My husband is an only child and has the burden of being a caregiver to his soon to be 91-year-old mother who has NPD. She is difficult to manage. Pretty much his entire life he has been blamed for all that is wrong with her. His father took off when he was a baby and I swear she blames it on my husband. In addition to NPD she has dementia, and some days are worse than others. She sometimes struggles with words and names. She gets confused with a calendar. She recently asked my husband for a relative's phone # who lives out of state and was thrown off by all the numbers. She claims she doesn't know what an area code is and kept asking my husband if he gave her too many numbers. She has been debating going home to her home country because she believes there are relatives there to take care of her despite being told many have died from COVID as her country, which happens to be a third-world country, was hit hard. She decided to speak with someone from the aging office here about getting home care and was told she has too much in assets and would have to pay out of pocket. She doesn't want to part with a dime. The caseworker told my MIL she really needs to do something about her depression. She also suggested MIL sell her condo and look into senior housing as she says she struggles with loneliness. Of note, my husband checks in with her almost daily yet she tells people she spends days alone. He has gone to check in on her and she is not home and never explains where she has been. She has some acquaintances who check in on her but has a history of alienating people due to NPD. She does not have a primary care doctor because she has crazy beliefs about doctors ("they butcher people"). I feel like something needs to be done but I don't know what. I know for many reasons she cannot stay with us. She has done too many things over the years and continues to. I feel like she needs mental health assistance but have no idea how to get it. I was hoping the aging office would do something but they haven't. I have no experience in this area as I lost my mother at a young age. Thanks in advance.
She should not be driving.
Your husband, if he is POA could place her in Memory Care where she would have 24/7 staff to care for her.
If she has not been diagnosed with dementia and she is then considered competent there is not much you can do.
This is his choice as to what he will do when and how much and for how long.
And as far as that goes support him but you do not have to help him.
Encourage him to realize that he can not do this himself and that she will be better in Memory Care.
MIL does not drive, never has.
She will not sign any POA as she is paranoid and suspicious. This is something she has always been.
I support my husband and I try to encourage him to read up on dementia and NPD. He knows his limits which is a good thing.
As long as she is competent, you can't force her to accept services. You can alert the Area Agency on Aging and APS to her situation, but basically you are waiting for her to fall or become very ill and hospitalized.
At that point, you tell the discharge planning folks that she can no longer alone (and that she's NOT moving in with you).
She was diagnosed by the aging office over a year ago and at that time was considered to be mild. We don't know why she hasn't been assessed again.
She will never assign anyone as POA as she is paranoid and suspicious.
I keep encouraging him to read up on things like dementia and NPD.
My DH's mom also has some form of NPD. I finally printed out a couple of articles about it--dealing with it and how to identify and not let it make YOU crazy!
He finally read both articles and came to me and said "I think my mom 'might' be a Narcissist!' Ya think?
Very strong boundaries keep him sane while still trying to help his YS who has been deemed the primary CG.
I personally wouldn't get involved. I have my own crazy relatives, thank you.
If your MIL has dementia, she should not be living alone because it's only a matter of time before she has some sort of crisis. THEN she will be placed against her will after the hospital or rehab SNF refuses to allow her to return back to her home to live alone. That's what happens to stubborn elders who refuse help, refuse to acknowledge a problem exists, and who insist on living alone. An accident happens that removes their power of choice and forces them into managed care against their will.
Until such time as that happens, your hands are tied. Your MIL will have to ask for help and agree to pay for it before caregivers can be sent to her home to help her out. Maybe your DH can talk some sense into her? Or get her to see the doctor for some anti depressants to address her depression issues. If not, you'll have to wait for an accident to happen, unfortunately, as many of us have had to do.
In the meantime, I suggest you and your husband read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.
The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2
She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.”
https://www.amazon.com/Isnt-Common-Sense-Interacting-Dementia/dp/1481995995/ref=sr_1_4?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468655&sprefix=jennifer+ghent%2Caps%2C631&sr=8-4
There are lots of good tips and a list of Do's and Don'ts in that book to help you deal with your MIL and her behavioral issues. Also coping mechanisms to help you deal with everything she's throwing at you.
Good luck!