution where she would be left to rot in a wheelchair? Is that what we have in mind?

I just went for a quick trot round Google to see what the state of play is in your neck of the woods. Interestingly, I read: "The Plano area is home to world-class medical facilities, including those specializing in brain health and dementia care..."

There are numerous results for specialist dementia care facilities. What's important about these, though, is the emphasis some of them have on their *specialization* in dementia care. Please - GO AND SEE SOME. Your mother's nightmare is just not what they are like.
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shad250 Jun 2019
All well and good, but if you do some more Googling, you'd see more NH closing down, including one rated one of the worst in the country, Fairlawn Rehab and Nursing Center, in Akron Oh
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We all have made that promise when we had no idea what in the h3ll we were promising. I also made that promise to my mother, however, I have come to realize reading the nightmares on this forum that I will take care of my mother until it (the disease) disrupt my life then she will go into AL or NH or where ever because I refuse to give up my dreams and my life for some one who had their time. I deserve to have the life that God planned for me to have and to be all that I can be!

Just my 2 cents!
Helpful Answer (28)

Dear Sleepless1,
Are you calmer now? Just checking in to see that you are okay.

Take some deep breaths. Take a quick walk outside.

You won't be "giving up" when you take the necessary steps to get the help your Mom requires for her condition. Admitting that she needs more help than you can give her is the first step. So change the word: "giving up" to "providing for her".

There is the possibility that you have been brainwashed or gaslighted by someone your entire life, and there is help for you if that has occured. And I can understand your concerns about your living situation, the finances, and your own disabilities.
However, keeping things the way they are is a very dangerous way to live. Try not to view all the possible solutions at once, taking one step at a time.

You can get help, for yourself, and for your Mom. Right now you are in a crisis that may be more of the same over the next few days. Can you bring in someone? Even a friend to talk to, be a witness? Even for an hour? Is there other family?

No one can solve a lifetime of mental illness in a few days, but right now, safety is a huge concern. Calling APS for a wellness check may bring the support you need, a trip to the geriatric behavioral unit will allow for an assessment of her meds, and stabilize her so she will not be behaving as if an animal. Her coming home, or being placed can be decided later.

Caregivers here can help advise you, and will care about not only your Mom getting the help she needs, but will care about you. As usual, take the advice that helps you think this out clearly, and ignore what does not help.

By the way, assisting a violent person to the floor as you did, so she would not hurt herself more was a very brave thing to do! Asking for professional help is not a reflection on your caregiving skills, it takes an entire team of professionals to do what you have been doing.
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Sleepless1 Jun 2019
Oh, thank you. Yes to eveeything you said. Thank you.
It’s time for a 3 day hospital stay...then talk to Social Worker there...& have her placed into SNF. If you want to be dead before her, just keep doing what you’re doing...Hugs 🤗
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sandy1955 Jun 2019
Wow. How caring!
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Oh, my dear. Please listen to CountryMouse... her posts on this thread I would echo 10 times over.

This situation sounds so similar to what we went through. The stage your mother is at is excruciating for a caregiver.

The despair, exhaustion was overwhelming... it took me, my husband, AND a 24-7 caregiver to handle my FIL (and MIL... both with advanced dementia and physical issues) in our home, and we STILL couldn’t do it.

I know to many here who have to do it alone (you are all always in my prayers) that sounds like it should be workable. But, it wasn’t. It was completely untenable, and we are still recovering from the toll those years took on our health.

You cannot fix this on your own. It will be very, very hard, but you have to turn off the guilt completely.

Also, her lucid moments are probably less lucid than you think. And those nightmare stays at respite... you can’t allow those to add to your misappropriated guilt. Change will be difficult for her, yes. But living like this is no walk in the park either. You are basically at choosing between two evils of the same magnitude from her perspective... the difference is one of the choices allows you to live. The other choice does not help her and it hurts you.

The nightmare is what is going on in her brain, and it is something you can only help manage by being kind and loving to her and supporting the team with proper training in a proper facility.

