Alcoholic parent with MCI and early Alzheimer’s. Do we choose memory care or AL?

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Alcoholic parent with MCI and early Alzheimer’s. Do we choose memory care or AL?

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My father is in his early 70s, and after a fall in home and hospital stay, he was diagnosed with mild cognitive impairment due to some short-term memory issues. Our family additionally ran the full spectrum of testing — MRI of the brain, 4 hr neurological testing and evaluation, and even non-FDA blood tests — which all point to early Alzheimer’s.

Mentally, he is still very sharp and has been recommended for assisted living by his neurologist and the director of the senior living facility after an evaluation.

However, due to history of alcoholism, our family is split, with two children pushing for memory care and the other two siblings suggesting assisted living with precautions such as a GPS tracker, limiting spending, and no driving.

Memory care seems like an overreach, as he has articulated his desire not to live there. He unfortunately does want to continue to drink, which will advance his disease.

Not sure how to handle this difference of opinions between family members. It’s already driving a wedge. Also not even sure putting him in memory care against his will is legal at this point…

Alcohol Abuse Assisted Living Care Decisions Early Onset Alzheimer's

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Memory Care Assisted Living is a last resort. I'd go with AL and if dad chooses to drink himself to an earlier death, so be it. Nobody tries to prolong the life of a senior with Alzheimer's and dementia anyway. If and when AL can no longer manage him, then they'll let you know it's time for Memory Care.

Good luck.

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Reply to lealonnie1

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Has he been tested for Wernicke-Korsakoff syndrome? This is a vitamin deficiency commonly suffered by alcoholics that produces dementia-like symptoms. If caught early and the deficiency is addressed and the symptoms may improve. But the person needs to choose sobriety after or it will just return.

You can start with a good AL and the admissions person will assess whether he is a candidate for AL or MC. If he's a flight risk then he's definitely going to be in MC. But is he doesn't have an assigned PoA and it isn't activated, then he will be calling all the shots. He probs won't go into AL either.

If he does have a PoA then this person now needs to read the PoA docs to see what activates the authority. This person should get the dementia diagnosis on their clinic letterhead and signed by the doctor, stating they have sufficient impairment that now requires the advocacy of the PoA.

Even if the PoA is active, you will still have a heck of time getting a physically uncooperative adult to move.

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Reply to Geaton777

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Thanks you. He’s been on B7/thymine supplements for 5 months and forced sobriety in memory care, but still having short term memory issues.

He has a very general POA “if unable to make my own health care decisions”. The facility recommends AL but family members have pushed for memory care for the alcohol reason.

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As you know, Assisted Living and Memory Care facilities do their own evaluations of prospective residents. You already have recommendations for Assisted Living. Tell your family members who want Memory Care that their preferences won’t prevail.

I wish you luck in finding a good place for him.

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Reply to Fawnby

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You're right... If his memory is not impaired to the point that his judgment is affected and he cannot make decisions well, it is not legal. As a former healthcare provider I believe that assisted living is appropriate for him at this time. Make absolutely sure that the assisted living facility knows his limitations. They will keep a close eye on him and if at a time he becomes inappropriate for an assisted living facility they will make recommendations for true memory care. Which as you know is a lockdown facility. They need to know about his alcoholism so that they can watch for signs of alcohol withdrawal and treat appropriately according to whoever his health care provider will be at the facility. Withdrawal symptoms can be very dangerous for the elderly.

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Reply to PhChris

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MC isn’t meant to used to keep someone sober. Let him go to AL and see how it goes. Most have happy hours and I’ve found that taking something away just means that they’ll get someone there to get it for them. Accept that there is only so much you can do to stop someone from drinking themselves to death.

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Reply to ShirleyDot

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WickedTuna, I see where you mentioned that some siblings don’t agree with assisted living and suggest memory care. By having dad go through evaluation at every facility you apply for, they will tell YOU where he qualifies to go. They won’t put someone in memory care that doesn’t need it. They use a whole scaling system to determine that. So really, the choice isn’t up to any of you, but the facility’s decision. My mother in laws primary suggested assisted living, however, her evaluation determined she needed memory care on a locked unit. Also, bring this question up with dads primary or whoever it was that said assisted living and how half the siblings agree and the other half want memory care. Also tell that to the facilities you apply at. You might feel better knowing the decision isn’t really in your hands

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Reply to JooFroo

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Sort of the exact situation my deceased brother faced with his partner. He went into assisted living. He eventually did have to go to memory care, but only after he became aphasic. He was diagnosed with alcoholic encephalopathy versus early Alzheimers.

