Re-posting for new member MariaT - alcohol and dementia struggles

MN Chickadee

MariaT says: 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.

MN Chickadee

I am tagging @harshedbuzz who is a member with experience with alcohol related dementia in her parent and kindly responds here a lot.
You may find you need to quit trying to convince your husband of his deficits, stop using logic and reasoning with him. His condition doesn't allow him to process logic and it's likely futile. A PWD lives in their own reality and we often need to meet them there instead of trying to orient them in ours. With most forms of dementia we have to use therapeutic fibs and work behind the scenes. You might tell him you already had the car looked at and the mechanic is waiting on a part. Next week same response since he will forget. Rinse and repeat. Has he gone through the diagnostic process? Has he been diagnosed with any specific kind of dementia? Many neurologists and specialists are not the type who are actively involved in ongoing care, more of a once a year or less contact. Does he have a primary doctor who is available to you and helpful? There may be medications to help in the process of weaning him off alcohol. How long has he been drinking?

harshedbuzz

@Maria Terrone

Hi and welcome. I am sorry for the reason to be here, but pleased you found this place.

You said: 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.

Amen to that. The intersection of alcohol and dementia is a tricky place. My mom and I dealt with this with my dad. His old PCP was able to get him off whiskey, but beer and wine remained staples. Chardonnay specifically. And yes, we did try swapping out non-alcohol versions and watering it down which only angered him. His brain was damaged, not his palate.

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."

It is possible there is some sense that he shouldn't be doing this based on his secretive drinking behavior. Dad was more of an in-your-face and "you're not the boss of me" drinker. Sometimes I think mom's efforts to limit consumption drove him to drink more.

Is this new? Has he been a long-time drinker or someone who morphed into problem drinking when memory issues hit and he couldn't recall how much he's already had? Is possible to have some realization that there are memory issues without being able to perceive how impacted he truly is.

When he was diagnosed, did they rule out an alcohol-related dementia like Wernicke-Korsakoff's? I ask because that can be treated and reversed to some degree with treatment and a sober lifestyle. Dad had mixed dementia, WKS and Alzheimer's so it made pushing for sobriety almost moot in the context of "saving him" from WKS so he could prolong his time with Alzheimer's.

Depending on where he is in terms of dementia progression, it might be possible to treat the addiction but probably not. We looked into a senior alcohol rehab for PWD in early stages. The director didn't offer us much hope for recovery as dad wasn't bought in. There was the option of placement in a secure facility to prevent access to alcohol. Dad had lost a great deal of their nest egg day trading early in the disease, so financially this wasn't a realistic option early on. Because of anger issues, we got dad in with a geriatric psychiatrist for psychoactive meds which might be useful in your situation. They may be able to prescribe something to curb his alcohol craving a bit. Dad's doc put him on Wellbutrin for apathy; it didn't help that but it did reduce his alcohol consumption.

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.

Be glad for that. If he can't drive, you might want to park it elsewhere to be less of a visual reminder/trigger. You could use a fiblet that it's in the shop for a recall or awaiting parts for a repair.

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.

You need to let go of this. Even a sober PWD no longer has the self-awareness, reasoning skills, executive function and empathy to follow a discussion like this. You need legal documents to act on his behalf and to use work arounds to take necessary steps to care for him.

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.

Good idea on a therapist for you. You might also consider meds if it isn't enough to keep you from feeling hopeless.

It sounds like maybe you're still working. Is he home alone during the day? Some folks do get a bump in function from Aricept so you might see if it would be OK to take with dinner or at bedtime. Let him think they're vitamins if that enhances compliance.

We found dad's neurologist pretty pointless once dad had a diagnosis. He agitated dad with the drinking/driving lectures. Plus, he kind of treated mom and myself as if we were the one's pouring the Kendall Jackson down his throat. For a guy with an MD and a PhD, he sure knew little about addiction channeling Nancy Reagan's "just say no" nonsense.

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

Not sure if this will sound familiar but worth a look.

https://academic.oup.com/alcalc/article/44/2/148/185585

HB

harshedbuzz

@MN Chickadee Thanks for the Bat Signal.

M1

Maria, welcome and I'm sorry for what you're facing. I have to ask: How is he getting the wine, if he doesn't drive? Does he threaten you if you don't bring it home? There might be a silver lining to that, in that if he is a threat to you, that's a good reason to hospitalize him and get him on meds.

PookieBlue

Maria,

My DH and I had awful arguments about his alcohol consumption. They were triggered even if I only asked him if he had finished his beer. He would drink a full bottle of Merlot and up to three beers every night. He would barely make it to the bedroom stumbling and sometimes falling if I didn’t help him. This went on for a few years and I was angry because I knew what he was doing to his brain. On the other hand, I didn’t want him to go into alcohol withdrawal so I continued to enable him by taking him to make his purchases and avoiding triggering an argument. He wasn’t a mean drunk, and I knew he had no other enjoyment so this went on for some time. Many wine glasses shattered on the tile floor and many spills for me to clean up. Then about 6 months ago, he seemed to have forgotten that he drank wine and only drank beer, 4 to 6 cans a night. He always has said that the alcohol helps him sleep. After about a month he resumed the wine, but didn’t always know where it was kept. The last two months I have been diluting his wine first 50/50 water and now 1/3 wine, 1/3 water, and 1/3 grape juice. He still has a couple beers also, but not every night. Sometimes he gets his wine out but forgets to drink it. At times he comments about how delicious the wine is. Sometimes he gets out of bed a couple hours after turning in and wants to go to the kitchen for something more to drink. I can sometimes redirect him to the master bathroom and give him some Melatonin. Every morning I prepare a diluted bottle of wine and set it in the cabinet next to his metal wine glass. He checks the cupboard a couple of times daily between 3 and 6 pm. He only drinks at night and I remind him if it is too early. When he’s done with his booze, he goes to bed around 8:30. I’m good with this solution. I don’t know if it would have worked earlier in his progression though.

adambaum

You're in a difficult situation! It's heartbreaking. Have you ever heard of Dale Bredesen?

trottingalong

as far as the meds, I took over my husbands. I originally bought him a 7 day pill holder and put his couple pills a day in it for his convenience. He never wanted one, but I said I wanted to make things easier for him. I would fill it once a week and then could tell if he took his pills. It quickly moved into me giving him his pills daily. He was really confusing his meds and couldn’t remember what he took, prior to my purchase.

MN Chickadee

M1 makes a good point - threatening behavior or even a fall or injury due to being drunk could lead to him being transported to the hospital. Many families here have had to call 911 due to their PWD being threatening; EMTs take them in on a psych hold while the docs and family decide on next steps. If you ever feel unsafe do not hesitate to call 911, you would not be the first at all. If he should ever land in the hospital for any reason - sprained ankle, chest pain, whatever - it may be an opportunity to have him transferred to an inpatient setting to get treatment/meds to help with this. They could also see if there are any effects from the alcohol that could be reversed like vitamin deficiencies. There are specific psych units for dementia called Geriatric Psych or Senior Behavioral Health where the doctors and nurses specialize in dementia related behavior. The closest one to me is a few hours away but totally worth it for those that need it. This may have to be your long game plan if you can't make inroads in other ways. Geriatric Psychiatrists are the best trained to deal with nuanced and extra challenging situations like this.