Sneaking Alcohol and Driving

Kamd

My DH was diagnosed with MCI about four years ago. He scored low in short term memory and executive functioning on his neuropsych exam. 2023 was absolute hell with sneaking alcohol, voluntary commital for suicide plan not acted out but still threatens suicide, physical violence twice (I wouldn't let him drive off in anger). He is very high functioning (still drives and is in church and civic social groups). He was put on new meds and I thought they were working. He is not as angry and his compulsions seem better managed but sneaking alcohol is alive and well.

I understand the losses due to his diagnosis. I know this isn't the man he was or wants to be. We have been married almost 40 years. We have put in the time and work in our relationship. I thought we had seen it all but we are in hell. He is in denial about his diagnosis and its limitations. This has carried over to sneaking alcohol and driving. He did not have issues with alcohol before this diagnosis. Every professional we have seen says no alcohol because of his short term memory and executive functioning loss. The professionals have heard the story of how last June, my spouse stopped at the liquor store before heading to the DMV to renew his license. Of course, his license was renewed. No one seems interested in pulling his license. It will be up to me but I know he will threaten and maybe even attempt suicide. His opportunities for the socialization that he craves and needs will be reduced to what he is willing to let me drive him to. He blames me for his problems now and this will make it 1000x worse. But I cannot let him hurt anyone.

I write this alone since my husband went to the local senior center to play pickleball. He seems to have stopped at the liquor store before he went in to play (I learned last year to put a tracker on his vehicle). I am furious. I hate him for putting us through this again and again. I have an email into his therapist. Does anyone have any ideas?

Ed1937

Kamd, welcome to the forum, but sorry you need it. I'd suggest that you make an appointment with his doctor. Write a note for him/her to read before seeing him for the appointment. You can give the note to the person at sign in desk, and ask that the doc read it before seeing him. You can share everything that concerns you, including drinking and driving. Ask that the doctor tells him he can't drive anymore. If you can get someone else to tell him, it will make it easier on you.

And of utmost importance is that the doctor knows of his threats of suicide. There are medications that can help with that, but that might require a Geri psychiatrist to prescribe the right meds or combination of meds.

I have a son with mental illness, and he attempted suicide twice. He has been dealing with the illness for 20 plus years, and finally someone found the right medication for him. He has been a different person for the last 6 months. When you get the right meds, really good things can happen. I wish you luck.

Kamd

Thank you for your comments, Ed. Every single doctor we have seen knows the whole story - Neuropsych, Neurologist, GP, CNP for mental health. Because I attend each and every appointment (I didn't in the early days and then COVID happened so I think we lost years in getting to the bottom of my spouse's anxiety, memory loss, depression) my DH sees my listing off of concerning behaviours to professionals as a disservice to him. He is almost manic in his search for a friend group. Last May he was "fired" from a civic group because of a complaint from someone regarding his attempts at humor (very inappropriate joke). I could drive with him to perhaps curtail some of his alcohol sneaking but I hate to be with him in public. He says the same jokes, goes off to talk to strangers and ignores me unless I am a useful front for being normal.

After today's incident, I have a second email to the therapist he is seeing to discuss his sneaking alcohol and driving. We started as a couple to talk/navigate through the issues this diagnosis has dealt us. It devolved into just him speaking to the therapist alone. I am no longer a wife but a caregiver dealing with the latest crazy behavior.

M1

Welcome to the forum Kam. This sounds very difficult and like an accident waiting to happen on multiple fronts. Literally.

There are many, many threads here regarding driving and it is one of the very toughest issues. Although this sounds terrible, I wonder whether there is any help to be had from your local police. If he were stopped for DUI or even an open container law, it might help you get him off the road.

I find it ironic that he is seeing the therapist and you are not. I wonder if he has the bandwidth to benefit from it.

You are not alone in dealing with alcohol issues as well as dementia, there are others here with the same or similar combinations. The alcohol will probably be easier to control later in his disease course. I wish I had more concrete suggestions but i don't. Unfortunately, you may be forced to be more of a chaperone than you want to be, however unpleasant. Unless you can hire it done, which seems unlikely.

JDancer

Please search "driving" and "car " on this forum and read the posts. Your LO should absolutely NOT BE DRIVING. It's not an easy things to stop, but lives may depend on it.

Thank you.

upstateAnn

First. I know this is terrible for you. Second. It is not his fault. Your husband has a fractured brain. He is sick.

