I am not sure about gin (can’t stand it) but when one elderly acquaintance went thru detox due to sudden hospitalization he switched to eating lots of sugar. Like ice cream with a heavy pour of Hersheys syrup, or cakes every day.
His doc said he was replacing the sugar in the alcohol with sugar. It kept him off the alcohol at least.
In the hospital, I switched out her nicotine gum (which she chewed continuously for 15 years) with Eclipse and she never noticed. She completely forgot about Nicotine. One time, while in the hospital, she said “It’s strange, I want a cigarette” and that addiction was over.
She never asked for a drink or mentioned alcohol while in the hospital.
The problem is that the AL has Wine Wed. (I have them giving her non-alcoholic wine and she doesn’t notice, but it raises the topic so to speak) and the AL has a pub. So impossible to remove the trigger. And her friends drink: she is competitive and constantly compares herself to her friend who also drinks too much (and now has a serious infection from a fall). HER kids are bringing HER vodka every Thursday.
Anyway, it is huge that both my brothers are now on board. We are going to try one drink in the pub but I emailed the activities person who bartends to alert her we want mother to have a drink that will last longer and have a gentler effect, meaning beer, wine, mixed drink- not martini with straight gin which she literally swigs in three swallows.
My brother, who has withdrawn a bit over this issue, is going to visit her today and take her out to lunch, so he gets the “positive engagement.”
She still has Lunesta to look forward to!!!
If this doesn’t work, we’ll try no alcohol at all because I truly believe that that might actually be easier for her. I can take her out from 4-6 for a few days in a row to get her to forget the routine.
If none of this works, then off to the hospital and a new placement in a locked memory unit. At least we know we will have tried our best to avoid this. So I feel like there are clear steps to communicate to AL and doctor if needed.
Writing things out on this forum and getting suggestions has been really helpful. Thanks! And trying to find some humor has helped too!
An AL without the pub and Wine Wednesdays would likely be a big help in interrupting her routine. Sorry for all this is taking out of you, @compmom.The gap in the literature for the intersection of alcohol abuse and dementia may reflect the absence of routine access to alcohol in higher levels of care. As many elders are on meds that make liquor contraindicated, constant availability can be a challenge even for those who are not alcoholics.
In my experience with a dementia patient in AL, the facility dining hall staff were not expected to get in the middle of a resident’s choice. At one time, my father was gaining weight because he couldn’t remember the two previous snacks he had helped himself to at bed time. When I asked if he could routinely be served half portions in the dining room, that was only possible if he could remember to request it. Understandable given the potential for stress if he noticed his meal was different. Navigating incidents is a bit past what the AL would expect from the waitstaff.
At some point, it is common for caring family members to wear themselves out in service of maintaining a status quo, perhaps one that is no longer optimal for their elder. I know I did at times; it took my heart a bit of extra time to catch up with what my head knew. These moments of reckoning are different for every situation. By way of encouragement, our experience was that we didn’t look back after each well planned transition, however poignant I found it at the time. A skilled nursing memory unit brought my father many perks, particularly social ones, with built in routine activities that he didn’t need to remember. It actually expanded his world. I feel for you; there is not always a clear way forward. I was part of support group for families with a member who had memory loss and found the input from others helpful along the way.
@compmom, I strongly admire your dedication to your mom and your perseverance through the difficulties of resolving this health issue for her while not having full support from your family and the facility employees.
In many parts of the country, alcohol is so in-bedded in social life that AL like the one your mom is in has to include it as part of their overall package of social structure/pub, wine Wed, etc. I live in the South (Alabama) and no trouble finding AL with no alcohol in social structure. I imagine residents can have alcohol in their apts, etc. Those that go out, have it with dinners there. IDK if our area assisted living places allow residents to bring wine to dinner. The upscale places here have fabulous chefs; even the mid-priced AL here have great eating.
Since you mom had ‘no withdrawal’ with the cigarettes/Nicorette gum, I am assuming @compmom your mom won’t show visible signs of the alcohol withdrawal (tremors etc). If that does show up, that will steer your decisions.
Good luck with the plan!
Thank you to people here for sharing information about knee pain treatments. To sum up, my mom refuses to do physical therapy unless it is associated with surgery, she won’t take more pain medication, and and my siblings made clear to me that they think I should not discuss treatments other than knee replacement, with my mom or with them. I went along to the appointment with the orthopedic surgeon, at which my sister said almost immediately, “We all think she should have a knee replacement.” I didn’t comment. I did ask a few questions, including one that resulted in the surgeon saying that 10-15% of people who get knee replacements wish they hadn’t.
Surgery is scheduled for mid-September.
Wish us luck!
I’m not sure I understand this correlation. @compmom I understand your need to keep your mom where she is. But as an alcoholic, rationing is unlikely to work. It seems to me, if you allow her to drink, she will fall and needs a higher level of care. If you go cold turkey, you have to remove her from her environment. I think detox and move to memory care seems like a reasonable alternative. But, good luck with your interim plan.
