Narcissism and the person with dementia
Narcissism is a personality trait where the person is self-obsessed. It doesn’t sound very nice to be around. It’s named after a mythical Greek figure who fell in love with his own reflection and wasted away staring at himself.
Living with a narcissist is said to be emotionally draining and challenging. You might feel constantly as if you are being put down. The person seeks attention while lacking empathy for others. They engage in “gaslighting”, which is when someone makes you doubt your own perceptions. The usual recommendation is that you run away from them and from that relationship as fast as your legs can carry you, because they won’t change. Escaping could save your life.
“It sounds disrespectful to compare a person with dementia—someone whose behaviour is the result of an acquired brain disease: with a personality trait that anyone would find unpleasant and unhealthy to be around. But what if the psychological injury to carers is similar?”
Living with a person with dementia
A similar experience arises when you are living with a person with dementia. It is draining and challenging. The changes in behaviour in someone you love may well make you feel put down. Do they ignore the efforts you are making to care? You are not doing it to get gratitude but sometimes it is noticeable that they want to hide the fact that you are now doing things for them that they used to do for themselves. Do they demand that you exclude any external help, to keep up the appearance that everything is under control? The “gaslighting” which is a result of their understandable fear and anxiety is demonstrated when they contradict you if you suggest that there are tasks that they are not able to do any more. That gaslighting is even more exhausting if they put on a good show for visiting family or doctors, who then cast doubt on your claims that something is going wrong. The mental stress from doubting your own reality is painful and damaging.
It sounds disrespectful to compare a person with dementia—someone whose behaviour is the result of an acquired brain disease: with a personality trait that anyone would find unpleasant and unhealthy to be around. But what if the psychological injury to carers is similar? If you look at it like that, the cause of the behaviour doesn’t make any difference. The effect is the same.
The burden of caring
The difference is that when a loved one has dementia, carers stick with them, even when their own health and wellbeing suffers. I know of cases where because of the burden of caring, the carer dies first, even though dementia itself is the fatal illness. They have tried too hard to keep things as they always were, and they’ve not asked for, or known about, the help they need to care.
Keeping up appearances because the person with dementia demands it is too much eventually for some carers and they need to protect themselves. It’s not selfish. It’s about staying well so you can continue to care, and so that you will not be left a complete wreck after the person with dementia dies. It’s a recognition that dementia is a fatal illness, even if in the early stages the person affected can live very well.
This is why dementia carers must be informed by health and social services at the earliest stages about what is available to them. Nurses, doctors and social workers… you can’t do that if you don’t know about it yourself! This is a plea to health and social care workers to get themselves informed of all the local supports and make sure people know about them before, during and after dementia diagnosis. Because carers have such a sense of love and duty, they won’t run away, even to save their life.
