Are people with dementia capable of understanding boundaries?

Now I am not judging. I see where you are coming from. But would have hurt to invite her? She was already there. I know, you don't want to start something. 😊

To answer your question, in early stages maybe not later on .

The boundaries are yours, not hers. So it doesn’t matter if they work for people with dementia. For the plastic surgeon appt you maintained your boundary as you didn’t participate in taking her, good job! You also maintained your boundary for dinner in fixing her plate to go. Joann has a good thought, maybe mom just wanted to eat and have the company, but you equally also know your mom and how far she might push this, and you’re also right to value your family time. I see your boundaries working

Good job for not being guilted into inviting her for dinner! How is she to know that you and spouse were not having some romantic one on one chit chat?

What if you dropped a note to the plastic surgeon's office including the particulars of your mother (DOB, name, address), and just said that she has told other doctors in the past that she has help at home of you, and that you are absolutely not helping with any surgical or medical needs. That you keep your help limited to keeping her spare key. That will make you feel better and will likely be put in mom's file.

Boundaries, boundaries, boundaries. That's the one thing my counselor enforces with me every visit. I will not be guilted into doing something for my dad that I don't want to. He used to be so respectful of my time but as his disease has progressed, he demands more and more of me, much of it he can still do himself. Give him an inch, he'll take a foot. You did the right thing.

Hah... when she said she wasn’t welcome, I’d love to reply “I guess you’re right. We just don’t do anything at all for you, do we?”. 😀

Though “mmmhmm” is fitting too!

The thing about boundaries is that they are not to change anyone else, but to protect you by setting limits, then consequences if the limits are not observed.

No you are not being unreasonable by protecting your private time. The consequence for interrupting you is that she does not get to stay for a visit.

Maybe in response to “I guess I’ll go since I’m not welcome here”.. you could restate the boundaries "Mom, you are welcome when you and I can work out a time than suits both of us. "

Re the cosmetic surgery - her problem, You have stated that you will not be involved - end of story. Try not to let it get to you. You can't control her, only yourself. People are allowed to make foolish decisions.

Then please understand that anyone who has dementia may or may not understand boundaries anymore. But this issue has nothing to do with her dementia..... it's more to do with her sense of entitlement along with a lack of boundaries. Please see what you can do to talk with your Mom and check into some therapy for the both of you. Being compassionate towards your loved ones, even when they get on your nerves, is part of being a caring person. It's not easy.... but trust me.... it's worth it. ;-)

I think the issue of boundaries depends entirely on the person. If they were good about observing boundaries before dementia set in, then they will keep that ability, at least for awhile. Those tend to be the elders who don't ask for help, don't call when they need something and generally don't want to bother anyone because they have a strong sense of boundaries. Those elders who were terrible at observing boundaries will be equally terrible at boundaries with dementia. With my mother, we worked on setting boundaries for years. Interestingly she struggled with setting boundaries for her mother. Then I struggled with setting boundaries for her.

But once the dementia really gets going and they live with delusions and anxiety and other symptoms, then there is no way they are going to be able to understand boundaries. It's very much like expecting a newborn to understand boundaries. They are struggling so much internally that they can't express that the concept of boundaries is simply too much, too abstract and too complicated.

So, my once sweet and thoughtful mother will now wake me up at 2 am to ask if she should divorce my late father because he's not coming home anymore. It's heartbreaking to be honest. She and my dad were in love and rarely apart, and especially happy the last 20 years together. She misses him so much. The way her dementia is working is that the people she misses the most, she simply no longer accepts/remembers/believes they are dead. But she is so alert that she has to construct an explanation for their absence.

I guess this and fecal incontinence are among the reasons that people do not take care of their own parents when they have dementia/Alzheimer's/brain issues.