The Noble Promise. I have less patience with that than I used to. In order to think kindly on those who ask it, I choose to think of it as a promise extracted in ignorance. It is certainly true that it is almost impossible - without having experienced it - to understand caregiving, especially for someone with dementia. But, remember, it is based in fear and self-centeredness to a large extent. It is not right for anyone to lay that burden on their child, no matter the child’s age and place in life. It is so very heavy. I watched my mother do exactly what you are doing (she felt stuck financially too) and lost her tragically to that decision last year. The stress literally killed her, and we lost our very good relationship and years to enjoy each other. I am sure you have others who don’t want to lose you:)

My biggest lesson in caregiving has been the fact that, especially for people whose tendency is to fix/solve/make right OR people with very soft, caring-taking hearts, we overestimate our ability to influence or control situations in life. Sometimes, we keep trying to force things that will never bend to us, and we break ourselves in the process.

As for your living situation, take that step by step... I believe there are resources that can help with that, especially if you have a disability.

But, honestly, you will be able to think more clearly when you aren’t defending your life from someone who should love you, when you can sleep through the night, when you can wake up in the morning and not feel the doom of Groundhog Day yet again.

Helpful Answer (21)
Sleepless1 Jun 2019
You stated it perfectly, it's something I just realized the other night: when Mom is deep in misery and confusion, crying, talking about dying... there is very little I can do to make her feel better. And if I can't fix it, then maybe I'm not as essential to the situation as I think. Maybe change is not entirely an enemy. Thank you so much for your compassion.
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You know when it's time when that little voice in your head says "all this is going to end me". Your mother's needs are only going to increase. It is impossible for you to care for her 24/7.

When you made that promise your intentions were good. However, promises about things over which we have no control are not really promises; they are either hopes or wishes. Hope is more for a desire that is likely to happen whereas wish, although possible, is unlikely to happen. All those years and since you were 8, you hoped or wished that your mother would be able to age in place. It was not your promise to make because you had no control over her and her health any more so than you did over the weather.

Be gentle on yourself. You have done your best including keeping her safe for a very long time, but it's no longer safe for either of you. And it's no longer possible for you to enjoy your mother. Is that really worth giving up just so you can keep a promise you shouldn't have been asked to make in the first place?

Countrymouse is right about Plano having top notch memory care!
Helpful Answer (20)

You’ve already received excellent advice but I must ask this question, to help put the situation in to perspective for you—

you say that going in to respite care was a nightmare for your mother.

well seems to me the current situation is a nightmare for YOU. Why is ok for you to live the nightmare situation? Because of a promise you made? Promises can be broken.

what about YOU? Your needs and feelings matter just as much as hers.

forget about her respite nightmare and do what what is best for both of you. She needs to be in a facility.
Helpful Answer (20)
lealonnie1 Jun 2019
Such great advice. So many women like this CREATE the "nightmare" scenarios to cause drama and amp up the guilt. The poor daughters can get brainwashed into thinking they're terrible people when they've devoted their entire life to trying to make mom happy. It never works because it's never enough. It's all about the drama and the game...sadly enough
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This will sound harsh I’m sure to some but here is how I look at things now that I’ve been through much with my dad. In your case she’s 94, severe dementia and says she will kill herself. No she won’ that’s off the table because just how will she accomplish that? That is an empty threat. And even if she could, she’s lived a long life and truly what is the point of living longer with Alzheimer’s? She is 94 with a horrible brain disease. That is actually worse on the caregiver than it is on her because she is living in her own reality and you’re on that ride with her. If she fell on the tile and as you said "breaks into a thousand pieces", isn’t that a part of being old and feeble? Then you go from there and send her to hospital . Something is going to kill all of us and if my dad at this age who is mostly bed bound gets pneumonia from not moving, well I can’t prevent that. I’m much more matter of fact about death now. Mainly because we are living too long usually with ill health because of modern medicine.
Your mom needs skilled help and caretakers before the stress you are enduring begins to cause dementia in your brain.
Ans if she qualifies for Medicaid to pay for said facility then you don’t have to sell your home.
Please get her where she’s cared for and safer.
Helpful Answer (19)
anonymous683453 Jun 2019
Harpcat is right, the threat is an empty one and designed to manipulate you into feeling guilty!
Your mother attacks you and you’re worried about HER safety?

Your mother manipulated you into making a promise that can’t be kept because of her behavior. It’s time to start acting in your own best interests.

Call social services immediately to determine what can be done to move her.

Give yourself a shot at a life for yourself.
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