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My mother is 86 years old and is showing early signs of dementia, she is adamant about not living in a nursing home and also not leaving her house, however, I have finally convinced her to come live with me I would like some advice on how to deal with the personality of a narcissistic mother that also has dementia issues. I do not want it to cause issues with my married life. My husband so far has been very supportive but I would like to get some advice on the front end on how to handle my new caregiver role. I am the only daughter, I have two brothers, one who is mentally disabled and the other who just doesn't care about my mother or her well-being so it's all in my hands.

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So, Thar, let's talk practicalities here.

1. Getting your mom assessed for dementia (if she is still pretty functional) requires neuropsych testing. 3 hours or so of paper and pencil testing, ordered by a neurologist. Will your mom agree to that?

2. End game--what happens when mom CAN'T be cared for at home any longer, or needs 24/7 aides in your home that she cannot afford, or you and/or your husband become ill, injured or disabled and can no longer provide care?

How will you get her out if she refuses to go?

3. How will you deal with her refusal to see a doctor? Bathe? Not wander around the house or exit the house during the night?

4. How will respite be arranged? If you want a vacation, need surgery or just need a break, what is the plan for that, especially as her skills decline?

5. How will you deal with inconvenience? What if she refuses to wear Depends and thinks it's fine to poop and pee all over your home?

Thar, these are not made-up scenarios. These are the questions that we field here everyday. From nice folks like you.
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Delusional behavior?

Has she been tested for a urinary tract infection? These often cause psychiatric symptoms in elders.

Aside from that, I think you run a HUGE risk taking someone who is delusional, demented and narcissistic into your home.

These folks have a tendency to throw their loved one's under the bus, acuse them of physical and financial abuse and damaging the caregiver's reputation with friends and family.
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tharrison8467 Jun 2022
Yes she just recently was treated for a UTI. And has not had any delusion episode since, and I talk with on her the phone at least twice a day.
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PLEASE, PLEASE read the posts tagged with “Burnout” on this site.

2 years ago, your story could have been mine.

By week six of my mother living with us, I was bedridden from the stress.

The decision that was made then began problems in our marriage that we haven’t overcome even two years later.

Please, take the advice of the posters who have chimes in here.
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Taking a deep breath before I wade into this one. My first instinct is to scream do not do this. But I get the distinct impression that you've already made up your mind. So rather than tell you not to do this - which I really....really want to do, trust me...I'll offer advice as to your question. And I apologize in advance because this is coming from personal experience and I'm going to be very straightforward.
1. BOUNDARIES. You are going to have to set them and reinforce them and you are going to have to do it every day. Maybe even more often that that. If she is a true narcissist. She will bulldoze right through every single boundary you set constantly. You and your husband need to agree on what you will and won't do and stick to it. If she needs more care than you can give, you need to hire additional help with HER money. Period. If she chooses not to help herself, you cannot do it for her. You cannot fall into the trap of doing it for her. If you give a narcissist an inch - they will take a galaxy.
2. Protect your marriage. She will take every moment you have. Do not let her do this. Plan time for yourself, and plan time for your marriage. Hire companions or caregivers but get away. Do not let her make you feel guilty for doing this.
3. Do not expect your abled brother to participate. He has made his intentions clear already - he will not assist - later on it is not fair to expect him to help you when he told you upfront he would not.
4. Whatever relationship you have with her will not be improved by moving her in.
5. Dementia/ALZ very rarely improves Narcissism. Only very rarely do you hear about a person with narcissistic tendencies reversing and becoming a sweet, loving elderly person. The typical outcome for a true narcissist is that their circle shrinks and they take it out on the people nearest to them. And it gets worse. You are moving her away from everything and everyone she knows (her narcissistic supply)
6. True narcissists lie. Develop a very thick skin right now - before you move her in. Because if you are expecting her to be grateful that you have done this for her, you need to be prepared. Unless she's just really not a true narcissist, you need to be prepared for what she is going to tell other people about you and your husband and how much you are willing to listen to. She will tell them you are stealing from her, that you are abusing her, that you don't take her to the doctor, that you don't feed her, that you don't love her, that you don't do anything for her. She will say all sorts of nasty things about you. She will not have anything nice to say about you. She will spin every story in her favor. And she will gaslight you to make you think you are the one doing something wrong.
7. True narcissists don't like having any faults pointed out, so if you are trying to help her be prepared - you will be the one doing it wrong, if she needs to be more mobile, if she should be more physically active, take her medication, needs to take a shower, if she forgot to pay a bill, forgot to eat...whatever the issue is....it will be your fault. And as the dementia progresses....there is literally no reasoning with her....you cannot reason with a narcissist to begin with - but you literally can't reason with a person with dementia - they don't have capacity.

