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Reply with quote  #1 
Rather than write out another post, I'm going to copy/paste an email I just sent to my sister. What I would like is feedback from the group on the topic of how to tell the difference between narcissism and early stage dementia. thanks....twinkle

Hi -----,

  We have a new phone number. We were getting a lot of unwanted calls especially in the evenings. So we changed our number.

  I have a dilemma on my hands. I don't want to involve you in my issues with mom but my latest interactions with her have left me wondering about her health and state of mind. Since she is aging I know that we will have to work together if she needs help with that. So I don't quite know what to do. I'm sorry if I'm not making sense. I'm very tired and feeling fuzzy minded.

 Would you promise me that our communications don't get back to mom? I don't need you as support for my issues I just need you to hear my concerns as a sister.

 I wrote mom a kind letter and clearly stated the things that were uncomfortable in our phone calls/relationship. I felt very good about it...anyone who reads the letter would see that my intent is for healing and that I was non-blaming and kind.

 She sent me an email and a written card in response. They were both so odd that I could hardly get the gist of what she was saying. Her handwriting looked strange to me. She signed her email..."love, Mom" in the middle of the message.

 It's been in the last 8 months or so that our conversations have really deteriorated. I've hung in there in the past, because I love her, and also because I could see a glimmer of her true self in there somewhere. Lately I've felt like I was talking to a parrot. She seemed to have an inability to hear anything I said. She was being her worst self....and I could not seem to break through that wall no matter what I tried. I hung up feeling physically ill and extremely upset and confused.  She has always made mean remarks about other people, but they used to be clothed in love and concern. In these past conversations it's like she's taken the gloves off and has been going for blood. I can't even express to you how disturbing it has been.

 I don't think I really explained this to you, but made it sound as if mom and I were having problems getting along. It's felt like much more than that. I haven't even really had the words to describe what I experienced in those phone calls.

  I know that she has some health concerns. Do you think it's possible that she has early stage dementia? One of the most prominent symptoms of early, early dementia is negative personality changes. Since mom has always been a somewhat difficult person to deal with I think it would be harder to see in her. I am part of an online group for people with difficult aging parents....not to complain but to find real solutions to deal with them. The topic of early stage dementia personality changes has come up from time to time.

  I became very concerned after getting her email and today, her card. She is usually so articulate and even though difficult, I know what to expect from her. Like I said, what I got is so......odd. Her handwriting is markedly different, with spelling mistakes.

 I noticed this in Grandma K--- when we were living so close to them in T----. It was so subtle at first....but there were the same red flags.

 I know that mom has high blood pressure. I also know that Grandma P--- had high blood pressure and that she had an MRI that showed that she had been having small strokes for a number of years. I'm wondering what all those emergency room visits were about ....when you lived in S-----. Was there ever a diagnosis? She's had so many health problems over the years that I tend to view her as *the little boy who cried wolf.*

 I'm just really concerned. I thought that if I set some boundaries in a kind way that our relationship would improve as yours has. But her response has me so puzzled.

It's possible that I just backed her into a corner and this is a sort of manipulative fog that she's presenting...not knowing what else to do with the situation.

I just felt that I had a responsibility to let you know that she doesn't seem like herself. You commented in another email that she seems kind of *out there* at times. How do we discern what is just her eccentricities and what is truly a red flag?

Once again, please don't go to mom with this. If this happened I don't think I would ever feel safe confiding in you again. I hope you understand. I have been so hurt by the triangulating. I've felt as if I've lost you by default.

Our new number is -------. Right now it's set up with one ring and goes instantly to voice mail. I haven't felt like dealing with the added stress of answering the phone.

I will look forward to your response. I am very grateful that I am not an only child. I know that you are a caring and reasonable person.

I've been educating myself on how to deal with my Ms narcissism. How do I deal with it if this is early stage dementia? How can we tell? My mother is an extremely difficult woman who has both narcissistic and borderline tendencies. We also have a family history of bipolar disorder and a recent therapist suggested to my mother that she was bipolar. She does not want to take medicine for this. Dealing with her has been a nightmare of epic proportions.


