How can I tell in non-clinical ways if my mother is entering dementia/Alzheimer's or if she's narcissistic?

Age is a factor: how old is your Mom? "Classic" age-related dementia doesn't really start until someone is in their 70s at the earliest. There are several types of dementia that occur for different reasons. ALZ is a dementia that can happen when someone is in their 40s, 50s, or 60s.

Dementia is usually diagnosed accurately by discounting any other medical causes, like a UTI, dehydration, vitamin deficiency (especially if the person is an alcoholic), diabetes, high blood pressure, stroke, tumor, etc. These are mostly found through testing and treatable with medication (stroke and tumors excepted). Once her primary doctor has checked these and nothing is found, then she should to to a neurologist.

Don't blend dementia and narcissism together... dementia robs people of their abilities to use logic, reason, good judgment, memory and empathy for others. It makes them appear to be narcissists. They are often described as "stubborn" but this is an early symptom of dementia that we often misread.

An accurate diagnosis needs to be gotten from her doctors. That's where she/you start.

There is really no substitution for diagnosis.

There really are no resemblances between narcissistic personality disorder and dementia.
Think of it this way: what narcissist do you know who cannot manage her own checkbook?

You are very vague in your question.
A few examples of exact situations would be very very helpful for us.
As you can imagine, we are simple a Forum of strangers who have never met mom!

Less than 1% of the population are "narcissists". Difficult people or those with Memory loss should not be labeled "narcissistic".

Below is a link to a website discussing signs of Alzheimer's and dementia to be aware of:

https://www.alz.org/alzheimers-dementia/10_signs

Good luck to you.

If there are big concerns, why avoid seeking a medical checkup & diagnosis?

"She may remain undiagnosed to the end.." Why? Because Mom would refuse?

In short, then Mom will live as she wishes sucessfully until she can't.

The level of assistance you provide to her daily life will be up to you, regardless of a diagnosis.

Are you ok with the current arrangments?

Thank you Geaton777
She's late 80's and has a clean bill of health through 1 month Nursing home stay from hip fracture, 4 ER visits with cat scans/mri's, many different Drs. No diagnosis for anything but fractures, contusions, swelling etc. Great vitals. In general very healthy, lol she's very hard to keep up with for me and I'm pretty healthy. Extreme stubbornness, but she knows/says she is. Maybe early dementia, I'll be researching further. She would NOT want to be evaluated so I can't suggest it to her. Have to wait until someone else sees something going on.
Thank you for the input!

What either/or? Narcissists can have dementia. As other have asked, why not have her evaluated?

There is a vast difference between being narcissistic and having dementia/Alzheimer’s.

Dementia/Alzheimer’s has to do with memory loss.

Narcissism, on the other hand, has to do with personality disorder. People who are narcissistic lack empathy/compassion. The only feeling they care about is their own. Nothing will ever be the narcissist’s fault; even when there’s evidence to the contrary, they will blame you for everything. Narcissists take you for granted. Narcissists only care about their needs and wants and you don’t count where they are concerned. Being selfish is an understatement of them. Everyone around narcissists or associated with them are viewed as objects to be used for their own gratification. These are just a few of the many, many traits of a narcissist. The poem of The Spider And The Fly brings to mind the exact description of the spider being the narcissist and this is exactly how a narcissist acts. Narcissists are charming when they meet you for the first time but once they entrap you that’s when you see their true colors.

When a narcissist has dementia, his narcissistic behavior becomes even more magnified.

We all know how little children are: they are hungry NOW, want that thing NOW, want your attention NOW. Have no insight or care to your wider day, your running late for work, a dentist appointment etc, need 5 mins quiet to reply to an important email or phone someone back before 5pm. Nope. It's all about them. We know their memory, forward time planning & problem solving skills are not fully developed. So we distract, we tell them the truth in a way they can understand. We are the adult so we manage it (well mostly 😜)

How many examples from elders does everyone have of similar behavior?

Want that thing NOW.
Want you to drive over today to change a lightglobe (in un usused room). Pick up biscuits (when you already did the whole shopping yesterday). Want to add 10 more tasks to the already full 2 hour visit.

Is this narcisstic? I dunno... Or a normal aging process of focussing on a smaller world, then just them?

Some may be poor memory or poor reasoning. Forgot the biscuits, cannot 'feel' when you last visited. Some may be lonliness - want to extend your visit. Lack of problem solving skills can turn into calling family for every problem large & small.

Is that what is going on?

My FIL was a narcissist. He also had dementia/Alzheimer's.

The reality of narcissism is that it typically starts in the teens and is often associated with some kind of trauma themselves.

If it is new behavior, it can be considered narcissistic TENDENCIES. As we age, especially as we become elderly - it is pretty normal to become very self-focused and shrink your circle. When you get dementia it is even more normal to not really show concern for the needs of others because it is all you can do to get your own needs met. People with dementia are really like interacting with 3 different people - and you never know which one you are going to get. Sometimes, they are the person you've always known. Sometimes they don't even know who they are. And sometimes they are small children who are "ME ME ME!!" and can't take care of themselves.

My FIL was a genuine, true narcissist. Add abusive into the mix (physically, mentally, emotionally, verbally) for my DH's entire life. My MIL spent years trying to cover it up and be the perfect Rockwell painting family. DH and his sister compartmentalized because they believed it was all perfectly normal.

