Narcissism and Aging

Recently I was taking a journey down memory lane, recalling the work I did with individuals and families who had a loved one who was aging and in need of care. This was when I was fresh out of university and working for a local health care agency as a social worker. Many families are quite functional and navigate this life transition with love, care, compassion and ease. There is a level of cohesion within the family and clear communication about the wants and wishes of the aging loved one. This however, is not the case if your parent, sibling or partner has been diagnosed with Narcissistic Personality Disorder (NPD) or has narcissistic traits. If you consider all the toxic and stressful dynamics that characterize a narcissistic family system, this tends to be much worse as a loved one ages and feels more vulnerable as they lose, or at least, perceive that they are losing power and control.

Narcissism in individuals is characterized by a series of traits, along a continuum of severity that creates impairment in the domains of work, life satisfaction and relationships. This includes, but isn’t limited to: grandiosity/covert attitudes, entitlement, lack of empathy, lack of self awareness, is envious and believes others are envious of them, consistent emotional dysregulation, delusions of grandeur, transactional interactions, needing to be the centre of attention. Consider all of these traits in the context of aging. So I am referring to simply getting older here, but also about when someone becomes physically frail and in need of assistance.

Generally, when feeling vulnerable, disempowered or threatened all of the afore-mentioned traits get worse. Narcissists tend not to suffer with age. When they are in the bloom of their youth, they may leverage that and their looks to get what they need. Although the loss of youth, their looks and the social/economic currency this provides is a disappointment to them - they do the exact same thing with their age and fragility. They may resort to a similar manipulation to get people to feel sorry for them. There can be a level over-identifying with any illness and perhaps a level of histrionics and attention-seeking that has not been observed previously.

The typical power dynamics within a family structure may actually get worse. A very common phenomenon is that the aging narcissist will create subtle competitions between family members, leveraging love, and if available, money. They will evaluate who is supporting them, helping them and just generally at their bidding and decide who is at the top of the hierarchy. Generally, in my experience, the person in the Golden Child role is either enmeshed and allows for their lives to be taken over by caring for the narcissist - or they are dismissed from any responsibility as they are ‘too important’ or ‘too busy’. Conversely, the Scapegoat may be guilted into an intense caregiving role - OR completely left out of any communication about the care plan. They may also be the target for any blame or rage. There may indeed be an adult child who was ‘groomed’ for the very purpose of caring for their aging parent.

The last decades of a narcissist’s life can be characterized by them feeling very irritated, agitated, perhaps bitter - but lacking self awareness to help them understand it and work toward some sort of resolution. Indeed, the scope of whom they choose to scapegoat and blame for how they are feeling may increase to include neighbors, friends, relatives, people from different races or cultures, or gender-identity. Their ability to fake social graces and edit their inappropriate comments can deteriorate. It can appear as though they are upset with someone or a particular situation most of the time, and they may burn bridges with people in their friend group or community. This is exacerbated at times by their resentment toward younger people as they lament their lost employment identities, physical prowess or sexual power. It is not uncommon for older narcissists to try to present themselves as being younger, wearing clothing geared toward the younger crowd, and investing in lotions, potions, procedures and plastic surgery.

In my experience, they can have a hyper-focus on getting their needs met, getting their way and making sure that they are being treated as though they are special. Their world gets smaller and thus they focus on things that may seem insignificant to other people. They may engage in more escapism, television, film, books and this may help them indulge in fantasies of being famous, rich and powerful. They may live more vicariously through these fictional characters they see on the screen. In a similar vein, they may become overtly or covertly interested in other people’s lives taking on an air of judgment and criticism and engaging in hurtful gossip.

If you are concerned that a loved one may have dementia, any NPD traits will make it difficult to tell what is part of their personality structure and what is changing cognition. For example, narcissists, especially if they have NPD, can become even more irrational, paranoid and suspicious - which at times can be an early warning of dementia. They can be hyper-fixated on their money and belongings and not trust the people who are closest to them. It has also been my experience that they become more confabulatory and will also revise history - retelling their personal stories from their own grandiose delusional point of view. Reminiscence can be a powerful tool to connect with our elders - but challenging with narcissists because they don’t have a grip on the past events.

In Erik Erikson’s stages of human development model, he refers to the end of one’s life as having a fundamental task of reconciling ‘integrity versus despair’. This basically leads one to the introspective question of: “have I been a good human being, successful, who has left a positive legacy and people who love me?” Integrity refers to how you have lived life according to what you believe in, your values and moral code, if you will. It also refers to how you have found meaning in the losses and challenges that life brings, leading to a sense of peaceful contentment at the end of one’s years. I believe that this is beyond the reach of anyone with narcissistic traits and they will face those final years with resentment and fear.

As loved ones with narcissist traits age, it is important to draw some lines of self-protection, create boundaries that match up with what you value, and have continued patience and compassion for both them and yourself.