Reply with quote  #2 
twinkle-toes,  I will be very interested in the replies you receive.  I am a total odd man out in the N venue.   Here is my take on this.  Being self centered may often be a part of dementia, but does not define a narcisist.  Being a narcisist is a personality disorder that would have showed up long before and independent of dementia in an elder. 

If an elder displays N traits and it is new to them, you have a hint that dementia may be beginning. 

For most who have truly N parents, they can track the trait from way back.  It is a seperate disorder.  Not one that shows up late in life. 

A demented elder may become self centered--like a child.  Very different from a narcisist personality.

OK all, did I get that right.??
Reply with quote  #3 
Thanks, BC. My mom has been difficult for as long as I can remember. Various therapists have suggested that she has one of the cluster B personality disorders...of which narcissism and borderline fall into.

That is why I'm confused. Is this my mother being her usual manipulative, critical, grandiose, entitled, and abusive self.....and getting worse with age or are some of these things also characteristic of dementia? I should have asked a different question.

How can you tell if a narcissistic parent is developing dementia?

Her behavior has worsened in the last several months and her handwriting looks odd. Her emails and card don't make sense.

She is an extremely intelligent and articulate woman who has never been at loss for words and who expresses herself very clearly in writing. I'm very familiar with my mother and her personality...behavior...writing style....etc.

I'm just seeing some red flags but it is SO difficult to tell what it is because her normal personality is to be angry, difficult, etc.

Reply with quote  #4 

I am at the same stage ..wondering if I am seeing early signs of dementia or if there is a different medical issue involved.  We can wonder and research for days on end, but really she should be checked by a physician. 

You mentioned high blood pressure.  I am told that these so called "mini-stokes" can cause a variety of behavior changes.  You probably won't know unless someone gets her in for a full geriatric evaluation.  Check with the geriatric department of the hospital nearest to her.  Most of them have a department devoted to this. I think you may need a referral from her attending physician.  Evaluations can be several hours long, and getting your mother to agree to this can be another issue.  This is my current problem!

Good luck.
Reply with quote  #5 
Hmm, this does sound like a change in cognitive function.   The change in her handwriting, is a clue, but for my mother it was just arthritis.   Mom has a level of dysphasia making her sound like she has dementia, but for all who know her, she makes total good sense.. 

For Mom, it is a verbal function, (not good, tried to have her checked for TIAs, nothing evident).   If there is not a personality change, or a change in reason, there still may be another cause that is nueroligical in origen.  TIAs (mini strokes) NPH, depression, swings in suger levels,  heck, many more...

If you can get her to a full geriatric evaluation... I doubt you will be sorry.   Good luck. 
Reply with quote  #6 
Hi twinkle, I think what BC said was basically right except that an elderly person with dementia who has become totally self-absorbed and childlike isn't dissimilar to someone with narcissistic personality disorder. Maybe more 'out of it' but many of the behaviors are the same. I suppose the causes are different ... as far as we know NPD isn't a form of lifelong dementia.

Anyway, people with NPD and/or bipolar disorder can also develop Alzheimer's or dementia just like the rest of us. It may be a little harder to detect because some of the symptoms overlap, which is apparently the quandary you find yourself in. The handwriting and verbal missteps are troubling signs, but only a thorough geriatric physical will tell. (Will your mom agree to one and who will be the sacrificial lamb who goes with her -- you or sis? Ugh.) However it is more a little suspicious that these 'confused little old lady' symptoms are cropping up at the exact same time you are setting boundaries and insisting that your mother behave herself. My mom will be acting like a stroke victim when she is playing me for something, then I will come back in the room and catch her acting sharp as a tack with the 'help.' On the other hand, her doctor think it's entirely possible she's had some small strokes because she does get genuinely confused about numbers and other cognitive matters, which embarrasses her and she tries to hide that! I'd have to be a psychic to know what to believe, frankly. Fun with mom.

