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Six months ago Mom was diagnosed with early-to-mid-stage Alzheimer's dementia. Before the official diagnosis, her decline in cognition had been apparent to her family for at least 6-7 years. To conceal her memory loss, Mom isolated herself from friends over the years and amazingly still manages to fool them into thinking she is "alright." I should mention that even before the diagnosis Mom has always been negative, self-absorbed, grandiose, blaming everyone but herself for her self-inflicted woes. Mom takes no responsibility for her emotions. It's always someone else (myself, my sister, or my father, etc) answerable for her misery and dissatisfaction, and the dementia only worsens her negativity. When my father passed away last year, my sister and I (against our better instincts) offered to have Mom move in with one or the other of us, which she refused. So, upon her MD's recommendation, my sister and I placed Mom in memory care. After 6 months, Mom has yet to settle in. She insists she doesn't belong there and scorns the scheduled activities. My sister and I call Mom regularly and take her out (often multiple times a week) for lunch dates, shopping excursions, church; anything we think she might enjoy, not to mention getting her to her doctor and dental appointments. In the meantime, as her POA I manage Mom's property, bills, and finances, making sure her needs (and many of her wants) are met. Mom is seldom thankful for any of our efforts. She complains about my sister and I to anyone who will listen, saying we "take advantage of her," "have no compassion," etc. I think she's looking for sympathy and strangely enough, often gets it from people who don't know any better. Here's my take on all of this: Mom's dementia is exacerbated by her narcissism. I have ceased trying to attribute her conduct to one or the other or both. What difference does it make, anyway? My sister and I still have to deal with the character assassination, the utter lack of gratitude, and constant complaints and demands. Thank God Mom didn't move in with us. In light of years of emotional abuse at her hand, I'm amazed I ever made the offer to begin with. So today, here's my question to any and all who have dealt with similar situation: Mom constantly demands to be removed from her current memory care to assisted living. My sister and I have explored other options but none (other than memory care) meet Mom's genuine needs for supervision and safety. How do we best respond to Mom's demands? Reasoning is useless; her lack of cognition prevents understanding, and at this point in her cognition, she's impossible to redirect. Mom seldom remembers much from day to day about our conversations on this topic; at most, all she remembers is her own feelings of outrage at our "failure" to cave in to her demands. I am exhausted with all of it. Please help!

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Rainmom's suggestion for a geriatric psychiatric evaluation is right on target. These professionals can work wonders with persons with such traits.
My SO is an 85-year-old aging narcissist. He acts in ways similar to your mother.
I suggest finding more about narcissists (unfortuately no one has written a book about aging narcissists). I left for the following reasons:
1. I never could please him, no matter what I did.
2. He made me feel bad about myself.
3. He would only compliment me on my cooking, even though I own a dementia care business and recently saved him $30K by showing him that his low-interest mortgage had exorbitant fees, which he did not recognize.
I suggest that you sign up for Quora.com, an online resource that focuses on personality issues. You will find a ton of info. on narcissists.
I found this book helpful to better understand narcissistic behavior,"The Object of My Affection is in My Reflection, Coping with Narcissists." by Rokelle Lerner. Published by Health Communications, Inc. www.hicibooks.com. I purchased mine on Amazon.
If it is within your means, I suggest that you consider discussing your mom with a qualified therapist. If you look for one, I suggest you ask them about their experience in treating persons who have/had a narcissist in their life. If the therapist does not have such experience, keep looking for one who does.
Also, beware that some people will suggest that you should be understanding because your mother is now old. This is a fallacy and a trap that will prevent you from understanding her behavior.
My heart goes out to you and I hope that you and your family can distance yourself from your mother's behavior--remember there is no pleasing her, no matter what you do.
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My mother was very much like yours, Amber. Getting mom into see a geriatric psychiatrist was the single best decision I made regarding moms care and my sanity. The psychiatrist did a complete medication overhaul- stopping some, starting others and in about a month mom was a new woman - and in no way a medicated zombie, I might add. My only regret is that I did not know of this resource much earlier in the journey.
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People with Dementia don't appreciate what is done for them.
They can't reason anymore. You have Mom in a good place. If she chooses to not participate that is her problem. I think u go over and above.
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To all responses to Strategies/Mom's Demands, thank you! I am truly at my wit's end and starting to doubt the wisdom of my commitment. No matter how pure my intent, no matter how many outings, sacrifices or fulfilling her wants, no matter how much compassion I extend to Mom make any difference whatsoever. She is what she is: a demented narcissist, the most miserable wretch on the planet. At the age of 8 or 9, I was chosen to be her emotional caretaker, which was a horrible thing to do to a child. And here I am, decades later, still Mom's practical caregiver. (I refuse to do the emotional part). My first plan of action is to get a referral for geriatric psychiatry. I'll also look up Teepa Snow on You Tube, find the suggested book and Quora.com. So glad I have found this helpful exchange of ideas. Hope something I say at some point will help some other caregiver. Thank you so much!
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I am very grateful that I have never had to deal with a narcissist. I'm glad that others who have are responding.

I also encourage an evaluation by a geriatric psychiatrist. From what I've read, no drugs are effective for narcissism, and counseling doesn't work because they believe so strongly that nothing is wrong with them. But if there are other kinds of impairments along with the big N, it would be good to treat those, at least.

