Neediness vs. paranoia.

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My mom should go into assisted living, soon. She has dementia and a lot of confusion, is hard of hearing, can't drive (license revoked) etc.
Issue is, I am the one who ends up taking her to the doctor (she won't see a neurologist or gerontologist, etc.: says she can't afford it, but frankly I feel I can't afford for her not to, and I think she can.)
She is driving me nuts, to be blunt about it. The money issue is a huge pain. She has a decent pension and she wavers between telling me to take money out to shop for myself or to pay my car insurance, etc. I don't feel comfortable with that. But then she'll waver and be paranoid, hiding money she's taken out at the bank and not finding it, so I (or my husband) get the blame. It's back and forth, between "take $1,000 and pay your insurance and get those new brakes and a muffler" to "you stole some change from me, and I can't trust you!" Even if everything is written down and accounted for with receipts, it does no good, but I'm so annoyed with the back and forth. I don't want to help to end up being accused of theft. Even buying paper towels and placing them on top of the fridge instead of under the sink gets me called a thief or stupid because I don't know where to put things. And even if the mistake is resolved or the confusion is cleared up, albeit temporarily, she still holds onto these little events and stacks them against me.
On top of that, if you read up what a textbook narcissist is, my mom practically invented the mold. Dealing with that "it's all about me" behavior paired with the anger and the confusion and the paranoia she deals out, I'm at a loss. How do people handle that? I can get some confusion and so on, but to be labeled as a thief or liar quite often is draining.

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If no one has DPOA, the next step is to file for guardianship, but that also involves getting her evaluated by two doctors to see if she is incompetent or not. Adult Protective Services may be able to help you.
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Dealing with someone who has dementia is difficult. It's not likely to get easier either, though sometimes medications can help reduce depression and/or anxiety. Try not to take it personally. The brain isn't working properly. With dementia there are stages or phases and sometimes the anger or suspicious stage may subside over time. It varies with individuals. My loved one was once very confrontational and aggressive, but over time, she stopped that and became needy, anxious and obsessed. Then she went into a mellow mode. It's difficult to predict. It depends on many factors.

Do you have or someone else have a Durable Power of Attorney for her?
If so, I would start to make some arrangements for her care, including a medical evaluation. She may not agree, but there are ways to convince her. The point is to get her evaluated so you know what she needs and where that can best be obtained, such as in a Memory Care facility.

Depending on her financial situation, she may be entitled to financial assistance or not. I'm not familiar with the resources in your state for Assisted Living.

If no one has a Durable Power of Attorney, then I'm not sure what you can do. I have read here about various county agencies you might contact to get her help, even though she doesn't want it. If she is no longer able to properly care for herself or she needs medical care and isn't mentally capable of getting it, it may be your only option. I would attempt to gently entice her to cooperate.
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