Father is a narcissist, let’s the dog piss everywhere and ruin the furniture and rug. He refuses help then throws a tantrum if we can’t help right away. Any advice?

It is your house and you have choices because you're the one holding all the cards.
You could evict your father. Tell him that you will not allow your home to be disgusting. He would get evicted from a rent if he let the dog pisd and crap everywhere.
Since it is your house why not tear the rugs up. Don't have carpeting in the area where your father is. This will certainly help with the smell and mold.
DO NOT tolerate ANY tantrums for any reason. There will be none of that. When he starts acting up and throwing a tantrum put him in his place. Then completely ignore him. Pay him no attention whatsoever. When you do decide to go in and help him do so in your own good time. Not his.

Getting to the end of your rope makes you look at your options in my experience.
Getting angry can be the fuel you need for tough decisions.

"I fear if we get him in a nursing home he will get himself kicked out".

That's a worry for the future.
If it did happen, it would be delt with, so forget it. Don't allow a future worry interfere with NOW decisions..

Fear. This can really hold us back. Push through.

Fact #1. Dad can't look after himself (or his dog).
Fact #2. He is refusing care. Health/decline status: Unknown. Decline may be impacting his ability to self-care (not yet assessed).

Start there. 1. Get the facts on that with a medical check up + the initial short cognitive screen test.
2. Move into a discussion on his poor living standards & your level of concern.
3. Ask for advice on a direction eg full needs assessment etc.

If you cannot persuade Dad to have a general check-up, try for a specific task like blood tests or a medication review. Or put your foot down & tell it plain *Tough Love* style
You are unclean.
I am concerned.
To continue living in my home, I insist you see a Doctor.

Decline is often quite invisable to the sufferer. (They insist they can still drive well).

You will need to be the one to bring change. (You take the wheel now).

The issue isn’t about the ‘dog’ destroying your property. Sure, that’s part of the situation, but the primary concern is that your father needs care.

You already know that you are not interested in being his full time caregiver and honestly he needs 24/7 caregiving services.

The ONLY solution is placing your father in a facility. The rest will fall into place.

I hope that you are able to find a good home for the dog. You will have to renovate your home after placing your dad and hopefully you will resume your life in peace.

Best wishes to you and your family.

If the dog can’t be toileted on a schedule—ie there’s someone to take him out—and he’s just incontinent and there nothing that can fix this, perhaps the dog needs to be put down. As others point out, it’s not like the dog can come with him to the level of care he may need soon.

I’m really sympathetic, because the only way to deal with this is ‘to get nasty’, which you don’t want to do. But think – “We own the house”. It’s your house, your belongings getting ruined, your work – but not your rules? And - “We are not allowing it”. He isn’t changing when you ask, ‘many arguments’ have no effect, and it isn’t getting better. In reality you actually are ‘allowing it’. No-one is forcing you to allow him to behave like this.

He doesn’t need “a full time nanny”. He is messing up around the clock, even just for the dog and the dishes. Around the clock care is three 8 hour shifts, plus the weekends, which is much more than the cost of a care facility. A ‘nanny’ wouldn’t tolerate this (just ask Burnt!), and he wouldn’t tolerate the nanny.

Could you re-home the dog? It wouldn't follow him to a facility, if it comes to that. And few 'nannies' see part of their job as cleaning up dog s**t.

What happened to his sister when she was ‘kicked out’ of the nursing home? What care did she get, and where? Can you prepare for the same thing to happen to him?

As he won’t change, moving him out is on him, the result of his behavior. Do it now, before it gets even worse, and before you lose any affection you have ever had for him. Eventually some people like this end up in a shelter, which he might like to think about.

Is Durant the butler? If not, move the "narcissist " out to assisted living, rehome the dog, and think long and hard before moving another stubborn and slovenly elder and his untrained pet into your personal living space. Just bc it's worked in the past does not mean it's working NOW. It clearly isn't. Dad is obviously cognitively impaired if he's ok living in squalor surrounded by uncleaned dog waste. Get him properly tested w a MoCA or SLUMS exam and if he is suffering from dementia and you have POA, you can place him in Memory Care Assisted Living w/o further ado.

Good luck

You do not indicate that dad has dementia so I am going to assume (dangerous I know) that he is cognizant. If so and you want to stop this you do one of the following
Legally evict him and he has to find another place to live. And while he is living on your property the dog is crated unless it is supervised and it has to be taken out on a regular basis.
Whatever help you are giving him STOP.
Without your help if he is a danger to himself or to others you can report self neglect or self harm to APS.
With the eviction he will have a certain number of days to find another place to live. While I said don't help him this you might want to help him with this task just to make sure he is able to move out.

What is your payoff in this arrangement? There has to be something or you would not let this continue.

Sounds like it is time for Dad to be placed in a home as he is not able to make rational decisions or able to care for his dog, let alone himself.

Its your house so why are you letting him trash it with this disgusting behavior?

Time to evict dad.

So, this clearly isn't working out. For anyone.

Dad needs more and different care that he will allow you to provide. He is creating an unsafe condition for yourself and him.

Dementia?

Call the local Area Agency on Aging. Ask for a "needs assessment".

Call Adult Protective Services to visit him and to report an unsafe living condition. See what they suggest.

Do you have Power of Attorney?

This may need to end unpleasantly in eviction.

Do you think Dad is capable of looking after himself & his dog?

In your profile, you state that he is 88 years old. He's not going to change.

I echo the questions below -- why is he living with you?

In another post, you state that he lives in filth and refuses help. So it's not just the dog pissing and him missing the toilet. Are you cleaning that up for him, or is he refusing your help, also?

There has to be a reason why you are letting this happen. What is it? Does he have some sort of hold on you? Money? Title ownership of the house? What else? Mistaken religious beliefs? Physical violence?

Without a reason, at a minimum you would simply ignore tantrums, and you wouldn’t put up with all this. Boundaries for him and the dog, tantrums ignored, alternative accommodation arranged. What have you tried? Why are you tolerating him?

Does your father live with you? If so, you should ask him to leave.

Do you live with your father? If so, I would suggest you move away.

I wish I had better answers, but, sadly, the best way for you to avoid this is not to live with it.