Any tips or advice re: interacting with elderly relative with borderline and narcissistic traits?

[Anonymous]

Does anyone have resources or tips on caring for/interacting with an elderly relative with narcissistic and borderline traits? She has been evaluated for dementia and depression but did not qualify for either diagnosis. She has always been this way but is getting worse with old age. The grandiosity, rapidly changing moods, flashes of anger and self centeredness are a lot. She talks about being "abandoned a lot" and loves to triangulate and be in conflict with neighbors, relatives, someone at various doctor's offices, etc. I try to keep conversations brief to avoid conflict but lately even that is not working. It can feel so chaotic and overwhelming just trying to convey 2-3 brief sentences bc it's all about her taking control. Anyone have strategies that worked to keep your sanity in dealing with a difficult elder who got worse with age? She will not do therapy and told a psychiatrist that there is nothing wrong with her. I know I can't change her but how can I change my approach to keep my own sanity? TIA!

[Anonymous]

Does she have money to throw at this? If so, you need an aging professional to be assessing her level of need now and then. If there is no dementia, it's her choice to take meds and get therapy or not, but you should not enable bad behavior. If she gets difficult make an excuse to leave or get off the phone.If she vents endlessly about the people who abandoned her let her know the best person to work through that with is a therapist.

Reinforce the good behavior if you can by staying longer for the visit. Just make sure you never reinforce antisocial behavior.

If she ends up in the hospital, make sure you make it clear to staff she isn't coming home with you so they can find an appropriate placement. If she insists on aging in place do not enable that. It turns into a revolving door of people quitting or not showing up and you don't want to list yourself as emergency backup unless she chooses residential. Much easier to work with staff to make sure she is properly medicated and visit her there than it is to deal with the sh$tshow of aging in place.

[Anonymous]

Also, you need to call the psychiatrist who said she is fine and any doctors who deemed her phone and spell it out even if you don't have a release. You can leave the info and document that you did
_ does not get along with others and reports feeling abandoned
-you can no longer take the mood swings, flashes of anget etc
-difficulty getting along at doctor's office resulting in....

If she has not been scanned to determine if it's frontal temporal dementia behavioral variant-push for that.

Doctors and nurses are happy to believe patient and make it family's problem until you make it clear she is scaring family off and it interferes with health care and ability to hire people.

Also, you need as many buffers as possible. Turn everything you can over to hired professionals if she becomes abusive and give them tips if the money is there.

[Anonymous]

Boundaries and documentation.

I went through this with my mother - she ended up firing every doc and professional she disagreed with. I hired an eldercare professional to help navigate the situation (I paid) but she refused to meet her or work with her.

Also, in early dementia patients can be very adept at masking for an appointment, social outing, whatever. They can appear to be mentally fit - but then you get home. If you are seeing things on a day to day level, document it and share it with your other family members.

Good luck.

[Anonymous]

Anonymous wrote:Boundaries and documentation.

I went through this with my mother - she ended up firing every doc and professional she disagreed with. I hired an eldercare professional to help navigate the situation (I paid) but she refused to meet her or work with her.

Also, in early dementia patients can be very adept at masking for an appointment, social outing, whatever. They can appear to be mentally fit - but then you get home. If you are seeing things on a day to day level, document it and share it with your other family members.

Good luck.

One thing to prepare you for if you are not a close family is... the other family members may gaslight you. "OH she is just stressed because x, y,z and once she takes more walks, gets together with a friend, gets a new kitten, (name your solution)...she will be fine!" Let the doctors know what you see and document it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Boundaries and documentation.

I went through this with my mother - she ended up firing every doc and professional she disagreed with. I hired an eldercare professional to help navigate the situation (I paid) but she refused to meet her or work with her.

Also, in early dementia patients can be very adept at masking for an appointment, social outing, whatever. They can appear to be mentally fit - but then you get home. If you are seeing things on a day to day level, document it and share it with your other family members.

Good luck.

One thing to prepare you for if you are not a close family is... the other family members may gaslight you. "OH she is just stressed because x, y,z and once she takes more walks, gets together with a friend, gets a new kitten, (name your solution)...she will be fine!" Let the doctors know what you see and document it.

PP here - this 100%
Document document document - and send copies to family even if you aren't close. My sibs and I are not close and they don't live nearby. Despite keeping them updated, when is was time to get more help for my mom (she is a fall risk, she had fallen and broken her vertebrae), I was completely vilified and essentially ostracized by the family.

Long ugly story that is unfortunately too common. I'm just glad I had documentation and the backing of my mom's former physicians. And now I have peace.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Boundaries and documentation.

