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That depends on what she is saying or doing to hurt you. If she is being mean and spiteful I don't see any reason to allow her to get away with it just because she has dementia. If she has dementia you can't argue with her or convince her what she believes is wrong, but you don't have to be a doormat either. "Mom, it really hurts my feelings when you say/do that, I'm going to go now and come back when you are in a better mood". Then go.
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Is it possible that what is happening is that your mom is agitated? Talk to her doctor, she may need meds to calm her. Or, if you have access to a geriatric psychiatrist, they can sometimes do wonders with meds.

The thing to rem0? Your mom's brain is broken. She is no longer reasoning in the same reality that you and I are.
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Oh, never let on good grief, if they know it hurts you it gets worse. freqflyer is on the right track, toss the comment back. "Yes, and when I am gone you will be so much better off" Clutch your chest and wince for added effect.
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Good advice here, from experienced caregivers.

1) Confrontation in the sense of trying to convince Mom she is wrong or shouldn't say those things is useless, and may only make matters worse.
2) Confrontation in the sense of acknowledging your own feelings and temporarily leaving the scene can help protect you and is worthwhile. Don't expect it to "teach" your mom anything. She has a broken brain.
3) If this behavior is unusual for Mom (she hasn't always been like this) and she seems anxious or agitated, some medication can be really helpful.

Hugs to you. It is extremely hard to make the sacrifices we do as caregivers, and then to be insulted on top of it is outrageous! My mantra was "This isn't my loved one talking, it is the disease." Repeat as needed!
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BTW, all of our advice is based on the fact your mom has dementia. Tough Love might be appropriate in other circumstances, but not when dementia is involved.
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I see from your profile that your Mom has Alzheimer's/Dementia.... thus my answer would be "no" you do not confront her. Please note your Mom's words are from the fact that her brain isn't working correctly, and confront her won't make sense to her.

If your Mom is saying things like "you are so mean", just reply back "Yes, Mom, I know I am mean". That would make you feel better. It's called therapeutic fibbing.
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