Alzheimer’s/Dementia or Just Narcissistic?

SunnyInSeattle

My covert narcissistic mom has had some off/on memory issues for the past couple years like where she puts things. My brother and I can’t tell whether it is normal aging or more than that. In the past two months, she has suddenly started making up stories about her youngest sister doing black magic, trying to break into her checking account and a number of other false wild stories. She also got angry with a guy she used to date and started making up stories about him that are clearly false. A couple of my aunts have reached out to me wondering what’s wrong with mom, saying they can’t reason with her anymore and repeating the outlandish stories to me. My mom is obsessed with her ex boyfriend wanting to move in with her, which he does not. One day, she called me saying he died because she “read it somewhere online”…another lie. She even acted upset like he actually died. She presents well to strangers, but says all this craziness to family. I can’t sort out if this is just her wanting attention or early dementia. She seems to want a reaction and gets mad when we don’t give her one. I have thought about suggesting she go for a general checkup, but I don’t think a doctor would see anything mentally wrong with her. The whole thing is baffling and frustrating. Any kind feedback would be appreciated.

M1

This sounds like pretty classic confabulation and delusions.  Family frequently know before anyone else does--you need to let her doctor know what you are seeing/hearing, in detail.  Recognize that it is not deliberate lying.  She certainly needs medical evaluation asap.  Does anyone hold medical and financial powers of attorney for her?  Remember, if you do not have HIPPA priveleges with her docs, they may be limited in what they can say to you, but that does not limit what you can report to them.

The presenting well to strangers also has a name--showtiming.  You can learn a lot about the various dementia manifestations and behaviors here.  

SunnyInSeattle

Thank you for your reply. I have been gas lighted by her my whole life, but what she has done recently is way beyond anything I’ve ever seen from her. I have medical and financial power of attorney in case of emergency. I think I’ll see if she will agree to go to my general doctor. She doesn’t have a general doctor. She has always hated going to the doctor or dentist and is paranoid about what they might say. Fingers crossed I can convince her to go.

SusanB-dil

Hi SunnyInSeattle -  Fiblets.  Going to have to get used to using fiblets - "You need to go to the doctor due to new insurance guidelines so they will not drop any coverage" often works. And yes, as M1 has said, document what you are seeing.  She may showtime for the doctor, but do let them know, regardless.

SunnyInSeattle

Fiblets—good word. Thank you for the suggestion SusanB!

luv2bcntry

I feel for you, I am/was in the same situation. I would say find a way to look at her finances. We questioned as you are too long. By the time we realized it was Alzheimer’s she had blown through most of her money. She has taken the help well, but her stories and the ex-boyfriend still cause issues. She literally tells people the cops showed up guns drawn and stuff like that. Please casually find ways to check on the import things for her future quality of life. And also understand most acquaintances just believe her/let her talk, and then give you the 3rd degree. Some even encourage the tall tales. I have been weeding those people out of my moms circle. My mom tells me almost daily I ruined her life, but I know that’s not just the disease. (Heard it a good portion of my life) I have found I do better at caring for her from arms length and getting sitters to come in and help with day to day living. Please take care of yourself!

harshedbuzz

SunnyInSeattle wrote:

My covert narcissistic mom has had some off/on memory issues for the past couple years like where she puts things. My brother and I can’t tell whether it is normal aging or more than that.
In the past two months, she has suddenly started making up stories about her youngest sister doing black magic, trying to break into her checking account and a number of other false wild stories. She also got angry with a guy she used to date and started making up stories about him that are clearly false.

Normal aging might include occasionally misplacing something. These crazy stories and accusations are not normal at any age. They sound like conflated memories referred to as confabulations. Often, a PWD will recall an event--often one with strong emotional content-- but not the details. This causes them to backfill the blanks in their memory with incorrect details around the who, what, where, and when. She may have heard of a friend being scammed and now thinks she was the victim. The stories about the ex-boyfriend might really be about one from high school or something she watched on TV. 

