Sneaking Alcohol and Driving

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.

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.

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.

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.

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.

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!

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