I received a call last night from the staff at the retirement community where my father lives, in the assisted living section, telling me that they had gone to get him for supper and found him in his room lying on the floor next to his bed with a glass near him that contained alcohol. My father will be ninety-four years old in eight days. Up until recently, I�ve never known my father to have a problem with his drinking and I never expected to.
Situations with his drinking have been occurring and as a family we were just unsure as to how to deal with them. With someone of his age, who hasn�t presented this problem throughout his life, and who has little life left, what do you do? His doctor, at our request, has already expressed to him that his medications won�t work properly if he drinks and that he should limit himself to one drink a day. He hasn�t been exceeding that by a lot, but apparently by enough.
This morning took us a step further into this than we expected when he told my sister that �someone is setting him up�. Yes. Recently it was that he wasn�t going to eat because there wasn�t enough food, then it was that he wasn�t going to socialize because he�s lonely, and now he�s passed out on the floor because someone is putting alcohol in his alcohol. I wonder if it�s common for 'paranoid delusions' to come on that quickly, or if he�s just that much in denial, or if he is flat-out lying? I don�t know.
It is reported that most drinkers who start drinking excessively (or enough to cause harm) later in life are usually affected by social isolation, physical health problems, grief or loss. My father has a wonderful social system set up for him where he lives, a lot of encouragement to participate in it, but he is not taking advantage of it. His physical health is actually excellent albeit the limitations of his age. He is a widower however he has a �family� of over a hundred people living with him, he is not isolated, and his immediate family is involved with him as well.
Doctors may not associate the symptoms (falls, appetite and memory problems, trouble sleeping, depression) with alcohol use; they may be uncomfortable �pushing the issue�, and treatment is not ineffective but isn�t �exactly� tailored to the needs of the elderly--logistically, content-wise, etc. The doctors we have taken my father to have asked open, non-judgmental questions about his use of alcohol and my father, not surprisingly, has minimized the amount and frequency with which he drinks. He has not made the connection between his drinking and his generalized and vague complaint of �not feeling right�. And of course, though suspecting such, the doctors can�t �decide� that for him and even so, what could they do? Realistically? Unfortunately, in my estimation he would not benefit from any available AA community and would not have the cognitive functioning necessary. But that�s moot anyway; he doesn�t think he has a problem.
Alcohol causes structural changes in the brain as well as reduced cerebral blood flow and altered electrical activity, which combined with the already diminished capacity of an elderly individual, can reek havoc on their functioning. I can see where it would affect thinking, feeling and physical abilities as well. In combination with eating poorly and perhaps some nutritional deficits (thiamine or niacin?), and possible previous transient ischemic attacks (TIAs or mini-strokes), functioning is really going to suffer. Since he has been feeling �down� to begin with, I would expect that will continue to be accentuated also. I don�t think his Prozac should be increased while he continues to drink and perhaps it wouldn�t need to be if he weren�t, but that isn�t my decision to make either.
My father doesn�t need any screening, he does have an alcohol problem and he needs assistance�now. I surely would appreciate any insight or recommendations, especially anything immediate that my family can do, from anyone reading this.