If your mother has always ignored all boundaries, then you're in for a hard time as that is unlikely to change. If your mother used to respect boundaries, and is losing that ability, then it will probably continue to degenerate. I do think it is ok to tell her calmly how you feel and what you expect. For instance, if my mom wakes me up at night to talk about how to find her late mother, then I tell her I will talk to her in the morning, and please do not wake me again. She is able to follow this instruction. I may hear her rustling about her room, but she is still with it enough that she is safe left to her own devices at night. She can turn on the TV , well sometimes she can. She has an Alexa device that she can ask questions to. And she spends hours calling 411 information and asking for the phone number of her mother. Since 411 does not charge for land line inquiries, then I don't care at all that she is calling them. They're not at all helpful. They're overseas. They don't listen. But they keep her busy.

What I don't really get is people expecting dementia patients to be normal people. Their brain is literally shrinking and disintegrating and losing connections every minute. They are lost in a fog of anxiety and confusion. They cannot make sense of people they love being gone. The only thing that they do not lose is emotions. They respond to affection. They feel quite a bit of anxiety. At some point the only impact anyone is able to have on an elder with dementia is to either make them feel safer and loved or to make them feel anxious, lost and rejected. It really gets that simple. It becomes the same as an infant. We don't reason with infants. We simply soothe them, or sadly upset them.

It’s you who feels the need for boundaries, not mom, so you must set them.

Keep in in mind that her behavior doesn’t bother her, it bothers you. That will help you come up with ways to set boundaries you can live with.

Ok, I have been gone for a while so I do not know if I have missed other questions or posts that you may have had but....
Just from your profile and the question you have posted here a few gut reactions.
1. It does not sound like your Mom should be living alone.
If she had been diagnosed with dementia she should not be going to a doctors appointment by herself. She probably should not be able to wander out of her apartment, house, condo by herself.
2. If your Mom is alone in her apartment/condo..and it is meal time is she able to make her own meals? Is it safe for her to do so?
3. It is lonely eating by yourself. We make eating a social "thing" and to eat alone is depressing and you mention that she has depression why take a chance on making the depression worse? Invite her for dinner, or you and your husband go to her place for dinner then you can leave when you like. But at least she will have a bit of company. No to mention as the dementia progresses eating can become a problem from eating all the time or not eating at all because you have forgotten when or if you ate.

As for boundaries. If she understands them, and if she does today she may not tomorrow or next week...
You can set a schedule that should work for you both. Get a calendar or dry erase board and write a weekly schedule on it that she can follow. Just know that she may or may not understand what the schedule is.
Also is it possible to get her involved in Adult Day Care of other activity? Something to give her socialization and something to do and in a place where she will not wander? (there will come a day when she leaves her property without the phone or the phone does or she looses it and you will not be able to track her. It is not a matter of if this happens but when.)

As I have said I have been gone for a while so if I have missed posts addressing these point forgive me.

OK, I am in the minority here, but I am speaking from experience. You can set all the boundaries you want. Your mother is going to do exactly what she wants to do. She doesn't understand your need for couple time. It is likely she has reached the stage where there is one person in her life: her. It's not that she doesn't care about you on some emotional level, but all she is thinking about is what she wants to do. I live with my 88-year-old mother with dementia and she only thinks about herself. I know she can't help it, and it is hard to deal with, BUT it's the reality of this disease.

I hate when people tell me to consider putting mom in a facility, but if you can't handle her demands, maybe it's time to consider a different arrangement.

You are being reasonable. You said she's been disrespecting your boundaries all of your life so this probably isn't due to dementia.

Without some sort of schedule your life is in her hands. You could have her over for dinner a certain day each week, which would give her something to look forward to. Eating alone the other days isn't going to kill her, and maybe she'll find new company. If she barges in unannounced you can politely turn her away until the next scheduled get together.

It 's good that you're protecting your time with your husband and not ignoring him in favor of your mother like some do.

Just a side thought... Vicodin ? Hmmm...

