jujube813

My 81-yr-old Dad's wife (my stepmom) recently passed away. He already had 2 DUIs prior to her death, and now with no license he is walking to the liquor store, drinking on the way back, and getting picked up by police and brought to the hospital to dry out.

Last time he was in the hospital I convinced him to try the inpatient program but when it came time for him to sign on the dotted line he refused. My brother was actually against any kind of program, inpatient or outpatient, because he says it won't work. I got my Dad to do the outpatient telephone screen but he lied about his alcohol use. I called them back later and told them the truth, but the fact that he's lying and they know it might disqualify him.

I live 3000 miles away from him and my brother is half an hour away from him. So I am not sure how much I can do. Maybe my brother is right, but the current situation is dangerous. My Dad is living on his own and leaving the gas on, etc.

I read the posters that have put their alcoholic parents into assisted living. This also seems like a time bomb to me. 24/7 caregivers from agencies also do not want to deal with it.

I have taken him to 3 doctors and spoken with a fourth and none want to get involved with a declaration of incompetence, although he has a "moderate dementia" diagnosis from a neurologist. I am trying tomorrow for the second time to get him to give me power of attorney. The first time he agreed but when we got to the attorney's office he refused to sign anything. $350 down the drain. Wish me luck!

What I've learned is that I'll have to lie about the dementia to get him into an alcohol program, but it probably won't work, and lie about the alcohol problem to get him into assisted living, but they'll probably boot him out. Perhaps my brother's attitude is wearing off on me. Has anyone tried this strategy and succeeded?

I don't expect anyone to give me a solution after reading the responses to the similar posts here. Just thought I'd vent. I'm down to prayer, and I guess I'll be giving Alanon a call.

Julie

tromboneliness

This is really hard -- bad enough when you're right there; from 3000 miles away, worse! My Dad died in 2010, at 90, possibly (there's no way to know for sure) from a chain of events starting with alcohol withdrawal (when he gave it up for a week or so).

There really is no way to get an alcoholic parent into treatment (just as with a younger person). They are the biggest liars and manipulators on Earth, and will say and do anything to avoid admitting the obvious. Actually, the problem is that's it's not that obvious -- that's why they can get away with lying to doctors, social workers, and everyone else about their alcohol use.

The thing about the incompetence is that somehow, the elderly alcoholic is able to summon up a reservoir of brain power that's just enough to avoid being declared bonkers -- I couldn't get a doctor to sign off on my Dad until he was bedridden and unable to speak more than a mumbled word or two. (I needed that letter in order to be able to pay his bills -- legally, that is; before that, I just used to go ahead and sign his checks.)

Al-Anon will help, at least to the extent of getting some help for you, which is important!

T

dollydo

My mother is going on 87, been a drunk for over 65 years. She lives alone 750 miles from me and my brother. Refuses to sell her house, refuses to do anything except drink.

So, we are waiting for her to fall down the stairs, or get picked up for roaming around
in the middle of the night, then we can take over, until then, our hands are tied. Something will happen, it has to. I have a power of attorney, however, it's useless
until she can be proven incompetent.

I am sorry,however, there really is nothing you can do and worrying isn't going to change a thing.

Kialua

Have you read this thread?
http://www.soberrecovery.com/forums/...need-help.html

The key for me was when my Dad was arrested and then forced into treatment. I know that doesn't always happen though. But "Mo S" had some interesting advice in the that thread.

I understand why your brother has given up if he lives near him all these years and had to deal with him. Good luck, keep us posted.

rosiev

Julie - it is really hard to get to the place where you accept that there is nothing you can do to change your Dad. Believe me, I know from ongoing experience. Then, once you get there, you might experience some glimmer of hope one day and it will send you back to thinking that you might be able to fix this sad, sad situation. My husband and I go through this all the time with his Mom and we've been through it with other parents and relatives, too. The one constant is that we've never been able to get them to do anything.

The other replies so far are right on target. Even an alcoholic elder with dementia finds just enough sanity to maintain their "independence" and keep up their drinking habit. They have strongly established priorities and they are very motivated. We actually sometimes wish that my mother-in-law would become demented enough so that we could trick her into not drinking or somehow control the situation, but it just doesn't happen. (This goes to the "can't control" part of the three Cs.)

