My 82 year old mother suffers from extreme narcissistic personality disorder but needs my help. How much do I give?

You owe an abusive parent nothing. Many religious texts actually state this.

Abusive parents are not owed anything by their victim.

It would be like asking a POW to be a caregiver to their elderly prison guard.

Can you get a court appointed guardian?

I think running away is a good plan. Running away from enmeshment with her, that is. Since you are POA perhaps you can't go completely no-contact, but low-contact is very feasible and advisable.

This would make a good movie.

If it were my mom I'd do what I'd do for a normal mom such as set up the Medicaid and make sure she has a place to live. Once she messed that up I'd let the state take over. Let her feel her karma.

My mom also lies, gaslights, "forgets" to do basic parental duties, and found a myriad of ways to shut me out of the family. She was so neglectful that her kids should have been taken from her. Now she says she's "so tired of taking care of everyone" that she can't even bear to water plants so she's replaced hers with plastic ones.

What great advice you’ve gotten so far. I would like to add putting a credit freeze on her, so she can’t get new credit cards. Also, call the existing CC companies and cancel the cards or at least stop having new charges put on them. Manage all her accounts on-line & don’t give her access to them. 
But that’s only if she has dementia.  If not, then she knows exactly what she is doing, which is being blithely irresponsible knowing that you will bail her out.  

Suggest an “assistant” (CNA, home health aide, whatever) to help her getting to places, etc.  That might be enough to feed her ego.

Tend to her needs, not her wants. Please, please, don’t give her any more of yourself than what is absolutely necessary. At the rate your BP is escalating, you may not make it. We are dealing with an NPD MIL and had to (again) cut off all ties with her in order to save ourselves.

She lived her life. A nice long life filled with adoration of others, lots of stuff in the safety of her own home. Now it’s your turn. She gets to reap the consequences of her behavior even if she is elderly. She is not a child. Children need us to protect them from their lack of understanding how the world works. She does not. She doesn’t have dementia and is not incompetent. She is just a shopaholic without a sense of her limitations. (Sounds like anyway). Remember who you are and what you need. Do not get pulled into her control dramas. What’s the worst thing that could happen? She gets injured and goes into a hospital? She dies? IT’s going to happen to all of us. She gets to choose how it goes. You don’t have to protect her from herself.

I've lived with the effects of a NPD mother most of my life. The only real answer is limited, or no contact. There is no treatment unless the patient is willing to undergo therapy and medication, and that is a crapshoot at best. I'm living with, and caring for my NPD, and it is constant abuse...verbal, emotional, and at times physical.

It's a nightmare...

You are indeed getting good advice here. But when a person has been in relationship with someone who is narcissistic, especially if that narcissistic person is in a position of authority and the relationship is long standing and unavoidable (AKA a parent), it can be difficult to change old patterns. You may find it difficult to suddenly and successfully withdraw, set boundaries, and otherwise care for yourself, especially when you are a kind person with a high moral code. All this to say it might be worth your while to seek help in navigating the suggested cognitive and behavioral these kind folks are wisely suggesting for you. A therapist, counselor, or coach can not only help you understand how to do this, but also help you cope with any guilt feelings or other saboteurs that arise. Try to remember that there is a reason we are instructed to put on our own air masks first before helping others (if you ever fly they tell you this as part of the instructions in case the air masks are deployed). I wish for you strength, courage, and comfort on the road ahead.

I hear you. My mother was not quite so dramatic about things but at 88, still insists on getting her hair dyed and permed. She is and has always been difficult, unlovable, psychotic, demanding....you get the idea. I learned to keep my distance and have taken long breaks from her. My sister tends to her mostly and I don't know how or why she does, I refuse to be treated like that by anyone. If you have POA and are her only caregiver, now is the time to get her into a AL facility on medicaid. It is a long painful process but the alternative is what you are doing now, which is unsustainable for everyone's sake. Sometimes if they refuse to go, it takes a catastrophic incident, like a fall or fainting, to get someone to carry them out and then they never come back. Its unfortunate, but sometimes its the reality. Try to detach yourself from the guilt and emotions as much as possible, love yourself and your husband, and this too shall pass.

EMA, sounds like the taxi habit is a bleed that must be stopped. I agree that you can’t be on stand-by for Uber rides whenever she wants one. Can she qualify for a CNA visitor, that can take her on errands along with general help? Try any angle to get someone assigned to her, then you watch over that service and make sure she’s taken care of. If you don’t already, I would see a counselor to help you work through the weekly decisions.

Thank you everyone. All very smart and sensible answers. I do have POA and everything is in my name.

Darn CM, I wish I had that book 50 years ago, LOL.

EMA,
We could have been twins! My mother wasn't a TV personality but she thought she was beautiful and witty enough to be!!!!
She and I never got along either. I'm an only child too and, at 61, am caring for her in a memory care facility that I had to commit her to. Sigh! :(

I really feel for you. My mom has had Alzheimer's for the last 6-7 years and is in stage 6 now.

Fortunately, I got her to sign me on her bank accounts as co-owner by telling her that she was forgetting to pay her bills (true) and that, if she passed away, I wouldn't have enough money to bury her (also true). Because of those reasons she also signed the papers for financial and medical power of attorney.

If you haven't done these things, you need to. Then your mother must be declared incompetent by an MD or psychiatrist.

That's when you'll have the power to place her in an appropriate facility.