My suggestions (but without experience to back them up):
1) Detach somewhat. Visit less often. Drop down to one excursion a week. This is for your sanity, not hers.
2) Do not sit through uncomfortable episodes. Don't get mad. Don't get defensive. She can't help it. But don't stay and let her assassinate your character. "Mom, I can tell you are not having a good day. I'll come back on Wednesday and maybe things will be better." And LEAVE. Again, this is for your sanity. Don't expect it will teach her something. Her brain is broken now even more than it used to be.
3) Use a line like pamzimmrrt suggests. "Yes. I know what you would like. Sis and I are trying to locate a place that has an opening." Repeat every time she repeats the question.
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It does sound stressful, but, what I might do is try to give yourself a break. You may be overloaded. . Limit your visits for awhile, if you sense that it's too much to handle right now. It sounds like you have backup and she's being well cared for. You may just be fatigued. I'd also explore if there is any other ways to distract mother.

Have you checked with the Memory Care unit to see what their schedule is. Do they have activities that are at her level and that engages her. Does she have a problem with a roommate or other resident who is bothering her? Is he in pain? Pain can cause people to act in odd ways.

I'd also talk to her doctor about her mood. Is she anxious, depressed, agitated, etc? Medication provided my LO, who is in MC, with a lot of contentment. She once was very worried, upset, but, the daily medication brought her relief. Perhaps, a Geriatric psychiatrist can evaluate her and help.

After exhausting all remedies, you may still have a person who is not content. And that may be her attitude until she progresses to another level. That's not uncommon. I hope you can take a break, recharge your batteries and/or find a remedy that works.

Also, my theory is to say whatever works.  If nothing you say works with her, then, I might just say nothing.  Just start talking about something else completely.  There are some videos on You Tube by Teepa Snow about managing challenging behavior in people who have dementia. I find those helpful. 
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Amen to the geripsych suggestion. For many of us here, it has been the only affection way of managing our parent's emotional issues.

No amount of reassurance, outings or phone calls helped mom's anxiety. Meds did.
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The advice given so far is spot on! You two are doing more than needed trying to please someone who can't be pleased. Then she makes you the target of all her displeasure. I've been through some of what your saying. When you realize you "are only responsible to her (such as her finances, buying supplies) but not responsible FOR her (such as her misery, wanting to move, not participating) then it takes a burden off you. Yes, of course we want them to be settled in and content but it's not our burden to make happen. You my dear need to take care of you...the only one you can control. My suggestion that helped me when I was in a position like you are, is to find a therapist to talk to. I could release all these emotions I had in a safe place to someone who was objective and caring. What a help that was!! Don't think you can handle it alone...you don't have to. Even a few sessions were helpful. I agree that getting her on meds will be helpful. It helped my dad.. set your boundaries. Leave her when she gets ugly to you. You do have a choice. Blessing be yours!!
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You are never gonna make your mother happy no matter what you do for her. Take a step back and take care of you. She is in a place where she is clean, safe, and fed and she has the power to be happy or not. Visit her only once a week for lunch. Let the facility take her to her doctor's appointments. Start taking care of you.
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after reading a few lines, i paused to see if one of my sisters was the author of this question. upon reading further, it crossed my mind "did I write this?!" [in a dementia-like deja-vu!]
Amber A - i am at a loss to add to your description, so thorough [and well written] - several EXACT DETAILS. ["...Reasoning is useless; her lack of cognition prevents understanding, ... impossible to redirect...."] many many times, i've come upon similar writings, but never to this degree. i have said to my sisters, friends and the staff of the IL facility [where she has been for 3 years, and is "just existing, not living!"] that her blame and accusations of stealing are only partly attributed to dementia; she has never taken responsibility for mishaps of any size; it was always denied and/or the blame put on someone else. ["...dementia is exacerbated by her narcissism..."]
oh! and how she can present herself as normal to others, quite an accomplished actor. when one of my sisters visited recently [tho she actually works in a similar facility and is knowledgeable of the disease] she saw first-hand what i have to deal with [i am the lucky sister who lives nearby]
i have visited less and less, eliminating taking her on outings.
as i was about to close, one other topic comes to mind - frequent calls [up to 10 per DAY, for a period, lessened lately] always the same thing "where is my furniture...my clothes...dad n i left the house with nothing but the clothes on our back" and "how much money did we get for the house...how much is rent here...how much money is in the acct...why don't i have a checking acct, a bank card..." these are the SAME repeated questions for about 2 of the 3 years she's been at the facility. i point out to family and staff - why isn't she calling her other daughters, grandson, her sisters, attending the myriad activities available, taking part in her meds-extended life..?.... no, instead: possessions, money...
for the time being, we are in holding pattern, awaiting the disease's slow but certain decline to determine when to move her to nh or mc.

{another observation - or unsure prediction: as she never worked.. [my much-loved 'can-do' renaissance-man dad was her slave, so glad he doesn't have to listen to her anymore] ..she is not experienced in problem solving, and seeks no creative solutions to everyday life [in a uniquely fine facility!] we can only hope that by having careers ourselves, we have some stored 'deal with it' neurons to help keep dementia at bay if/when it hits us...so as to not tax our own sons/daughters with this exhausting relationship}
btw - she just called me [chuckling]" the funniest things just happened..........[sparing you the details here]............the cleaning lady had to take it, it can't just walk off..." i replied i'll have a look... "no! it's not misplaced. someone HAD to take it!" hung up [not chuckling]

well, i ought read others' more helpful comments now, i trust they'll be valuable as they often are..thank you :)
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