Know that even if you were there every day, you would still not be able to fix this situation, and your sibling can't either. My husband and I literally live next door to his Mom and we see her twice a day and we are still losing the battle. I really don't think assisted living would help that much either. Nothing will stop them from self destructing if they don't want to change their lifestyles.

I'm so sorry you're going through this. Please find a support system of some kind. Being able to talk about this with people who understand the reality of the situation is a HUGE help. It still won't fix the problem, but it will help you get through this very painful time. You must take care of YOURSELF.

Kialua

From Mo S on the other thread:

Based on my personal experiece; there are plenty of nursing homes which accept alcoholics with dementia. Considering the cost of 24 hour care; it might be a good option. Ive had plenty of residents where i worked in a similar situation. I wish you the best.

Yes; based on the level of care he needs - it would be a lockdown situation. It all starts with you and his doctor. He will be evaluated for dementia and his doctor will establish that he needs that level of care AS well as the fact that he can't stop drinking. I would think it would be a safety issue. If the senior community he was at wanted you to hire 24 hour care then he is probably at the level to qualify. Hopefully' he has a good doctor who is not only aware of all you have been going thru with him and, understands you've reached a point where someone is telling you he needs 24 hour supervision. I wish you the best.

Kialua

From Mo S on the other thread:
Based on my personal experiece; there are plenty of nursing homes which accept alcoholics with dementia. Considering the cost of 24 hour care; it might be a good option. Ive had plenty of residents where i worked in a similar situation. I wish you the best.
Yes; based on the level of care he needs - it would be a lockdown situation. It all starts with you and his doctor. He will be evaluated for dementia and his doctor will establish that he needs that level of care AS well as the fact that he can't stop drinking. I would think it would be a safety issue. If the senior community he was at wanted you to hire 24 hour care then he is probably at the level to qualify. Hopefully' he has a good doctor who is not only aware of all you have been going thru with him and, understands you've reached a point where someone is telling you he needs 24 hour supervision. I wish you the best.

Kialua

oops double post

jujube813

I just noticed that Mo S is in Sarasota, Florida. The laws are very different there. No wonder, in Mo S's experience there would be "plenty of nursing homes which accept alcoholics with dementia".

I am thinking Marchman Act. Is believe it's exclusively a Florida law.

Anyone from New Jersey, where they have to be homocidal or suicidal for lockdown? This according to an addiction med doc who is director of a rehab. I hope he's wrong. I also asked the police, since he has 2 DUIs. No help.

Juju

Kialua

MN is pretty easy for nursing homes too. I heard from a client of mine who builds nursing homes that federal money is going to them more than assisted living facilities. Have you checked with a social worker or contacted nursing homes in his area? Or a county hospital? My client made it seem like it was federal money and instituted nationally.

Kialua

I don't know what county he is in but here is one that has a list of nursing homes
Senior Services - Nursing Homes | Camden County, NJ

"Senior Services - Nursing Homes

Licensed by the New Jersey State Department of Health. For individuals not requiring hospitalization provides 24 hour medically supervised patient health care. A registered nurse and a plan determine the level of care prepared for each individual. The plan includes assistance with activities of daily living, and drug administration as well as provision of physical, speech, outpatient and other therapies. Nursing homes may be appropriate for people with catastrophic illnesses; debilitation or chronic changes in mental or physical status; multiple hospital admissions with past 6 months; previous nursing home admission within last 2 years; major health needs. All licensed nursing homes must provide: 24-hour skilled nursing care; personal care; pharmacy; dining; activities; recreation; housekeeping; social work; and transportation. Cost of services: Since nursing home care is the most medically intensive of the long-term care services, it is also the most expansive. For those that meet clinical and financial qualifications, both Medicare and Medicaid programs pay for nursing home services, although Medicare coverage for nursing home care is limited..."

Then there is a list of nursing homes to call. You would need a lock up ward or dementia ward for him.

Is your father a Veteran? They have some services for Vets that we used for my father.

Just some thoughts.

