How to tell between BPD behaviors and dementia behaviors?

I have been going through this dementia/BPD, feeling so alone and judged. Not by my spouse or family, but by my mothers care providers. I too have made sure she has the care she needs and is looked after in the most appropriate setting to the best of my ability. I visit once a month, I pay her bills, take her to appointments, look after all her medical issues. All while she rants at me, leaves many swearing messages a day at times. Today I am here because I went to the hospital with my grandaughter, hoping for a 'good' visit and she was happy to see her, happy for a while, until she didn't get what she wanted, money, the bank machine 'declined' and she took a fit, started swearing, took a fit when I asked her to not swear with my grandaughter there... ugh.
But I have felt alone is this because I am just coming to learn about the complexities of what and who she is and how I have gotten here and how this has impacted me. Now I am trying to figure out what is next? If there is no way to have 'good' visits, and predictibility, and relationships (not that I didn't already know that), then what I have been feeling for years, of pushing her out of my life, feeling less love for her, less need for her, more toxic and hateful towards her... it makes sense to hand this over to trustee, drop it, and let go.

I did a search on BPD and Dementia and came to this page. So much knowledge and experience. Amazingly insightful and helpful.

My mom was dx with dementia in 2009 and has mild to moderate memory issues, but just recently dx with mania and personality disorder. My sister and I knew she had some type of personality disorder... It was a crazy life growing up, chaos, rages, anger.
A very calm and typical example is my grad, I was the only one who gradutated and she didn't want to go to my grad, she complained the whole time and took fits. My dad insisted the family go... it is always and forever about her, mean, jealous, warped and hateful.
The situation right now is that I am her power of attourney and a pschiatrist admited her to a psych unit in hospital (after she 'attempted suicide', because she wanted a psych evaluation stating she was 'competent'). Tomorrow she is finally moving to a permanent placement in a care home. I have had a difficult time enforcing many boundaries. She has lost relationships with everyone in her life, I am the only person left, and I am ready to jump ship because she is so difficult. But I was hoping to build within myself the strength to set/make/reinforce boundaries on an ongoing basis and have success and be able to have a reasonable relationship with her. That will never happen, and she has taken too much of my time and energy already. I feel like there is nothing left for me to do but let go. Focus on my family, my life, my future, myself and work on improving boundaries each day.

Caregiver4now - You are right on track.
Just because somebody is a blood relation does not give them some kind of right to run all over anybody.

Whatever happens, my advice is to NOT under any circumstance become her POA or guardian or any type of role that has a legal connection to her in any way.
It's very easy to get sucked into a very time consuming and stressful set of work to keep their finances, medical assistance, etc up & running. Forget about the time for social visits to them. Just do not do it to yourself.

The court can appoint a professional guardian for her who will deal with filing taxes, audits, inventories, and getting her bills paid.

You have done your part, so prepare to let go of that aspect as well.

I have been dealing with my elderly aunt in recent years since her husband's death. They had no children. Throughout my life, she was under her husband's thumb...doing and responding to him in whatever ways he dictated. Personality wise, I would say she was more of a dependent personality disordered individual back then...but certainly also anxious and afraid most of the time (she never learned to drive, they never had anyone over for dinner "ever", awkward socially outside of their foreign-language speaking peers, etc.) In any case, once I got involved with her after my uncle's death---I realized how much she gaslights me (manipulates reality in order to manipulate me and my perception of reality) by using half truths, lies, exaggerations, omitting information that is relevant altogether, etc. in order to get what she wants when she wants it. She is clearly BPD "now" but she is also, IMHO, sociopathic. She has NO empathy; NO ability to put herself in someone else's shoes. You know that saying, "Love people and use things...NOT use people and love things." Well, she's the second part. She uses people and is extremely demanding....but yet is suddenly "clueless" when they call her out on her exploitative behavior (like her neighbors...like handymen she's called to "check on this".. etc. etc.) So---My opinion is the same solution I came up with myself; she will be moving into a facility where my involvement in her care will be down to a minimum (because she really and truly does NOT care one way or the other, so long as someone is caring for her!)...and her primary caregiver will be male (because she is SO much better with men than women anyway!). That's my two cents. Good luck and God bless.

My mother is 74 years old with Dementia & border line personality disorder. She has always been in competition with me. I didn't realize this until she called the bank where I work and told a loan officer there that I was jealous of her and that she wears a size 8 and she looks good. She also called and left a voice message, at the bank, saying that I was jealous of her and that she wanted to kill me. The bank called in the police and I was so embarrassed. I had to get a restraining order against her. She has threatened my life before but she is getting meaner now. I haven't talked to her in over a month because of a fit she threw cursing me & my husband. She has called me at 2:00 am before talking crazy so I had to block her from my phone. I am seeing a shrink and have been for 2 years. She has advised me to stay away from her & after the bank incident she told me to get a restrainting order too. I wish I could help her but nothing I do pleases her. I can't feel guilty because my mother seems to think her kids owe her.

