We might want to believe that as people age, they grow in their wisdom, their kindness, and their interest in giving back to others. While this is true for many older adults, individuals who were diagnosed with personality disorders earlier in their lives are likely to carry those traits into later adulthood. In fact, one study (Penders et al., 2020) indicated that as many as 15 percent of older adults living within their residential communities have diagnosable personality disorders, and around 58 percent of those in nursing homes do. Not only are professionals being faced with growing challenges in treating these individuals, but families and children of these older adults are faced with increasing challenges, as well.
While research suggests that older adult men are more likely than women to have a personality disorder diagnosis (Treagust et al., 2022), women are more likely to have other mental health diagnoses. Narcissistic Personality Disorder (NPD) is more common among men, and it appears that it arises as a product of early interpersonal relationships and temperament—anger levels in youth are related to the development of NPD (Lenzenweger, 2023).
Recognizing that narcissists have overly high estimations of their ability, entitlement, and status, it makes sense that they may react with extreme anger when they are thwarted or denied what they feel they are due. Anger and a desire to lash out are frequent reactions when they feel they have been disrespected, not given the credit they believe they deserve, or their demands have gone unmet.
As people age, the frequency of social interactions often decreases, which can lead to loneliness. However, while most older adults experience less loneliness when they engage with other people, narcissists do not experience a similar mood shift (Zhang et al., 2020). Older narcissists don’t value social interactions in the same way—nor do they feel better for having spent time with others. In another study, Zhang et al. (2022) found that the verbal expressions used by older narcissists are markedly different from their peers. They not only talk more, but they also swear more, and use more aggressive and less agreeable language.
While growing up with a narcissistic parent can be unbelievably challenging, the hope that you may one day escape and live your own life may be dashed when your older parent needs your care or support. Unfortunately, narcissistic behavior and the myopic, self-centered perspective can seemingly grow in magnitude as an older adult diminishes in other abilities. They may make everything a “life or death” situation as they hound you into responding to their needs and their whims. They may blame you for poor decisions they’ve made, missed opportunities, and lash out at you because of their failing health or reduced capacity.
If you’re caring for a narcissist and can’t understand why you have it so much harder than others who care for someone, you might be relieved to know that research (Day et al., 2020) shows that your load is greater than many others. In fact, caring for someone with NPD is harder than if they had some other serious mental illness. It carries more of a burden and diminishes well-being, yet it is unlikely to increase feelings of grief or sympathy for the person with NPD who acts out in aggressive ways.
Perhaps the most important rule to remember when caring for an older adult narcissist is to not get overly emotionally involved and not to overly engage in criticism. Both of these maladaptive coping styles negatively affect the person trying to cope. Recognizing the limits of what a caregiver can accomplish in terms of rehabilitating a narcissist is a gift you can give yourself. Getting overly involved in their symptomology doesn’t help anyone, and being highly critical of them is unlikely to change their behavior.
To find a therapist near you, visit the Psychology Today Therapy Directory.
References
Lenzenweger, M. F. (2023). Proximal Processes, Temperament, and Pathological Narcissism: An Empirical Exploration from the Longitudinal Study of Personality Disorders. Psychopathology, 56(1-2), 41-51.
Penders, K. A., Peeters, I. G., Metsemakers, J. F., & Van Alphen, S. P. (2020). Personality disorders in older adults: A review of epidemiology, assessment, and treatment. Current psychiatry reports, 22, 1-14.
Treagust, N., Sidhom, E., Lewis, J., Denman, C., Knutson, O., & Underwood, B. R. (2022). The epidemiology and clinical features of personality disorders in later life; a study of secondary care data. International Journal of Geriatric Psychiatry, 37(12).
Zhang, S., Gao, S., & Fingerman, K. (2022). DETECTING NARCISSISM FROM DAILY LANGUAGE USE: A MACHINE LEARNING APPROACH. Innovation in Aging, 6(Supplement_1), 611-612.
Zhang, S., Ng, Y. T., & Fingerman, K. (2020). Narcissism, Social Encounters, and Mood in Late Life. Innovation in Aging, 4(Supplement_1), 388-388.
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