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My 82yo grandmother (likely) has LBD and is a narcissist. Her and her husband both live in a skilled nursing facility as they are unable to care for themselves. His dementia is more mild than hers. His primary symptom is a short memory span with no behavioral changes but she has severe hallucinations and delusions in addition to having memory issues. She also has a history of lying (and has for her whole life), so we have trouble deciphering when she is telling the truth. Recently, she told my entire family and the nursing staff that her husband is the reason why she has frequent falls. She blamed him, saying that he pushes her, and said that the bruises on her arms are because of him. It is likely that the bruises on her arms are from him, because when she falls and tells him to help her, he grabs her arms and tries to pull. He is 92 and is not strong enough to lift her, so he just pulls harder, causing bruises. However, he does not push her. She made it sound as if he was abusive, hence why the staff separated them. We have told them countless times to call a nurse for help rather than relying on him, but neither one listens. They also fight constantly because she is always yelling at him. This prompted the staff to move her to a different room.


All hell broke loose when they moved her. She has been screaming nonstop, calling us at work, saying that they won't let her see her husband (not true) they are abusing her (not true) and that we are abusing her (not true) and stealing her money (also not true). It is clear that she is doing worse away from her husband, but he is actually doing much better. She always starts fights with him and stressed him out but without her around he's very calm and clearly much happier. So question #1, should we do what's best for her or him? Keep them apart for his sake, or put them back together to get her to stop screaming?


Question #2, Is this behavior common with people who have LBD? The constant lying, delusions, accusations, and overall difficult personality? Is there a medication that can help keep her calm? She's already on Xanax 3x a day. She swears that we are stealing her money, but their money is being used to pay for their care. I know that you can't rationalize with people who are delusional but how are we supposed to just sit there while she screams in our faces that we're stealing from her and mistreating her, and that she's disowning us? My family has dropped everything to care for these people, and to be treated like this in return is infuriating.


The nursing home is debating whether they should send her to a psychiatric hospital because of these issues. She has been at this hospital before because she threatened to kill herself, and she demanded that she never be sent back there.


I am so frustrated and angry with this woman. I don't know what else we can do at this point. My family is tired of dealing with her constant accusations and difficult behavior. I guess reducing our visits is the only option to protect ourselves from her harassment. I'd like to know if anyone else has dealt with behavior like this and can offer any insight.


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She's sick, so stop blaming her for her behavior. If you can't do that, step away.
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You can't argue with, reason with, or control dementia. It has no reasoning capability at all. Narcissism may have been a problem in the past, and may complicate things now, but each patient and his or her descent into Lewy's is as individual as his or her own fingerprint. I am so sorry that you are all going through this. As to what drug cocktails may or may not work that is largely a case of experimenting until something works that doesn't cause too much stupor. Lewy's is notorious for balance issues, so that will figure in trying to find the correct medication and often there honestly is NO answer that works. I am so sorry there isn't better news and I hope something is found that will work.
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LBD causes people to be assertive and sometimes violent. Your grandmother needs medication. I would send her to a psychiatric hospital. Its no longer what she wants its what she needs. She is no longer competent to make informed decisions about her health. I would also let her children handle this. A grandchild, IMO, sjould be involved when the persons children should be handling her care.
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JoAnn29 Nov 2022
Thats "should not be involved.
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Encourage the nursing home to send her to a psychiatric hospital. She’s dangerous to herself, her husband and the staff. You shouldn’t feel guilty about that because at this point the most important thing is to keep everyone safe. It no longer can matter what she wants. Sorry you and your family are dealing with this.
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She DOES have behavioral symptoms. If this is a sudden change, it could be due to a UTI. Get that checked out first.


She badly needs to be seen by a geriatric psychiatrist.

At my mom's NH, there was a geripsych who came by at least once a week to see patients. Get GM seen; sending her to a psych hospital is also a good option for getting her on the correct meds.

In terms of "doing what's best for whom", sometimes in eldercare there are no "good" solutions, only the least bad one

Stop answering your phones. Don't listen to her accusations. She is mentally unwell. Address that fact and keep grandfather safe.
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Try supervised brief visits for this couple.
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Your family can opt to resign any PoA or guardianship and let the county/state become her guardian. Then everyone is done dealing with her. You can still visit her, you'll still have to block her calls but you won't be to blame for where or how she lives. You will need to put up and defend boundaries. Everything about dementia/LBD is hard. So sorry for this distressing situation.
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Scampie1 Nov 2022
It's terrible what happens to the elderly when the brain is diseased and they lose control. The psychiatric hospital would be able to treat her accordingly. I agree with giving up the poa for their own sanity. It's only so much you can do when our loved ones get to this state. Narcissistic behavior is a challenge within itself and throw dementia in the loop, no one can deal with the lying and the power plays. Sometimes violence and verbal abuse becomes an issue. Let the people who are trained in behavioral medicine deal with this and let grandma go.
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