I have a 76-year-old mother who has Alzheimer's in combination with narcissistic personality disorder. While her NPD is undiagnosed, looking back at her younger years, she fits the characteristics to a tee. The Alzhiemer's with NPD is so hard and difficult to endure. She was brutal when I was a kid, but it's like 100 fold now.

My mother thinks that she has no dementia problem. She has no problem whatsoever and it's everybody else's fault. My father is currently taking care of her, but he is almost 77 and is getting so physically drained and exhausted. My dad just had surgery to put stints in and within 5 minutes of him coming out of surgery and in the recovery room, she starts laying into him throwing a temper tantrum. The temper tantrums are daily occurences. He is constantly accused of philandering. She gets physically aggressive when he's driving and has had to pull over so as not to get into an accident. She makes up stories that she's being abused by my dad. She constantly complains that she is disrespectd by everyone despite the fact the fact that she's a good person and has done nothing but good things for other people and this is the thanks she gets. We are constantly being accused of talking bad about her. She finds no pleasure from even seeing her grandkids. She has become so emotionally detached because everything is so focused on her. She has her moments when she can be tame, but the negative, bratty, beast side is far more prevalent than the tame kitten. Her list of antics goes on and on. It's exhausting.

We have been contemplating putting her into an assisted living center (ALC) for the elderly and memory impaired. We've also contemplated getting a caregiver. We know that she will fight either one of these as she does not think she has dementia. My dad and I are just mentally exhausted. It's my spiritual faith that hasn't broken me from this dreaded disease, because we are both human punching bags and it's no fun.

Has anyone had to deal with an Alz + NPD parent that absolutely refuses to go to an ALC? If so, how did they deal with it and how were able to get them to one (if you were successful)? Any advice is greatly appreciated.

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My FIL, may he rest in peace, no longer has to endure my MIL. So while I'm grateful for that, in a way, we don't want the same happening to your father.

Can you involve APS on the grounds that your mother's dementia is causing her to be increasingly abusive to your father? Your mother will never agree to investigations, never agree to see a psychiatrist, never accept even the possibility that there is anything "wrong" with her - how could there be? Has she ever in her life been or done "wrong"?

So, ruthless though this sounds - and I am sadly concluding I will never persuade my MIL's family to think about it so I don't expect you to jump for joy at the prospect - you need someone with the authority to take the situation out of her hands and deny her the choice.

If the we part of "we have been considering" does include your father, and if he has already accepted that something has to change, comfort him that your mother will benefit from a safer, more structured environment just as much as he will benefit from no longer having to be responsible for her welfare.

From your point of view, there will be a crisis and there will be a change. It's a matter of doing your best to make sure that the crisis isn't injury or worse to your father.
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Has your mother been seen by a geriatric psychiatrist? Meds might help the aggression and agitation.

She exhibiting dangerous behavior. Being physical with the driver? Screaming at your father as he's coming out of surgery? You're not going to have dad for long, at this rate.

She doesn't acknowledge a problem; why do you think she would agree to move? Perhaps you should remove Dad from the equation. Without him there as her caregiver, you can report her as a vulnerable adult to APS, and they may step in and force her placement.
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