I am wondering if anyone else has encountered this situation and can advise.
For the past 30 years my mother has experienced very high levels of anxiety about her health to the extent she only seems to feel calm and joyful when she is undergoing medical treatment and interacting with doctors. She has recently been undergoing low-dose radiation therapy for a lymphoma (a very treatable type) and was the happiest I have seen her for quite a long time. The treatment has now finished and the daily discussion with doctors has ended (she does have follow up appointments) and she is now extremely anxious and raging. She thinks the doctors and nurses are lying to her, etc.
Most people being treated for cancer are likely to be experiencing high levels of anxiety. The challenge is that she is unable to recognize she suffers from any anxiety, although she is taking an anti-anxiety medication. Several health professionals have tried to discuss this with her, and she was offered counselling as part of her treatment, but in her mind, she is not at all anxious and the issue is that people are lying to her, not responding to her needs immediately, etc.
This seems to be part of a larger pattern of not being able to admit to herself or others that she is not perfect. She has always been incapable of apologizing or saying thank you, is severely entitled, lacks empathy and rages about anyone making even the smallest mistake. From what I have read, this may be narcissistic personality disorder, but I am not a psychologist.
I would like to support her but don't know how. For example, if I say "This must be very hard. Anyone would feel anxious," she flies into a rage and says she is not anxious and that all her (very paranoid) fears are real. However, I do not feel I can 'keep the peace' and agree with her that doctors are lying, and everyone is out to get her. She becomes extremely angry if I do not agree with her.
Her doctors have tried to help. They have done evaluations, etc., but she is not suffering from dementia and under our country's laws, she cannot be forced into any form of treatment. It would also be pointless if she cannot see that life might improve for her because of talking to someone or addressing her fears (an extreme fear of death is one of these).
Any advice on a helpful approach would be much appreciated.
- is she telling you this was the outcome or were you there when her doctors said she "doesn't" have dementia? She would not be the first 90+ yr old to deny, fib about or forget about their diagnosis.
- when was the last time she had a cognitive exam? At 94, dementia can start at any time.
- If she was being treated in the hospital, and was either catheterized or anesthstatized, she could have a UTI which may explain her rages. I would get her into Urgent Care of the ER for testing.
- are you her DPoA?
- Have any of her doctors suggested meds to treat her anxiety? If so and she has refused, then it is a no-win situation.
If you truly think she has no dementia then when she fixates over her health issues, try "extinguishing" the behavior by changing the topic to something completely unrelated to her or her life. Just keep doing it. It will make or mad, confused, frustrated but it may reduce or stop her from talking to you about it. Otherwise, walk out of the room and do something peaceful or productive.
Thank you for your thoughtful reply. I am my mother's POA for health and finances but the POA hasn't been activated for health as mum is judged quite capable of making her own health decisions. She has undergone a number of assessments - she is extremely intelligent and they are often taken aback by her intellect and cognitive ability. She reserves the raging and paranoia for me and is very charming to medical staff- and that has been a longstanding pattern.
And yes, she has been tested for a UTI in the past few weeks and has regular checks.
I will follow your advice about "extinguishing" the conversation with the approach you suggest. The fact that she can control the behaviour with other people is interesting. Thank you for your advice.
https://lifelessons.co/personal-development/covertpassiveaggressivenarcissist/
If your mother fits a lot of these 25 signs, you're fighting a losing battle. Debbie Mirza writes books and has podcasts with lots of helpful tips and coping mechanisms for you to learn from.
Hopefully you can step back from your mother after offering to help her find a caregiver to assist her with whatever she needs in life. You can't fix this level of broken, not at 94. Save yourself and disassociate with the woman as much as humanly possible. That's my suggestion. Mental illness like this that she refuses to recognize sounds quite hopeless.
If you are living together, move out. Your folks will have to arrange for carers to come in to the home daily to help out, or to move into managed care.
Best of luck