When someone with low-functioning borderline personality becomes elderly, how can you tell they if they have lost the capacity to make decisions for themselves, particularly financial ones?

It seems as if this personality struggles with executive function and slow processing speed. Problem solving is hard, choices are almost impossible to settle on unless a crisis compels the choice. Actions don’t match words and promises. There is no identity, no sense of self, hence no self-knowledge or instinct about wants and needs — just emotion, impulse… Categorical and abstract reasoning are weak. Home shopping and parasocial relationships are the drugs of choice that fill the emotional hole. Hundreds of thousands of dollars become piles of purchases and packages.

I know “damned if you do, damned if you don’t” is par for the course if you have a borderline in your life, but is it common for them to actually rewrite history? For example, discuss a choice, he struggles, but decides on x. Because he can’t function fully independently, you help with steps to do x, but at the first sign of discomfort, he explodes and claims that he never wanted this in the first place. Further, the revised history, of you as controller, decider and persecutor, becomes part of his permanent life narrative.

This is scary if this person has capacity to sue. Should we risk coming near him to help?

I know that all this has to do with external locus of control and black-and-white thinking (an inability to hold ambiguity in mind) that is characteristic of borderlines, but the weak EF, the compulsive daily spending/vulnerability to salespeople, the history-rewriting? Are these red flags? If not, can you name the red flags we should be looking for? (From the USA)

A:  Thank you for your email. There is often an overlap between psychological and legal issues, and I believe your questions and description already has enough “red flags” to be concerned about the legal implications.

I highly recommend a legal consult. Someone with good experience with elder-law and families. This will be the best consultation for right now. Beyond the diagnosis and stress, there are legal issues that you can become aware of and take measures to correct.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral