How do you deal with your narcissistic parent with dementia and their confabulations?

Narcissism with dementia is a double edged sword. You can't reason with or change dementia. And you can't reason with or change narcissism - at least not true narcissism, it's a personality disorder. It's an incredibly difficult personality disorder to stomach because on the surface it looks like they are being a colossal jerk by choice (and frankly sometimes they are) but at it's core - they still have a mental health disorder either way.

That is not to say that you have to keep a narc in your life. In fact, currently dealing with a raging narc who is moving into at the very least age related cognitive decline - I fully recommend as little contact as possible. Because it typically gets worse as they decline. As their circle shrinks, they tend to get meaner and more controlling and say worse things.

You have to decide that either you don't care what they say and to whom (and that you are going to control the narrative to those that you do care about), that you are going to ignore the flying monkeys (because those do seem to dwindle as time goes on - at least in our case - or at least they don't seem to fly as often), and that you can deal with everything else and manage the attitude. OR you are going to limit contact as much as possible. Because you have to develop a thick skin with a narc or they will zero in on any perceived weakness and use it to their advantage.

On the dementia front - there is a slim (very slim as in probably none - but I have heard tales of miracles - although I have heard far more tales of the other extreme so remember that) where narcs collapse and become so scared that they become meek and mild. From what I understand that is the exception and not the rule, and more often than not, it goes the other way and narc symptoms get worse and of course in tandem with the dementia there is no reasoning or discussing with them. So that thick skin is going to be a requirement if you are going to be a caregiver in anyway.

In this case, I really recommend looking into your options for memory care early. At the very least you wouldn't be the primary caregiver and would have the ability to walk away and leave her in the care of someone else when you need to breathe rather than it being on your shoulders all the time. It won't make it easy but at least it would take the pressure off of you and you would know you can have an escape door. Keep very clear boundaries.

My 85 YO mom (a narc w/dementia and a host of other medical issues including clinical depression) sounds much like your mom. I am in virtual no contact now, but am her POA and "health agent" so I still have some tasks to handle but with no direct contact with her. I do a monthly drop off of "treats" to her with a very brief typed note (she cannot read my "terrible handwriting"), but I just drop the pkg at the front desk (no actual in person drop offs nor visits, no calls). I have blocked her phone, so the intrusive 4 am calls have stopped; but she can still leave me a voice message and I can choose when/if to listen. Most messages are nonsense rants or requests for me to bring some long gone items that no longer exist which I just ignore. I acknowledge in my notes that "yes, I do get your voice messages" but I do NOT actually respond in writing to what she says or asks -- what is the point other than for her to confabulate it all into some other "her daughter is awful to her" narrative. Like your mom, mine is a perennial victim. Nothing is every her fault, she can do no wrong, and there never is any apology for anything. For her, all a puppets that must perform accounting to her screen play.

Working with a great therapist to unpack things that have happened over decades and the narcissist treatment I got as a child from my mom have been very helpful. I now know about setting firm boundaries for my well being and mental health; like the no direct contact decision. As others have said, we cannot change others. My mom and yours will not change no matter how much we wish it or try to be "good daughters" or try to "explain or reason" with them. We can only change our own behavior(s) and develop strategies that work for us to protect ourselves.

Adult children do NOT owe their parents what they may demand. Having a narcissist parent, especially a mom, is very hard. This is NOT the mother any child deserves. Add dementia to the equation and their potential need for help and one has a total "hot mess" of a situation.

My advice is find a great therapist to help you with this to come up with boundaries/strategies that work for you, for you to protect yourself. If it is full no contact, so be it. If it is limited contact, so be it and have exit strategies or preempt things. Next time if out for lunch, when ordering ask for separate checks at the outset (confirm ahead of time the location does separate checks) and make sure you choose the location to assure separate checks OR just stop doing lunches at restaurants. Bring your own snacks and a water bottle so you are not famished. Or set a finite time for the outing that ends before you get hungry and just stick to the end time and a firm NO on eating out with her. You do not need to explain why as "NO" is a complete sentence. Do the shopping w/her after lunch, always. In other words, come up with a strategy ahead of time so you are in control of the situation and have clarity over what you will or will not do moving forward with her.

You did not mention where your mom is living now (independently, in an AL facility or at a NH?). But with dementia, at some point she will likely need nursing home or memory care, in other words some type of long term care at a facility. Something to plan for if not already done.

My mom is in a nursing home (NH) now since October 2020 because of the dementia and an inability to do most ADLs and IADLs. She can barely walk 5 feet with her walker now.

All of this is so sad and hard. Dementia is like having one's parent land on planet Mongo -- everything is upside down and not working. Add narcissism or other behavioral issues and it is impossible for most of us to handle direct contact at all.

Good luck with this.