I guess my best guess with your mom and mine is ... it's probably both. Personality disorder PLUS some age-related brain disfunction. You and sis probably do need to play Sherlock Holmes and see if you can get mom checked out at some point. If she has AD, then there are drugs that might help her, and whatever it is has the potential to advance to the point that she will need a supervised living situation. You have all my sympathy. Been there, totally.

Reply with quote  #7 
I was writing at the same time BC was posting last. Yes indeed, other behavioral changes in the elderly can be caused by UTIs, blood sugar, sodium levels -- and on and on and on. You need a doctor to help you ferret any physical problems. Not that we can be sure personality disorders don't have a physical cause ... just no way to know. Be careful and protect yourself if you attempt any eldercare activity with your mom. Think of pulling a thorn out of a lion's paw!

Reply with quote  #8 
Thank you for the insights.

Prodigal, the more I read about your NM the more respect I have for how well you deal with her. I do need to be suspicious that she is so confused and out of it now that I've set some boundaries. It sounds like you've developed eagle eyes in dealing with your NM.

I live about 10 hours south of NM and Nsis lives 2 hours north. She is much more involved with Nsis and her family. Nsis used to live 5 minutes away. Before this latest mess with her and my mom she confided to me that she needed to get further away. She had given NM a spare key to their house and NM was going over there when they weren't home and sis only found out about it from her neighbor.

They are tricky little characters, aren't they?


Reply with quote  #9 
Twinkle Toes, my mother has probable Fronto Temporal Lobe dementia, which first manifested many years ago as personality changes, including those which would appear to be an intensifying of her already somewhat narcissistic personality.
Looking back in time, she was always "off" - not quite stable mentally.
But in her early 50s she had a shift that we all just lived with at the time, but now see was the beginning of dementia.
Everything from becoming incredibly rude, to cutting off contact with old friends for imagined slights, to being much more demanding to things that were just plain bizarre.
I suspect, that like us, you won't know the answer to your question until some time has passed.
Reply with quote  #10 
This situation just keeps getting messier and more difficult. I sent an email to my sister expressing my concerns. I got an email back.

I think that NM is playing my sister like a fiddle. NM is really laying it on about her health problems....and my boundary setting has pushed NM over the edge and she's now having multiple panic attacks every night and taking a lot of Xanax. Sister thinks the Xanax is the cause of the shaky handwriting.

My sister sounds honestly freaked out and scared that NM is going to die of an overdose or something. Since I am out of the picture, NM is doing to sis what she has been doing to me all of these years. Only my sister is buying into the *I'm so fragile*...*I don't know what I did to cause this rift between us* *I'm having multiple panic attacks and I have all of these other health problems and your sister is pushing me over the edge*..* I'm taking soooo many Xanax* .etc.

NM always has had one or two dire health problems since I can remember. Now she also plays the *I'm a little old lady* card...she's 74 and does have some health problems...high blood pressure, low cortisol levels, a bleeding ulcer last year. But mostly the doctors can't find anything badly wrong with her. She's had multiple ER trips in the middle of the night and goes through doctor after doctor. Last year she said she was battling Lyme disease...but when I brought it up several months ago she acted irritated and said that she was over it. I don't think Lyme disease is that easily eradicated from what I know.

She's really got my sister going. My sister says over and over that NM just doesn't know what she's doing. She doesn't understand why I've abandoned her and why we have this *rift* between us. She's too fragile to impose any boundaries on. You get my drift.

I felt guilty for about a minute. I think I'm over it. Trying to get some healthy distance from my NM is like trying to get gum off of your shoe. Now she's roped my sister in as her Rescuer. Did I make it clear that NM loves to play the victim.

I should mention that there is nothing in my sister's email acknowledging my long term health problems which are actually more serious than NMs. Both my medical doctor and my therapist told me that I needed to set boundaries/get some space from my mother or I would not get well.

Why is this so hard? I really envy those that just walk away from a difficult parent and don't get reeled back in. This is both a vent and a plea for advice.

