My whole life, I knew there was something "off" about my mom, and often felt like a fly that would continuously fly into her web, get emotionally beat up, and subsequently spit back out...only to fly back into that web again. Over dinner with a friend, I found out that Narcissism is an actual psychiatric disorder! To make a long story short, at 50, I discovered my lifelong struggle with my mom had a name...just in time for it to be enormously magnified in conjunction with having to move her into a nursing facility (she had recently been diagnosed with Parkinson's, with mobility issues that caused her to fall frequently). Over the past year, her behavior has become progressively worse...ringing the call button constantly to use the bathroom and then calling the front desk when an aide fails to appear within 30 seconds; stating she is aspirating and/or choking (she has been through extensive swallow evaluations and her diet is appropriate); faking choking and passing out/dying; and most recently deliberately 'falling' out of her wheelchair in front of the nurse and acting 'dead'. She is rude to the aides and can be very oppositional and demeaning. A psychiatrist evaluated her and her doctor prescribed anti psychotic drugs, which did not appear to work. I need to know at what point I look into having her placed in a psychiatric facility for evaluation and medicating. I feel so horrible and guilty at the thought of doing this, but she is driving everyone nuts. It is wearing on me terribly and I feel she has burnt her bridges with everyone and I have no unbiased person with whom to consult.

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I think she should stay where she is to be treated
. Change is not always the best option for someone with dementia.Talk to the people who should be able to help you,--the social worker and her doctor. I can understand how upset and frustrated you must be. Sadly, sometimes there's only so much that can be done. I hope you go out and do things good for your own health. Prayers for you and your mom.
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Thank you all for your responses! They are all really helpful.
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flyweb, I agree with what Babalou and Jeanne wrote. I would trust the counsel of the people working with her -- the staff of the nursing facility and her medical team. I know that it embarrasses you that your mother should act out like this, but the staff knows that it isn't your fault.

Something I read about narcissistic personality disorder just recently is that the new diagnostic classification manuals won't include it. The trouble apparently is there is a continuum in the disorder and many crossing overs with other disorders. Even though psychiatrists are now turning away from diagnosing it, people who deal with it know how difficult it is. And that it usually becomes more difficult as a parent ages. Often the best thing we can do is walk away. We can only do our best if we stand at a distance. It's too easy to get stuck in that web again if we don't.

I wondered the same thing that Jeanne did about the possibility that your mother had dementia that often goes with Parkinson's. Maybe you can talk to the doctors about the possibility and see if there is someway to curb the effects of it. Lewy body dementia responds fairly well to some medications. It will be more complicated, since the potential disease is overlaid on a difficult personality. But maybe they can find something to calm her.

I have a feeling that you've done all you can and that your mother is lucky to have such a good daughter. It sounds like you are better than she earned -- but let me not talk about your mother.
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Disconnect from her when she is manipulative. Get up grab your coat and go. Limit your visit to once a week AND bring someone with you. We found mom did not act up when sis took someone with her, oh no she would put on her happy face for others.
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I agree with Babalou. The NH will tell you when she is beyond their abilities.

Sometimes patients benefit from a brief stay in a psychiatric facility to evaluate and adjust their meds. If a psychiatrist suggests that, I would go for it. The goal would be to get her stabilized on helpful meds and return her to the nursing home.

Everything feasible is being done for your Mom.

You are the one I am concerned for. Your mother is mentally ill. Perhaps she has undiagnosed narcissism. She has Parkinson's. Perhaps she has the dementia that often accompanies Parkinson's. She is ill. This is Not You Fault. You did not cause her to be ill. Nothing you are doing is making it better or worse. You are doing your best to see that she gets the best care available. Her need for care is -- repeat after me -- Not Your Fault.

For you to feel guilty for anguishing over what to do next for her care is just plain wrong. But I understand that is how you were raised (by a mentally ill person) to feel. You don't deserve it! Now that you understand that your mother has an illness and it has a name and it Not Your Fault, you need to begin healing the damage that has been done to you.

Other here deal with or dealt with narcissistic parents. (I am grateful that I only know about by reading.) They'll be along and suggest some books for you to read, and share some coping mechanisms that worked for them.

I also suggest seeing a therapist to help you learn to cope with your mother's illnesses. You deserve to pursue your own happiness.

But my main message to you is This is Not Your Fault.
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So she's in a nursing facility toght now. Are they asking her to leave? If not, don't move her.

If there is a geriatric psychiatrist there who is treating her, give him/her a chance to get to know her, try some different meds. I'm sure the NH has seen yhis kind of behavior before. If they can't meet her needs, they'll tell you. And being the staff lots of baked goods; it helps.
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