Once MIL passed, his behavior became unbearable. He didn't care who he hurt or what it did to his relationships - he had to have his needs met. He was obsessed with having only the best, he judged people out loud about their appearance, he was racist, sexist, chauvinistic, and the most demanding person I have ever known.

As a result - his social circle shrunk to only people who didn't get stung by his behavior, and his immediate family who consisted of his son and daughter, and their spouses (me, BIL). And multiple grands. His son and daughter stuck around because they were conditioned by fear to take care of their father. The spouses stuck it out trying to protect my DH and SIL. And the grands abandoned ship - every single one of them. They only interacted with him if we were there and they had to for some reason.

He was such a narcissist that he engineered multiple acts of sabotage, trying to ruin DH's relationships to isolate him. Down to the minute he was trying to sabotage the move to SNF - KNOWING that we could no longer keep him at home. He instead suggested that my DH LEAVE ME and our family and move in to help him - on top of SIL and BIL already living there. He didn't like me because I had too much influence on DH.

The selfish behavior started LONG before the signs of dementia. Some signs are similar. The impulsivity, the selfishness, the focus on just their own needs.

BUT, narcissism doesn't just start when you are elderly. It would have been around for a long time.

Dementia - DOES just start later in life and look a lot like narcissism unless you've had a true narcissist in your life.

So my question to you is - has this been your mother's behavior for most or all of your life? Or is this new behavior. (new in the last few years)

FIL's narcissism got worse when he got dementia. He had moments of 'sweetness' that felt like lovebombing rather than genuine kind moments. They were few and far between. But THAT could have been narcissism OR dementia.
But the dementia certainly made it worse. (in rare cases it can ease the behavior).

In my mind, if this is recent behavior - it's being caused by the dementia. Our dilemma was always "is this his narcissism or does he have dementia now?" rather than "is this narcissism or dementia?"

You mention 'mental and psychological' things going on with your mother. She may very well have some form of dementia along with undiagnosed mental illness.

I was a caregiver for 25 years to more elderly people with Alzheimer's or some other form of dementia than I can remember myself.

I find from that long experience that the negative traits a person had before dementia will be magnified when they are elderly even of they do not have it. The same if there's a history of mental illness.

It's like I said in a comment below. If a person was selfish, snide, manipulative, cruel, etc... when they were younger and in the prime of their life, most likely age on it's own is going to increase these lousy traits a thousand times. Then add some Alzheimer's or some other type of cognitive, age-related decline and that's when the real party starts.

Take your mother for some testing. Her doctor can set this up. It's a starting point. Then it's one day at a time. You should be looking at care facilities now and exploring homecare options. It's always best to arrange these things before you're at the end of your rope and can't handle her anymore. Take her to the doctor. Talk to him ahead of time about what your concerns are and that you think she may have Alzheimer's or some form of dementia.

The root of narcissism seems to be environment and usually develops during the teen years.

The root of dementia is physical changes in the brain and typically develops after 60 (with the exception of FTD and ALZ).

"Dementia is a term used to describe a group of symptoms affecting memory, thinking and social abilities. In people who have dementia, the symptoms interfere with their daily lives. Dementia isn't one specific disease. Several diseases can cause dementia.

Dementia generally involves memory loss. It's often one of the early symptoms of the condition.

But having memory loss alone doesn't mean you have dementia. Memory loss can have different causes.

Dementia symptoms vary depending on the cause. Common symptoms include:

- Cognitive changes
- Memory loss, which is usually noticed by someone else.
- Problems communicating or finding words.
- Trouble with visual and spatial abilities, such as getting lost while driving.
- Problems with reasoning or problem-solving.
- Trouble performing complex tasks.
- Trouble with planning and organizing.
- Poor coordination and control of movements.
- Confusion and disorientation.
- Psychological changes
- Personality changes.
- Depression.
- Anxiety.
- Agitation.
- Inappropriate behavior.
- Paranoia.
- Hallucinations."

Source: https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013

IMO someone who wasn't a narcissist during the majority of their younger years but then develops dementia shouldn't be treated the same way as someone who is an actual narcissist. Someone with dementia can't help what is happening to them, and there is no therapy or cure for it.

My MIL (89) has short-term memory loss but not really dementia, compared to my other (deceased) Aunt who had both. They behaved very differently. My MIL is still very sweet and asks us about ourselves and our lives and seems to be able to be happy for us. Not my Aunt. And increasingly now, not my Mother (94).

It grieves me to think about how many people on this forum have (or had) to struggle with figuring out what to do (emotionally and literally) about narcissistic parents who now have dementia. May you receive clarity, wisdom and healing, and peace in your hearts.

They are not mutual exclusive. But, narcissism would have been evident your whole life.

I don’t think it’s easy to miss the traits of a narcissist. It is easy not to notice that dementia is at play. Many people, including myself, have missed the early signs of dementia with my mother.

I wish that I would have known to discuss what dementia looks like with my mom’s doctor. Like you, I asked questions on this forum.

My mother’s neurologist didn’t bring up the topic of dementia, even though she had Parkinson’s disease.

Not everyone who has Parkinson’s disease will have dementia but it would have helped me greatly to know what to look for instead of dealing with not knowing what was happening when it occurred.

Wishing you peace as you go through this difficult caregiving journey. My caregiver days are over. Mom died in 2021 at age 95. It’s very hard to see our parents losing their independence.