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Old 11-25-2008, 11:03 AM   #1
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I can't be the only one...father with alcohol related dementia...

Hello,

This is my first post on here. My father, who is 70, was recently diagnosed with dementia. As a background, my father has been an alcoholic for years and stubbornly never accepted that he had a problem, even thought we successfully intervened in his drinking and he agreed to go to a rehab, but once he sort of sobered up down at this facility, he saw his "functional alcoholism" (never fired, attorney, never ended up in the gutter) as better than these people around him who had hit rock bottom and thus didn't accept that he had any problem at all. This is in 2005, two years after his triple bypass at age 65.

He comes home from rehab and goes right back to the drinking, eventually alienating myself, his son 28 years old, and my mother, his wife moves out as she can't handle the forgetfulness, the nastiness, and the wandering at night.

During the year and a half he is by himself, he, being retired, slowly devolves into a shell of himself. Drinking at all hours, not taking care of himself or the apartment, calling neighbors at 5AM for Scotch for "visiting guests." He begins to hallucinate and think things are happening that aren't. He's invents things that happened. His short term memory is kaput, calling our financial advisor sometimes 5 times a day to ask the same questions. This is especially nervewracking as he handles the family finances.

Mom and I eventually are so worried about his memory, and that he's not eating, not taking care of the dog, sleeping on a bare mattress and losing his teeth that we do a second sort of intervention with only 4 family members and focusing only on his memory and not on his alcoholism.

He is taken to a detox/psych evaluation place, willingly, to undergo some testing and to be monitored during withdrawal. Our main purpose is to understand where he is brain is and what's causing the memory problems, and how closely related is it to the alcohol abuse.

Amazingly, he shows not signs of withdrawals from the alcohol. He's very disoriented in the facility and his usual stubborn self, wanting to leave. We learn from the psychologists there that he has dementia/alzheimer's, probably as a mix of drinking, "wet brain" and from a few small strokes he has suffered. While these will affect his control and his judgement, they will show no physical damage to his motor functions. Because he has these neurological problems, our hopes that he might enter a long term alcohol rehab are dashed because he can longer cognitively process the rehabilitation scenario. The idea of addictions and recovery wouldn't process with him as he cannot make new memories.

We're told he cannot be alone anymore, and within two weeks had to make a lot of hard decisions. We are told assisted living places are the best bet as we are not setup to have him at home with full time care. He is put in a first assisted living place, and after only four days he leaves the facility, finds a local store and buys a large bottle of beer. When found with that, the facility fears they cannot properly monitor him to keep him safe and want him gone. We convince them to let him stay, but a few days later, when trying to leave and being blocked from the elevator by a custodian, he hits the custodian and they immediately (the *******) put him in an ambulance to the nearest hospital, wiping their hands of him before even calling us to let us know.

He spends two weeks in an actual hospital, just in a bed, because we're scrambling to find the next right place for him. I know some might think it cruel not to bring him home for those two weeks, but we felt very strongly that it was best for him and for my mother that he not be reintroduced back into the apartment because we feared it would further disorient him to move twice and because we frankly didn't have the resources to look after him.

We eventually found a assisted living place in CT with a great locked memory care unit. While there have been problems in his adjustment there, always wanting to leave, lashing out at other patients, complaining of having little to do since he is 70 and younger and far more with it than the other members of this dementia unit, he has slowly adjusted with better medications.

But now, the good and bad news is that he has, by virtue of having a routine with structure and proper medication and no alcohol showed real signs of coming back. His mind seems clearer, and they're not sure whether he's a right fit for the memory care unit and he may be medically competent to make his own decisions meaning he'd be able to leave if he wanted. So now we're stuck in the hard place of where he goes now. He has dementia, but a mild form of it. His long term memory is strong, mid term ok, short term pretty bad. We know that if he comes home, even with an aide, he'll begin to drink again. Frankly, I don't mind if he drinks himself silly, but not in the apartment with my mother who has been through enough with this crazy man and needs this place as her home base and sanctuary and bringing him here is an undue burden on her. The memory care unit place thinks he might adjust well to the simply assisted living half of their facility, but my fear is he'll still want to leave and now he's allowed to.

I don't know how to get it into his head that he can't come home again, that things have changed permanently and he needs full time care. Does anyone have similar stories, dementia with a history of alcoholism and a older man, who's still very much with it, intellectual, needing stimulation, very stubborn and needing to be in control but who needs to be supervised? Where do you put such a person? Help.

W.

 
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Old 11-25-2008, 12:55 PM   #2
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Re: I can't be the only one...father with alcohol related dementia...

Dear W,

My sympathies to you. No you did not do the wrong thing .. he must be put, kept, locked into a place where he cannot get at any alcohol.

Although he is only in the first stages of Dementia, it inevitably worsens and he will continue to need the care he has now, plus more.

A nursing home may be the answer. If he has long term care insurance, they wil pay for it; if not, it is a daunting proposition. The place my Mom was, on Long Island, NY, cost $11,000 a month. When her money ran out she was finally accepted into Medicaid.

