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Drinking and Dementia Don’t Mix: How Families Can Help

People with dementia who are also experiencing alcoholism or alcohol abuse is a very challenging situation for family members to manage. Alcoholism speeds the decline in the skills needed for independent living, worsens behavioural problems, and raises concerns of safety for the affected family member and those living with/caring for them. This is in addition to the known health risks of alcoholism (e.g., cirrhosis of the liver, alcohol withdrawal syndrome and death).

Statistics reveal that 40% of adults 65 and over drink alcohol. We also know that almost 15% of older adults have Alzheimer’s disease or another form of dementia. The issues surrounding dementia and alcohol are becoming more prevalent as our society ages. We need to work together to find solutions to manage this difficult situation.

For families who are caring for a loved one with dementia such as Alzheimer’s, alcohol use becomes extremely challenging. The person is already impaired cognitively (in thinking, memory and processing information) and adding alcohol to the situation makes it much worse. A person with memory impairment may not appreciate how much s/he is drinking and will often neglect nourishment and basic hydration. It is even harder for family members to keep on top of things when the loved one lives independently. I have seen this problem in many settings such as when the person lives alone, or with family members, or in long-term care.

Family members ask what can be done. There are a few things that can be tried; however, there is not a clear-cut answer. I would like to share with you some of the common problems and solutions related to drinking and dementia.

Problems:

Practical Tips for Helping a Loved One with Dementia Stay Safe:

Solutions

Detoxification and rehabilitation are difficult and usually impossible for persons who have irreversible brain damage from chronic alcoholism. I have seen situations where the person is hospitalized, detoxed (removing toxins and abstaining from alcohol), then move to a secured facility for older adults which offers either no access to, or controlled access to alcohol. Voluntary recovery is almost impossible in persons with dementia. A person needs certain mental abilities to benefit from rehabilitation (restoring to optimal health and functioning). Most programs are based on cognitive-behavioural changes, which is not possible for someone with mid to late-stage dementia. A person with mild or early stages of dementia may be able to benefit.

I have seen success in persons who have dementia and whose lives were derailed by alcoholism when they are detoxed in hospital, then moved to a supportive environment where there is no access to alcohol. They benefit from living in a secured environment where they have stimulation, supervision and activities. They thrive with regularly scheduled meals, medications, and personal care assistance. In my community, these facilities are called Supportive Housing or Personal Care Homes (also known as Nursing Homes.) One unfortunate (or fortunate?) side-effect of this is that the person thrives and does so well that he or she may get to the point where it appears that s/he will be safe and capable of living independently. We fear that once the person moves out and lives independently, they will start drinking again. With proper supports and increased diligence (although the person may not see a need for it) it is possible for them to move home.

Preventative Measures

Families can encourage older adults to ensure that Power of Attorney, Wills and a Living Will/Advanced Health Care Directive is prepared well ahead of time. This will help prevent any major problems down the road — for example, when it comes time to sell property.

If you or someone you know has an addiction to alcohol, seek medical advice or call your local addictions organization. Education and support are key to aid in prevention and treatment of this challenging situation.
This article first appeared on angelagentile.com.

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