(((((((hugs))))) sandwich. I am 5 hrs. away and only go down to visit mother a few times a year. As you say, it does not matter a whit what others think. The nurses have called when mother was upset and asked me if I wanted to talk to her. My answer is no, as it would likely cause her anger to escalate. I have never been able to talk her out of a rage, and believe me I tried for years. Now I have a gut infection that flares up with stress and have to consider my health first. Mother is well cared for in her facility, she is safe, and professionals are in charge, I look after her finances and other business, have moved her several times in the past 5 years, am sorting her stored items, and these days that is almost more than I can manage.

I truly am sorry that some family still blame you for her behaviour. That is ridiculous but hurtful. The nurses should know better, IMO. But, as we see from some of the comments, anyone who has not walked this road does not know what it is like. As you say, we do the best we can.

"They say" that for every hurtful comment in a relationship, 5 positive ones are needed to offset the effect of the negatives. Living your whole life with the constant negatives, which far outweigh the very few positives, strains the relationship beyond repair and creates stress from any contact. Mother could not live long enough to make up for that, even if she had a change of heart/mind. I don't hate her. Sometimes (often) I dislike her behaviour, but still choose to do what I can to help her. I also choose to protect myself by detaching and distancing. It is the healthy thing to do. I see you do that too. Good for you.

Success with a BPD, NPD, Cluster B personality disorder person can never be measured in calm or happiness. You will never be able to have what will seem like a "normal" pleasant visit. Frequent visits may never be possible. You have to redefine normal for you and ignore people with other expectations. They have no idea what you are dealing with and how it's not an episode of the Waltons.

I visit my mom every 4-6 weeks. It has to be on the weekend because I work full time. It can't be in the evening because of sundowning. It needs to be between 10-12 to be honest. This is not a huge window and sometimes there are conflicts with other things. No, the nurses don't always understand and think I should be there more often. Some family think her situation is my fault for going off to college,etc. It doesn't matter one whit what they think. We do what we can the best way we can and that's that.

We are in the same boat with my MIL. We had to put her in assisted living and now she is angry as well as BPD, NPD and has dementia. We visit less often then we did at first as even a visit from us sets her off. We check on through contact with the staff. Lately the director called us and what we decided was to have the DOCTOR reevaluate her meds. THAT WORKED! Her behavior improved, her demeanor improved and her angry decreased! She is much better now and she is happier too. Good luck to you.

Your mother sounds a great deal like mine. My mother is a borderline and is bi-polar, but she now has something called Dementia with Lewy Bodies which involves cycling and isn't the same as Alzheimer's disease. She remains very clever some of the time. I have no doubt that some day there will be a better understanding of these various diseases and how they are all linked to neurotransmitter issues. Look at the Lewy Boday Dementia association web page LBD.org I have found it to be very helpful. Good luck.

Oh, I wanted to add that it's not the craziness of a personality disorder being turned on and off. It's the symptoms. One minute they can appear truly loving and caring. The next, mean and nasty. Their moods can be quite changeable and volatile depending on whether they are getting what they want from you.

My mom has had NPD (Narcissistic Personality Disorder) for the duration of my life. I am 55. Now, as she's turning 81, she is also displaying a lot of signs for classic Alzheimer's. I say "displaying" because often when she is forgetful it turns out to be selective forgetfulness. She seems to be turning it off and on at will. Only people who have experienced a loved one with a personality disorder can understand this. (So to the person who was full of judgment and "shoulds", I'm afraid you're out of your knowledge sphere; sorry.) Anyway to have NPD is to play games, lie, manipulate. And so, it is hard to know when the forgetfulness of dementia is real or not. One measure I use is whether a memory of something (say, a conversation we've had) is there at least several hours later that probably means it has gone into long-term memory and therefore entered through "short-term" memory. If this happens again and again, the memory problem is not as severe as displayed by the personality disordered person. Of course, the memory if it's truly on the Alzheimer's track will get worse and you'll see less and less of the person remembering anything later on. Having said this, if you know someone with NPD, do your best to make sure their needs are being met (the senior center drives my mom to Walmart each Friday for groceries), then walk away emotionally and mentally. My husband volunteered to screen her calls to me with his cell phone. When she is being particularly nasty, he just doesn't listen to all the messages. We are actually have some peace and happiness in our lives now! Yeah! I want everyone who is experiencing a NPD person in their lives to give themselves permission to have a life of their own. NPD people are extremely resourceful, although so often acting like their a poor, helpless victim. BE good to yourself. Be the nice person to you that your mom was not.