If your father is lucky enough to be placed in the kind of facility where my Mom was, he could be quite happy there. They had discussion groups, outings, books, one lady was a talented painter who did oil paintings in her room, those at worse stages of dementia or other disbilities just sat around with those scary blank stares. The others took part in games, quizzes, musical entertainment, etc. All the time my Mom had 24/7 professional care, they made sure she was washed and dressed and eating her meals and taking her meds.

Not all people in nursing homes have memory defects. Many are just physically handicapped, wheelchair bound, and unable to manage on their own. I saw a couple of gentlemen playing chess, and having heated intelligent political discussions.

It is absolutly right for you to protect your mother from any further scary and impossible situations.

I hope that your Dad has a will, has appointed someone Power of Attorney over his affairs, has a living will (health directive) designating what he would want done with him if he is in a coma, and designating the person he trusts enough to make life or death decisions in his stead if he is not able. Ideally it would be his wife, your Mom, but under the circumstances maybe he would appoint you.

Someone really has to take over his financial affairs. People in even the earliest stages of dementia have been known to give away huge fortunes to scam artists and crooked investment advisors, gamble away their house (a friend of my Mom's) or make out new Wills which are irrational and ignore previous rational plans they have made. It is very hard to get all this done AFTER the person has beome totally irrational, but in a lucid moment they may be willing to sign such agreements with a lawyer or notary present .

The saddest thing is to see a previously intelligent, educated and rational person forget who their children are, who they are, and what life is all about. Most of us here on this Board have seen it and gone through it or are still in the middle of it, and most are only too happy to share their stories and give advice. Consulting an Elder Lawyer was an enormous help for my family, as he helped us to do the best thing for Mom with her limited financial assetts. Example - by pre-paying her funeral and his own fee, her own money was 'spent down' sooner and she got on Medicaid sooner.

In the case of your dad, I would urge you to treat him just as we all treat our loved ones with Dementia - no blame, no ''if only you had" or "why did you" kind of talk. They are beyond reasoning, and incapable of understanding what has happened to them or why. They are in despair, and do not need to feel blamed or rejected on top of it. Your own depair and that of your mother are another story - and I highly recommend counseling to help both of you deal with your feelings. After my Mom passed away I went to a mental health counselor for over a year for weekly sessions. Everyone has a lot of guilt in these circumstances, needlessly, since we do the best we can. It is good to talk to someone about it.

I wish you luck. You are very young to have to deal with all this, but you will get through it, one step at a time.

Love,

Martha

Last edited by Martha H; 11-25-2008 at 12:59 PM. Reason: typos

 
Old 11-25-2008, 02:53 PM   #3
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Re: I can't be the only one...father with alcohol related dementia...

Welcome to the board W. I am truly sorry that you need to be here but glad you found us. I echo what Martha has already said. You are absolutely right in not allowing your father to move back in with your Mom or with you. You are right not to want to move your Dad more than necessary because of the confusion it causes but most of all you and your Mom need to protect your sanity.

Even though your Dad may appear to be better than he was, he still has dementia and it will only get worse. If you can leave him in the locked unit, to prevent the drinking, that would be ideal. If not, try him in the AL unit. He should have a patient plan in place and that should include his ability to leave the facility unattended. I assume he is not allowed to drive, I hope, which limits him to walking. Even though Dad is in AL, he had a monitor bracelet that alerted them if he went out of the door. He was not allowed to leave unattended. Perhaps this is something you can work out with the facility. It would be so much better for him to leave him where he is and not make yet another drastic change. No drinking, eating better, sleeping on schedule, has caused him to respond and his general well being to improve. You want to keep it that way.

I do wonder about the "mentally competent" label. Those with intellegence can make you believe there are competent when they are not. If you listen to my Mom, with no background information, you would think she was in the here and now. But when you find the facts behind what she says you realize she has little contact with the real world. She can discuss the stock market with me but is totally incapable of doing her monthly bills. She can make you believe that what she is saying is true, but when you talk to those that were there, she has created her own story out of bits and pieces and it has little similarity to what happened. So you have to be careful with intellegent professionals because they will fall back on what they know. With your father being an attorney I am sure he has a long history of making logical arguments... even if he doesn't remember what the current basis of the argument is. I would definitely have him retested before I believed what I saw.

The POA, medical directive/poa, and whatever else is needed to conduct his business both financially and medically are of utmost importance. I can tell you from experience that it makes your life so much easier!

Mom is somewhat in your Dad's situation. She was never a drinker but she does have ALZ. She is not as far along as most in the facility but she can not maintain at home and take care of Dad who is well into vascular dementia. She has found stimulation in AL. She enjoys the outtings especially. She also had difficulty adjusting but is getting there. I konw that even though she has good days.... she could not maintain at home. So she is where she will stay

Again, welcome to the board. I agree that your Dad doesn't need to go home with you or your Mom and that you need to find a suitable place for him. Mom and Dad are in an AL that is designed for dementia so even the apartment residents have some limitation, depending on their personal needs. So talk to the facility where he is ans see what they can do. If that is not suitable, find a facility that is somewhere between locked and total freedom.

I wish you luck and will keep you and your family in my thoughts and prayers.

Love, deb

 
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