Coping With the Aging Parent With Borderline Personality Disorder

As a child, all you wanted to do was get old enough to move out of your parents’ home. You figured this would bring the ultimate relief.

It did get better. She couldn’t barge into your room whenever she wants anymore. She couldn’t seek you out throughout the day whenever she needed something or was lonely. Or angry.

But you still had to deal with the frequent phone calls, texts, and emails. You still had to deal with the frequent “emergencies,” such as her computer not working right and the mouse in her basement, for which you were expected to drop everything and go running.

Now she is getting older. More will be needed. More will be demanded of you. Don’t panic. Here are some issues that typically arise during this phase of life and how to adjust your boundaries accordingly.

Healthy people are naturally driven to maximize their independence. Autonomy and self-reliance build their self-confidence and sense of worth. These individuals do not depend on their children for wellness or survival. They have loving relationships with their children and take care of themselves so as not to be a burden.

Individuals with symptoms of borderline personality disorder tend to develop codependent relationships with their children beginning in early childhood. They seek consistent emotional validation while maximizing their reliance on their children in daily life as a way of demonstrating their worth. They don’t seek independence because they experience other people not doing for them as abandonment and hence reinforcement of their worthlessness.

Adult children of parents with symptoms of BPD dread signs of physical and emotional decline in their parents because they know that their parent will not struggle to maintain independence. Rather the parent will expect their child(ren) to take care of them. And to do it cheerfully.

Resistance to Making Plans for Aging and Retirement

Individuals with symptoms of BPD often assume that as they age they will be taken in by their family, most often their children. They do not buy long-term care insurance. They do not consider help from anyone who is a non-family member. They are offended by your wanting to even have a discussion with them about it. Below, Harvey tries to have a discussion with his mother after his mother fell out of bed and broke her collar bone.

Harvey: Mom we need to make sure that you are living safely.

Mom: I am fine just where I am.

Harvey: This is your second fall this month.

Mom: That’s because my children are too busy with their lives to pay any attention to their mother.

Harvey: How about if we get you some help.

Mom: Can’t you help me?

Harvey: Mom, I have to work.

Mom: I am not having a stranger come in my home.

Harvey: It is not safe for you to be home alone.

Mom: The only place I would consider living is with you.

Harvey: We don’t have room for you in our house.

Mom: Of course not. I am only your mother.

Harvey: It’s a small house.

Mom: Maybe I will just end it right now.

If Harvey is accustomed to giving into his mother, it may seem impossible to avoid taking care of her in his home. This will lead to an almost instant regression to childhood times of living with no privacy and being constantly on-call to his mother. What else can he do?

Set boundaries, of course! As he is accustomed to, his mother has created a situation that can only be solved by doing exactly what she wants, which is worse for Harvey and his wife and children. Harvey needs to set a boundary with his mother that offers only solutions that work for both his family and his mother. It might sound like:

Harvey: Mom, we have to keep you safe and there is no room in my home for you. That means that we either need to bring help into your home or you have to live in a place that has help available all the time, such as assisted living.

If she threatens to “end it all again,” then Harvey needs to get her immediate psychiatric attention. If she refuses to cooperate, then he should explain that if she falls again, the hospital will not release her to live alone again. It will be obvious that this is no longer safe and then she will have to make emergency plans and have fewer options. This is what will happen if she refuses to cooperate. If she agrees to cooperate, then many other options can be considered. The choice is up to her.

If you have been giving into your parent consistently to avoid conflict, then you will have a harder time now. She will expect you to give in as you always do. You can’t force her. You can warn her that if she falls again, she may suffer permanent debilitation. The broken hip is one of the most dreaded injuries to the aging population, as it can cause life-long difficulties in the ability to walk and get around, which increases the need for assistance.

If your parent refuses your attempt to avoid further injury, then she will probably get injured again. This is her choice, not your negligence. It is a form of “hitting bottom” where she comes to realize, through experience that her life as she knows it has become unmanageable.

She will then attempt to solve the situation through codependency: moving in with you. You will then restate her options: help in her home or transfer to assisted living.

Harvey’s mother will eventually accept the changes that need to occur. She will probably blame Harvey for being ungrateful, neglectful, and a bad son. But she will have to accept the change. Harvey can then set boundaries around the verbal abuse and tell her that he will not visit her while she is abusing him and that if she wants to see him and his family she will have to be civil.