PStiegman - I *wish* she had a psych. She has vehemently refused to see any kind of "crazy doctor" (her words, not mine). She has a lot of 1940s views on anything mental health related, so she's never had that kind of help ever.

This whole thing has made me conscious of my own stress, and very willing to work with therapists and my doctor to make sure my anxiety is managed. I work in a high-stress profession and have my mom situation and life's normal pitfalls. But, I also believe some things in my life can't be controlled with a pill. I'd rather try therapy, meditation, exercise, relaxation techniques than jump right into a higher dosage. But that's just me.

When BPD combines with aging, the borderline disappears and both good and bad behaviors will seem amplified. The patient is probably not choosing to be fine one moment and bad the next. The good part is that aging makes them easier to redirect from their anger. You change the subject and they follow your line of thought, unable to concentrate on their own. Her psychiatrist may be able to suggest ways to keep her UNfocused and easier to manage.

Living with a BPD person is its own special kind of hell. There's no sweet little old lady with a touch of forgetfulness in there. Years of therapy has helped me understand that I'm not the bad guy for having personal dreams, goals, and boundaries against manipulation and abuse. I am a separate person put on this earth for a reason, which is not to be her "mini-me".

Madeaa - I have done all the homework/paperwork thanks to good advice I received a while back. And fortunately she is going into a continuum care facility. You start at one end and keep moving down the block into different "neighborhoods" as your care needs increase, until you wind up in the care center (nursing home) end. I'm so grateful this place had an opening.

In highschool, the few friends I could bring over due to mom's antics would tell me that I won't know when she goes senile (the preferred word of choice back then) because she would act out so often, particularly when:
1. There was some important event not focused on her
2. You needed to be on time to something like work
3. You had accomplished something or gotten an award/reward for something outside the home
4. You had admitted the stress was getting to you. I remember my dad begging her to lay off because it was killing him. And it was. He died of his 4th heart attack.
5. No discernable reason in the world. Random was always a possibility.
6. It would alienate/isolate you for her to chase off the people you had brought over.

Maybe it doesn't matter what's BPD or dementia. She's never going to get therapy for BPD, and if her dementia accelerates, it wouldn't stick anyway. The care workers at the facility can deal with her far better than me. I decided my role here was to look out for her safety and that's it. I can't make her happy. I can watch over her bills and personal business until there is none. I can see that she is safe until the end. No more than that.

I think what is important to do now if not done already is to get in place the powers of attorney, wills, etc, find out her wishes now while she still can tell you, it is necessary and it is what it is. Your profile states she is again living with you till her senior apt is ready. Is this an assisted living senior apt? You will have to make plans now for her care if she has dementia, early or not, better now to get a care plan in place, find out just how much assistance she will need get and can get at the new place. If they can not accommodate her growing dementia needs, rethink where she will go to live. You don't want her to move in and then have to go to another place because her needs are beyond the capacity of care at the senior apt. I understand all about histrionic personality disorders and narcissistic mothers, dementia it seems make these mood disorders worse. I got the point where I decided, I can no longer be a victim of what was done to me before and it is up to me to take responsibility for my life and what I want and don't want now, no more well, I suffered for years from this or that, forget about it, it is now time to break away from all of it and live the life you want, you desire, you define what is your morality, ethics, standards, not her or no other person. Your happiness is up to you and you never will be if you keep giving your power away. Do what you can to help your mother, draw the line when it steps over your boundaries, learn how to detach with love and learn how to say no and walk away. I make sure my mother is safe, well cared for, and has what she needs and within reason wants, I can not be an extension of her or have her live through me in some sort of parasitic manner. We have to learn how to fledge, really fledge and define our own existence.

I am in the same situation. Distance yourself as much as possible. Don't feel guilty. Often, what feels cruel (and she tells you is cruel) is exactly necessary to keep yourself sane and healthy. If you live long enough to make other peoples' lives miserable - you've lived too long.

"When someone shows you who they are, believe them". I will add to that my own theory - people become more of who they already are as they age. If your mother has always been verbally or mentally abusive or both don't expect this to change. We have several very elderly relatives who have dementia and for the most part, the core personality remains/remained. The blessing is that she won't know you in time and by then her personal vendetta may abate some, resulting in her treating you more nicely. Just do the right thing and if you need distance and help get it. I have the same experience with my very nasty mother who my dad says has, he thinks, alzheimers. However, he won't take her to a doctor to find out until she 'gets worse'. She has always timed her digs and cruelty toward me very well. Sticks the knife in when no body is looking and she is still capable of that completely. She does it to him too; has to have a target always, but can be charming to whomever she is trying to work. I just can't be closely around her but I would never allow her to not be cared for. I just wouldn't do it myself. She has been so hateful to me most of my life that I don't think I feel love for her. But she is a human being and she gave birth to me so I would see it through.