Thanks all and for the many good points.
She really didn’t seem to need detox when she went to the geriatric psych. unit in March/ They did some valium for three days but very little and I was told she wasn’t showing that many signs of withdrawal. Lately she has been having less than before that hospitalization.
Today I talked with the activities director who bartends and she is putting tonic in with the gin and handing it to my mother saying “I have something new for you to try.” That could make the one drink work, if it takes her longer to drink it.
Or not!
The activities director also went over activities with me, we circled some, and she is going to call my mother a half hour before. She gave me her email so I can remind her before those activities. Better for her to call my mother than me, so I will call the activities person but keep the connection between them.
My mother loved the idea of miniature golf with me but told me she doesn’t want to do any of the AL activities. We are still going to try.
Progress: my brother told her he won’t bring gin and then she called me, and then she said “I guess not.” I was amazed. I suggested the pub and told her Patty had something new to try for her. Then she allowed me to move on to another topic.
Honestly this little interlude may be temporary. She may cause a scene or whatever. Then we try abstinence, then back to hospital and new placement or direct transfer to memory unit but at least I will feel okay about it.
I really appreciate the feedback about parents being relatively happy in a memory unit and I can see that. She was happy enough even in the geriatric psych, ward with lots of attention (and a few meds!!)/ I can see that it might not be so horrible and will ponder that for awhile.
Rosered good luck with the knee issue. I mentioned PRP once before- not sure it was for you- but I know sometimes it doesn’t work with older people. Knee replacements do seem miraculous for many people but it is a lot to go through.
Have a good weekend everyone.
Please, please, please, do not remove the alcohol from your mom without the supervision of an MD. She has a history of heavy alcohol consumption over many years. The chances that she will have both physical and psychological withdrawal symptoms are quite high. www.detox.net/alcohol-detox-guide/
I hear you EC and thank you for your concern.
I diluted her gin 50:50 for a week and now she is having 2 oz in the pub. Next step, but only if needed, is abstinence.
She was professionally, medically detoxed in a geriatric psych. facility in March and I was told (after the fact) she did not need much detox despite the fact that she had had 7-8oz straight gin for 70+ years. This is a bit of a mystery honeslty.
The psych. facility was difficult, because she was so confused by the move. I would rather move her amounts down outside of a facility. Her doctor is involved and speaks to me on the phone. He wants a facility mainly to get her into a different placement (locked) because we cannot find an AL that is dry. He is okay with what I am doing.
At this time I am not concerned about physical withdrawal, so much as psychological.
When she returned to her apartment, I had the furniture moved and changed (she didn’t remember her apartment), and forbade my brother from buying Wheat Thins, which she always had with her drinks. Those little details may sound silly but we were trying to create a fresh start in every way. The change in routine of going downstairs for pub and dinner got her out of the tv/dinner upstairs/8 oz gin fog routine that she had been in.
I worked with the homeless for many years and educated people on withdrawal, ironically. The #1 question was whether to give money to a drunk panhandler and I would say yes, because not having alcohol is dangerous until a person goes to treatment.
Distraction in the form of taking her out to do things, possibly at the drinking hour, is the only thing I can think of to help with psychological withdrawal. I would love to move her to an AL without a pub but there isn’t one.
She would, I think, forget about drinking if there wasn’t any alcohol around. That is why I was going to live with her. But everyone warns me that I shouldn’t do that. I am medically fragile myself and they are probably right but living with her is the only alternative to a locked unit. The locked unit will happen soon enough.
Sending hugs. You have tried everything to help your mom. Glad that your brother is on board now.
Thanks EC, good luck to you too.
Anyone else dealing with recent increases in long term care costs? The prices for my folks are increasing over 20%. Mom, who just needs direction for personal care needs, by a little over 10% and dad, who needs incontinence care plus some one on one dementia care, by about 30%. It’s painful as I’m working out finances, but I also very much understand why and as I’ve thought about it, I support the new cost changes. The aide turnover, like everywhere, is too high and something needs to be done to keep good help and they deserve more. I have a meeting with the director today to work on, with the cost changes, more differentiated care from mom who is able to do a lot more and needs more engagement.
Also, based on these price increases, I have decided to purchase long term care insurance. Not traditional, but an asset based plan. I have studied this like crazy for 6 months. Let me know if anyone wants any information on such plans.
@GTalum when I moved my folks into their ALF i chose the lock in rate. A little higher initially but it pays for itself in less than 18 months (It was weird to do the calculation on that). The monthly add on fee for services can still increase but mom doesn’t currently receive any and dad only gets one hour a day so it’s negligible compared to the overall rent.
I have learned an enormous amount about all these types of facilities and the different levels of care. So naive to think that moving them into a CCRC could take care of everything for the rest of their lives no matter what happens. Now they are in ALF but I have since seen residents there have to move out if they become too feeble and need more than 3 hours of “care” a day. I cannot imagine my father surviving another move.