Kialua

Department of Human Services | Health Care Services

Medicaid is a state- and federally-funded health insurance program that provides coverage for more than 1.2 million New Jerseyans who are income-eligible or who are aged, blind or disabled. It pays for hospital, doctor, prescription drugs, nursing home care and/or many other health care benefits.

Since 1995, most New Jersey Medicaid, including NJ FamilyCare beneficiaries, have been enrolled in managed care. With managed care, beneficiaries are enrolled in an HMO that manages their health care and provides services in addition to the wide array of Medicaid health benefits to which they are entitled.

NJ Long Term Care Facility Search - Set Search Criteria

Search for Long-Term Care Facilities
Search By County and Facility types
Select a county from the list below, then select one or more facility types.
Hint: if you want a list of all the facilities in a county, just select the county and click the Start Search button.

A couple more options. (Both my Dad and my hubby work in public housing so I thought I would search NJ and see what I could find) Good luck, I know there is an answer for you out there. Even if your Dad doesn't want it.

jujube813

Kialua,

Thanks for your suggestions. My Dad is not income-eligible for Veterans benefits or Medicaid, but I have been looking into some assisted living facilities in the area that have dementia units, just to price them and see what they have to offer, with the idea that we might set up a tour to see if he would prefer community living to living at home which is often lonely for him despite all the activities and caretakers we set up for him.

My concern is the places like that where my father might agree to live might not want to deal with an alcoholic. For instance, my father currently goes to a senior day care 2x/wk that he loves, but once he showed up drunk. That day care has an associated nursing home, assisted living, and memory care...the whole gamut...but I wonder if he would be accepted as a resident since they know now of his alcohol abuse. It's worth a try, but you can see the challenge here. Even if accepted, if he can get up and go to a liquor store any time they won't put up with it for very long (it's a religion-based center).

My father would never agree to live in a nursing home or lockdown...not yet anyway. As long as I cannot declare him incompetent I have no ability to place him in a living situation that he won't agree to. This has been told to me by doctors, lawyers, police, anyone I go to for help. Assisted living with memory care is the compromise, and I went with him on a tour once and he was like, "these people seem so old compared to me!" And he was right, not in years but in his demeanor, he seems younger by a lot. I would imagine he might get up and walk out of a place he didn't like, since he's paying for it.

Say a prayer for him, he's back in the hospital tonight with some cellulitis-type infection likely brought on by drinking so much.

Kialua

I will pray for him - and you. I guess the lockdown units will have to wait until the dementia becomes more prevalent, then he won't have a choice. The lock down unit is your best hope, because they understand the drinking and trying to leave component.

jujube813

Thanks again Kialua. It turns out he has MRSA infection, so he is in quarantine...kind of a mixed blessing. He is actually getting over the infection fine, but they are concerned about it spreading to other patients. The doc is hearing me about the alcohol rehab and has sent for a psych consult. So relatively speaking, things are looking up.

Before the MRSA diagnosis and subsequent haloperidol to subdue him, he was trying to walk out the door. Nothing I would say would stop him. It was not my Dad, it was like some monster had taken over his brain. Infection and all, he was ready to walk out of the hospital!!

Kialua

Wow. Well let's hope the doctors can see through him for his own good. I understand how he would walk out even if it would kill him. That's what alcohol does, takes away all reasoning.

tromboneliness

Oh, dear -- MRSA is deadly in elderly people (that's what happened to my mother). I take it they're probably giving him stuff like Daptomycin or one of those? My Mom was never able to shake the infection, and it killed her in about six months. I became convinced that an infection like that also affects the brain -- it certainly seemed to, in my Mom's case. It probably wouldn't entirely account for the "monster" that hijacked your Dad's brain -- but it might have helped it along.

Hope things work out better for you.

T

jujube813

T

So sorry to hear about your mother, that's awful and you have my sincerest condolences. My goodness what a horrible thing to go through.

The MD was not that concerned about it maybe because they caught it in time and it hadn't spread beyond his finger. A very perceptive nurse at his day care first noticed it and sent him to the hospital on Monday, and even before the culture came back MRSA+, they had him on a vancomycin IV. So I think time was on his side, but if he continues to drink I'm worried about it recurring. Time to get the house cleaned thoroughly. At least I can do something about that. Sigh.