Piper please see My message

You have the absolute right to control who comes into your home and when. This applies even to your mother. Later in the course of dementia, the person does not understand boundaries. Based on what you write, she is not there yet. This is a situation where you can set boundaries. I mentioned before about an elder who would grab my breast when I was doing up her seat belt. In that case, boundaries are no longer recognized by the person. In your case, you need to set clear boundaries and enforce them. The enforcing part is most important. If you give in just once, it is a big setback for you. In the case of the keys, stand at the door, leave her outside, request husband get the keys. Keep her outside, physically block her from entering if necessary or close the door, unlock her door and return home. Ignore any talk about your dinner. If I came to your door, invited myself in and started eating your dinner, would you allow that? (if so, what's your address?) I've recommended before that a person needs to think about their response ahead of time in boundary situations.
As for the plastic surgery, it is not you business to stop her however poor the choices. You can advise, but she appears to be competent. Are you crossing a boundary trying to stop her? I think yes.
Regarding your post later about her getting your husband to do something about a chair. When you enforce boundaries, she will turn to violating his boundaries. You two should get on the same page withbthis.

I don't have an answer, I wish I did. I understand where you're coming from, my mother has no sense of boundaries either. She just can't understand why I don't tell her every little thing. Questions everything I do. It is very frustrating.

A person with a broken mind is not capable of knowing a boundary, sadly.

I know I will be the off-key note here, but in all honesty when I read your description of the situation I felt that it wasn’t handled the best way or with tact. I fully agree with Grandma1954’s concerns which I find are more important than if she can understand boundaries. Should she be living alone and having complete freedom to go anywhere by herself with no supervision other than you being able to track where she is? If she has dementia even in the early stages her safety becomes priority number one, I think.

And about what happened to her, first locking herself out (maybe part of why she should not live alone? Although I see you live close to her which is a relief). We all can get locked out at any age, but the elderly are more prone to have certain things happen to them, therefore to me that is entirely not her fault, just an accident. Then she goes to you to look for the spare keys, that seems reasonable to me. Then she mentions that your food smelled great, which to me means:
- That your food in fact smelled good!
- That she was hungry or got hungry when she smelled your food
- That she saw an opportunity not to eat alone, instead have a family meal
- That she didn’t feel like going back to her condo to be by herself, she wanted to have a conversation, to feel “normal” and included.

One of the most important things that most elderly people lose is PURPOSE and connection. Purpose in the big picture means why am I alive? And in the daily picture, what will I do today and why?
If you think about that, dementia or not, if you had no purpose, no occupation, how would you feel? I know I would feel empty and lost, then add dementia to the picture and it is a tragedy!

And connection means that one needs to belong, to be an important part of something, more so of a family.

What I see with her going to the plastic surgeon is a combination of dementia not helping her to discern properly and also a way to fill her day, to find a purpose for that day.

What I see with her intruding your home and disrupting your meal is simply coming from her need to connect and to belong.

My very personal way to handle situations related to elderly people is to always put myself in their place and to try to understand their motives. Now, will they ever return the courtesy and put themselves in one’s place and understand one’s motives? Unlikely, not impossible but unlikely; I certainly will not be expecting it. But I think once we understand their motives there has to be a level of compassion that we all as human beings are armed with. That compassion does not translate into having zero boundaries, but it should translate into finding ways to make things work without hurting their feelings. I honestly think you may have hurt her feelings as any other person or any mother without dementia would have felt when you told her to take a plate and go eat home.

I'm NOT saying this to make you feel guilty Piper, not at all, plus I don’t think you would feel guilty. I’m saying this because 1)it is my opinion, and 2) maybe it will help you to be more aware and conscious of how her mind and heart May be thinking and feeling, and how unnecessary it is to cause that someone that is lonely and needy -even if too needy- feels rejected. What would I have done? well first reassess if her living conditions are appropriate for her physical and mental state, and secondly I think I would have asked my husband if he minded that she ate with us, and I would have had her over for dinner and as soon as dinner was done I would have walked her to her apartment and make sure all is ok. Then come back and have some quality time with my husband even if it is just a cup of ice cream as dessert talking, or a glass of wine, or watching something on TV together. That is just adjusting to the circumstances because the situation was an exception. And set up you & your mom time, family and mom time, and then move within those scheduled times.