They did have LTC insurance. Mom does not qualify to collect but after a 10 month fight I finally am able to access dad’s benefits. He is receiving a monthly amount and that can last up to 3 years as long as he remains eligible (which he will, it’s not like this T1 diabetes is going away).
I am not sure what the difference between traditional and asset-based is, can you elaborate?
We purchased LTC insurance for ourselves about 7 years ago. At that time, the company had NEVER had a rate increase (which is why you buy young, and supposedly lock in at the lower rates). However, over the last 3 years, they’ve increased premiums 15% each year (or over 50% total increase from our initial rate). Each time that happens, we have the opportunity to walk, and get our principal investment back, but are constantly advised to keep what we have since similar coverage is supposedly no longer available. It still stings and I wonder if worth it. I’d be very interested in your more recent research on current options @GTalum.
What I hear is that it is VERY difficult to qualify, because the insurance companies always find work-arounds. For instance, you could possibly be able to feed yourself with adaptive serving ware, but if you can’t drive, or shop for food, it does little good. Yet, by being able to feed yourself, that’s one ADL that does not apply.
Traditional LTC insurance it what most of us know. We pay a yearly rate for the ability to draw x amount of dollars/month for qualified care. Asset based is tied to something live a universal life policy or an annuity. You pay a lump sum or installments over a certain number of years. You can draw on that money for long-term care. Usually the max amount you can draw for long term care is more than the policy is worth. For example, the plan I found, I can put in a lump sum of 88K for a life insurance payout of $125K each. But, with the long term care rider (included in the 88K) it will give us (spouse and myself) 5K/month for as long as we need it. If we spend more than 125K each, no life insurance payout. You can also pay in installments over 10 years.
These plans are easier to qualify for since the insurance company has the money, and there are no rate increases. With 2 parents with dementia, I don’t qualify for traditional plans. Though my spouse does. I’m merely looking to be able to get the care I need in case of dementia. My parents have had dementia for 7 years, needed long-term care for the past year, but still physically going strong and I don’t really see an end in site. They are 82 and 83.
Oh, insurance companies do play games - and sometimes even with a very good company you have to fight for your benefits. For example, I had a private disability insurance policy, and as a SAHM with aggressive stage III cancer, I had to be considered 100% disabled to receive any benefit (I actually paid too much for the insurance, because no partial benefits which I would have received with loss of income if in a PT or FT job and unable to work some/all hours). Full disability is if you are considered 80% disabled. Medical oncologist said pain 8 -10, nausea 8 - 10, fatigue 8 - 10. Insurance company had a retired FBI contract employee come to my home to interview me (I had a friend retired gov’t there to help be my advocate as I knew she could do a better job than H) - I believe his report was favorable to me. Still the claims person said their doctor believed I was not fully disabled - so I said, “well your doctor, who is not a board certified medical oncologist and who has never seen me doesn’t the insight and expertise of my medical oncologist, but I guess I need to call my attorney in the morning.” The next day they called and said I was approved for claims payments.
H and I have had very solid LTC insurance policies since 2003. Worth every penny. You hope to never need to use.
My mom’s dementia (she died at age 77 in 2010) didn’t show up by then. I think LTC insurance policies examined family medical histories more intently after we received our policies.
The average stay at AL is 3 years, may be different now, but that is what they were. Wonderful when someone lives much longer there with price stability.
The nursing shortage, increase in regulations (for safety) and increase in demand will drive up cost of care IMHO.
Could I Kill My Mother?
I am not a doctor. I am not very brave. But I want to do what she wants.
https://www.nytimes.com/2018/08/31/sunday-review/mother-death-euthanasia.html
This has come up in my family.
Hi everyone! I’ve been a long time reader and have been comforted, advised and counseled through your stories and wisdom. My mom passed from congestive heart failure and had vascular dementia in 2016 - 2 days after my son’s high school graduation. The ever self sacrificing mother - she knew of his graduation and I know she held on long enough so I can be part of that and then be with her.
I am now navigating through my father’s aging journey. He’s 88, extremely independent and his body is so healthy, no medications, no known heart disease, no high blood pressure, I could go on. But his mind is failing him. He took such good care of his body, but in one moment of desperation he shared, “I never considered my mind would go.” He does have dementia but so far has been able to live independently.
We are now trying to figure out if or when it will be time for a memory care unit. He doesn’t wander, but yesterday in his attempt to be independent he got on a bus and rode to Whole Foods because he wanted to go shopping (thank god he got off at the right place or who knows where he would be in the city). How he had the brain power to figure out how to do this - I have no idea. This isn’t a long term memory thing, he always drove a car. He didn’t think about how he was going to pay since he has long lost the ability to remember how to use his debit card or the readers in the store. And all the heavy bags, with his walking stick? When we discovered him missing, we called police, drove around his neighborhood in case he fell and had about an hour of pure panic. My husband found him at the store blissfully and happy shopping, completely unaware of the panic and drama we went through.
The sheriffs office recommended a program called “project lifesaver”. Does anyone here have any experience with it?