A couple of my aunts have reached out to me wondering what’s wrong with mom, saying they can’t reason with her anymore and repeating the outlandish stories to me. My mom is obsessed with her ex boyfriend wanting to move in with her, which he does not. One day, she called me saying he died because she “read it somewhere online”…another lie. She even acted upset like he actually died.

That your aunts are confirming this suggests that she's progressed quite a bit. It If she conflating stories, she's likely not managing her IADLs safely and may need you and/or brother to take over. If you don't have DPOAs, you may want to talk to a CELA about obtaining control of her situation. 

My own dad had a difficult personality. More of a anti-social/bi-polar+ type than a narcissistic type, but he, too, tended to become even more self-focused as his dementia progressed so it was kind of easy to miss the onset of the behaviors as they were not that unusual for him. I will say that personality persisted well into the end stages of the disease for him; in the last several weeks before he died he got nicer.

She presents well to strangers, but says all this craziness to family. I can’t sort out if this is just her wanting attention or early dementia. She seems to want a reaction and gets mad when we don’t give her one. I have thought about suggesting she go for a general checkup, but I don’t think a doctor would see anything mentally wrong with her. The whole thing is baffling and frustrating. Any kind feedback would be appreciated.

There are screenings a PCP can do that can start the process towards an evaluation. At a minimum the PCP could order bloodwork to rule out any hormone or nutritional deficiencies associated with similar symptoms and order imaging to look for evidence of a lesion or past stroke that can as well. Finally, they could do a quick screening like MMSE, MoCA or SLUMS to see if there are any deficits in memory or executive function. It's best to contact the doctor privately to share your concerns and describe what you and other family are seeing because she will put on her gameface for the appointment. My dad was so adept at showtiming that I sent certain docs short videos of him acting out so he could get a sense of our reality at home. When you go to the appointment, take the seat behind your mom so you can non-verbally confirm or deny her reporting as necessary. My dad told his PCP all manner of nonsense. 

BTW, attention-seeking and dementia (not sure this is still "early") are not mutually exclusive. 

HB

LaurenB

I would add that when you make the doctors appointment, you inform the doctor ahead of time of the nature of your appointment. Emphasize before the appointment that this is a concern to family and friends.  This could allow the doctor time to understand what this appointment is going to be about.

SunnyInSeattle

Thank you all for your feedback, I really do appreciate it. I keep pretty close tabs on mom and she seems to take care of herself, bathing, grocery shopping, cooking, exercising, paying her bills. I mentioned today that I need to go for my annual checkup soon and mentioned she may want to make an appointment just to stay healthy. She seemed a little receptive, but wanted to make it herself. I’m trying to use gentle encouragement at the moment and told her we could go for lunch the day of the appointment. I keep a personal diary and have documented some of my conversations with mom that are abnormal. If she can just get an appointment, then I’ll follow up with the doctor beforehand to prep them. 

She called me today again asking my advice about letting her ex boyfriend move in with her. They broke up last year. She was definitely in fantasy land today. She is supposed to visit tomorrow and kept telling me she might not be able to come because he is moving in tomorrow. This is going to be a long road. Glad I’m not alone in this.

harshedbuzz

Sunny-

Given her delusional thinking, I wonder if you could make the appointment and get away with "reminding her" she made it the day before. Sometimes family caregivers use "fiblets" to manipulated their LOs into doing things that are best for them. A few people have presented the Medicare Wellness Check as a requirement for keeping insurance these days. Others are able to coerce their LO to see the doctor under the premise of needing a prescription refill or even to accompany you to the doctor as moral support. 

Whatever it takes.

HB

Iris L.

SunnyInSeattle wrote:

 I keep pretty close tabs on mom and she seems to take care of herself, bathing, grocery shopping, cooking, exercising, paying her bills. 

Do you know all of these for facts, seeing with your own eyes, or are you guessing, or relying on her own reporting?  I am not nearly at the level your mom is, yet I have difficulty in handling my higher ADLs.

Iris L.