I hope you aren't sick of me yet. I feel like it's taking me forever to extricate myself and have a more peaceful life. Then again, maybe my reading about my dilemma will help someone else in a similar situation.

I come from an extremely enmeshed family. What was the name of that Erma Bombeck book? Family: The Ties That Bind(and Gag) I think it was.

I feel bound and like I want to gag. I want to run far far away....change my name...go into the witness protection program.

Maybe I can sell my family of origin on Ebay? Anyone want to do a swap? It's late on the west coast and I am babbling.


twinkle-toes   (getting very low on twinklyness these days...)

Reply with quote  #11 
I forgot to say that sis doesn't think she sees signs of personality change in NM. She thinks that the things I noticed ...shaky writing, poor train of thought, are all due to my mother taking Xanax.

I don't think my sister really understands much about either dementia or narcissism. She just sees NM as being very difficult, but extremely fragile so we all must walk on eggshells around her so she doesn't get upset.

If sister thinks I'm going back to my usual role of NMs Punching Bag, she is going to be sorely disappointed.

I still think NM could have some damage from small strokes due to her high blood pressure and the family history with her mother. I'll have to handle sis with kid gloves and gently suggest she take mom in for a geriatric evaluation. I'll try to get her calmed down first. Right now she sounds like mom is going to explode if anyone looks at her funny....poor kid, she's doing the best she has with the knowledge she's got....

Reply with quote  #12 
Morning Twinkle, so so sorry to hear you had a rough night thinking about all this. You know, it was sweet of you to say you respect me for the way I handle my mom, but it's been every bit as messy as what you're going through. If I seem somewhat calm, it's partly because my Nmom has been behaving a little better since she moved to AL last year, but lord knows how long that peace will last. Also some of my 'calm' is just emotional and physical exhaustion. I have been my mother's emotional crutch since I was a small child and she's just worn me out. My best self -- my empathy, compassion, love -- has been so exploited and used against me that I can hardly access it anymore with her. So I know I probably come off as rather detached, possibly even cold or hard when discussing these issues. I don't mean to be ... I know how complicated and painful all this is.

Our mom scenarios have much in common. For as long as I can remember, I've been walking on eggshells in order not to upset 'my poor mother.' She's too physically weak, mysteriously ill, fragile, depressed. Her 'nerves' can't take much. We 'just have to do whatever she wants. Let her behave however she wants.' Oh yes, and she's dying. For the past 30+years. So we had to let her have her way and say and do anything she wanted because she 'wasn't going to be with us much longer.' Needless to say, this conspiracy of indulgence from those of us in her small world just made her worse and worse and worse.

I tell you this because I want you to be prepared for just how far this may go. I hope for your family's sake it doesn't ... but it sounds like your mom's gearing up for a real doozy of a medical crisis. Narcissists have a very bad, sometimes violent, reaction to boundaries from people they are accustomed to controlling. They will fight to defeat the new rules -- will resort to more and more drastic measures to violate the much hated boundary and get back their narcissistic supply. Even to the point of physically harming themselves. I am somewhat afraid that my mother either consciously or subconsciously fell the last time on purpose. Her very first comment when I made it to the hospital was, "Well, I guess I will HAVE to come live with you now." She had been campaigning for this ever since my dad died, and I had not accommodated her. I am horrified at the thought that she may have broken her bones and ended up in a wheelchair in one monumental attempt to get us back under the same roof and me back under her thumb. I had done everything I could think of to reason with her and make her living situation safer ... but she just wouldn't accept that she couldn't get exactly what she wanted and the results were disastrous for her.

What it boils down to is this: you can either cave and go back to letting 'fragile' mom have her way. Or you can continue saving your own life and accept that mom will retaliate in any way she can -- hounding your sister, over medicating, etc. And there's nothing you can really do about that. Your mother is an adult and makes her own choices, and whatever mess results from that is not your fault in any way. However driven by her personality disorder they are, these still are HER choices and HER responsibility.

