Anger, Depression and Wine

Dawn MB

My mother was diagnosed with mid-stage Alzheimer's last year.   She is 80 and currently lives with my father (82) who is her main caregiver.  I am an only child and I typically spend Thursday nights with her, and then work from there on Fridays to give my father a much needed break. She tells me how lonely she is all the time and how much she misses me and that I am the only person she cares to even see.  She barely speaks to my father, and could not care less if my husband, her sister or nieces come to visit.   But, beyond that, she is terribly depressed and feels isolated yet will not go anywhere.  I understand that fear of going out is part of the decease, plus she has neuropathy and has terrible balance.  She is so down.   

To make the situation more depressing, in the last 2 years she has turned to wine to "calm"  herself, as she says.  The Dr. said that many people do this, or Benedril, or Tylenol PM to escape what they know is happening to them.    If she does not get wine, she is unbearable to be around.  Yelling, screaming and then sulking.   The next day, she has no recollections of her behavior, of course.  The Dr. said as long as she is safe, to just give her some wine even thought it's not a great idea.  But once she has had one, or two, she will search the house for more all while screaming and yelling. Trying to keep her seated is impossible.  She has had falls.  I know it's because of the wine, but she does not remember the wine; only that she fell and is in pain.  She always says, "I only had one", but we know better.   She was never never a drinker!! My dad is beside himself and my heart breaks for him.  I call every day, often, and I try to distract her and keep things light but its becoming increasing more difficult.   I am afraid she is going to fall, break an hip, and then that will be a slide she does not come back from.   

As for a plan?  He has saved about $50k for a home health aid when the time comes. He will not even consider the possibility that she might need to be placed somewhere.  And if he did, there goes the house they both love so much.  I know $50k will not be enough, but I cannot talk to him about financial things as he is from that generation.  "Not something my daughter needs to be concerned with".  No plan was made earlier by either of them to plan for the potential of long-term care. They both refused.

I am rambling at this point, for sure and I apologize.  Has anyone had a similar situation?  I guess it might be nice to know we are not the only family struggling like this. 

Thank you all for "listening".

Dawn MB

SusanB-dil

Hi Dawn MB - welcome to 'here'...  You are not rambling at all.

Does the doctor know the full story? The doctor who diagnosed the alz should be able to re-evaluate the need for different meds. Obviously, wine is not the answer. Does she have a neurologist?  just a thought that an anti-depressant and possibly something to decrease agitation would be in order.

Dawn MB

Thank you, Susan.  I did forget to mention that she is also on anti-depressants. (Who isn't, right?)  Her neurologist did up the dosage about 6 months, but to no avail.  It will be a topic of discussion at her next appointment..not sure when that is though.

harshedbuzz

Dawn MB wrote: 

To make the situation more depressing, in the last 2 years she has turned to wine to "calm"  herself, as she says. 

This is self-medicating. It's not ideal. Alcohol is a depressant and toxic to an already diseased brain.

The Dr. said that many people do this, or Benedril, or Tylenol PM to escape what they know is happening to them. 

Oy. Is this her neurologist or a PCP? Is he "suggesting" a medication containing diphenhydramine which some medical professionals feel is associated with dementia?

Given her mood, which is not unusual in PWD, it might make sense to get her in to see a geriatric psychiatrist who could prescribe a safe medication of low dose combination to help relieve her depression and anxiety. 

  If she does not get wine, she is unbearable to be around.  Yelling, screaming and then sulking.   The next day, she has no recollections of her behavior, of course.  The Dr. said as long as she is safe, to just give her some wine even thought it's not a great idea.  But once she has had one, or two, she will search the house for more all while screaming and yelling. Trying to keep her seated is impossible.  She has had falls.  I know it's because of the wine, but she does not remember the wine; only that she fell and is in pain.  She always says, "I only had one", but we know better.   

In dementia, short term memory would be an issue. She truly believes she's only had one. Being the alcohol police sucks. It would be better to not have it in the house and deal with her anxiety and cravings with medication. She no longer has the cognition to understand or make safe and sensible choices.

Most PWD do start to have falls whether they drink or not. Neuropathy would exacerbate this. She might still be a fall risk even if you are able to force abstinence.

She was never never a drinker!! My dad is beside himself and my heart breaks for him.  I call every day, often, and I try to distract her and keep things light but its becoming increasing more difficult.   I am afraid she is going to fall, break an hip, and then that will be a slide she does not come back from.   

As for a plan?  He has saved about $50k for a home health aid when the time comes. He will not even consider the possibility that she might need to be placed somewhere.  And if he did, there goes the house they both love so much.  I know $50k will not be enough, but I cannot talk to him about financial things as he is from that generation.  "Not something my daughter needs to be concerned with".  No plan was made earlier by either of them to plan for the potential of long-term care. They both refused.

It's not too late to get your dad in to see a CELA to do some Medicaid planning. Every state does this a bit differently, but unless their home is worth much more than average, he could remain in the home as a "community spouse" if she needed placement. In some states Medicaid does have programs to provide some hours of care to keep people out of facilities. If he won't listen to you, perhaps a lawyer could get through to him. Doing nothing risks it all. 

I am rambling at this point, for sure and I apologize.  Has anyone had a similar situation?  I guess it might be nice to know we are not the only family struggling like this. 

Thank you all for "listening".