In the mean time, steal (yes, steal) her checks and credit cards so she doesn't run up bills. I took them right under her nose. Mother would catalog shop, once buying a ceiling fan duster... she didn't HAVE a ceiling fan!
She also paid her hair stylist by check after a wash, cut and set-$800.!!! Thank God the hairdresser was honest and gave it back to me.

Now is the time when the tables turn 180 degrees. We become the parent and they become our responsibilities.

I believe my mother never meant to have children so she could stay in the spotlight. She only gained 9 lbs. her whole pregnancy.
She used to refer to herself as "baby". I think she was inwardly jealous of me showing up (hey, the sex was her choice) and stealing all the attention away from her. It's normal that everybody gravitates to little girls in their frilly dresses and patent leather shoes, right? Mom would have been better off with a son. (Well, not in the long run.)

I gave up wanting a nurturing mother a long time ago. She wouldn't (and couldn't) give anything of herself. My girlfriend's mother sort of filled the bill at the time. 

I heard how my long, straight hair was ugly (hey, early 1970's-that was the style), how overweight I was (15-20 lbs.) and how badly I decorated my room. Sheesh, nothing I did made her happy. I got pretty good grades in school but "you could always do better".
Mom had 4 husbands over the course of 65 years, all of them alcoholics, as was she.

As you know, you and your mother will never get along. You, for your own physical and mental health, must have her sign POA papers, then have her declared incompetent, then place her in any appropriate facility. If found mentally incompetent, Medicaid will pay for her placement. (Medicare won't pay for mental or custodial care.)

I know exactly how you feel. Do you have trouble hugging or kissing her?
I did all my life. Even though my dad was an alcoholic, he wasn't narcissistic and I loved hugging and kissing him.

My mom no longer knows who I am but she recognizes my face. She doesn't remember ANYTHING about her life and lives in a "void".
But, in a moment last week, completely opposite of her previous personality, she told me how nice I looked and that she loves me. I wanted to cry. Why, at 95-1/2, brain wrecked from Alzheimer's, do I finally get the words that I've waited all my life to hear?
How ironic. It took a brain disease to cancel her narcissism.

I hope you can get your mom settled, then back out of her life a bit, focus on improving your health and having the satisfaction that you've done the best you could.

Sigh.

You could cut your own head off and hand it to her on a plate, and it would still not satisfy your mother's need for demonstrated admiration.

Although you may feel morally bound to ensure your mother's wellbeing, this goal is alas not attainable. You do not have the necessary legal standing to control her environment; and no emotional input from anybody is ever going to be enough. The latter is a true hiding to nothing.

More happily, thanks in no small part to your hard work, nothing terrible will happen to your mother if you withdraw. She will be housed, fed and cared for. Just not by you.

If I were you I would buy a cheap cellphone and make sure she has only that contact number, and I would keep the phone turned off except to call her at appropriate intervals.

And no matter what happens, that woman does not cross your threshold. She's your mother, you love her, you will do what you can at a distance; but you do not invite a vampire into your home.

'Understanding the Borderline Mother' by Christine Ann Lawson is a very practical guide to setting effective boundaries, by the way.

How much do you give?!
Well not your health.
Focus on that first.
Then set boundaries for yourself. For starters.
How much time?
How much money?
Do not bail her out until you get the paperwork in order. If she won’t sign a DPOA then save the bail out money for the certified elder attorney where you go to get guardianship. The dr who fired her should be able to tell you if she is incompetent to the degree needed to gain guardianship over her.
If she isn’t then you only need wait for “the” event that lands her in a vulnerable situation where you can act to protect her ( and yourself).
I can’t imagine the drama your birth must have caused her so I’m sure she does believe you owe her. I’m also sure you love her very much.
Just remember how hard life will be for her without you there for her and take good care of yourself.

I agree about POA. #1 on the To-Do list.

She won't be out on the street since she has Medicaid. If it comes down to it she can go into a nursing home and Medicaid will pay for it.

Set boundaries for yourself and make them clear to your mom. Don't let a phone conversation morph into a screaming match. Hang up before it gets to that point. Don't hang up angry, just tell your mom that you have to go, say goodbye, and hang up.

Why is it your responsibility that she feel safe? Why are any of her feelings your responsibility? You're setting yourself up by believing that. Her feelings are her responsibility and your feelings are your responsibility.

Narcissists rarely change. They lack the capacity to have insight which is required for change. You will be the one who has to change and you do that by boundaries. What's OK? What's not OK? Think about it and come up with some realistic boundaries and then stick to them. Your mom won't be happy about it but it you're not doing it for her, you're doing it for you.

Wow. I’ve read about toxic relationships on this site, but...

Understand that as long as you keep enabling Mom and bailing her out, she will continue to do as she darn well pleases and wait for you to Pick up after her . And you, being you, will. It’s a vicious merry-go-round and you need to get off. The bell has rung.

We all have moral obligations, but not when they negatively affect our lives and health. If Mom is now financially embarrassed, apply for Medicaid for her. Then get off the merry-go-round and tell her she’s going on a grand new adventure where there are people just dying to hear about her wonderful past life. She will have a new audience! She can even perform for them if she wants to! She can dress to the nines every morning (and she will have “staff” to help her) and spend the day regaling her new friends about her adventures.

Oh, and if you don’t already have POA, get it. Cancel the credit cards. You’ll need to grow a thick skin but it’s pretty much the only way you’ll survive.