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Medical Forum / Diseases and Disorders / Alzheimer's / September 2004

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Problem with Mum's alcohol

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Barbara Rose - 25 Sep 2004 20:15 GMT
Hi All

Now that Mum is really settled in the home, I have encountered another
problem.  She had blood tests as she wasn't getting out of bed and didn't
want to eat and now the Manager of the home is saying that as a result of
her bloods they have to take her sherry away.

I phoned the doctors for the results but the receptionist said she thought
they were OK so I challenged the home and they said they had spoken to the
doctor who has asked for further blood tests, which have now been done.  The
results aren't back, but they are blaming the sherry and rationing it to
Mum.

Needless to say this is not working.  Although she can't remember anything,
she is aware that the sherry has been taken away and is very distressed and
saying that at her age (nearly 89) she should be allowed it if that's what
she wants.  I agree with her but the home still refuse to leave it with her.

I tried to phone the doctor but can't get him until Monday.  Is it an
infringement of her civil liberties, I'm not sure?

She has had enough and just wants to end her days in peace.  No way is she
going to make a miraculous recovery and I would rather take responsibilty
for her going downhill, than see her unhappy.

Yesterday she was demanding to get out as she couldn't get her sherry, I
just don't know what to do.

Barb in UK
Dennis White - 26 Sep 2004 01:17 GMT
> Hi All
>
[quoted text clipped - 25 lines]
>
> Barb in UK

Barb,
    As an American and  former resident of the UK I'd say that refusing
your mother alcohol is probably in itself *not* an infringement of her civil
liberties.  However, it most probably is her legal right to drink unless she
has been ordered not to do so by a court, or if whe has been judged
incompetent.  Even then, while probably not being an infringement of her
civil rights, it is highly doubtful her right to drink could legally and
justifiably be taken away from her if she were living outside of a care
facility.
    Having said all of that, if the home she is in does not want her to
drink, then she may not drink...in  that environment.  The home may have a
policy regarding drink.  The home may have a policy that allows them to
manage and control the actions of their residents.  In any case, they are
fully within their rights in common law to discontinue availing their
services to your mother.  There are questions of their responsibility to
assure the health of your mother to be considered.  There also may be issues
of liabilty on their part.
    It is my opinion that anyone who reaches the age of 89 (and for that
matter even a much earlier age) should be allowed to do pretty much what
they wish to do as long as it hurts no one but themselves.  Unfortunately
the facility your mother resides  in also has the ability to decide what
they feel is best for themselves.
   If your mother is under the care of National Health you should direct
your questions to them.  Good luck!

Dennis White
Barbara Rose - 26 Sep 2004 21:14 GMT
Thank you Dennis, that is what I am pretty much coming up with.  I aim to
speak to the doctor in the morning.

Barb in UK

> > Hi All
> >
[quoted text clipped - 56 lines]
>
> Dennis White
Robert E. Lewis - 27 Sep 2004 03:00 GMT
> Hi All
>
[quoted text clipped - 13 lines]
> saying that at her age (nearly 89) she should be allowed it if that's what
> she wants.  I agree with her but the home still refuse to leave it with her.
...

> She has had enough and just wants to end her days in peace.  No way is she
> going to make a miraculous recovery and I would rather take responsibilty
[quoted text clipped - 4 lines]
>
> Barb in UK

Barb,  my father was very fond of his martinis (had a real drinking problem
at one point, was ordered off alcohol by a 'damned Muslim doctor' (Dad's
complaint, but he stopped drinking) five years ago.  He would occasionally
have one martini if we went out to dinner.

But at his last doctor appointment in July, the doctor *prescribed* ONE
martini per day, agreeing that quality of life was more important at this
stage than drawing it out longer at the expense of giving up a beloved vice
completely.

Dad seems to be able to remember most things he does every day so far, and
the ritual of making his once-a-day martini has fallen into that daily
routine.  I was nervous he'd lapse into heavy drinking, but so far he comes
in mid-afternoon, measures the vodka and vermouth into a measuring cup and
puts it into the freezer for a while, then pours it into his martini glass
and sips it while wathcing M*A*S*H reruns.