My 67 year old brother has been living with me for almost 3 years now. He has been disabled since the age of 14. ( seizures) I didn't believe it at 1st. but after being here 24/7 I have caught him lying often, faking seizures so I wont ask him to help with yard work or to sympathy from my friends, standing outside the bedroom door to listen, reading peoples mail, etc. Don't get me wrong, he is on meds and he does have problems but I no he totally understands his situation but he loves sympathy type of attention. There is a lot more to this but for now I will say good luck and hang in there. And to the person that wrote you should no all your mothers antics. Nooooo!!! she doesn't have a clue to what your dealing with.

The answer is it is extremely difficult to tell. I am going through the exact same thing. And anyone who says that she cannot "turn her craziness on and off" at will has never dealt with someone with BPD. And it's very difficult to be supportive to a person that has manipulated you and abused you your whole life. I've been in therapy for over 30 years and I still have problems dealing with my anger towards my mother, who has some dementia (although she vehemently denies it) on top of BPD and narcissitic personality disorder. But I am "doing the right thing" by taking care of her although she continuously makes my life a living hell. The bottom line is just be easy on yourself -- you are doing a very difficult thing. I try -- as much as I can -- to not feed into my mother's craziness. My therapist says, "Of course your mother knows how to press your buttons -- she installed them". That is true. I find that if I don't react as much to her pressing my buttons then sometimes the situations don't escalate to the point that they could. I also try -- when I can -- it's hard -- to feel empathy for her and "go with love" in my dealings with her. Once again, extremely hard when dealing with someone who gave me PSTD and is the reason I've been in therapy for 30 years and on high doses of antidpressants/antianxiety drugs. I'm constantly trying different methods of dealing with her. I also recommend a book called "Elder Rage". It is about a woman who had to deal with her father's dementia on top of his BPD. It's written in a very irritating style -- she thinks she's a comedian when she's not -- but the message and the information is useful.

Hang in there. It is so so hard. I feel for you.

I had a very wise friend once tell me, "As we get older, our good qualities get better and our bad qualities get worse."

If you have been experiencing her behaviors your whole life, then you should be able to recognize which is which. Dementia behaviors are pretty straightforward. You cannot remember things and I hardly think she can "turn her craziness on and off" at will. Having a mental illness does include dementia, so get her diagnosed properly and take one day at a time. I am sure it is very difficult for her to cope with her declining health and you can help by being more supportive.

My heart goes out to you. I cared for my mother for six years after she fell and broke a hip at my house. It meant emergency surgery, looking for an acute care facility, looking for an assisted living facility....as well as selling her property and responding to her every phone call or wish/want in the meantime. My father left her in good financial condition; but, by the time she got "into trouble" with credit cards several times and had to refinance their property, she ended up with about a fourth of what it was worth. I insisted on her investing what money she had left; but, I ended up subsidizing her monthly rent and personal care. At first, since my mother had not displayed the behavior you describe, I did everything for her...made arrangements for her ccs to be paid off, paid for her conveniences at the ALF, saw her almost daily, and would take her whatever she said she needed any time of the day or night. She began to get more and more dependent and demanding on me and began abusing my love for her. So, I told her I would buy and take her "necessities," but I would not drop everything and take her "luxuries" (lemon juice for tea she never drank, her very own brand of sweetener for the same tea she wouldn't drink...just little things to get me to go back to the ALF sometimes as much as three or four times a day. I finally had to set boundaries. I told her what I was capable of, what I would be happy to do for her...but, for the sake of my own health and the wellbeing of my family, I could not respond to every phone call that I received asking me for something else...basically for getting more of my attention. I put a white board on her refrigerator and told her to list, or have one the aides list, her needs and wants...and I would be able to keep up with the things she needed or wanted. If it were on the white board, I would pick it up the next time I went to the store.

As time went on, I started to feel guilty and as if I were not being a "good" daughter. It almost cost me my husband, my health, and my job (after first retirement job!). You must rely on what her doctor says (if he/she has been her doctor for a long time and knows her) and share your limitations, as well as your love, for her. I ended up in therapy because of the "control" issues I had. My main advice would be to stay in close touch with her doctor, and her medications!, and only do what you feel is what you are capable of doing to help her through her ageing years. Take care of YOURSELF! Stay in touch with your doctor and tell him/her of your situation. I am no "young chick" myself (67), so I finally had to tell myself that I wanted to enjoy being with her, to do all I could for her, to love her....but not at the expense of my priorities. When she passed away about three years ago, we had spent time together and done all of the things we enjoyed doing together. Although I missed her more than I ever thought I would, I comforted myself with knowing I had done all I thought was possible to make sure she was loved and cared for properly.

I wish you well. Our situations are quite a bit different, but your question touched my heart. Remember that you are not the only one who has gone through this type of situation and do what you can live with when she is gone.

ProfeChari