However, you point out some serious issues. I was fortunate on that my DH stopped drinking almost twenty years ago because it irritated his throat. He also voluntarily stopped driving because he felt his perception was off. He said if he did not feel comfortable driving his grandchild he should not drive at all. I was so so lucky

Since you have the cognition that he does not have, you must become tougher and stronger. As my daughter said, you are the decision maker and the boss. I hope he no longer controls your finances, etc, I know this is terrible. Your husband is ill and cannot change or be reasoned with. Get support. And get a therapist. BYW, my husband and I are very open about his dementia. We still socialize a lot together. Since our friends know about his illness, it is so much easier. They also watch out for him. Alzheimer’s is a disease, not a reason to be cast out of society,

Pat6177

Hi Kamd and welcome. I may be repeating things you already know but just in case… You say your DH is in denial. Chances are that if he has dementia, it is not denial, it’s anosognosia. This is a medical issue that affects both people with dementia and with TBI. He truly is not able to understand that he has limitations. With denial, a person could work with a therapist and come to understand. With anosognosia, he will not be able to understand his limitations.

If he can’t understand his limitations then he will see no reason to stop driving. And there will be no way that you can reason with him to get him to stop driving. Check out the other recent threads about driving. One person found that she had to be non-confrontational with her DH and came up with all kinds of ways to keep her DH out of the drivers’ seat including disabling the car and then telling her DH that they were waiting for parts to come in. It requires a lot of creativity and many of the ploys only worked for a limited time but they kept him off the road.

The other issue I wanted to mention is that you have been giving his history to new professionals in front of him. If he has anosognosia and can’t see his limitations, then he probably doesn’t agree with some of what you are telling others about him. To avoid that situation, try to provide the details to the new professional privately and that will be probably be in writing. If there is a patient portal, upload it that way. If not, mail your comments to the professional beforehand. And then bring a copy along to give to the receptionist and ask that it be provided to the professional prior to coming into the appt.

And yes, we do become caregivers. It’s part of the grief we all experience.

housefinch

@harshedbuzz might have additional thoughts

harshedbuzz

Hi @Kamd and welcome. I am sorry for your need to be here but glad you found us. The intersection of alcohol, mental health issues and dementia is not an easy needle to thread. I dealt with this with my dad with whom I never enjoyed an easy relationship. My mom was the victim of many of the same behaviors you both describe and seemingly hint at. My thoughts below-

You said: My DH was diagnosed with MCI about four years ago. He scored low in short term memory and executive functioning on his neuropsych exam.

It sounds as though his MCI has progressed into dementia since he was initially evaluated. This is pretty typical especially given what you are describing. It might be useful for you to take a look at the Tam Cummings Stages to help you make sense of what you're seeing. Rule of thumb is that a PWD is considered to be in the latest stage for which he has symptoms/behaviors. This 7-stage model is more about caregiving; doctors use a simpler 3-stage one.

Tam-Cummings-LLC-Handouts.pdf (tala.org)

2023 was absolute hell with sneaking alcohol, voluntary commital for suicide plan not acted out but still threatens suicide, physical violence twice (I wouldn't let him drive off in anger). He is very high functioning (still drives and is in church and civic social groups). He was put on new meds and I thought they were working. He is not as angry and his compulsions seem better managed but sneaking alcohol is alive and well.

I am so sorry. That is so hard. Especially in dementia where you can't always be sure if the alcohol use is because he can't recall he's not supposed to drink or how much he's already had, if it's a protest and a way to show you can't control him or if it's related to self-medicating because he has anxiety around his perception of what's going on.

What sort of meds has he been given? Are they being prescribed by a psychiatrist or geri-psych. We found the geripsych the most useful for dad. Dad even enjoyed the appointments because the doctor was so warm and respectful and because I could communicate all of dad's shenanigans via patient portal/email or non-verbally communicate when dad's reporting was utter fantasy. This allowed me to position myself as an ally rather than the villain. He was already on a healthy slug of Prozac when diagnosed in the middle stages. We added 25mg at dinner to improve sleep and then added another 25mg in the morning to keep his aggression dialed back. I think a lot of the aggression was anxiety driven and Prozac just wasn't enough. At one point his geri-psych added Wellbutrin to help "activate" him out of extreme apathy. It didn't but it did seem to lessen his desire to drink tremendously. He went from a bottle or 2 of Chardonnay nightly to maybe 1-2 glasses which he might not finish.

Dad had mixed dementia. He had Alzheimer's and an alcohol-related form called Wernicke-Korsakoff's. He was not supposed to drink at all. He was diagnosed during a hospitalization for a psychotic episode and then sent to a SNF for PT/OT during which time he didn't drink. Once home, he climbed back into the bottle and he progressed rather rapidly. Many people here did suggest non-alcohol wines or watering his wine down. We tried it and it did not go well. His brain was diseased, but his palate was intact. Well-meaning advice that confirmed my suspicion they'd never met a real drunk. I looked into a special senior detox and rehab facility that offers an error-free learning approach to therapy but the director told it was pointless given that dad's non-existent short term memory and executive function would prevent him learning to recognize when to employ his new strategies or even remember what they were. Plus his anosognosia around his executive function was entrenched-- he thought he was right as rain and that we were crazy to think otherwise. He was paranoid and suspicious and just ghastly at times. I was not about to subject my mom to the abuse she endured attempting to be the alcohol police in the context of him also having Alzheimer's which would eventually become more problematic. The result was that we medicated as we could and watched him disappear before our eyes.