There really is no way to deal with anyone. We cannot change others, and trying to do so is frustration. It is much like folks are taught in Al-Anon. You have two choices, stay or go. You cannot change anyone else. Only the person him or herself can change him or herself.
This is compounded when you think of Narcissism and dementia. There you are REALLY up the creek without a paddle.
The way to deal with these issues is to move slowly away from them. In the case of dementia, only, will you need to ignore wishes and pronouncements if you are POA, and take charge for the safety of the elder. In the case of personality disorders, however, you will have no power to do so.
In your own case with the lunch? If Mom paid, and then ran around and said you "forced her to pay" I would just smile and sweetly say "Yes, Mom, I did. But wasn't it GOOD!" Honestly, sometimes there is no answer but to fight things with a strong sense of humor. It can be fun to come up with responses.

She's been running around where? Saying this to whom?

Are you sure it matters? She probably tells people you never reached out to her at Christmas, too. People like your mother talk for effect: as with headline-hungry journalists, they never let the truth get in the way of a good story. Don't the people who gave you this recent feedback already know that?

So, you either accept her personality as it is and you know it to be, or you go back to minimal contact.

i had two of them. father lived to 89 but mother lived to 105 and i am 74. she JUST died. the truth is, i finally just cut my mother loose. she was in a lovely facility and not really too aware of who was in and out. i sent flowers, keeping live ones in her room at all times. she abused the nurses, and that made me very sad. they tried so hard. now she is gone. i have not cried and i feel really at peace. you're not a monster. just do enough to keep yourself from feeling guilty. talk with a therapist and set big fat boundaries. try to ease up on yourself. good luck. i send you a hug.

The best advice is to say goodbye to coming up with strategies ( which will never work with a narcissist mother), you also like all of us are getting older- do you want to look back one day and regret letting yourself be subjected to all of the abuse and stress she causes you? The best thing you can do is drastically limit contact or go no contact and reclaim your life and peace of mind. Over time if you continue to have contact it will likely affect your physical health as well, have you ever talked to a therapist who’s knowledgeable about this disorder? Best wishes, these people do not change they retain the same manipulative qualities into their last years

WAtchison youtube vids on narcs, grey rock ( not answering and getting sucked in to their nasty remarks etc) you no longer care.
Codependence-
https://youtu.be/R07vVt-2diU

Also how to say no. Stop feeling the guilt they trained you to feel. And stop fixing their problems.
AND recognizing your being sucked back in.
Richard Grannon is also a good one to watch. He has different insight, than the others.
Setting boundries, and the guilt when you do.
You can drive the car, or multitask while listening. It will help you see the abnormal relationships and how to handle them. Bc usually children of narcs attracts more narcs as friends and loved ones.

Id also stop to eat before you go, and limit visits if she tries to embarrass you in front of others. Or pay, and if she says something nasty, say yea I'm so horrible, I bought you lunch. That's what horrible people do.
And leave immediately if she says anything nasty. You never stay to get abused more! Never. And say Im not here to be your verbal punching bag bc your in a bad mood. Then don't visit for awhile. You must leave immediately and every time. Even if she says something snarky within 1 minute of you arriving. And do not feel guilty. Remind yourself, you are setting proper boundries, not being horrible bc you left. You would not take nasty remarks from a coworker, or stranger. You shouldn't from her either. A lot of good info on YouTube.
You have been conditioned to take the abuse. You can learn to see it immediately, and react appropriately.
You will grieve the relationship you never had and wanted. I still do. I never had a normal relationship. Still don't with my sibling. She pitted us against each other.
BUT you can create good relationships with others. The way you want them to be. Good luck.

My mother was never a present parent, during adolesence is when she starting not caring, no love. This is one of the Narc traits. I am a middle-aged man now. It took me a long time to realize my mother has multiple mental issues. For the longest time, I thought it was me, my fault. This turned me into a People pleasing, Perfectionist. It was exhausting. I did everything Right. Mommy Dearest taught me how to clean the Perfect way, her way, and Yes, she did use a White Glove to test if I dusted right.She had little to no patience with me while I was young, and still does not. I remember I had to learn fast so she would not get upset for me asking questions.  All I wanted was to please her so she would love me. I did all humanly possible to please her until the day I found out I was being abused. I was in my 30’s. It took me that long because I was already Conditioned. I learned to put up boundaries, but I still fell back in old ways she conditioned me to be. Since then, she doesn’t really like me and her evilness, yes you read that right is getting worse as she ages. She is now 81 yrs old and “needs” me (Only Child) more to come over, clean, cook, organize you know the usual, being her punching bag, doormat, and modern-day Slave all while not appreciating one damn thing I do for her. I work from home and use to adjust my schedule around so I could help her x5 days a week, but My mental health was going down. Many sleepless nights, wondering what was wrong with me and how can I do things different so she wouldn’t get mad at me.I spoke to a nurse friend of mine and she mentioned dementia then I started doing more research and fell upon Narcissist, Borderline personality disorders. She has been diagnosed with Severe Depression and Anxiety disorder, but not Narcissist, or Borderline personality disorder. She won’t be officially diagnosed, because she is Perfect in front of the therapist and it’s everyone else’s fault. (Narc) She plays the victim. She is left alone in this cruel world to fend for herself while her only child (me) has his own life (guilt, feel sorry for me BS) Her therapist reached out to me one day and I was completely transparent with her. I told her she was very toxic and my mental health was being affected by her so I did not go help her as often. x5 days a week. I cut my time to x3 per week and less hours. The therapist understands the full story. The more I research the more educated I have become on my mother’s mental issues (several). I myself meet with a therapist once a week so I can discuss my concerns, and learn more about how to be around someone with so many mental disorders. I also learned not to Respond or Defend myself as I did before.
I am not dealing with a mentally sane person. I have to remind myself this. It’s hard when it looks and sounds like your mother, but its not anymore. She's very toxic and I can only stand so much. I am not used to being Controlled or verbally abused anymore. Unfortunately, I have to put her on “Probation” which means I take breaks from her, while this is good for my mental health. I return to a smelly, filthy disorganized luxury penthouse apartment I put her up in. Which means I have to work harder to Clean up the filthy mess she made. I now take deeper breathes, pray for protection against her evil being and I use aromatherapy. I make jewelry & blend essential oils. I use this locket and put my favorite Patchouli/Musk blend in it and wear it around my neck as a reminder NOT to take The Bait. That is what Narcs feed off of, our Reactions. When she wants to argue I just smell my locket and it reminds me NOT To take The Bait. I say “I can do all things through Christ who strengthens me” and I say "She is sick". "Don’t fall for it". All this self-talk and my special locket really does help me. It’s a new tactic. Deep breathes people hang in there, limit your precious Time, do what you can and get OUT. Most important YOU are not alone in this messed up Narc War.
Angel

