As many of you know- my FIL has initially been told by his primary that he has no real cognitive decline. No real assessment was done - this was just a statement made by his primary for FIL's benefit (long, detailed story). Relevant detail is that FIL is also a raging narcissist (not diagnosed personality disorder but lifelong based on conversations with his sisters and symptoms that the entire family has observed over the years - this is NOT just selfish behavior, this is overwhelming, not within his control narcissistic behavior)
So to that end we would like to officially get a "real" assessment (he is 88) due to a number of factors but he has extreme ability to “showtime” and we have also repeatedly run into second guessing ourselves as to whether his behaviors are due to the potential dementia or just his over the top narcissism.
I have come to this group before with a similar question about different behavior because quite frankly I guess I'm attempting to build a portfolio of behaviors that we are concerned about to present to his doctors to discuss in an effort so show how his behaviors are declining because we know he is not going to even CONSIDER allowing an assessment.
And I tip my hat to those of you that are dealt with loved ones with dementia. With my grandmother - it is so clear -she definitely has dementia. It's clear cut, no question. With FIL - his behaviors are so - odd but could go either way.
The example I bring to you is the newest behavior. He has ALWAYS treated anyone that provided a service to him as well... in service to him. You can read that any way you want. But sufficed to say, when he left a tip, we went back and added to it, we apologized to wait staff for behaviors etc. So he's not the most pleasant person to deal with if you are in any way put in position to help him.
But here recently - it's just - I don't know - taken a bizarre turn. On multiple occasions - across multiple platforms - he seems to NOT understand that someone who is providing a service to him cannot also provide another service. Examples: The internet provider sent out a repair person to fix his modem. While they were there he asked them to fix his channel line up on his TV. His television provider is NOT the same as his internet provider. This one we actually clarified with him that he KNEW that his internet provider was not his satellite provider and his response was "it can't hurt to ask". The next example was more recent. He went to the eye doctor and as he got there his hearing aid was causing him problems. SIL told him just to turn it off and they would deal with it when they got home. He said he would ask the doctor to fix it. SIL said "Dad, the EYE doctor can't fix your hearing aid". He didn't say anything else but she said as soon as they finished the eye exam he launched into asking her to fix his hearing aid. The eye doctor was caught off guard but advised that she couldn't fix his hearing aid since she was indeed not trained to do so and my SIL asked him again why he asked the EYE DOCTOR to fix his hearing aid. His response was "it can't hurt to ask".
We are perplexed because this behavior keeps occurring and we can't figure out if the narcissism is getting worse and he just thinks that all people are just here on earth to do anything HE needs now. Or if he genuinely can no longer distinguish that people have actual jobs and don't do all things. I literally want to sit down and ask him if when he was working if when he went to do his job if someone had asked him to do open heart surgery while he was there if he would have done it, but I suspect he will just tell me he would have tried.
Has anyone experienced this type of behavior with their loved one with dementia? Is this something that is potentially dementia - just not having the ability to distinguish the roles someone actually plays? Or are we just dealing with his inability to understand that not everyone is here to do his bidding?
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You need to get your FIL to a Neurologist. He will test him and order the appropriate tests, like an MRI, to find out if there is any Dementia present. At 88 it just could be age decline. Let him ask the eye doctor if he can fix his hearing aides. As you have found out you telling him does not work. I would, though, look for other signs. Forgetting how do use a phone, a remote for the TV. Leaving a pot boiling on the stove. Short-term memory loss. Paranoia. Blaming you of stealing. His Narcissistic traits getting worse. And with all of this, you set the boundries just don't expect him not to try and cross him. When he gets too much, then u place him.
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My husband told me to treat everything as the dementia, because all the filters were being destroyed by the dementia, so my dad was still the same, he just didn't have the same ability to hide the ugly side of narcissism, less ability to be covertly manipulate.
While reading your examples, I said, loss of executive function = dementia. He knows he has a need, he just isn't completely clear on who can help with the need and he's right, it doesn't hurt to ask.
I would encourage your family to get regular breaks. I know that you and your husband relieve your BIL & SIL from caregiving, God Bless You guys for this, but is it possible for the four of you to take a week away? Hire someone to come stay with dad, you guys get away and have some great times and recharge your batteries?
My personal experience was that I could never really determine what was at play with my dad, I just knew that he got harder to deal with and I had to ignore lots of his crap or not engage when he was being "special sporty". That's the term I used when he was being impossible.
Oh, a doctor told me that smart people can hide a LOT of dementia, so I always kept that in mind and knew when he was "working" it by things he did or said that I knew would not have happened pre-dementia.
Best of luck, this is a tough situation for certain.
PS: no such thing as a stupid question. :-)
I had a faculty member call me shortly after they retired from the university. When they cleaned out their office they accidently left some personal items in a filing cabinet. They wanted to know from me where those personal items went. I explained to them that I did not work in that department and that they would have to contact the Chair of their former department to see what happened. After a long story the faculty member *thought* they left a key to a storage unit in that cabinet. Then they wanted me to call their storage unit and ask for a refund for him because they were going to be charged to replace the key. I finally after about 15 minutes managed to get this faculty member off the phone.
Does it matter if this new behavior is dementia or NPD? Would it change YOUR behavior or response?