My dad was also unfiltered and offensive in a bid to be seen as fun. He burned though friends and family in PA. He and mom moved to MD and created a new social circle which was great for about 2 1/2 years before they were ceremoniously dropped because of dad's behavior. They bought a place in FL and started over spending 8 months a year there. Folks in FL were a bit more used to mouthy and quirky folks, so they were more accepting of PWD. But eventually invites weren't as forthcoming as they'd been. I expect, he'll be dropped socially and sidelined in his volunteer activities fairly soon. It'll be hard to watch.

I understand the losses due to his diagnosis. I know this isn't the man he was or wants to be. We have been married almost 40 years. We have put in the time and work in our relationship. I thought we had seen it all but we are in hell. He is in denial about his diagnosis and its limitations.

I'll be married 40 years next year. It's a long time. My dad was diagnosed in the hospital on his 60th anniversary. Perhaps I am projecting, but my parents' marriage was not always a happy one. They went through some difficult stuff-- dad's recurrent infidelity, some health issues with mom, my sister's illness and death which was what triggered dad's drinking. He'd been an occasional/social drinker until my sister-- his favorite and mini-me- died when he was about 60.

He's probably not in denial. It's likely he has anosognosia which means he is unable to recognize the degree to which he is impaired. Dad would always admit to his short-term memory but claim it was "a normal part of the aging process". What he couldn't "see" were the other deficits that arise fairly early on in dementia-- the executive function losses, the lack of social filter, the loss of empathy and of reasoning skills. In their minds, they're just as fine as ever and to suggest otherwise is insulting. This means a lot of working behind his back using work-arounds and bald-faced lies to keep you both safe and afloat as a couple.

This has carried over to sneaking alcohol and driving. He did not have issues with alcohol before this diagnosis. Every professional we have seen says no alcohol because of his short term memory and executive functioning loss. The professionals have heard the story of how last June, my spouse stopped at the liquor store before heading to the DMV to renew his license. Of course, his license was renewed. No one seems interested in pulling his license. It will be up to me but I know he will threaten and maybe even attempt suicide. His opportunities for the socialization that he craves and needs will be reduced to what he is willing to let me drive him to. He blames me for his problems now and this will make it 1000x worse. But I cannot let him hurt anyone.

More to follow.

harshedbuzz

I write this alone since my husband went to the local senior center to play pickleball. He seems to have stopped at the liquor store before he went in to play (I learned last year to put a tracker on his vehicle). I am furious. I hate him for putting us through this again and again. I have an email into his therapist. Does anyone have any ideas?

WTF does he have a therapist? Given his short term memory issues and executive function deficits, this is money better spent on support for you now or respite care later. He's not getting anything from it. If the therapist is not familiar with dementia, they could be working at odds to the steps you need to take to right your ship.

Thank you for your comments, Ed. Every single doctor we have seen knows the whole story - Neuropsych, Neurologist, GP, CNP for mental health. Because I attend each and every appointment (I didn't in the early days and then COVID happened so I think we lost years in getting to the bottom of my spouse's anxiety, memory loss, depression) my DH sees my listing off of concerning behaviours to professionals as a disservice to him.

So, he's got behaviours with a "u" as opposed the American kind. Are you not in the U.S.? I'm not sure how other countries manage things like patient confidentiality and such, but we (me) were able to communicate with dad's team either while he was doing a quick cognitive exam in another room or via patient portal so we never had to throw him under the bus or contradict him. Dad always "showtimed "for his geripsych (held it together temporarily-- a common MO for doctors and family members) which made me look like I was trying to sedate the man when I was just trying to keep him from killing anyone. I sent him a few videos I took on my phone of dad threatening me and acting out which helped him see what we were dealing with. Even if you don't capture a picture, the audio can be useful.

He is almost manic in his search for a friend group. Last May he was "fired" from a civic group because of a complaint from someone regarding his attempts at humor (very inappropriate joke). I could drive with him to perhaps curtail some of his alcohol sneaking but I hate to be with him in public. He says the same jokes, goes off to talk to strangers and ignores me unless I am a useful front for being normal.

I don't know who I feel worse for-- this man who just wants to belong and be appreciated or the wife who is watching his cringe-worthy antics. There were times when I kept dad home to protect what dignity he had before dementia.

After today's incident, I have a second email to the therapist he is seeing to discuss his sneaking alcohol and driving. We started as a couple to talk/navigate through the issues this diagnosis has dealt us. It devolved into just him speaking to the therapist alone. I am no longer a wife but a caregiver dealing with the latest crazy behavior.

