My father has Alzheimer's which has recently progressed to moderate. He has become agitated a lot. He was an artist and now instead of painting on canvas, he paints the floor and walls of the upstairs of their house every week. He asks for money for paint and if we say no he becomes so agitated my mom gets scared, and generally gives in. They are on a fixed income and it is hard for her to afford. He is impossible to redirect and continues to argue. Additionally, he constantly vapes tobacco and gets drunk. Same with buying vapes and alcohol - impossible to say no. Sometimes he will steal money from my mom and walk to the store and buy himself while she is at work. He drinks endlessly and never had an alcohol problem before the diagnosis, so all of this is new to us. Has been to the ER three times for alcohol poisoning. Does anyone have any suggestions on how to deal with this, how to redirect, how to treat etc? Any guidance would be helpful.
I’m fairly sure that there is a medication that reacts with alcohol and causes vomiting, very off-putting. You could ask the doctors about it. The only other options seem to be cutting off his money and any other alcohol sources. And of course not keeping any in the house, or in any facility you move him to.
“ There comes a time when many people with Alzheimer’s/ dementia can no longer be cared for by family “.
These were the words my mother’s doctor told me , when my mother was too difficult and would not listen to me . She would not wash, change her clothes , or eat anything other than cookies . She would cry and have meltdowns and say “ Why are you doing this ?” when I asked her to change her clothes , or eat a meal , or take her medications . She thought she had done these things already and that I didn’t believe her . My mother had to be placed in a facility , where she got her medicines and ate food and calmed down and improved physically . She was still angry at me , but she was better and being cared for .
In your father’s world he does not understand why the people he loves would want to stop him from what he wants to do . In his eyes his family are giving him a hard time .
So to answer your question , there is no way for you to say No that will make Dad understand . For all of your sakes , a facility placement may be needed if a medication adjustment isn’t enough .
I’m so sorry , this is a very difficult situation , but it may come down to it being safer for your Dad and your mother if he was at a facility .
Needs help now.
Needs to take action now.
Let's park the alcohol issue for now.
We know your Dad was a loving, good father. That he was not somone with a long standing alcohol abuse problem before dementia happened to him. Comments about alcohol & al-anon etc appear to touch a sore spot.
Dementia has happened to your family. It can cause all sorts of mahem. Even if one problematic behaviour stopped tomorrow, a new issue will emerge. It is progressive. His needs will increase.
The lack of daytime supervision is the one that leaps out at me.
Southerwaver hit another sore spot mentioning Dad getting lost & a silver alert.
Excellent that you use phone &/or other trackers. This adds some safety to Dad as family can locate him faster than without a tracker.
Another question to ask is what will trackers PREVENT?
Will it prevent escapement?
Will it prevent his setting the kitchen on fire, getting wedged under his car, driving & crashing a car, walking accross a busy road & being hit by a car?
The above are all taken from real life events reported directly to me. From work colleges, friends. It was our neighbour who wandered at night onto the main road. The son refused to accept the severity of his Mother's dementia, refused to 'put her in a home'. She had wandered many times from home before that night. She died from her injuries, under palliative care in a care home. Took a little over one month to do so.
Focus on now.
Is your Dad safe at home today.
Talk frankly to your Mother.
Yes this is terrible. (But don't be my neighbour).
Next time he has one of his tantrums, I would call 911 (ambulance not police) and report an out of control person that is an endangerment to himself and others. This way he can get to an emergency room and maybe go to detox. He could easily fly into a rage when he is outside or forget where he is going.
I had a friend (older lady) years ago whose husband was an alcoholic who developed dementia in his later years. He disappeared and was later found in the downtown area in a park. He was pretty much too far gone and was placed in the hospital where he died later.
My heart goes out to the people who are going through the anxiety and heartache while cleaning up the messes our loved ones make for us.
"if we say no he becomes so agitated my mom gets scared, and generally gives in".
FEAR is enabling this situation to continue. I hold NO judgement on your Mother.. heck I could in no way PHYSICALLY stop my husband stealing my purse, walking down to the shops to buy wine if he wanted to. But I COULD ensure he had no access to money. Card stopped, no cash left about & my purse well hidden.
*Natural Consequences* can provide the barriers.
If his behaviour becomes threatening or aggressive, LEAVE & seek a safe place to be.
If he attempts to shop without money, he will have a problem at the store.
You could consider pre-calling the local bottle shop but staff reactions may vary - some may be quite limited/useless. They may need to call the Police or Paramedics if he presents in an aggitated way or harrasses staff.
What about calling your local Police Station to advise he has Alzheimer's Disease & needs MEDICAL help if brought in? (Paramedics may be more suitable & better trained in dementia than Police).
I understand those may feel like drastic steps.
