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My lifetime, mom is paranoid, narcissistic, physically abusive. Paranoia worsens everyday. Narcissism is textbook. Delusions and hallucinations began a year ago. I’m concerned radiation therapy for cancer will greatly diminish already diminishing quality of life. Can anyone share experience?

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TChamp, can you ever respond without being so morbid and such a naysayer?
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Cancer treatment at her age and with all the other heath problems she has, a quicker death is on the horizon.
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I was POA for my Daddy and when it was time, I made the decisions. My siblings were informed about the situation with him but I was the one with the responsibility. I did keep them informed of the medical issues and up to date with what was going on with him. When end of life came. I let them all know and they could come and visit or not. No hard feelings I just wanted my Daddy to be comfortable.
As far as radiation therapy - my sisters was sooo bad that it stopped working and City of Hope in California wanted to start her on another. She was still sound mind and body and declined anymore treatment... she was tired and the cancer over took her. She won in the end because she is now at peace, no more pain, no more treatments, no more doctors. Make sure you know what your mom wants, or wanted before she became paranoid and delusional. Prayerfully she has an end of life plan.
prayers for you and your family.
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Rad treatment so close after an operation is I think a challenge, for anyone of any age. Is this in conjunction or b/c of causes provoking the hysterectomy?

You'll need to do a lot of planning, for trips to the treatment facility, someone to be with her and return her to home. I suspect that she'll become as mentally fragile as you are.

If your siblings haven't been involved, they likely aren't going to be now. So find assistance elsewhere, once you determine how much and what you'll need. Someone to drive your mother to and from treatment would be helpful. Are there friends, church members, or volunteers in the neighborhood who might help with this?

My sister had whole brain rads, once a week if I remember, and she was younger than your mother. The treatments were exhausting; she always slept for quite a while afterwards, and I stayed with her. (By that time I had temporarily moved in with her).

Food might be an issue. My sister also had cancer. We had trouble finding something that was palatable; most foods no longer were appealing. We did find thick juices to be helpful, but solid foods were not.

I think you could benefit from researching the type of cancer your mother has, trying to find an organization that can provide not only information, but perhaps support through contact with others. Gilda's Club comes to mind. Also ask the radiation staff if they can recommend an organization. If you're in an area with a a large hospital, it might have have more support groups than smaller hospitals.

If by chance you're Jewish, definitely contact the JWF; I've found that they extend assistance and courtesies that also reflect a compassion not always seen elsewhere, such as in the AAA.

I can't offer any insights on narcissistic personalities; when I've had contact with those kinds of people, it's not been on the family level, more like co-workers. Some years ago I read a book by Sona Friedman, "Smart Cookies Don't Crumble". Despite the catchy title, it offered a lot of insight into dealing with people of widely varying personality types. Something like that might help.

Has your mother actually been diagnosed with NPD, or is this your observation? If the former, was she treated? If not for her, a consult for you with a med pro in this field, such as a psychiatrist or psychologist specializing in it, might be helpful to identify coping methods.

But generally, I stood my ground and just felt glad I wasn't burdened with more issues than I already had. That's not much help, but all I can think of now. I know others have more experience with this personality disorder and will likely offer better insights.
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It may well do so.
Do you live with your Mom in her home, or does she live with you in yours?
If not, see to it that doesn't happen.
At some point Mom may need placement. Your support may not be enough anymore. I am sorry for all you are going through. You have unpleasant choices coming.
I think honestly I would also advise that if you are not now POA do not take on that difficult task. It is onerous when doing it for someone bright, cooperative and relatively well. It is impossible for someone difficult.
I wish you the best. I would limit contact if you are able.
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