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My father, who has been a heavy drinker most of his adult life, lost his wife in 2017. His eyesight was failing before she died but is now is almost completely gone. His neighbor helps him by buying groceries for him and alcohol (she herself drinks heavily and has no issue supporting his habit), but as his mental status complicates the situation, I want to understand my options for assisted living. He is totally resistant to quitting drinking so please don’t recommend rehab - I’m asking could he still be in a care facility and continue drinking or does that not exist?

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When my mother lived in 2 different Assisted Living places, she and my dad were FREE to drink alcohol as they wished. In fact, both ALs had happy hours on Friday where wine and beer was served. There was one lady who would get drunk every week at happy hour and the other ladies would whisper nasty gossip about her behind her back. My mother kept several bottles of liquor inside her apartment in the cabinets to drink as she desired, even though she took medication. The goal in AL is to be fairly independent and not 'monitored' by staff 24/7. Help is available when needed and to a certain degree only.

My mother now lives in Memory Care Assisted Living where alcohol of any kind is completely prohibited. If a resident wants to drink, a prescription has to be written by their doctor ie: Mary Jones can have 1 beer per day. Honest to God. So, if your dad has dementia and belongs in Memory Care AL, then yes, they will prohibit him from consuming alcohol there. You'd need to make SURE of that before placing him, of course, but the 2 MCs I've been involved with BOTH prohibit alcohol w/o a doctor's written RX for the resident to have it.

Not sure how things work in Skilled Nursing.

Wishing you and your dad the best of luck with a difficult situation. I hate how alcohol can ruin so many lives.
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Ahsam80 Apr 2021
Thank you for the insight into other situations and my options, however limited.
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No nursing home is going to put up with an active alcoholic. People can drink privately in their own apartments in an assisted living. No one in an AL will go and get alcohol for someone though. They will not allow a resident to stay if there is any incidents because of drinking. That person will get evicted. Your father won't go into rehab either as you say.
The best possible outcome will be that he'll end up drunk in the ER. They will see that he is an elderly alcoholic with dementia.
Then a social worker will contact whoever is his next of kin. If it's you then you must tell them that he is alone and you cannot and will not be his caregiver in his home or yours.
The hospital will keep him admitted there and he will be put into a nursing home. They will not allow him to have booze.
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Beatty Apr 2021
He will probably need alcohol withdrawal care, overseen & managed by medical team as withdrawl can be very traumatic for long time drinkers.

After that, transfer to NH is done. Sometimes with a Doc's order for one glass of something with dinner. Amazingly, this can be enough.

If physically able to leave NH (pay for taxi, get back home) sometime people do. Neighbours call the family, Police etc. Then off to court to ascertain in Guardianship is required & can he live alone IF he accepts & can pay for services to his home. A lot end up back in the NH, but not all.
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My husband was a heavy drinker. In his younger days, he drank beer. Later, it was wine. As his dementia and anxiety got worse, so did his wine consumption. When we downsized to a condo, I refused to keep wine in the apt. But I’d get him beer and put a strict 2-beer a day limit on him. Surprisingly, some days he didn’t have any beer. Now he’s in a care and board home for people with dementia and I stock their fridge with non-alcoholic beer. Amazingly, he doesn’t know the difference. In the evening, when he sundowns and thinks his golfing buddies took his car, wallet, and golf clubs and left him at this “motel/hotel,” he calls all upset and tells me I need to come get him because he has no money, no car, etc. I tell him to stay there tonight and I’ll call him in the morning. He eventually calms down but remains upset that he has no money. What if he wants to go to the bar and get a beer? I tell him I’m familiar with that property and it’s all-inclusive and, yes, even tips are included. So he tells tells me he’s going down to the bar (the kitchen down the hall) for a beer and then going to bed.

I dont know how much your dad drinks, or if weaning him off alcohol with a fake drink is possible. If he’s alcohol-dependant, this won’t work. If he’s just a heavy drinker, dementia can work in your favor in getting him off it. In my husband’s case, I think he was self-medicating with alcohol as dementia ramped up the anxiety he’s always dealt with.
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We discussed this issue with my father’s doctor and the doctor prescribed (facilities can’t give residents even a vitamin without a script) up to two shots a day. Dad was not happy with that amount and even more unhappy when his assisted living facility would only give him one shot a day but the promise of more if they found that he could tolerate it without falling etc was enough for him to accept it. We supply the vodka and it remains with the nurses locked up along with all medications.

Three years later; the nurses deliver him his shot and he doesn’t even ask for additional alcohol anymore.

Talk to your dad’s doctor. If your dad has been drinking every day for years like my dad...it would be unsafe for him to go cold turkey.

I wish you luck and peace during this difficult situation
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I think what you are asking is can he stay at an assisted living and still drink heavily? If his drinking would cause problems for him or his fellow residents and staff, then he could be asked to leave. There is a difference between having a beer or a cocktail every night and heavy drinking.

As for nursing homes, I have known doctors to “prescribe” a small amount of alcohol for residents - like one beer at night or one 4-6 ounce cocktail with dinner. The family would have to purchase the alcohol. The staff would have to “dispense” it. But that would depend upon the facility and the doctor. Alcohol withdrawal can be very dangerous for lifelong drinkers and resident will sometimes elope in search of a drink.
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Honestly, I can't imagine any facility agreeing to allowing alcoholism to continue  in its facilities.    There could be severe legal ramifications. 

And, although I don't mean to be cruel, I think your father's refusal to quit drinking is a reflection of how he may or may not cooperate in a care facility.   

I wish there were better options for you.
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This is a question to ask the facility. Most do not allow excess drinking, but DO allow drinking not in excess. Excess drinking is disturbing to others, and contributes to ill health and falls. Discuss with facility. He may have a better chance in a small Board and Care, dependent on his demeanor when drinking.
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Some counceling for yourself through Al-Anon may help to support you & help identify what pathways are available for him.
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Short Answer No!

If he wants to drink, leave him where he is.

He is doing what he wants and
The alcohol will kill him soon enough.

It would not be right, especially with his eye sight gone to make him move to unfamiliar surroundings, he would be totally miserable.

Let the drinking neighbor continue to help out with groceries and visiting.

At least he's not alone.

Don't put him somewhere just to ease your mind.
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My dad was a heavy drinker as well had dementia. I had the same concerns you. I was actually surprised that once he was placed in memory care facility his need for alchohol actually diminished. Out of site out of mind. One blessing of dementia. Most memory care facility are equipped to handle most situations.
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