I would explore what options you have to curtail driving. Dad's neurologists both told him he couldn't drive or handle investments anymore. In the U.S. as a POA, we had a duty to prevent dad driving against medical advice. Had he had an accident driving AMA, as POA we were exposed to legal action for not stopping him. I was less interested in taking away dad's license (which was still valid when he died) or making a symbolic statement with "taking away the keys". I reminded him his doctor said no and that while we were on his side, we couldn't let him drive until the doctor said it was OK. I heard about driving all the time. But at least it wasn't "my fault" and I could validate his upset and unfairness of it all. The very last thing I said to him hours before he died was to promise to bring his Taurus to the MCF in case he needed to go somewhere. I said "sure" and promised to park it in the employee lot and leave the keys with the receptionist. He wouldn't remember, but it made him happy in that moment.

Good luck.

HB

AnderK

Does your health plan have a driver's assessment program, usually through a resource that also does PT,OC and the like. In MN, Courage Kenny does them, and it is intense...3 hours long. My understanding is that the results then can be submitted to the DMV.

Cutting off drinking while someone is able to drive is hard. My heart is with you.

Joey50

https://alzconnected.org/discussion/comment/194400#Comment_194400

Thank you for this information. I am new here. My spouse is also an alcoholic and has moderate dementia. Not sure if I should be concentrating on his dementia or alcoholic issues.

MariaT

This is my first time on the forum. I was feeling very alone, thinking that no one else had to face dementia plus alcohol dependence (white wine) in a spouse, which makes everything so much worse and harder. Of course, his doctors have told him he must stop, but he remembers nothing and gets angry at the very suggestion that he has a problem with memory or alcohol. I was using the term "denial" but tonight I learned a new one: anosognosia, which probably is more accurate. He hides bottles in closets and storage bins—never drinks in front of me or outside. He has fallen at home many times from drinking. Last September, he broke three ribs. Another time he completely tore two shoulder tendons. Other times he hit his head on furniture handles and was bleeding. He tells everyone in a cheerful way that he's "fine."

There is also the problem that he thinks he can drive. Fortunately, the battery has died because he hasn't driven for almost a year, but he thinks he has and keeps saying he wants to go away with me by car for a few days. Saying that the doctors told him it's unsafe to drive led to great anger. Fortunately, he hasn't attempted to get the battery fixed. He simply forgot. He has a lot of pride and acts independent, and as if I'm persecuting and controlling him when I try to talk with him rationally about his behavior.

It's been miserable. I am seeing a therapist but I don't think his neurologist cares at all. I'm not even sure that my DH takes his Aricept because he gets up so late and I don't see him ingest his meds, which he keeps thinking are vitamins.

I would appreciate any help or advice. But just knowing there are others grappling with these terrible problems is a help.

trottingalong

https://alzconnected.org/discussion/comment/207219#Comment_207219

Maria, you posted your message on an old thread from January that people won’t see. Start a new thread of your own so others can help and respond to you directly. You aren’t alone and there are many very supportive people who could help.

easy23

The ER doctor told me that the only way to get my DH to stop drinking was to leave him. I didn't do it, but I did place him in memory care for 5 weeks. He stopped drinking and has been sober since Sept. 2020. Every now and then he forgets that he doesn't drink and asks me to drive him to the liquor store. I refuse.

MN Chickadee

Maria Terrone you have commented on an old post, I will repost your message on the main board so you get some replies specific to your situation. Common mistake as new people are learning how to use the message board!

MariaT

https://alzconnected.org/discussion/comment/207293#Comment_207293

Thanks very much. Would you please tell me where I can find the main board and the reposting…yes, I am very new at this!

ButterflyWings

https://alzconnected.org/discussion/comment/208068#Comment_208068

At the top of this page there is a button on my screen that says "NEW DISCUSSION". Not sure how it looks on your computer, but starting a new thread will post your topic and question for people to see and respond directly to you. If on this old thread, they may not open it.

I think MN Chickadee may have reposted it for you as an original thread of your own. Good luck! I did not have to deal with alcohol abuse (not with DH anyway) but he has had anosognosia from very early in his diagnosis and that means no awareness that he is impaired. Lots of PWDs suffer from this. So, we can tell them things not to do, all day long, but it seems like we are gaslighting them. I had to disable the car, disappear the keys (multiple sets), sabotage the garage door, and eventually disappear his car to keep him off the road once he was no longer reliable behind the wheel. He never knew it was me.

Please Please do whatever it takes to stop the driving, especially if he is drinking. You can't reason with a PWD so don't try. Just disappear they keys and use fiblets.

MN Chickadee

It takes a little getting used to when you start posting here, no worries. I reposted it on the main board so you would get more responses to your specific situation. @MariaT

https://alzconnected.org/discussion/69036/re-posting-for-new-member-mariat