Dawn MB

Michael Ellenbogen

II drink my beers every day and would not have any other way. It helps me relax  and think more straight because  I am more calm

jmlarue

Non-alcoholic wine? Sparkling grape juice? Is she still capable of reading labels? Ditch the bottle. You could pour it into a pretty decanter and say, "This is the good stuff, Mom. It needs to be decanted so it can breathe before drinking." You could also do as the Italians do with children - dilute with water - gradually, until she complains. Maybe she never will.

Don't feel guilty. The fine art of deception and fiblets are the only way some of us caregivers survive. BTW - Amazon has non-alcoholic wines. Nice to get them delivered to the door.

Stuck in the middle

Michael Ellenbogen wrote:

II drink my beers every day and would not have any other way. It helps me relax  and think more straight because  I am more calm

I guess you don't have depression, then.  Alcohol and depression are a bad combination.

I'm not a doctor, just a depressed man who used to drink.

May flowers

Or just empty out a wine bottle and refill it with grape juice… maybe mix half and half to start and slowly lower the wine content until she’s only drinking juice.

BassetHoundAnn

Welch's in a pretty wine glass. Works every time for my mom. It actually calms her down too. The placebo effect is real. But if I serve her grape juice in something other than a wine glass she realizes that it's just juice and makes snarky comments. So do pull out the biggest, prettiest wine glass you have. Presentation is everything. Bar-style snacks also help.

harshedbuzz

DawnMB-

A lot of people here suggested watering down dad's wine when I first came here or swapping it out for a non-alcoholic version. When they did, my immediate thought was "wow, it's really cute that you think that".

That said, there are wise people here and many of the strategies they suggested that I side-eyed did work every bit as well as promised so I did give it the old college try. I even procured a top-rated non-alcohol wine and pouring it into an empty Kendall Jackson Reserve Chardonnay bottle, of which he had many. I even over-chilled it to dull the off flavors. His brain was damaged, but not his palate. I tried varieties that tend to be lower alcohol (Vinho Verde there's even a Kim Crawford line now called "Illuminate") but he just drank more. The non-alcohol beers were a bust as well. I would still try watering in down <shudder> or swapping out something else and be delighted if you are able to fool your mom.

Dad needed to be abstinent to have a chance to maintain the cognitive improvements that were the result of him being treated with IV Thiamine for WKS. He'd become a high functioning alcoholic after my sister died; he had no interest in sobriety nor the cognition to parse his situation and learn to make better choices. 

The one thing that helped here was medication. FTR, dad was on an SSRI for depression from the time my sister became ill. But it wasn't enough. His geriatric psychiatrist tweaked his meds which help a lot. We were frank with him about the alcohol, and he added an additional depression/anxiety med (Wellbutrin) to address his apathy that is also indicated for smoking cessation. It didn't activate him at all but it did lessen dad's urge to drink and the amount he consumed. It's worth a discusstion.

HB

May flowers

I can’t vouch for any of these but may be worth a try? https://justwineapp.com/article/9-non-alcoholic-wines-for-dry-january-and-non-drinkers

harshedbuzz

May flowers wrote:

I can’t vouch for any of these but may be worth a try? https://justwineapp.com/article/9-non-alcoholic-wines-for-dry-january-and-non-drinkers

It's always worth a try.

I can speak to the Ariel- it's pretty bad. Off flavors and it tastes a little cooked.

Dawn MB

Thank you so much for your words. The suggestion to give her the wine came from the same doctor that gave her the test to determine she had alzheimers, not her neurologist. There are so many ideas here and I appreciate everyone 's help!

Dawn MB

Great idea!

Jo C.

Hello Dawn; you are a loving and caring daughter who is trying her best to be of assistance to her parents; they are blessed to have you by their side with this difficult problem.  It may be possible that your mother is feeling severe anxiety and is self medicating with alcohol to try to ease it.  Anxiety can be overwhelming and horribly painfully upsetting physically as well as psychologically, so that may need to be assessed.

It is true, anything with dyphenhydramine in it such as Benadryl and most of the PM Meds are strongly contraindicated with dementia or in elderly persons.  This is because the dyphenhydramine interferes with and blocks the chemical messsenger, acetylcholine, to the brain and affects thinking and memory.   This is also true of tricyclic antidepressants and meds to control an overactive bladder as well as some drugs used for Parkinson's Disease.

Perhaps the specialist may need to assess the meds and if her symptoms have increased since the increase in her antidepressant, it may be that some of her meds are affecting her in that way.  If the antidepressant is a tricyclic one, it may be part of the issue.  It will take the dementia specialist a bit of assessing to determine how to best approach.   Some anti anxiety med such as Ativan or Xanax or  may help; but we also know that it must be low dose in order to not affect the body coordination or other undesireable effects - of course this is also true of alcohol. If it is anxiety that is driving the alcohol train, then perhaps relieving that would be part of the answer.

As for alcohol, I would use an empty bottle from the real stuff and add the no-alcohol pseudo wine into it. It appears she is drinking to relieve symptoms and is not a wine connoisseur, so she may not detect less than desireable wine flavor.   If this does not work, the the only alternative other than letting her have free access would be to limit her to one three ounce glass of wine three times a day IF your father is willing to do this.  If not, there is nothing more you can do except wait for the next shoe to drop and eventually it will. 

It is also a good idea as already mentioned that if you can get your father to see an Elder Law Attorney, that he would be helped in fixing their finances into place as best can and also learn about the various other options that would be helpful for your mother and himself.  Don't know if you have Durable Powers of Attorney in "estate planning," but if not, this would be a good time to get things set into place.

Let us know how you are doing; it is a difficult place to be and we understand.  Hopefully a way to manage the issue will soon be found.  Sending best wishes for a good outcome to be found.

J.