I do not allow toxic people in my life, family or not. She has made it clear that she really doesn't care for you, you are a pawn in her life of misery.

My mother, if I would want to pay for a lunch she would say "I am not a bag lady" ok so the next time I would not offer, she would say "We need to split the bill, ok" the next time she would say "You pay" and on and one it went, until I said "I will not go out to lunch with you anymore". Problem solved.

Just an example of the crap I went through with her, I haven't spoken to her for 11 years and never will again, I am one of many who have stopped having a relationship with her, her entire side of the family has not spoken to her for over 30 years. Prior to that I was NC for 9 years, I went back because she was getting old, BIG MISTAKE never to be repeated.

Do what is best for you she cannot step on you if you are laying on the ground, get up and walk away, for your emotional well-being.

Similar situation here. My mom's hallmark line when I was growing up was "Don't have only one child. they will always disappoint you." Ummm...I'm your only child?

A NPD's goal is to tear everyone around them down and when you are the child of that NPD, you suffer the worst. Everyone wants to be loved and approved of by their mother, don't they? Well - it just doesn't happen for us. They will never love us more than they love themselves so we just have to learn to compartmentalize them if we have to deal with them.

I was NC with my mother for 15 or so years before she made contact with me nearly 3 years ago. In a weak moment, I agreed to see her and I learned that my stepdad had died 5 months earlier and it was evident she had dementia. Out of respect for my dad and stepdad and because God wants me to honor my parents, I agreed to begin to help her. Even then though, I only made that decision after much soul searching to decide whether I was strong enough to deal with her without doing harm to myself. In my own mind, I reserve the right to change my decision at any given time if my own wellbeing begins to suffer. I do, after all, have other people who rely on me for love and care and I have to be okay for them too.

When her narcissism outweighs her dementia, I have to step back and remind myself that I am only a caregiver, not a family member. I have to think that way for my own sanity and to be able to maintain the standard of character I have come to expect of myself. By doing that, I am able to give her the same level of basic courtesy and respect that I would give to a stranger, but nothing more. When her dementia is weighing more heavily, I am able to be compassionate toward her and patient and forgiving, but I never, ever, ever let my guard down.

Just this past Sunday, my mother embarrassed me horribly in church. I left her sitting in the pew and went to the car to wait for her. She managed to drag at least four other people into the situation and she was absolutely loving the attention. I won't bore you with the sick details of what all happened, but after the dust settled, I'm very sure I was shown in a bad light among some of my fellow church members thanks to her. Yep, it bothers me. These are my friends. My only hope is that they know me well enough to know I wouldn't treat my mother as shoddily as she made it seem OR that they don't know me at all and so I really don't/can't care what they think. People will believe what they want to believe. The one thing that kept me from going off on her in front of them is the fact that I have a higher standard of behavior for myself and I knew I would be disappointed that I let myself down.

I went NC for the week this week and I don't feel bad about it. The director of her AL called me last night to "discuss a few things". Turns out - she's been on a rage all week. I'm currently contemplating how to approach this weekend. I always see her on Saturday and then church on Sunday, Knowing she has been on a tear, I'm fairly certain I will tell her I won't take her to church Sunday because she can't behave, and if she isn't courteous when I go to see her tomorrow, I won't stay long and I won't take her anywhere. I've come to realize that the only real way to deal with her bad behavior is to give her negative consequences.

Sucks to be the child of a narcissist with dementia. I feel for you.