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Can long term use of opioids bring on early dementia? She has been on opioids for the many back surgeries over the years and has constant pain. The medication does check the pain for the most part. She has always been a narcissist, but she seems to be getting more angry and particular about almost everything. She’s fussy, complains a lot, and repeats what she says continually and then tells the same old stories. She is mostly negative and brings up upsetting memories regularly. I was present in most of her stories, but she tells them like I am a stranger and wasn’t there-she has been doing that for a few years. As well as, hears a story and will say…that was me, or, I was this when that happened-narcissism? It’s always about her. She doesn’t listen well and will always forget what you say, or maybe never hears you/listens to begin with. She alienates many people and especially her doctors. She doesn’t believe them and does not always follow through on what they tell her to do. She also claims that she gets up to urinate every two hours which is not true from my observation. Her hearing is going. I’m trying to get her to wear a hearing aid. She had a fall a few months ago and has more memory problems since then, and now gets headaches. She would not get a cat scan and had cancelled it three times. I’m following up this week to make sure it gets scheduled and she goes. She has asthma that is not always controlled and refuses help at home from any cleaning service. She lives three hours away with my younger sister who is partially physically disabled. Sister helps her some, but is dependent on her financially. (Sister smokes a lot of medical weed and takes medications for back pain and anxiety.) I’m not always sure what is narcissism, normal aging or dementia with my Mom. She has noticeably declined since my step-father’s passing early last year from Alzheimer’s. I love her but find her extremely difficult to be around, mostly from her narcissism and negativity. (I have a lot of patience with her now being slower and helping her.) I am always steering the conversation to something more positive. It’s exhausting. Maybe I am too sensitive. Other times, we can have a very pleasant conversation. I never know when it’s going to change. If anyone has navigational experience with helping family on long term opioid use and their changing personality, and being able to differentiate narcissism with normal aging and narcissism with dementia, I would appreciate your thoughts. I know it’s a lot, but thank you.

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Diana, could she feel like she is on vacation at your house and you guys should be doing things?

Does she do this with your sister?
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DianaGearhart Oct 31, 2023
She and my sister fight all the time. They have a very toxic relationship yet they can’t be away from each other very long without calling several times a day. She apparently does act this way around my sister. My sister acts strung out most of the time around her, but manages to do enough for her to get by.
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What really is the difference whether you are dealing with narcissism or with dementia or with addiction? Or with a combination. The real question here is "does she live alone and is she safe in doing so". Because whatever the cause of problems the results are the same. And whatever you are dealing with is not going to change. She will REMAIN uncooperative, narcissistic and addicted.

You say she has always been this way.
So she still is.

In all of this it isn't clear to me what help your mother has in the home. Nor, again, is she safe being alone IF she is alone.
Again we are down to is she alone, or does she live with someone, and if she lives with someone who does she live with?

You mention a scan that is scheduled yet you do not tell us what that scan is for.
You mention problems with urination, yet you don't tell us if she is negative for a UTI.

I think what I need is simply to know what your question is?
Do you really only want to know if we have only seen this before?
Are you just wishing to vent about Mom, because if so, there sure are many here with similar stories to share.

If, however, the question is regarding whether or not Mom has dementia, then we have solid ground to cover:
A) What evidence of dementia is there? The things you mention could, as you tell us, be due to anything including narcissism or addiction or aging or any and all.
Is she able to do her bills? Is she able to function safely? Is she falling? Leaving on gas jets?
It sounds as though she is functioning, certainly well enough to get her drugs, which, for an addict is difficult enough.
B) Who has POA for your mother should she need testing?
Has anyone written her primary doctor to suggest that either the opioids are getting to her or she has dementia? Because, while he/she cannot talk with you about her if you are not MPOA, she/he CAN know all this and try to follow up with his patient.

You describe a difficult woman on opioids.
If she is ever hospitalized then it is crucial hospital personnel be informed, because if she is suddenly withdrawn without support..................well, just let me say "you ain't seen crazy yet" until you've seen that.

Good luck. This all sounds very difficult to deal with, especially when you throw in Sis. I honestly wish you the best. Let us know if you have a good solid question for us, but as to what is to be done with an addicted narcissist, that is almost always a question without a good answer.
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DianaGearhart Oct 31, 2023
She does not have a UTI-thankfully! My disabled sister lives with her and she has POA. She goes to a pain management center for her medication. She can drive but has recently veered to the shoulder a couple of times. She can make out her bills. She can do laundry. She can shop, but I noticed that she was unstable while walking since visiting this time. She said yesterday that she doesn’t cook any longer. She is truly not remembering very well of things that were said just two days ago. She doesn’t want to listen to suggestions about her health, hearing, or housekeeping. She’s very stubborn. My sister says that she keeps a monitor on her. Because I don’t live with her, it’s difficult to know completely how things are going at home day to day. Thank you for your thoughts.
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Your Mom is probably addicted to her pain killers. I agree though, she needs a full physical at her age to rule out anything physical. And your sister, she better find a way of financially caring for herself, because when Mom goes, she will be turning to you for financial support.
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DianaGearhart Oct 2023
I have already told her no. She is on Medicaid and can go in a nursing home. Mom is leaving her some money which I’m sure that she will blow through. Love her but can’t be around her.
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If the memory issue seems sudden, she could have a UTI so I personally would take her to Urgent Care of the ER to discount this very common problem.

UTIs are extremely common in older women due to lower estrogen levels, physiological changes and pH changes, not necessarily hygiene.

In elderly women the most common symptoms are not classic ones like frequency of urination or pain, but instead sudden changes in behavior and cognition, including confusion, agitation, hallucinations, etc. Maybe not even a fever. But if left untreated with antibiotics, can turn into sepsis, which is life threatening.
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DianaGearhart Oct 2023
I will check to see if her doctor checked her urine from her recent doctors visit. Thank you.
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Probably a combination of everything, but I think you need to make an appointment with a neurologist to find out exactly. If she is constantly repeating the same conversation or questions over and over that is a sign of dementia.

It is now time to start thinking about the bigger picture by formulating a plan for her future care.

Best of luck navigating this.
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DianaGearhart Oct 2023
As long as she can use the bathroom without assistance, my 2 sister’s and I have agreed that we would each go to her house a couple days a week to help her when time comes and hire help the other days we can’t be there. Eventually, it may mean getting her into a nursing facility with memory care.
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