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She's 87 years old with demenita. She moved in with us in 2013 after knee surgery for 10 months, went home for 2014 and came back in Jan 2015. Prim dr started treating her for depression with Zoloft and added Wellbutrin a few months later. My husband convinced her it was time to move in with us and sell her house. She looked forward to it and we were not having any problems in general other than memory. We moved into our new home in 2015 and furnished it with a good bit of her furniture. She started hallucinating and had paranoia immediately afterward. I knew moving would be stressful but had no idea it would be this crazy. Primary sent us to a neuropsychologist who sent us to neurologist for mri. She did the 1.5 hour cognitive testing and was diagnosed with dementia in June and put on Aricept and a few months later Namenda. We saw much improvement, organized thinking and conversations for a few months. She stays in her room so much and avoids my husband and I. She watches Fox news continually (maybe because of the repeating info so she can retain it?) but lays in bed with her back to the tv and says she is not sleeping but when I go in she startles awake. She lies to us regularly about what she does but the evidence isn't there so we know the truth. This last visit with the neurologist's PA she was put on Lamictal for her mood. Lately she is really acting selfishly and not hiding her displeasure with us by flinging barbs & making nasty comparisons of me w/ people she detests and despises. Nothing has really changed on our end other than I try to walk away and not defend myself nor engage her in potentially sensitive topics. She is not supposed to let our little dog outside but did so while we were getting ready for church. The dog got out of the fence but was unhurt. My husband lost his temper with her. She kept our previous dog in 2014 while we went out of town and he died on her watch because she says she forgot him outside in the heat. She seems to enjoy the dogs and knew she should not let the current dog out. Perhaps she forgot? Either way, she did show some remorse for the dogs but doesn't for people. After work this past Wed, my husband got home and she was dressed and ready for him to take her to the store because she had a list. She has never asked him to do this before. He was not feeling well and told her so and that he could not take her. I got home and told her we could go after her event at the baptist church the next day, which we did. She evidently is holding a grudge because when I asked him to get her walker that night because we where going out. She dramatically said "oh, don't bother him" very sarcastically. She mocks me with her head if I am answering her questions, as I am expressive with my body as I converse or give info she is asking about. It angers me to be devalued. I know NPD cannot be treated with meds and I suspect her filters are being removed because of the dementia. She is in the stages 4-6 range of dementia as she has urinary incontinence, has trouble speaking and recalling words, walking is impaired at times but she can recount detailed stories from my childhood and still remembers family. Two weeks ago she forgot how to make coffee in her coffee pot temporarily and but has made it correctly since. She also sees people at times that aren't there and talks nonsense occasionally. It would be uncomfortable to tell the neuropsyche dr that I suspect narcissism in front of her since she is aware of more now on meds. Should I even bother telling the doc or let them figure it out on their own. Thanks to all of you on this website I have finally recognized what has gone on in my family as an only adopted child raised by a narcissistic, image driven mother. Thankfully, I had an unconditionally loving father who normalized life for me and made me feel secure. His life was probably hell and he died at 65 years old from a heart related incident as he had previously been battling genetic heart disease with surgeries for 10 years prior. She had him to herself for 7 years but they could not have a child of their own. She slipped up one day retelling the story of how he wanted a child so they adopted. I pointed it out and she became furious and stated how much she has always loved me, etc. I have never felt loved by her and I think we only partially bonded. She told me that when I was a baby I pushed away from her to reach for my dad but said it with scorn, blaming me. She has never been able to forgive me or anyone else whom she perceives as offending or hurting her. Sure, she took care of me by providing for my needs extravagantly because it made her look good. I was never allowed to express my opinion and was forbidden to shave or wear makeup when my friends were starting. My identity is not wrapped up in her thankfully and for most of my life we have lived 3 hours away. This helped tremendously though it hurt when she refused to move near us and our kids a few years after daddy died. I am now glad she did not!

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My husband and I decided to cancel mom's neuropsyche appt this week. Aside from a day of throwing nasty barbs at me, she is doing fine on the mood stabilizer. He kept reminding me that there is nothing to give a narcissist to make them stop being one. I realize that. Whoever recommended the book "Will I Ever be Good Enough" I thank you. It gave me a lot of insight into my mother and my relationship.
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Thanks for the advice.
To the contrary, mom is not impaired other than having narcissism and dementia that is mild-moderate at best. She is no longer seeing any dr who will give her a panacea treatment. She is doing well physically speaking but emotionally she is a wreck but doesn't acknowledge it because of the narcissism and being from the silent generation. Once she slips into constant negative, abusive behavior and or total incontinence of both types mixed with physical deficits, she will find herself in new accommodations.You all have helped me decide that in this forum. : )
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As to "how" to tell the doctor, I suggest a concise list of things you've observed. Get it to him before the appointment.
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ksordh, I think on general principle all of your observations about your Mother's condition should be reported to her doctor. Let the doc decide if it is relevant to treatment or not.

Also on general principle, it is not always a kindness to keep an impaired elder at home. We kept Mom home until we really could not, and we were all amazed at how much she blossomed in the NH environment!
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I have a feeling the neuropsychologist has already done the bloodwork that identifies alcoholism. Addictive and Narcissistic personalities work well hand in hand. Do some reading on alcohol related dementia and metabolic changes, including depletion of thiamine.
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pamstegma Thank you for answering. Coffee- 2 cups max & only in morning. Alcohol not a drop since a margarita knocked her on her butt when mixed with (unknown by us) xanax/painkillers I found afterward (trying to escape life) during holidays 2014. That is what clued us into moving her because I found them (as I had after total knee replacement in '13). Her former pri dr prescribed them never bothering to check her for sleep apnea that was found during the knee surgery. She was with us in our 23 year old home the year before we moved to new house. Her home is will be sold to pay off this house we are all in. She has nursing home insurance but we want to keep her home for as long as possible (bowel incontinence/ falling/ wandering at night as we still work pt) or when she becomes impossible. Her father was an alcoholic and she definitely has the tendency. We found hidden alcohol in her closet in her house packing up. We have ours put away where she can't get to it and have started locking our bedroom door because she is going in and taking 800mg ibuprofen that is contraindicated for the elderly with history of ulcers and fragile vessels leading to stroke. I think this may be what has set her off but she would never admit to sneaking in our room. Dementia is probably from vascular strokes associated with the apnea according to neurologist. She also acts like LBD at times too.
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Zoloft, Wellbutrin, Aricept, Namenda and Lamictal? She drinks a lot of coffee to counteract all those meds. And it works. Hallucinations and Paranoia immediately after the move? Perhaps from no alcohol?
Could she more of an addict than a narcissist? Or both?
Move her to Memory Care, it is time for that.
She does not know she is destroying you.
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