91 year old narcissistic mother, assisted living, wheel chair bound, severe COPD, some dementia is becoming increasingly angry. Need help.

Your mom will eventually progress to the next level of care. Right? That’s the plan? When that happens the ALF or your mom’s doctors will let you know. Your mom’s health issues will progress.
I suspect the staff has dealt with many before of similar temperament.
She is probably saving her anger and resentment for you if she is like most in her condition.
The best course of action for you is to remember that you are doing the best you can, treat the staff as your partners in this journey and try to have empathy for your mom even though it’s doubtful she has any for you. You are her hero but she is 91, wheelchair bound, has COPD, Dementia, Angry and most likely scared. Probably a little unrealistic to expect her to be a ray of sunshine.
Whatever happens you will deal with it. You have and you will. Let the ALF help and do get her tested for a UTI just in case.

Is this an ongoing thing? Or has it come on suddenly? I ask because we always suggest a urine test for infection when the elders start acting like this.

Go to the Director of Nursing or even the Administration and share your concerns. If Mom is combative, she can strike out at a staff member or another resident and then you have big problems. My mom did both and clawed me once as well. I’m sure the staff is familiar with elders who are verbally less than happy with their situation but if Mom becomes truly physically combative that’s a different problem. Soon after her last physical outburst against her roommate , my mom was placed in Memory Care. Your fears need to be addressed. Mom needs to be re-evaluated.

Thank you 97yroldmom - your reassurance helps. She has been NPD for most of her adult life. Your words about the staff are especially helpful. Excellent staff with years of experience and little turn over. They are very much my best all allies and hers. LOL, no she is not ever going to be a ray of sunshine.

Ahmijoy - UA often. No sign of UTI or other suspicious findings. I have an appointment with the facility director tomorrow. I think the only person she would be combative with, at this point, is ME. I need to remind myself that the staff is wonderful and caring, and there to support me as we take care of her. Thanks for your words.

You’re welcome, Caregiver91. You are me a few years ago. When I visited Mom, I got all the $h*+ she’d been saving up since the last visit. I swallowed it all and remembered this was the mom who made doll clothes for all my dolls one Christmas when my dad was laid off and we had no money. It helped.