I went through this with my mother - she ended up firing every doc and professional she disagreed with. I hired an eldercare professional to help navigate the situation (I paid) but she refused to meet her or work with her.

Also, in early dementia patients can be very adept at masking for an appointment, social outing, whatever. They can appear to be mentally fit - but then you get home. If you are seeing things on a day to day level, document it and share it with your other family members.

Good luck.

One thing to prepare you for if you are not a close family is... the other family members may gaslight you. "OH she is just stressed because x, y,z and once she takes more walks, gets together with a friend, gets a new kitten, (name your solution)...she will be fine!" Let the doctors know what you see and document it.

PP here - this 100%
Document document document - and send copies to family even if you aren't close. My sibs and I are not close and they don't live nearby. Despite keeping them updated, when is was time to get more help for my mom (she is a fall risk, she had fallen and broken her vertebrae), I was completely vilified and essentially ostracized by the family.

Long ugly story that is unfortunately too common. I'm just glad I had documentation and the backing of my mom's former physicians. And now I have peace.

I want to thank you for sharing this and I know first hand how painful it is. I am the family villain as well for trying to do right by my parents. I have friends from functional families who just don't get it and I feel so alone. My therapist hears a lot of these stories and says it is common so I don't know why I still can't get over it all.

[Anonymous]

I would distance myself, OP. That's what I would do.

[Anonymous]

Find out if any of her friends have gone into a nearby CCRC. If they have an are loving it, let her know. Let her know about all the social activities. Then whenever she complains say "sounds like you are lonely. Betty is having the time of her life at The Fancy House." "Sounds like you are sick of your neighbors. Betty says she has great neighbors at The Fancy House."

I have known 2 people and read one story in a newspaper a while back about how a narcissistic and difficult parent over time turned into a different person in residential. Yes, sometimes they just isolate and remain obnoxious, but some become the belle of the ball. Having a happier parent with friends makes your life easier. Plus, when you visit, only visit in commons areas. Those types need to keep up appearances and will be less likely to have a public a "flash of anger" in public. (Oh I know those flashes of anger too well.)

Normally I hate manipulation, but if you parent raised you telling you how your cousins, siblings and the neighbor's kids were better in every way I think it's fine to keep bringing up Betty having a much happier life at the CCRC.

[Anonymous]

I finally was able to just walk away when my mom started in on me, and over time, she did get better and was nicer, because she wanted my company.

It’s very hard. Practice what you are going to say when certain issues come up. Be ready with a response.

If you didn’t know, elderly people can seem much worse when they have a UTI. They might not have symptoms, but UTIs can really impact social functioning. And I make sure my mom stays on the Prozac.

[Anonymous]

OP here, thanks for all of this, much appreciated.

It's sad and the old dynamics are so heightened as sibs jockey both for money and to evade responsibility.

[Anonymous]

Anonymous wrote:OP here, thanks for all of this, much appreciated.

It's sad and the old dynamics are so heightened as sibs jockey both for money and to evade responsibility.

You have succinctly and brilliantly put into one sentence what I have spent hours and hours in therapy trying to process and accept. Just the fact you wrote it helps me feel less alone.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here, thanks for all of this, much appreciated.

It's sad and the old dynamics are so heightened as sibs jockey both for money and to evade responsibility.

You have succinctly and brilliantly put into one sentence what I have spent hours and hours in therapy trying to process and accept. Just the fact you wrote it helps me feel less alone.

+1

SIL is master of "empathy" with MIL - SIL maneuvers what she wants, on her terms. Much like MIL! Guess what goes around does indeed come around.....

Do they really only see the good in each other and not the bad? So enlightening!

[Anonymous]

Treat them like the toddlers they are. Lots and lots of praise - even for dumb stuff, like how they did their hair today - and ignore the bad stuff. My mom was a narcissist. When she would start to go off on a negative nelly trip, I would change the subject by giving her a compliment. These folks need to be praised 24/7. It's ridiculous, but it works.

Read Nina Brown's book, Children of the Self-Absorbed. I used her techniques and was amazed.

[Anonymous]

Anonymous wrote:Treat them like the toddlers they are. Lots and lots of praise - even for dumb stuff, like how they did their hair today - and ignore the bad stuff. My mom was a narcissist. When she would start to go off on a negative nelly trip, I would change the subject by giving her a compliment. These folks need to be praised 24/7. It's ridiculous, but it works.

Read Nina Brown's book, Children of the Self-Absorbed. I used her techniques and was amazed.

I will check this out, thanks. I find the negativity overwhelming so having a plan is quite appealing.