How do I know what's real?

My mother has done a lot of this, but the only big scene she caused in public was throwing a safe deposit box key at a bank employee. That was the worst. But a lot of the beliefs that other people have done her wrong, etc.. all ring true. She’s quick to anger, recently getting agitated because her pain Dr office was too cold . She took it PERSONALLY.In our case, I was able to call my mother psychiatric NP privately because I have HIPAA access. She is a new provider to my mother, having only been around for about a year. But she says my mother has symptoms of several personality disorders in addition to her anxiety. She is noted that a lot of this stuff comes from paranoia, such as saying her neighbor had her power shut off when in reality she failed to pay the bill. She theorizes that my mother might actually have. I think it’s called depression with psychotic features. In my mother‘s case, she is stable enough now to not warrant any medication changes, because a lot of the meds are dangerous for seniors. I’m not saying this is what is wrong and your loved ones, but I think evaluation by a mental health professional would be a good idea. But I also know getting them to go is a real challenge. In my case, my mother had already been under the supervision of a psychiatrist for many many years.

Yes, she is very mentally ill, and untreated. And possibly untreatable if she never cooperates.

I'm not sure what type of "suggestions" you are seeking. Others who have gone before you and dealt with aging LOs with untreated mental illness have their hands full, to put it mildly. Even if you somehow gained legal guardianship for her, you still can't force an uncooperative adult to do something they resist (like take meds, or live in a facility, for example).

Therefore... like others have suggested: you need as little contact with her as possible since you have no actual control of any of it. If she appears before you and seems detached from reality please call 911 and have her Baker Acted. That's as much as you can/should do. Your own mental health is at stake. Please realize since you were raised by this person you now have a very high tolerance for chaos. Please consider talking with a therapist so you can identify clear boundaries and learn tactics to defend them. Your Mom will constantly try to ram your walls. Don't allow her in.

If she does ever go the ER, make sure they know she needs a social admit (is an "unsafe discharge") and that you are NOT her caregiver or PoA or guardian. Allow social services/social worker to take over her case. They will have more ability to help, manage and protect her than you ever will. The more you insert yourself, the longer that process will take.

I'm sorry, I know this sounds heartless but your is not the first such post with this exact problem. So many on this forum have had to deal with this. There are no good solutions, only "least bad" options. May you gain clarity and wisdom and peace in your heart as you defend your boundaries.

What's "real" is your mother's mental illness. Anything else is pure conjecture.

I wonder what kind of ethical dentist pulls out healthy teeth because they may need to come out one day down the road?

I'd try to get mother to a geriatric psychiatrist for a workup but in the meantime, I'd keep very low contact with her, honestly.

Our "reality" is subjective. That is to say, you aren't paranoid if they really ARE coming to get you!

Bit of a lame joke there.
The interesting thing here is that you say that your mother was "always" like this.
So I would say that you may have a mom with some sort of borderline personality disorder that was never diagnosed. Or you may have a mom who has a narcissistic disorder or tendencies.
Really, if you, who give us examples and have lived with this for many years, don't know, I think it would be hubris for us to hazard any guess at all.

If there is any personality disorder, that will make any sort of diagnosis in future regarding dementia all that much more difficult.

This is quite honestly, whatever her situation is, a woman I would have long ago distanced myself from.
I recommend that you read a memoir by Liz Scheier called Never Simple. Her mother had mental disorders and she tried to intervene to keep her safe for many decades. She became familiar with the Social Services safety nets of the entire city and state of New York, but all along, over time, nothing that was done was any help. All was to no avail.

I am so very sorry. What a sad thing. What a tragedy really.

For starters she sounds like a very nasty person with a long history of untreated mental illness.
Now that she's a senior it gets more complicated. Some people can get so deep in their own lies and denial that they have convinced themselves they don't remember. My mother has done this for years since I was a kid and I'm 51 years old.

I've known many people like your mother. I call them professional victims. When they don't get their own way on something, they turn on the tears and the tantrums because they are being unfairly persecuted. They never do anything wrong and it's always everyone else's fault. These kinds of people are used to getting away with their behavior because no one actually holds them accountable for it. Someone (their enablers) always comes to their rescue to put out all the fires they start and clean up the messes they make.

Who was your mother's main enabler? People like this always have them. Then when these people get old they become senior-brats. A senior brat is exactly like a kid one only old.

I agree with KNance that she should definitely see a geriatric psychiatrist and get some testing and to address her behaviors. She may very well refuse to see the doctor. That won't be your fault.

Sadly and unfortunately many times the only way to get a person the help they need is to let them fail. Stop being a player in her manipulative games and don't be her enabler. Don't put out her fires or clean up the messes she causes. Tell her plainly that you will not be seen with her in public because of the way she behaves and she's an embarrassment to you. Then don't take her out in public.

If she wants to drive around with a broken seatbelt, report her to the police in her town and let her face the consequences. Don't smooth things over for her on anything. Let her take the heat for her own actions and behaviors. Trust me the poor, pathetic, senior act only gets a person so far. You'll be doing her a favor.

I second KNance's response. She is not mentally stable.

Me, I would back away, there is nothing you can do to make her mentally fit. Definitely would not go anywhere with her in public.

Sorry about this!

She Needs to see a Neurologist and a geriatric psychiatrist .