The Aging Narcissist: Adding Dementia to the Mix

By: Christine Hammond LMHC

Despite what a narcissist will pontificate, even they are subject to the effects of getting older. Becoming elderly is a normal part of the developmental stage of life for most people, but not for the narcissistic. They view aging as an ultimate evil. Some will engage in ridiculous plastic surgery in an effort to look as young as they feel. Others will begin a new career while their peers are retiring. And still others will take on far younger partners.
But what the narcissist can’t do is dodge the effects of dementia. As a progressive indiscriminate disorder which sometimes transforms into Alzheimer's or other disorders, dementia affects every area of the brain in a random order. What seemed natural and habitual now becomes foreign and difficult. Memory becomes scattered and unreliable. Familiar people become strangers or even enemies that are out to get them.
For the narcissist, this is completely unacceptable. Most narcissists rely heavily on their cognitive abilities as a way of constantly demonstrating superiority over others in performance, influence, power, beauty, or money. Any sign that it is deteriorating or diminishing is out of the question, something that cannot and will not be tolerated. This is when the narcissist is most at risk for suicidal behavior.
Make no mistake; narcissists don’t threaten suicide just to get attention, they actually follow through on the action especially when they begin to view their superior identity as slightly inferior. They would rather die than be revealed as fallible, vulnerable, or depending on someone else to do the basics of life. When a person has spent their entire life belittling and mocking those believed to be beneath them, they cannot in the end be revealed like them.
There are seven stages to the progression of dementia as listed below. However, how a narcissist responds to each stage is very different from other patients. This is because the narcissism is like a web inside their brain, affecting more than one area.
1.       No Dementia: No Cognitive Decline. This first stage is what pre-dementia looks like where there is no memory loss and a person, including the narcissist, functions normally.
2.      No Dementia: Very Mild Cognitive Decline. As a person ages, forgetfulness becomes typical but it doesn’t impair normal functioning. For the narcissist, their forgetfulness is often blamed on others.
3.      No Dementia: Mild Cognitive Decline. Forgetfulness becomes more consistent and trouble concentrating for long periods of time increases as work performance declines. Narcissists begin to notice this stage but work very hard to hide it from others. It is typical for them to have increased aggravation over their perceived slowness which they frequently project onto others.
4.      Early Stage: Moderate Cognitive Decline.Despite the best efforts of the narcissist, their decreased cognitive abilities become apparent to others. They typically struggle to remember even recent events, accidentally send too much money to the electrical company, or get lost easily when in new locations. Complex work tasks become too difficult but the narcissist won’t admit to it. Instead they will blame others and distract with elaborate stories of past successes. To avoid embarrassment (the Achilles heel of the narcissist), they withdraw from family and friends. When needed, the narcissist can function at a select event for a short period of time but as soon as it is done, so are they. The disengagement is extreme and may even appear catatonic.
5.      Mid-Stage: Moderately Severe Cognitive Decline.The memory deficiencies become significant as even common tasks such as cooking, dressing, or grooming require some sort of assistance. Some narcissists can weather this stage well if they have a caretaker who is willing to pamper them and tolerate their aggravation. But others slip rapidly into a depressive state which adds to the frustration. They may not remember major life events or people any longer. However, what the narcissist values is definitely revealed at this stage. If work over family was important, they won’t remember family vacations but can still remember a major deal they negotiated.
6.      Mid-Stage: Severe Cognitive Decline. This is when suicidality becomes a possibility if they are able to carry out the task. No longer able to care for themselves and having embarrassing problems such as eating or bowel control, narcissists shut down. For brief periods of time, the narcissism will disappear and what the person would be like without it appears. This becomes a hope that most family members cling to but the progression of the dementia is so advanced now that it becomes discouraging. It is also common for the narcissist to have delusional thinking such as watching something on TV and believing they are actually doing it. Anger outbursts are common as are paranoid delusions. The narcissist is so convincing even at this stage that they are able to draw others into their delusional state.
7.      Late-Stage: Very Severe Cognitive Decline. At the last stage, there is little to no communication, psychomotor skills, or walking. Everything requires assistance and the narcissist is a shell of what they once were. No longer able to recognize themselves or others, all of the narcissistic symptoms have disappeared along with their personality.
Watching any person go through these stages is traumatic; however there is a glimmer of awareness that is unique to a narcissist who has dementia. The key lies in remembering the brief moments when the non-narcissistic side of them appeared. This is who they really were, instead of whom they became.
To schedule an appointment with Christine Hammond, please call our office at 407-647-7005.

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