He was already seeing a neurologist, and now the neurologist and hospital psychiatrist are working together on his case. This is truly a dream come true for me. It may not work, but it's progress. I'm trying to focus not necessarily on the ultimate goal, getting him sober, but just on getting some sort of clarity on how treatable alcoholism paired with dementia is, i.e., how much of the dementia is attributed to the alcohol. They are drying him out during the quarantine period and the psychiatrist will reassess him before discharge to see if he shows any memory improvement. If so, outpatient may be possible. More likely there is some component of the dementia that is genetic and therefore permanent in his case, I'm being pretty realistic about this. And also some component of alcoholic dementia that may not be reversable over this short period of time, or ever, due to his heavy drinking.

But I'm taking the attitude nothing ventured nothing gained. This is contrary to my brother and everyone else who rightly believe that he's got to help himself to ever get better, but I also think he is somewhat like a child, and does not know how to even begin to help himself, so this is a little head start. The rest is up to him. If we try to just let him hit bottom, he will die first due to his age and the dementia, without ever realizing what hit him. Like a 2-yr old leaning too far over the edge of a cliff. Of this I am certain.

Our pastor said something to this effect a few weeks ago, during a talk: "Yes it may be true that some alcoholics believe they have to hit bottom before ever getting better. But in actuality alcoholics taking that elevator down to the basement have a choice to get off on any floor". Or something like that. I think he said it more eloquently, but that was the basic jist.

My Dad sounded kind of tired tonight but the nurses said he was doing great. He is otherwise extremely healthy so I have confidence that the medically supervised withdrawal, although it may be hard on him, is better than the vodka he might have consumed over the same period of time. Thanks for the prayers.

Kialua

That is terrible Mike that your Mom got that infection. It is something to watch. jujube813 I'm glad that the doctors are on top of that. Good luck, will be praying.

jujube813

Quick update: My Dad was discharged to his home and we tried 24/7 home health aide. Once he was more mobile, he started leaving the house without telling her, to go to the liquor store.

So I managed to cajole him into going into a skilled nursing facility since he was still not walking properly, and it was covered by Medicare due to the recent hospital stay. He's been there over a month now, rehabilitating. He requires a caretaker to sit with him in the evenings or he will try to leave.

I have been setting up appointments for him to visit assisted living and memory care facilities but so far I'm having difficulty getting him placed. He is suprisingly compliant, it's the facilities that don't want him. He's too mobile, too with it (27/30 on the MMSE) compared to most memory care residents, but has severe STM loss, and is too much of an elopement risk due to alcohol seeking for assisted living.

So I had him evaluated at an outpatient alcohol rehab and his dementia was judged to severe for any sort of group counselling, and they had their doubts about individual counselling. So they suggested Campral, an NMDA antagonist/GABA agonist that reduces alcohol craving with little if any side effects (I think the worst is diarrhea) so it's safe for seniors. (Antabuse is contraindicated for the elderly.)

I also set up an appointment for him to visit Arden Courts, a home that specializes in memory care, and may have a more highly functioning patient population that would be a better fit for my Dad. Arden Courts are all over the place, not here in California but in NJ where my Dad is, and lots of other states.

The layout and activities were developed after researching what sort of community setting would best serve the memory impaired. It's about the same price as any memory care and it's flat rate meaning even as a resident require more care the rates stay the same. But no Medicaid. My Dad is fortunate that way though, probably won't require assistance. It's too bad the alcoholism is the only sticking point in this whole scenario.

I also had him visit the Actors Home, he's apparently logged enough hours in the entertainment industry to qualify. I filled out their extensive application and when I got to the post office the postage scale registered nearly 7 pounds of paperwork. I'll let them plough through that and we'll see what the verdict is. It's as expensive as any other place, it's not like it's free for retired actors or anything, as is the rumor, but they don't turn anyone away due to financial distress.

Let me tell you this is a huge project but I'm happy to do it if my Dad can live his years out in a healthy safe manner. I'm willing to do almost anything to ensure this.