Paranoia is a common feature of dementia. For example, person with demential misplaces things but can't accept that, so they start to believe that someone is stealing from them, etc.

My Mom had FrontoTemporal Dementia. The main feature was her normal lifelong anxiety turning into paranoia and delusions. Only thing that helped was medication. She was a nightmare without medication. Still difficult but manageable while on medication.

It doesn't *really* matter what it is. Use your energy to make sure they are placed so they receive medical care by professionals.

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I have found my people and relate to almost everything here. The good news OP is she/he is going to a nursing home. I know you said meds aren't helping yet, but at least at a nursing home you can work with them on meds and dose and they can MAKE SURE meds are taken.

Forget the horror stories about over-medicating. These places will work with reasonable families. Make sure you are reasonable and think about the emotional (and sometimes physical) safety of those who have to interact with the elder. Sadly some abusive elderly need to be heavily medicated to be safe to be around. They are not going to do that right away with your input. It's a gradual process, but yes, sometimes it must go there. Crazy, mean abusive dementia runs on one side of my family and most of them were that way before dementia. but not so extreme. The only way my grandma could be a decent human was if she was heavily medicated to the point of being a tad stones. Is that ethical? Resounding yes. It protected those around her (she became physical) and she could receive proper care because people were no longer afraid of her.

Definitely dementia. Paranoia often happens with the progression of disease, and life-long behavioral tendencies can exacerbate. Talk to your parent's doctor. Also, you or a trusted person needs medical POA stat, possibly financial.

Anonymous wrote:OP - I just came in to say I feel you. My mother is, I believe, a narcissist. I don't think I realized until much later in life that she was. Now, in her last 80s, it really shows. I also think there's a little BPD in there, too. She can be so normal and sweet some days and just nasty and mean others. I can tell when she's taking her anti-depressants and when she's not.

OP here, thx….what are the features that make you think narcissist? The Jekyll/Hyde mean/nice play?

OP - I just came in to say I feel you. My mother is, I believe, a narcissist. I don't think I realized until much later in life that she was. Now, in her last 80s, it really shows. I also think there's a little BPD in there, too. She can be so normal and sweet some days and just nasty and mean others. I can tell when she's taking her anti-depressants and when she's not.

Anonymous wrote:

Anonymous wrote:My dad is a narcissist and the literature basics says that difficult people become elderly difficult people. They don’t mellow. If they were always controlling, inflexible and uncompromising they will be more of the same. My parents refuse to maintain their home but also refuse to move out, refuse to give up driving but complain about caregivers, won’t eat food that anyone else prepares, refuse to learn anything about technology but insist that we drop everything to go to their house to reset the tv channels etc. Pick fights and gossip and stir up trouble in the family and best of all keep score in terms of who drops everything and comes running most often,

Thx this is helpful- the point about difficult people becoming difficult elderly people….and I guess worse. Not certain of the initial personality disorder and it went undiagnosed/treated for 80 years so here we are.

+2

Sorry PPs - it is difficult to navigate someone like that, because you are damned if you do, and damned if you don't - and if the elder is looking for trouble, they will find it. Glad we are not alone!

In our case, the elder picks on one person as the "bad guy" and that person can do no right. It is called "splitting" in psych terms, and has to do with how that person (the elder) sees themselves. So, if they act out toward you or badmouth you - it has nothing to do with you, but everything to do with them, FYI. Anything related to their favorite offspring is perfect and golden. Fun times!

Anonymous wrote:My dad is a narcissist and the literature basics says that difficult people become elderly difficult people. They don’t mellow. If they were always controlling, inflexible and uncompromising they will be more of the same. My parents refuse to maintain their home but also refuse to move out, refuse to give up driving but complain about caregivers, won’t eat food that anyone else prepares, refuse to learn anything about technology but insist that we drop everything to go to their house to reset the tv channels etc. Pick fights and gossip and stir up trouble in the family and best of all keep score in terms of who drops everything and comes running most often,

+1

This.

Anonymous wrote:Can you talk to their doctor about prescribing some antidepressants or antianxiety meds? My MIL who was not very confrontational generally got quite angry and difficult when dementia hit in her 80s. Her GP prescribed them and it has help some. But if they have always been difficult I don't think you can expect it to get better, just hopefully not much worse.

They started person on antidepressants last week but they haven’t kicked in yet. Unless policed/monitored the person won’t take them so we’ll see if any improvement later this week I understand it takes 7-10 days minimum

Can you talk to their doctor about prescribing some antidepressants or antianxiety meds? My MIL who was not very confrontational generally got quite angry and difficult when dementia hit in her 80s. Her GP prescribed them and it has help some. But if they have always been difficult I don't think you can expect it to get better, just hopefully not much worse.

What do his doctors say? If it's some type of dementia would be good to know. Get a neurology consult.

Anonymous wrote:My dad is a narcissist and the literature basics says that difficult people become elderly difficult people. They don’t mellow. If they were always controlling, inflexible and uncompromising they will be more of the same. My parents refuse to maintain their home but also refuse to move out, refuse to give up driving but complain about caregivers, won’t eat food that anyone else prepares, refuse to learn anything about technology but insist that we drop everything to go to their house to reset the tv channels etc. Pick fights and gossip and stir up trouble in the family and best of all keep score in terms of who drops everything and comes running most often,

Thx this is helpful- the point about difficult people becoming difficult elderly people….and I guess worse. Not certain of the initial personality disorder and it went undiagnosed/treated for 80 years so here we are.

My dad is a narcissist and the literature basics says that difficult people become elderly difficult people. They don’t mellow. If they were always controlling, inflexible and uncompromising they will be more of the same. My parents refuse to maintain their home but also refuse to move out, refuse to give up driving but complain about caregivers, won’t eat food that anyone else prepares, refuse to learn anything about technology but insist that we drop everything to go to their house to reset the tv channels etc. Pick fights and gossip and stir up trouble in the family and best of all keep score in terms of who drops everything and comes running most often,

81 years old, always introverted, intolerant, controlling and aggressive personality…now paranoid, talks of conspiracy theories, isolated at home now doing same in rehab, mean to medical professionals, says they’re bullying, refusing meds, care, bathing, and physical therapy …getting worse by the day and about to be discharged to nursing home. Argues with everyone…obviously very unpleasant. Physically declining rapidly…Dementia? Or is this just old age amplifying the worst characteristics of personality?