Best of luck!

Unless I'm missing something, I don't think in this was a deliberate violation of boundaries on her part. She got locked out and turned to you for help. She probably would not have dropped by if she hadn't needed her door unlocked. As inconvenient as it was for you, it sounds like she had a legitimate reason for coming this time. I do understand about plans for visits - I have post traumatic stress, and I appreciate people asking if I'm available - and lacking that, at least give me a 5 minute warning so I don't have to wonder who is at my door.

The elaboration of the problem here makes me wonder if your mom was this way before. My mother would deliberately do things like this even when we were young. She was manipulative and nasty even then. The closer you were to her, the worse it was. If we didn't perform every request, we'd get snarky, nasty comments very similar to what your mother delivered. Staff at the nursing home and doctor's office blamed it on dementia, but no, that was just Mom being Mom...I hope you don't mind me asking what she was like when you were young - if she has a history of making people feel guilty earlier in your life. (My mother would blame her friends for not calling, saying "they must be mad" - it would drive me crazy)

No, you were not unreasonable. Her statement was intended to guilt you into letting her do whatever she wants. I applaud you for letting her fix a plate and helping her get back to her place to eat it!!!!!!!!

I think they do understand what boundaries are, though they'll probably need continual reminding.

You said, ........"Not to be judgmental of you either, but it's my opinion that people should keep in mind when they respond that not all experiences or solutions are the same. Some of us are actually trying to take care of our abusers. If you don't know what that means then consider yourself lucky."

I get it.

Exhausted,

Here I go again. Your remarks resonate.

The continual sense that along with the dementia, you're still dealing with your mom's long-term Standard Operating Procedure of disrespecting boundaries. The disrespect your violated Child remembers. Different boundaries perhaps, but the same attitude that your feelings, your life, your "person" come second to theirs.

The way that I see it, you moved your mother in next door to you. That was a good move for several reasons including that she is not living in your space and it's easier for you to keep an eye on her. All good things when you are the caregiver.

I am a big proponent of whatever is convenient for the caregiver because, like it or not, caregivers are usually younger and have more things to do each day on top of caregiving.

You are not responsible for your mother's happiness. You are not responsible for your mother's contentment. You are not responsible for living your mother's life. You are her daughter. You are not her nurse. You are not her teacher. You are not her safety net. You are one person whose own life matters.

If anyone needs to learn to set boundaries it's you because of your childhood and the damage your mother did to your relationship. Your mother is responsible for that damage. And there's nothing to undo it. No amount of caregiving is going to satisfy your mother. Accept that.

Also accept that you have nothing to feel guilty about.

You and your marriage come first. Your mother will never accept that regardless of how many times you say it. The more you try to explain yourself to her, the more explanations she will want. You will never get to quit explaining yourself to your mother even though you are an adult.

Your boundaries are yours. That she has dementia does not entitle her to violate them. She will try but your boundaries are there to protect you and your marriage. Enforce them. Boundaries are not cruel. Boundaries are necessary for survival especially when you are dealing with a parent who damaged you as a child.

And please don't let a few people on this forum who believe in "boundless compassion" or "duty until death" or whatever nonsense, deter you from establishing and enforcing boundaries with your mother. Recognize that they may be miserable in their current situations and just want company!

It sounds like she might be lonely, eating alone is depressing especially for a widow, divorcee or empty nest mom. Perhaps a planned meal each week she can look forward to, perhaps take turns hosting or cooking or cook together. As dementia progresses a person can become afraid to be alone because they don’t understand always what they see, hear, smell, touch or feel. A car going by can cause fear someone is coming to get them, a doorbell ringing on tv can strike terror as they worry who is at the door & why.
My dad is in early Parkinson’s dementia & panics if I’m not near when he wakes up. Call or drop by often so she feels connected & cares for & go from there. Good luck!