That's why I ask if your Mother is ready to speak up.
I don't agree about contacting the liquor store, they aren't liable in any way and if they have rotating cashiers they won't be able to re-tell this info in any consistent way. It might even be against the law for them to refuse to sell to someone.
Elderly parents do decline over time. Some slowly, some quickly but they decline.
You mention that you want to start a family , so will need your own family time, and as much sleep as you can get. So have to factor that in with what will likely be increasing needs for your parents....
I have to wonder though at something you mentioned in one of your replies below:
“He is under the care of a geriatrician, psychiatrist, family doctor, and Alzheimer's specialist. We are working with all of them.”
Why the actual HECK haven’t the geriatrician, psychiatrist, etc. offered any helpful guidance to you and your mom after 3 ER alcohol poisoning visits?
Maybe advised family to say no.
To stop access to money, therefore stopping his ability to independantly buy alcohol etc.
The first question was "How to say no".
Question 1 - "how to say no" , in this situation, there really is no verbal way to "say no".
IF dad was in a situation that he had no access to alcohol, and was pleading with daughter or others to bring in alcohol, then yes, there are ways to "say no". The best being " sorry dad, I am just not bringing you any alcohol". Just as when someone is in a facility and wants to know when they can go home , there are various tactics to "say no".
But in this situation, there seems to be no way to "say no". Dad is able to do things, get money, go get alcohol. So some action needs to take place.....
Question 2: "How to deal with alcohol abuse?" My answer: Option 1: find a way to restrict all alcohol access. IF that cannot be done, then I dont see a way, there's not a great option 2. For someone with dementia with free access to alcohol, I don't see any way of dealing with it without changing something.....
If suitable supervision cannot be provided by family, then supervision by non-family (eg aide) is usually the next option.
If there are behaviours of concern, a Medical Team approach would be best practice. Assessment, medication & behaviour plan.
A withdrawl from alcohol plan may be needed first. This may need to be done as inpatient (geri psych or similar).
The short of it is: if Dad cannot safely remain at home, then he cannot safely remain at home.
Q1 Is Dad at the point yet?
Q2 Is your Mother ready to speak up?
How is he getting access to money to buy the booze & tobacco? All the money has to be taken away from him, even if he has a tantrum. And, if he has a tantrum your Mom calls 911 so he is Baker acted and then maybe goes to psych wing for medical detox & other drug therapy for his agitation, aggression.
This is so distressing. Please understand that at this point you may have to accept the "least bad" option as the solution. Doctors can't do much about someone's willful drinking. He can't do rehab. You can't reason with him. There's not many other options.
Who is his MPoA?
There is truly not much that can be done about someone who chooses drink (I always tease my partner that "it IS an option". His mom basically died of pickling herself in vodka). If someone stays in such an unstable household, either getting the alcohol or caring for the alcoholic theirs is a world of suffering.
I do hope this family goes to Al-Anon, because if any group has "an answer", even a imperfect one, I think they might.
Alcohol abuse kills, and the lucky ones go quickly. My brother's ex suffered on many years after D. was gone with alcoholic encephalopathy that robbed him of his brain, and eventually even of his ability to communicate at all.
ALZ disease and this woman who never touched alcohol before drinks now, not as much but enjoys 2-3 glasses of wine, hardly eats anything.
And if your father is that bad, he probably should not be left alone any more, so your mom may need to quit her job, even though I'm sure that her job is her sanity break from her real world.
Or better yet, the next time your father ends up in the ER, you let the hospital social worker know that he CANNOT come back home as he is an unsafe discharge, and that your mom no longer feels safe with him in the house.
Your mom of course will have to put her big girl panties on and stand her ground and let them know in no uncertain terms that he CANNOT come back home as she can no longer care for him and that she fears for her life.
If you all stand firm, the hospital will have to find the appropriate facility to have your father placed in. Now they will try and offer all kinds of help that they can provide to try and get you to take him back home, but DO NOT fall for their lies, or you will remain in the same boat you're in now.
Also if there is no money around for him to steal or people to go get his alcohol and vapes, he can't do either can he? You nor your mom want to responsible for enabling him as you're probably doing now, so start saying NO, as NO is a complete sentence. Period.
And if your father gets violent, you call 911 and have him taken to the ER, and then you DON'T take him back.
Your father needs to be in a memory care facility sooner than later and I hope and pray that you and your mom will once and for all put a stop to your fathers nonsense.
Such a hold kicks off services that are available based on professional assessment of the individual. There will be recommendations and, hopefully, help for him and mom. He's not going to get any better - he can't. His brain can't function, and with Alzheimer's there's little learning new behavior.