A warning. They WILL get alcohol and his mode was to go on the bus to the Walgreens for huge bottles of Listerine while he could. Soon couldn't do that and was in a locked (but still ALF) cottage. But took all the mouthwash he could find of any kind.
There's a reason you see Listerine on the end aisles in the stores in huge bottles, and that reason isn't that we suffer pandemic bad breath.

So very sorry. Try the easier way, and try to do it someplace where they also have memory care. A good facility will be your guide. Best of luck. If this is early Alzheimer's it can progress very quickly.

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Reply to AlvaDeer

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I'm going to side with the siblings who suggest assisted living with precautions.

If AL is what is recommended, and is a good fit for him now, and he is capable of making his own choices, then you really have no reason to try and force something else.

But, because his condition will continue to deteriorate, I agree with a GPS tracker, take away any vehicle, so he can't drive.
If he's on board with the decision, he could name someone to take control of his finances, and allow him a debit card with a limited amount of funds available for his personal spending.
You can not control another person's decisions and life choices.

You may feel that preventing him access to alcohol is in his best interest. But, what do you have in your life that you wouldn't want another family member taking away from you because they don't agree with it? No one in history has been able to stop an alcoholic from drinking. And yes, it will probably kill him.

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Reply to CaringWifeAZ

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Taking someone abruptly off alcohol can be dangerous. He would need to be detoxed first to prevent delirium tremens or dt's. This is a tricky situation. I've had clients with dementia and drinking problems. There is a dementia called Weirnicke Korsakoff that is caused by drinking. Since your father still has some wits about him, he still has some say about where he wants to be placed.

There is a such thing as mixed dementia meaning more than one type of dementia can be at play here. I wouldn't rule the alcoholism out as a cause of memory problems.

If he goes into an assisted living, he may still gain access to alcohol and rent a car. Assisted living is not like being in lock down or a jail like environment. Clients can come and go as they wish depending upon their mobility and other health constraints.

I had a client that was totally out of it one day, and the best I could do during that shift was to make sure he didn't fall and crack his head open.

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Reply to Scampie1

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So, I am an alcoholic in recovery. I’m now 40, and I used alcohol for about 25 years. I was a terrible black out, drink when I first wake-up in the morning, everyday drinker. With a couple years of sobriety about 2 or 3 different times during that 25 years. Alcohol is scary. What’s even more scary is coming off of it. It’s one of the few substances that you truly need to medically detox from, as people have died from going cold turkey without assistance. If your loved one is an alcoholic to the extent I was, I highly suggest to talk to his primary doctor about medical detox and if it’s something that your dad needs. It is SO much easier and safer to detox in a treatment facility. It takes about 5-7 days, with some people needing 10 days. They use comfort medications to ease you through it. Now, detoxing off the alcohol takes care of the physical addiction. Dad will probably have the mental addiction for it, which is tough. I have no idea how it would be for someone of your dad’s age. I have seen people in their 50s and 60s kick the problem with continuing on with their recovery (aa meetings and/or therapy, etc…) however, I have also seen people go to detox and never drink again that don’t do AA or therapy. Each person is so different. It could be possible that he detox safely and go from the detox facility straight to assisted living/memory care.
As for the memory care, dad would have to qualify for the memory care unit as it is usually for more advanced dementia/ cognitive problems. Assisted living sounds right for dad at this stage, BUT, he could still gain access to alcohol by walking or getting a ride to the store. I’m pretty sure in some assisted living places that alcohol is acceptable to have. So that would be my worry with assisted living. Maybe dad shouldn’t drive anymore and gps sounds like a good safe idea. I’m sure at some point as his disease progresses and he has more severe decline, he will eventually really need memory care unit. *When touring these places, be sure to ask that if dad becomes immobile, will he still be able to stay at their facility and they take care of him when he becomes immobile. Some places don’t do that! So I was taught that very valuable question to ask! It sounds like your siblings and you are working as some sort of a team. Which doesn’t happen very often. So that’s great. I hope you guys find your answer soon. I wish yall the best!

Alcoholic parent with MCI and early Alzheimer’s. Do we choose memory care or AL?

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