Of course, I can see a point at which this may stop working, that he may
start forgetting he's had the martini, and wanting another.  I had
considered this even before the doctor brought up the one-drink-a-day
suggestion, and I imagined making up a calendar and having him check off
'daily martini' on the calendar each day as I made the drink for him.

Your Mum may be too far advanced for that to work, but perhaps a fiction
that she's officially prescribed ONE glass of sherry each evening might
work, if the staff would keep the bottle packed away and brought out for her
one glass (I can't quite picture nursing home staff delivering an aperitif
each evening, though).
Dennis P. Harris - 27 Sep 2004 08:38 GMT
> (I can't quite picture nursing home staff delivering an aperitif
> each evening, though).

thirty years ago i had my appendix out in a catholic hospital run
by an order of nuns, and they had several elderly patients in
their "elderly care" wing (this was before we had a local nursing
home).

they would bring each of the elderly gents a shot of brandy or
whisky every night after supper.  IIRC one gent had canadian
club, one scotch, and one brandy.
Mary Gordon - 27 Sep 2004 17:09 GMT
How much is she drinking? Are we talking one little glass a day or what?

Is she a diabetic?

Mary G.
Barbara Rose - 27 Sep 2004 22:44 GMT
No, she isn't diabetic and was drinking more than a bottle (large one) every
day.

I spoke with the doctor today and also with the home and they are going to
give her the allowance in a bottle so that at least she doesn't have to ask
for it, which is what upsets her most.

They are all a bit vague about the bloods but the results aren't all back
yet so I'll phone again later in the week.

Mum seemed a bit more resigned to it today, but she is just staying in bed
all the time and is so pale and confused.

Thanks all of you for the advice.

Barb in UK
> How much is she drinking? Are we talking one little glass a day or what?
>
> Is she a diabetic?
>
> Mary G.
Mary Gordon - 28 Sep 2004 02:35 GMT
Holy cow, she's almost 89 and she was drinking a large bottle of
sherry daily?? Sherry (unlike regular wine with an alcohol content of
10% or so) has an alcohol contenty of 15-22%. In other words, she has
been drinking the equivalent of TWO large bottles of wine a day - that
is a LOT by any standards. I'd call that an alcoholic in a younger
person - and in an older person, drugs like alcohol clear the system
much more slowly than in someone young, so someone in middle age might
have to drink 3 or 4 bottles a day to get the same impact.

I confess to being a bit gobstopped that you are surprised they might
think that much sherry daily might not be great for her - for her
alertness, for her health, for her safety (i.e. balance etc.), for her
ability to socialize.

I thought we were talking about a little daily glass or two as a happy
hour thing, or after dinner or before bed, so so many people enjoy as
a small pleasure. The quantity you mention is a whole other thing - or
did I misunderstand?

Mary G.
Dennis White - 28 Sep 2004 03:29 GMT
> Holy cow, she's almost 89 and she was drinking a large bottle of
> sherry daily?? Sherry (unlike regular wine with an alcohol content of
[quoted text clipped - 16 lines]
>
> Mary G.

    As hard as it is to hear the words, I'd say your mother is an
alcoholic.  Remember, all alcoholics aren't in the gutter.  I can see
exactly why the staff at her facility are worried about her intake.  Sadly,
if she were refused alcohol at this point it could likely kill her.  This is
strictly my opinion, but you should seek medical advise.  The best that can
be done is to ration it under the supervision of a doctor, and hopefully
lower the intake over the course of a few months.
    My aunt was an alcoholic.  One day she fell and broke her hip.  She had
to taken to the hospital and after to a convalescent center.  During her
stays she had to give up alcohol in favor pain relief, etc.  The hospital,
the doctors and the convalescent center simply could not risk the liability
of allowing her to drink.  My aunt died from the sudden withdrawal.  Please
don't let something like that happen to your mother.  Try to see that her
intake of alcohol is lessened.  That way if something happens to her and she
is forced to quit alcohol all at once, her body won't react violently.
   In case you haven't seen someone die of alcohol or withdrawal from
alcohol let me assure you it is very ugly.  The organs begin to shut down in
a sort of chain reaction.  It is painful and quite horrible to see.  I don't
mean to scare you, but this is reality.