About mom - she needs to get out of there. She shouldn't remain at the mercy of a sick demented angry thieving addict, and that's what he is. Please help her find a safe place to go - and dad shouldn't know where she is.
Next time he goes to the ER - if he survives - tell the discharge folks that it's unsafe for him to return home because you and mom can't take care of him now. Then they'll find placement for him and he'll have professional care.
The vaping, alchohol , causing fear in your Mom and stealing, are a problem I think we would all agree. If you can figure out what to do to stop those, BUT still allow the painting and repainting of the upstairs, might that help in a way to let him "keep himself busy" with the painting? Just a thought, rather than stopping everything you mention above. ? i.e. allow just the painting to occur...?
I told my kids once, when I get to the age I start annoying people, put me in a room , cigarettes, alcohol, and weed. Might as well enjoy myself before I go.
It is unclear from your question what your role of caregiver involves. In your profile, you mention mom has mental health issues. At face value, I question the wisdom of dad continuing to live with mom, for both their sakes. Sometimes addiction comes in many forms and can be "hidden" right before your eyes. Denial is a close companion to those living with an addict. Mom doesn't sound equipped to be the decision maker.
Who has POA? Are there financial resources to provide for dad to stay in AL?
Going down that road will present its own set of challenges but after placement in AL, issues related to mom and dad should be more manageable. And, you will be freer to move forward with your family plans.
I hope you will share more details about this situation that will help the forum provide some specific feedback to help you.
I want to make it VERY clear that the addiction piece only started when his dementia started - he never had any addiction problems before that. My mom is not even close to being in denial about this - she's the one who sounded the alarm. I don't know if you've ever dealt with an agitated dementia patient, but it's really challenging. She tries to say no, and is very bad at redirecting, instead usually starts getting upset and emotional herself. Ultimately both of them end up frustrated and my father just follows her around until she gives in. So again the addiction piece of doesn't have all these "addiction" type things like denial, etc - it is literally the Alzheimer's piece that is challenging. Meaning he has no concept to reason, but is still well enough to walk around and try to get his way.
I don't feel comfortable going into too many of their personal legal and financial situations. We have it covered and are doing our best to get them the best care we can. For now there aren't really any options except being home. So I am really curious about if anyone has dealt with this issue and if/how they were able to manage it, redirection tactics, etc.
Call dad's doctor immediately and report this behavior which falls under the compulsive part of the OCD spectrum I would think. I would also think there are medications available to treat dad's compulsions to drink till he's poisoned and paint the floors and walls till he's flat broke. He can't help these compulsions......his brain is diseased. Nobody WANTS to live this way! See what the doctor has to say about medicating him, or hospitalizing him until he can be stabilized. He may wind up having to be placed in managed care at some point if he cannot be properly medicated and calmed down with the compulsion to kill himself with alcohol.
Wishing you the best of luck with a difficult situation.
If this is so I don't understand why MD not consulted already?
Also, sounds like wife not used to saying no, or limiting anything with this gentleman. Likely placement would help him.
Or medication for compulsive behaviors.
Difficult now to tell the effect of the alcoholism and to gauge his behavior related to disease.
Might need neuro psyc eval and inpatient treatment in psychiatric to try to get together what's happening here.
3 ER visits with alcohol poisoning, and no one to say no is going to make this pretty self limiting in that he will kill himself with alcohol pretty quickly if some sort of control isn't exerted by someone.
You CANNOT DEAL WITH AN ALCOHOLIC.
You go to Al-Anon and that's where you and mom need to head right away.
There you will quickly learn that there are two choices with alcoholism: stay or go. No other.
You will not control it.
You will not change it.
You cannot manage it.
That much must be straight first of all.
I suggest the GO choice and think that Mom should leave at once. However, most co-dependents stay with their alcoholic for life, and don't ever go to al-anon for support. THAT is THEIR problem.
Then you have their family and friends doing their ritual dance around the alcoholic and the co.
And it is honestly a three ring circus that you portray beautifully here.
My advice? Accept that this man is an alcoholic and get him all the paint you can; hope it is good art.....................OR
help your mother to leave now and report the man who cannot be lived with as a senior at risk to both his doctors and to APS. He will soon enough crash and burn (hopefully not literally but some do) and you will be getting the call from hospital and he will be placed in care. There he will likely be down to stealing everyone's listerine for his fix (yes I have witnessed it MORE than once).
I am so sorry to be so blunt.
If you can support your mother to leave, and she wishes to do so, please take her to elder law attorney to get a division of assets so that her own funds are preserved, or better a divorce so that her funds aren't taken and he can go on Medicare in care without affecting her.
I am honestly so sorry to be so blunt (but then I am know for it).
There is no good and easy way out. You are intelligent and you know that because none of this is new. I am so very sorry. What an awful combo your father is prisoner to.