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