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Both my FIL and my grandmother have(grandmother)/had(FIL) dementia.
My grandmother prior to dementia was one of the sweetest, most selfless people I have ever known for the most part. She would give you the shirt off of her back. She and my grandfather fostered over 50 young women from the time my mom was a teenager until I was a tween. But once dementia got a hold of her- she has become someone I don't even know. She says incredibly mean things to all of us. She is selfish, angry, hateful, and worst of all - she directs the worst of this towards my mother, her only child - who bends over backwards to take care of her. Her world is only about her - no one else matters.
And then we have my FIL. He was the TEXTBOOK definition of a narcissist - from the day I met him. My MIL did a good job of covering for him and I was naïve I will admit, and very much in love with her son, so I missed a lot of the signs. My MIL did her level best to make sure that I wasn't exposed to my FIL a lot. And my DH was immune to it I think. He has experienced YEARS of physical, emotional, mental, and verbal abuse from his dad. Their entire family had. It wasn't until my MIL passed away that I really started seeing it. My MIL, if I'm honest, was the one that we all thought was kind of of a shrew for years because WE thought she treated HIM terribly - it was the only way she could keep him in line and survive we realized after she passed away. The last 12 years with out her, dealing with him - have been akin to hell on earth.
My SIL, her DH, my DH (his son) and I became joint caregivers a few years ago. Knowing the difference between narcissism and dementia is often difficult because a true narcissist does NOT live in reality. They tell lies and make up their own narrative 100% of the time. They cannot take accountability for anything. They are deceptive and their own needs are all they care about.
But the biggest difference is that a person with JUST dementia hasn't always been this way. Narcissism typically develops in a younger person, Usually in the teen years. From trauma.
You don't just CATCH narcissism when you get older. You can get more selfish or self-focused. I think that's normal as your world starts to shrink. To worry more about what is within your reach. But there is self-focus. And then there is narcissism.
I have only ever known ONE narcissist in my life. And that was my FIL. He had ZERO empathy. He literally could NOT put himself in other people's shoes or understand how he hurt others. He deliberately caused pain to other people and could not understand why they didn't want to be around him. His grandchildren (ALL OF THEM) avoided him. The only time I have ever felt sorry for him was in his last days. He sunk into delusions and hallucinations from his dementia and essentially barely recognized anyone. He had to be sedated. It was very sad. It's not a way anyone wants to live.
But what a person with dementia experiences who is not a narcissist before they have dementia - that is NOT narcissism. I promise you. It's not even remotely close to it.
Narcissistic abuse leaves an imprint. Research even indicates that it maps certain parts of the brain of child the same way that brain injury or damage does in places like the amygdala and the memory center. I can totally see how that would be true in my DH and SIL from years of my FIL's psychological and physical abuse.
Dementia is cruel. It can change a person dramatically. It's awful to watch.
But as reported, my dad went through ALZ a few years back and was as kind as he always was. I have heard it said once, maybe anecdotally, that when people get older, their bad thing become more intense. I suppose many situations that defy that, like people who were very nice become mean and nasty. Thank you commenters to references to Teepa Snow. I had always meant to look into that but forgot, but will now.
If you're asking the question then it means that you need to educate yourself better about the horrible disease of dementia, so nothing that comes up will surprise you and you will be better prepared.
Welcome to the world of dementia!
We of late throw the diagnosis of narcissism about like rice at a wedding.
What happens in dementia is that all the "social inhibitions" are gone.
So we become quite honest, quite self-absorbed, and quite loud in our opinions.
For instance. I just got an awful haircut. Scalped really. Now Irma in her right mind may say to me "Alva, you got your hair cut shorter than usual? Are you going to a different salon".
But Irma with dementia will almost certainly say
"lost a skirmish with the Native Americans? Because looks like they scalped you!"
You get the picture.
Not only this, but often the person with disinhibition will be the most brutally honest with those he/she most loves and trusts, because--hey--it's SAFE to do so.
I recommend looking at all the videos you can find such as Teepa Snow on communication with those impaired by dementia, and reading Oliver Sacks books--he had a life long love affair with our brains and how they work.
Best out to you. Put on the armor and try not to take things too serious. Learn to respond to just about EVERYTHING with a smile, a shrug and a "Have I told you lately that I love you?"
But Irma with dementia will almost certainly say
"lost a skirmish with the Native Americans? Because looks like they scalped you!"
My MIL actually ordered me to go get my hair put back on because she couldn't stand to look at me when I showed up to help DH take care of her. Then, when I put on a bandana instead, it was "I hate that thing. I told you to get your hair fixed. If you won't, get out of my house!"
As for trying "Have I told you lately that I love you?"
When I said I love you, her screaming response: "You are not capable of love. You are evil. If you weren't, you wouldn't have hurt me by killing my son. Get out of my house." -- all this while that son stood next to me IN [legally] HIS HOUSE hearing it all.
Sometimes it doesn't matter what world they live in, you just can't do anything to help so your only option is to walk away.
Teepa Snow has YouTube videos on dementia and caregiving that I thought were really helpful. She gives ideas and strategies on how to interact with our LOs with dementia so that our engagement with them is more peaceful and productive.