Caring for a Grandmother with Vascular Dementia and Narcissism

Jacque writes,

While I had considered providing you with the full backstory, it's clear that the details won't significantly contribute to the resolution. The crux of the matter is that my grandmother is a narcissist who has estranged all her children save for my mom, and even her contact with Mom is limited.

When my grandmother's manipulation ceased to yield the results she wanted from my mother, she sought alternative targets. Having exhausted other options, she couldn't oblige anyone else to her desires. Her grandchildren have all experienced the turbulence of her unpredictable behavior, making the prospect of caring for her unappealing.

I find myself in this situation not out of a personal desire to care for my grandmother, but due to her offer to sell us her house. This proposition morphed into a lease option contract when she struggled to relinquish control.

The condition of her house—plagued by foundation problems, termite infestation, plumbing and electrical failures, mold, insulation problems, rodent presence, water damage, and non-compliant windows—is such that it would typically warrant demolition rather than repair.

The contract obligates us to cover all property-related expenses, including her utilities, while providing us with the financial flexibility to carry out the necessary repairs. Despite dedicating a third of our income to repairs over the course of a year, we estimate needing another year to complete the renovations. Thankfully, our ability to perform the repairs ourselves has prevented the expenses from surpassing the house's value; otherwise, demolition would have been the prudent choice.

Recently, my grandmother decided she'd had enough of our presence and attempted to argue that we had voided the contract by altering the house's original state during the repairs. She reached out to various relatives to propagate the notion that we were exploiting her while relying on her social security to support our family of six. She falsely claimed that we reneged on our promise to invest in the property's maintenance.

Amid these distortions, she even asserted that we were now tenants and that she had removed our contract from her trust. When my husband calmly explained that we were in the process of purchasing the property according to the contract terms, her responses ranged from backpedaling to threats of selling the house to keep us away, and even threats of arson. My assurance of having retained documentation to substantiate our actions seemed to unsettle her.

The challenge I'm confronting, alongside her narcissism, is the emergence of concerning health indicators. I am convinced she suffers from obstructive sleep apnea, which she has likely had for decades. More recently, she has exhibited classic symptoms of congestive heart failure, and I suspect early signs of vascular dementia.

Combining dementia with a narcissistic personality disorder poses a formidable challenge. I have endured berating and belittling for issues as minor as a broken hose or using a dishwasher. Although my mother holds the power of attorney, she minimizes contact with her mother. It took six months of a persistent cough and a couple of significant memory lapses occurring in her presence before my mother acknowledged the dementia.

My grandmother's aversion to doctors, coupled with her awareness of a potential diagnosis, contributes to her reluctance. In the meantime, she frequently engages in brief conversations with an out-of-state uncle who tends to discuss us or focus exclusively on the news. Despite these interactions, he remains oblivious to her manipulation.

I've never sought my grandmother's approval, yet it pains me that my favorite uncle now holds negative sentiments toward me based on unfounded accusations. Without a professional diagnosis, I find myself treading water, anticipating the next major conflict in which facts will be distorted. Meanwhile, I am grateful for my foresight in documenting the entire agreement and for my meticulous habit of preserving receipts.

Do you have any recommendations for dealing with distant relatives when obtaining a diagnosis is improbable?

-Jacque

Jacque,

Your situation is undoubtedly complex, and navigating the intricacies of dealing with a narcissist is akin to threading through a minefield. The crux of the matter lies in your current circumstances and the challenges you face with your grandmother's behavior and health.

Your grandmother's narcissistic tendencies have clearly strained family relationships, leaving only limited contact with your mother. When her manipulation tactics no longer worked with your mother, she shifted her focus, attempting to control others. This behavior has left you entangled in a situation where your involvement is more circumstantial than voluntary.

Her proposition to sell her house to you, which turned into a lease option contract, reflects her reluctance to relinquish control. The extensive issues with the house—foundation problems, termite infestations, plumbing and electrical failures, and more—make it a candidate for demolition. However, the contract obligates you to cover property expenses, including utilities, while allowing flexibility for repairs. Despite a year of work and dedicating a third of your income to repairs, the project is far from complete.

Recently, your grandmother has escalated the situation by contesting the contract, spreading false information about your family, and alleging exploitation. She has made claims that you are relying on her social security and even implied that you are mere tenants. These fabrications, coupled with her deteriorating health and narcissistic traits, present significant challenges.

Adding complexity are her health issues, which you believe include obstructive sleep apnea, symptoms of congestive heart failure, and potentially early vascular dementia. The combination of these health concerns with her personality disorder complicates the caregiving dynamic.

Given the intricate circumstances, here are some considerations:

1. Document Everything:
   Maintain meticulous records of all interactions, agreements, and financial transactions. Documentation will be crucial for addressing any false accusations or legal disputes.

2. Prepare for Crisis:
   Gather essential information such as medical and insurance documents. Having these ready will help you manage unexpected situations.

3. Set Boundaries:
   Establish and enforce clear boundaries to protect your mental and emotional well-being. This includes limiting exposure to manipulation and setting limits on interactions.

4. Engage Support Networks:
   Connect with support groups or others who have experienced similar situations. Their insights and strategies can provide guidance and reassurance.

5. Focus on Your Family:
   Prioritize the well-being of your immediate family. Balancing caregiving with personal responsibilities is essential to maintaining your own health and happiness.

Navigating the complexities of dealing with a narcissist is undoubtedly challenging. From managing property agreements entangled with control issues to balancing health concerns and manipulation, the path ahead is difficult. With vigilance, clear boundaries, and the support of a network, you can maintain equilibrium and find a path forward.

Remember, your well-being is paramount. By embracing resilience and seeking guidance, you can navigate this intricate terrain and emerge stronger.

Warm Regards,
Diane Carbo, RN