Well....I'm not sure if we take this as our answer....or what. I've mentioned here several times that we were preparing to ask FIL's primary for an initial cognitive assessment. Brief history - he is a raging narcissist - and I know there are some here that think that term is overused. In his case - this is not an exaggeration - this is 100% truth. He is an abusive narcissist and always has been. This is not new behavior.
Recently, he needed to sign some paperwork and was asked to provide a doctor's note stating that he is of sound mind. His primary doctor has provided this. Not only provided it but used the words "perfect cognition" His primary did not perform any cognitive assessment - even the initial basic stuff. He has been his primary for a number of years and his portal documentation always basically says the same thing after his visits - patient is pleasant and neurologically aware. However, in most of his appointments most of the talking is between the doctor and whomever attends the appointment with FIL, with the doctor addressing FIL only when needed.
So we are now concerned that we have hit a brick wall. And we are second guessing ourselves. Is it possible that a personality disorder could skew his decision making skills so much that it could look like dementia to us? His doctor has rarely if ever seen that side of him. He is 100% able to keep up the image of sweet little old man for the amount of time it takes to see his doctor for less than an hour. He has never seen the abusive narcissist that we see.
Have we been so far off base?
Some examples just for context.
- Is it his narcissistic mind that leads him to answer unknown numbers and engage with scammers - thinking he can outscam them? Even though we have told him that they are potentially voice printing him, even though we have told him there is literally no reason to answer unknown numbers, HE tells us he can fix them.
- He will sell his soul for free stuff - my SIL has walked in to hear him giving out his home address for free stuff - because - again we have told him a million times - that they aren't going to do it - but in his mind he is the ONE person they are going to give the free stuff to.
The list goes on and on - ad nauseum of things that we have thought were poor decision making due to age related cognitive decline or potential dementia - but now with this we are second guessing ourselves. Could it really be the narcissism? Seriously? I'm having so much trouble wrapping my head around it. We know he is an over the top narcissist - he literally checks every box - but is that really what we are dealing with?
Or are we overreacting to a form letter with no actual assessment behind it and should we still pursue getting him assessed anyway?
I'm just so confused now.
Are they not able to work and get out from under him?
As far as the rest, I'm not privy to a lot of the details so I really don't know the answer.
What we have basically all agreed to is this - if the other shoe drops and the worst case happens- AKA he cannot stay in that house and there is literally no choice but to send him to a SNF - meaning he can't physically get out of the bed to walk to the bathroom - which is all that he literally has left - the ability to get out of the bed and walk to the bathroom and back or the car and back for drs appts (he transports from the car via scooter and cannot walk more than about 30 feet with the walker) that they will have to find other accommodations - there will be no choice because the house will have to be sold for his care. Other than that we stay out of their arrangement right now.
If FIL becomes non ambulatory, he will need care beyond what AL will offer. Yes, some will take him and the cost will be astronomical and the care will be lacking, be on the watch for that. A needs assessment by an impartial third party will direct the level if actual care required. I don't trust a facility to do a needs assessment, they benefit financially from greater needs, just MHO.
Some states will allow the caregiver child to remain in the house after placement. There are rules and regulations about how this can be accomplished, have your SIL do the research or help her. This could help ease some of her stress with dealing with her abusive dad. Knowing what happens to life would be reassuring to me, so I imagine it would be for others.