My 74 year old widowed mother lives alone in a house with no family in driving distance. I visit her about once a year. She has been a source of conflict in our family as long as I can remember. I am learning now that she is likely a narcissist. She has pushed everyone away, me included, many times. She doesn't seem to understand I would have a hard time with this though.
Up until two years ago, I thought I kept trying to have a more meaningful relationship, but realised it was pointless her repeated personal attacks. I stay in the picture to try and be a good person. I have tried to encourage her to move into a community. She has the funds. She is not wealthy, but she has options. She kept toggling between saying she should move and changing her mind due to the expense.
Lately, she seems very confused about details and doctors appointments and her short term memory is not great. I know that she needs help, and sometimes she will seek it, but always ends up finding something negative about the help and rejects it. She doesn't seem to be motivated to thrive.
I don't know what my role is in this.
This is really tough position in which to find yourself. Your intentions are obviously good but the circumstances are conspiring against you being able to execute them.
Your issue breaks pretty neatly into two halves. Firstly, the practicalities of your mother's health on basic human level, what can be done to protect her and ensure that she receives the medical attention she requires. Secondly, how you process this situation both intellectually and emotionally. Only one of those pieces is currently within your control, and it’s not the first one.
So many of us face the stark reality of having to deal with ageing and sick parents, it is a huge toll on top of an already busy life. You don’t say if you have siblings but if you do, a family council meeting is definitely in order. I know of a family who dealt with a very difficult situation by appointing ministerial titles for themselves. Minister of Finance, Minister of Health, Minister of Education. They chose their roles and stuck to them to ensure that everyone was working to the fullness of their capabilities in dealing with their lot.
If you have suspicions that your mother might be at the early stages of dementia, I really good idea is to identify a suitable nursing home near to where she lives. https://www.hiqa.ie/ carry inspection reports of all registered nursing homes to help you make your decision. Your mother may not need that level of support now, but she will eventually. Put her name down for a place, they all have waiting lists. When you get the call to say a place has become available, if she’s still not ready, ask for her to be kept at the top until you are. That way, when the time comes, you have options.
It sounds like you have repeatedly tried and failed to put structures in place to support your mother, and in that case, you can’t keep doing that in perpetuity, you will over and everything else will suffer. We found two expert professionals to offer advice in both areas of this problem, their answers are below.
Because of GDPR, as our Public Health Nurse is an employee of the State, her advice has been anonymised, but with fifteen years experience, she assures us that your story is not uncommon.
Public Health Nurse
Is she able to manage herself with her activities of daily living or ADL’s as we call them? Is she shopping for herself, able to pick up a prescription, all the normal functions. The crucial question is, does she have a GP and is the GP aware of her failing memory?
Assuming she does have a GP, call them and have a chat about your concerns. If the GP isn’t aware of the situation, they can make a home visit. This can of course be done discretely without revealing that you had contact as this could provoke a negative reaction by the sound of things. If they believe that supports are required within the home,the GP can get in touch with the Public Health Nurse and then the system kicks in.
If there is a serious amount of neglect going on, it’s self neglect. If she’s refusing services, there’s very little that can be done. We can’t as professionals serve the patient if they refuse the care, put plainly, it’s illegal.
If that does happen, the next step would be to involve a social worker and as Public Health Nurses, we would make that call. There are specific social workers with an area of expertise around dealing with reluctant patients and those who are neglectful of themselves.
If she is deemed to be Compos Mentis and she is refusing services then there is nothing we can do. However, if she has an assessment and they feel she has either some mental health issues or failing memory and is suffering from neglect and is at risk, then something can and must be done. In terms of available and specialised supports, it does somewhat depend where your mother lives, There is a higher density of supports in urban areas for obvious reasons.
The stark reality is that if your mother doesn’t want your help, there’s nothing you can do about it, you just have to walk away.
Cathriona Edwards MA, BA(hons), HGdipP, MHGI
Your role is to look after yourself. That is not to say that you dismiss your Mother’s needs, but it means that you give yourself the permission to look after yourself within the relationship: you put your oxygen mask on first. What could that look like?
With narcissistic-leaning personalities, their need for control and attention are over-weening, often stealing the control and attention away from those close. Attention is directed solely inwards, on themselves, with little empathy demonstrated. Some would argue they’re incapable of empathy. The other person in the relationship is left impoverished. This vital psychological fuel at the heart of each and every relationship is missing.
Because their needs are so loud and in full focus, narcissists grab absolute control of themselves and everything in their environment in order to try to satisfy them. That means controlling others too. The consequence is the ‘other’ person is left feeling and being manipulated and used.
This is not fair or functional. You, like us all, need control and attention too.
The first step is in understanding and acknowledging the reality of these dynamics for you. Acknowledging at a deep level that the deficits in the relationship hurt. And that you deserve better. Understanding that it’s reasonable there be a reciprocation of attention in the relationship with your Mother frees you to feel justified in your need of it and your rejection of the lack of it. That frees you to act authentically and think clearly.
Then, it’s about making a plan to answer your needs in the context of your Mother’s. How do you gain a sense of control? Set your terms and conditions - plan for public/private care, the number of visits you’re willing to do over a specific time horizon, sibling share of the load (not sure if you have siblings?). Your conscience will be clear. Only your Mother can choose to accept that or not, but you have done your bit and your best.
In terms of your need for attention, I believe it’s setting expectations that serve you. What hurts us is when our expectations of someone or something are thwarted. Don’t expect that your Mother will give you the full recognition you’d wish for. I’m sorry to say that it’s a pattern unlikely to change at this stage. With growing age and illness, research suggests it will go in the opposite direction.
Reconciling yourself to this is a process. Seek the attention you need elsewhere: Talk to someone - a sibling who is sharing this reality would be a great source, an aunt, an in-law, a close friend, or a therapist to validate this experience each and every time. Ensure you’re spending quality time with your nearest and dearest. This is not a direct replacement of a more satisfying relationship with your Mother, Jennifer, but it will help answer your innate need for attention, understanding and acceptance.
Know throughout that, as with each one of us, your Mother’s behaviour is a function of who she is and not who you are. It is nothing you have done or not done.
Wishing you love and light.
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