Good Luck
Dennis White
Darryl - 28 Sep 2004 04:18 GMT
>No, she isn't diabetic and was drinking more than a bottle (large one) every
>day.

Alcoholics can suffer from various B vitamin deficiences (especially
B12) that lead to dementia.  For everyone involved, it sounds like
it's time to cut the alcohol consumption in a stepped fashion like
Dennis suggests.

Darryl.

>I spoke with the doctor today and also with the home and they are going to
>give her the allowance in a bottle so that at least she doesn't have to ask
[quoted text clipped - 7 lines]
>
>Thanks all of you for the advice.
Mary Gordon - 28 Sep 2004 16:15 GMT
I did some quick calculations - a big bottle of sherry has to have
something like 1000-1300 calories in it. Not only empty of nutrition
(no vitamins, no minerals, no protein, no fiber etc. etc.), but I
would think if this proportion of her daily calories come from sherry,
its reasonable to assume it would be killing her appetite for "real"
food.

There is a nutrition calculator that lets you figure out a ballpark
daily intake required to sustain weight for people of various ages,
heights and weights. Its located at
http://www.workoutsforwomen.com/nutritional_calculator.asp

Just as a ballpark guess, I entered in an 88 year old person, 5" tall,
weighing 140lb, sedentary, and the calculator says the person's daily
caloric intake should be between 1352 and 1465 calories a day. If she
has a limited appetie and is drinking all that sherry, then she's
pretty much getting all her calories from her tipple.

Not good!

Mary G.
Evelyn Ruut - 28 Sep 2004 13:07 GMT
Hi Barbara,

You have gotten some excellent replies, and I must admit that I agree in
that a large bottle of sherry every day is a considerable amount.   I have
heard that there is a kind of dementia that comes from long term alcohol
abuse, and it is also true that elderly people have a harder time clearing
their system of drugs or alcohol than young people do.

I think the staff may be worried for some good reason.   A couple of small
glasses of sherry after dinner isn't strange at all, but a whole large
bottle a day is good cause for concern.  If I were you I would go with the
staff's impressions and recommendations.   They are the professionals and
they know how much is too much.   It sounds as though they have been pretty
liberal about it thus far, but they have seen it is time to trim her usage a
bit.

Total withdrawal at this point could be too shocking to her system, but
cutting her to a manageable amount sounds completely reasonable to me.

Signature

Regards,
Evelyn

(to reply to me personally, remove 'sox")

> No, she isn't diabetic and was drinking more than a bottle (large one)
> every
[quoted text clipped - 19 lines]
>>
>> Mary G.
Lee - 28 Sep 2004 13:22 GMT
would  it be possible to dilute it with something - water or 7up or
something, so that she'd maybe feel like she was getting more than she
actually is?

> No, she isn't diabetic and was drinking more than a bottle (large one) every
> day.
[quoted text clipped - 17 lines]
> >
> > Mary G.
Barbara Rose - 28 Sep 2004 20:29 GMT
Thank you all.  This group is  my only source of sense.  I have tried
diluting it, but she noticed.  I spoke to the doctor and the home today and
they are giving her "the ration" in  a bottle which I think is the best way.

Evelyn is right, there is something called Korsifkov ? syndrome, totally to
do with alcohol and I think that is what she has got, although no-one has
ever said.

Barb in UK

> would  it be possible to dilute it with something - water or 7up or
> something, so that she'd maybe feel like she was getting more than she
[quoted text clipped - 23 lines]
> > >
> > > Mary G.
Darryl - 29 Sep 2004 04:41 GMT
>Thank you all.  This group is  my only source of sense.  I have tried
>diluting it, but she noticed.  I spoke to the doctor and the home today and
[quoted text clipped - 3 lines]
>do with alcohol and I think that is what she has got, although no-one has
>ever said.

Wernicke-Korsakoff syndrome is a vitamin B1 deficiency that is often
associated with alcoholism.

http://www.ninds.nih.gov/health_and_medical/disorders/wernicke-korsakoff.htm
 
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