I'm so sorry if this is brutal. Handling your new caregiver role - my thoughts are - hire help, don't try to do it all yourself. Get her involved in outside opportunities - maybe adult daycare. Don't let her slow down and just sit at home all the time. Don't be her only person. Keep yourself involved in whatever you enjoy.

My gut says do not do this. Taking on a caregiver role under the best of circumstances is daunting but taking on the caregiver role for a narcissist is just unimaginable. And very hard on a marriage. And I'm only doing it from the outside. My BIL and SIL live with my FIL.
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BlueEyedGirl94 Jun 2022
My DH and I live an hour away and do as much as humanly possible to offer respite and help however we can. But it is taking 4 of us to juggle my FIL's needs. And it is stressful. All of the time. And it has caused health issues for my SIL, BIL and my DH. And every single time I interact with my FIL I leave with a migraine.

I just want you to be fully prepared for what you are walking into and go into it with your eyes wide open.

What you want to do is very kind. I just hope you are being realistic.
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You say you are taking a narcissistic and possibly nearing-dementia Mom into your home. How can you imagine this will not have severe repercussions on your marriage, on your home, on yourself?
I would recommend against this. It is very crucial in life to know and recognize our own limitations. The failure to do so can literally RUIN our lives.
I was an RN all my life, worked with many elders and loved it, but it was always clear to me that this was not something I could do 24/7 for anyone.
If you do intend to do this I think it is important to first discuss with Mom and with husband together what the expectations are for privacy time, for living, for duties, for rental, for help with utilities. A visit should then be made to elder law attorney to draw up your POA. You will be doing finances eventually and will need this; know if you are capable, as it's a big job and it has needs for meticulous record keeping, and a whole lot of time spent on the phone with about every utility and entity you can imagine.
Know also that once taken into your home your Mom is under the law a TENANT with full right, whether she pays rent or not. This happens the day she receives mail at that address.
Be clear that if this DOES NOT WORK FOR ANY OF THE THREE OF YOU, then it is not working. Reassess together every six month.
I would say even if ALL THE ABOVE is done, this is a mistake. It is not good decision making.
I must tell you that NONE OF US want to leave our homes (I am 80) but the fact is that in life not everything can be fixed and there comes a time there is no other choice.
I would think about this carefully. After that, the choice is all yours.
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You seem to be posing a false choice to your mother, and to yourself.

Nursing Home or live with us.

Please, dear Lady, before you take your mother into your home, look up Assisted Living, Memory Care and Ccrc (continuing care retirement communities) in your area. Tour them. Pick 2 you like and take mom to see them. Let her make a choice.

Having a narcissistic parent with dementia living with will be the end of you, your health, your sanity and your marriage.
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Cover999 Jun 2022
The places you mentioned may not put up with her either.
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Oh holy heaven, I hope it isn't too late to change your mind.

There's a line in a tv series you won't know - a private soldier asks his captain what to do if he should accidentally step on a mine. The captain answers: "well, the usual procedure is to leap two hundred feet into the air and spread yourself over a wide area."

So: how should you deal with the personality of a narcissistic mother that also has dementia issues? Simple. Bring her into your home and blow up your entire life.

Please listen. You Do Have A Choice. This is NOT in your hands, because you cannot control your mother's personality or behaviour or the impact it may have on you, your husband, your marriage. You cannot accept responsibility for a situation which you do not have the power to control.

Your mother wishes to remain in her home. Fine. You are concerned about her safety and wellbeing if she does stay there alone. Also, fine. It Does Not Follow that you must therefore sacrifice your life to give her an acceptable alternative. You are not responsible for your mother's failure to plan for her future, and it does not fall to you to compensate for it.

There are many things you can do to support her wellbeing without bringing her into your household. You can find out about services from the Area Agency on Aging. If concerns become urgent or serious, you can contact APS. She may change her mind about living alone, so find out about facilities near her in advance so that you can get things moving fast if she ever does.

But to cajole her into doing something she is reluctant to do and move her in with you will be the biggest mistake of your adult life. Don't do it.
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If there's any way you can back out do it. I could have written your post. Now, my marriage is in shambles, I have PTSD from the toxicity of my home environment with my mother, and on top of all of that, I have to figure out how to move her out before I completely lose my mind.
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I know this is probably not what you want to hear, but since she is not yet living with you, I would strongly suggest you reconsider your decision. It may seem like you can’t and that things are decided, however, nothing is done yet and you still have options.

If she is already refusing AL living, once she moves in, I cannot stress how hard it will be on your marriage, your lifestyle and your physical and mental health. If you are anticipating this as a trial and moving her into care “later” if need be, understand that many people on these boards had the same plan. It is unbelievably hard to move an elder out of your home once they are in. You say you are doing this with a narcissist you haven’t lived near for 40 years. It is incredibly hard to have someone who is compromised in your home even when they are compliant, kind and loving, much less someone with a difficult personality.