My infamous turning-point conversation with my mom that I've mentioned before was when I tried to gently explain to her how painful and destructive our interaction had become for me and tried to suggest ways we could have a better relationship. She went berserk and started crying and yelling that I had to let her say anything she wanted to -- I HAD TO!! I was so incredulous that I actually asked her, "So you think you have a RIGHT to hurt me -- that it doesn't matter what effect your actions have on me?" She just kept hysterically repeating that I 'had to' let her say anything she wanted. The idea that she would have to change her behavior in order not to hurt someone, even her own child, was horrifying to her. That's when I began to take her NPD diagnosis more seriously and to educate myself. Looking back, I understand her reaction completely.

So, no, twinkle, your sister and your mother are definitely NOT going to consider your health problems. Your mother doesn't care about anyone but herself, and your sister has been trained not to care about anyone but your mother. Only you can rescue you, and I was glad to see you write:
"If sister thinks I'm going back to my usual role of NMs Punching Bag, she is going to be sorely disappointed."
Yeah! And obviously it's your sister's choice to decide whether or not she wants to be played by mom either. You can't decide for her.

Your sister may be right about one thing -- your mother's shaky handwriting and strange rambling may well be the result of Xanax abuse. My mom was overly fond of Valium for years and when she was high, her grocery lists were unreadable.

And, hey, nobody's 'sick of you' -- vent away. It does take forever to extricate oneself from a destructive enmeshed relationship, especially a dysfunctional parent/child situation. And I think it may be a tiny bit easier to turn your back on an angry, yelling parent than an 'innocent, pitiful little old lady' who knows how to play everyone. They're like quicksand. Hang on to the rope!

Reply with quote  #13 
p.s. When I started writing my post, it was morning but I got interrupted. So let me add, good afternoon! Hope you're feeling better today.

Reply with quote  #14 
Prodigal, you're a gem.  Seriously, you really are and I hope you know that.
Reply with quote  #15 
I am breathing a huge sigh of relief after reading your post, Prodigal. You get really get it. You absolutely nailed it. Your descriptions of your NM and her issues, your struggles and feelings while dealing with her, the whole back story.....we could be twins.

I am trying to extricate myself from a destructive, enmeshed relationship of 50 plus years. I realized today that this is going to be even harder than I thought. It's such a huge mess. NM has always held me hostage to her intense fragility and illnesses. My relationship with her resembles a *trauma bond* more than any kind of real love or intimacy. She is an extremely abusive woman who trained me to meet her needs, be her emotional dumping ground, and her punching bag. I have worked through the abuse I suffered as a child and come to a point of forgiveness towards NM and my F(who sexually abused me).

What I am dealing with is the way NM continues to treat me. I tried for years to just dodge the bullets the best I could, be the bigger person, forgive.....and every encounter just kept getting worse and worse. She continued to expect me to be her emotional dumping ground and her punching bag.

I  got to the point where I felt I needed to get some distance from her or I was going to go down with the ship. Both my doctor and my therapist told me that I needed to get some distance from NM or I would continue on a downward spiral.

I've chosen this course and I can't go back. For the first time in my life I am putting my own needs first. I anticipated NM resisting my boundaries and acting in a raging, demanding, grandiose way...but I didn't anticipate this level of manipulation.

I feel calm this morning. All the reading I've been doing..both here, online, and books has had the effect of immersing me in truth
. I can see the family system of dysfunction and lies without getting caught up in it. I can't go back to the old ways. NM is going to have to deal with it. Her choices are her own. I don't even feel sorry for her any more. I can see it for what it is....a desperate attempt at manipulation by an aging N who has lost one of her primary sources of *supply*.

I'll continue to post and ask for help as needed. I've been in recovery for long enough to know that we're in this together....that my recovery can help someone else and that those of you who answer my calls of distress are continuing your own healing as you assist in mine.

It's such a relief that people understand the dark depths of the craziness that I am dealing with. For many years I thought I was unusual in having a family with this depth of pathology.

Prodigal, your hard earned wisdom is a blessing to us on this forum. Thank you for facing the dragon-beast-mom and living to tell the tale!

big hugs

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