Moving her in with you may seem like the only option in light of her refusal to go elsewhere. This type of all or nothing thinking (she needs help, she won’t go to AL, moving her in, therefore, is the only choice), often ends with good people who are trying to do right by a loved one trapped in a place they can’t get out of.

I say this with kindness and coming from many years of experience. It is very hard for someone who hasn’t cared for parents in their home to see all of the issues you will be facing for possibly years to come.

You may be worried about her reaction if you change the plan. She may be mad. But, that is likely to be nothing compared to what this situation is likely to do to you and you DH. And frankly, she is going to be mad no matter what.

That is all I’ll say for now. If you decide this is what you really want to do, I certainly wish you all of the best. But, if you do want to revise your plan before the weekend, I and others here can suggest options and language. It won’t be easy and some of the options will seem crappy. Unfortunately, caregiving is often making the best choice out of a bunch of bad choices.

Just really read through the posts on these boards and then sit down with DH and talk about all of the eventualities you read about, especially in light of her personality.

Best wishes to you.
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It' not an easy task. Alzheimer's is an incurable, progressive disease that gradually destroys the neurons and its connections in the brain. The brain, being like a marvelous computer, begins to send distorted messages and it fails to interpret correctly communications from the outside. This means that the patient becomes confused, forgetful and disoriented. Their logic, common sense and intelligence will go down hill. They frequently suffer from anxiety, depression, insomnia and even panic attacks ( sundowning). The deterioration is progressive and nothing will slow it down or stop it. They live an average of 8 years. Some times less, sometimes more. Currently there is no treatment. Some doctors might prescribe medicines to "slow down" the deterioration. However, in practice, those medicines don't seem to help. The progression is unstoppable. By knowing what is ahead, you can prepare in time for what will be needed along the way. Patient's forgetfulness and stubbornness may be irritating, but there is nothing you can do about it. She will resemble a child growing backwards. Physical deterioration including sphincter incontinence will also occur in her late stages and it will require round the clock nursing care. You may or may not continue to care for her when she reaches that point. Good luck in your endeavor. Don't forget to prepare ahead for what will be coming.
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Just want to add, she's not yet been diagnosed with dementia but is definitely showing the signs, mainly delusional episodes
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againx100 Jun 2022
Since the wheels are already in motion, try to take some deep breaths and calm down the anxiety. It's going to be a huge change for you all! I would suggest having your mom do as much for herself as possible. You want her to be as independent as possible. Keep her physically active and if she has mobility issues, get her into PT.

Have her be responsible for some chores. Even just folding the laundry. Getting the mail. Emptying the dishwasher, etc. Keep her busy and useful.

Is her house in the same area so she will keep the same doctors etc?

What is the setup in your house? Is her room next to or near yours? My mom's room is in the other end of the house so we have some privacy. Is your husband on board or reluctant? Your marriage comes first. Set reasonable boundaries, get assistance and don't overdo it to try to prevent burnout.
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How is your relationship with her? I think dealing with a narcissist is challenging to say the least! My mom, without being narcissistic, and with early dementia is a handful. You're going to have to set some firm boundaries, depending on her level of dementia. My mom's short term memory is horrible so I can't expect her to remember anything I tell her and she can't learn to do new things, etc.

You already know your brothers won't be helping you so that's better to know than hope they will help and then be disappointed.

I suggest you do what I did. Hire a cleaning lady, with mom's money. Make sure she pays her way on everything.

Do you have POA? If not, that must be done. If she has a dementia diagnosis, that will be tricky. Will, etc.? I made sure my mom's paperwork was in order before she moved in, which was well before dementia struck.

Depending on where your mom's abilities are, hire in help sooner rather than later, whether she likes it or not. It is for YOU so that you do not burn out.

Do not ever promise that she will not go in a nursing home. No one wants to live in one. But depending on how the dementia goes, it is likely she will need to be in a facility at some point. Many issues can just become too much to deal with sanely at home.

Best of luck. Post questions here as often as needed.
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tharrison8467 Jun 2022
Thank you for your input, my relationship with my mom is pretty good right now, mainly because we have lived in a different states the past 40 years, however, we have had a strained relationship off and on in the past due to her narcissist personality, my husband and I will pick her up this weekend and I have made an appointment with an elderly law attorney to get advice on what to do with her home since it is paid for in full and also I plan on getting a POA, I am very anxious and concerned about the decision I have made to be her caregiver and hope that I don't regret it, she has not yet been diagnosed with dementia but she is definitely showing signs, mainly she has episodes a delusional behavior
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