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Kingsbridge Asked August 2018

My dad has mild to moderate alcoholic Dementia & disagrees. Should I provide more written info to him to help him accept it?

The doctors diagnosed my dad a year ago. His own facts are all twisted - he believes he has a concussion & is getting better. He fixates on having lost his license & getting it back, the doctor iss making up the diagnosis, and his children telling lies to the doctors. As part of the diagnosis, they stated he lacks insight. He is unhappy, unwilling to make any changes that will improve his quality of life. He tells the story over & over again to those he has any connection with. He still lives independently, and is 88 years old. The doctors gave him 7 pages with an overview of dementia when first diagnosed. Would giving him excerpts from this site or others help him accept it better? Or is this just another hopeful dream I have of wanting my dad to work with us better to improve his life, and improve our relationship with us. He is very difficult and trying to reason with him is most times met with “you think you know everything”, “you got all the answers.” He does believe other people over us - grasping only on things they say that back up his belief of his situation. Maybe he would believe communication from places like this site, Mayo, or Other?

Grandma1954 Aug 2018
Kingsbridge...to answer the question about falls and dementia.
I think it a disconnect with motor movement and visual cues.
I have heard one way to stop someone from leaving the house is to place a black rug in front of the door. They think it is a "hole in the floor". Perception is a problem, this is one of the reasons in many Memory Care units the floor and the lower part of the wall, below the hand rail, are a very different color so you can easily tell there is a floor and a wall.
Perception is also one of the reasons that driving is not a good idea, misjudging a turn, the distance between cars, how fast the other car is coming at you. Mind you some of these things are general age related.
I have read it takes 45 seconds for the brain of a person with dementia to process something that they have heard. You ask a question and get no answer, so you assume they 1. did not hear the question, 2. do not know the answer, 3. forgot the answer to the question. (I don't know about you but in 45 seconds I am off on 3 other topics!) So some of the may play into the processing of visual cues as well.

It is possible that your Dad, if he can participate and understand direction might benefit from physical and or occupational therapy. It might improve his balance, or you will get a professional opinion as to why he falls.

Sunnygirl1 Aug 2018
Kingsbridge, this is a response to your follow up question about your dad falling and not realizing that he fell or what caused it. Frequent falls are not uncommon with dementia. Often there is a very poor sense of balance and then the person my forget to use a cane or walker. Getting them to do use care and their cane or walker, is very challenging and even with constant direct supervision, which is helpful, is still challenging. One problem though with a person who has dementia living alone and unsupervised, is that if they fall and injury themselves, they may not be able to summon help. I know people with dementia who have fallen in their home with their phone or Emergency alert button right by them, but, they just won'd call for help and may lay there for days. When rescued they can't explain why they didn't think to call for help. The brain just can't process how to do it.

The alcohol dementia that you describe is quite specific. I'm not that familiar with it, but, do know a couple of people who had it. If your dad is not able to properly care for himself in his home and his doctor is aware of it, the doctor may report it to adult protective services, if he feels it's warranted. That sometimes happens. I hope you can find some answers that help out.

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PrairieLake Aug 2018
Your story sounds like our story. Until Dad failed and a social worker in the ER actually had a conversation with him, they always sent him back home. It took Adult Protective Services-3 calls by different people, took an evaluation that he was not able to make his own decisions on the geriatric floor of the hospital, and me being able to use the DPOA to have him sent to a skilled nursing home to get him somewhere safe.
When I talked to the doctor, I said that Dad was very confused, but could pass all the mini mental tests, knew how to con everyone, but Dad did not believe he had dementia (it was dx as vascular dementia, even though he was a life long heavy drinker). The doctor said, “No one that is confused ever thinks they are confused. They think everyone else is confused.”
Assisted living, senior housing, a group home would never have worked, because he could leave whenever he wanted to. He would not allow anyone in his apartment.
It took the evaluation that said he did not have the capacity to make his own health care or financial decisions, and me having the durable power of attorney signed and witnessed by a third party in the hospital the year before when he was judged to be competent.
Then we had to go file for guardianship of person in probate court to keep him in the nursing home so he could not walk out. He is 90 and finally the long Dad drama of 70 years has come to a halt. We can all breathe now.
I can guarantee you your Dad will not gain any insight or cooperate with you to take away his independence so he can drink and create drama.
You will have to try it all on your own and keep trying until you succeed.
And you have all my sympathy. Or you could just walk away and let things unfold as they will. And anyone who has walked this path will understand completely.
Kingsbridge Aug 2018
Thank you so much for taking the time to reply to my post. I have not come across many who are dealing with both dementia & alcohol together, but suspect there are many more we have not heard about. My dad says drinking is the only thing left that he has to enjoy. But his age cannot keep up with the drink anymore. I hope we can stay connected. He is a strong force...I know the time is coming some day where I will have to be strong enough to go against his wishes to remain independent. I know it will get harder. I want to run away, but I will not as he is my father and I love him; but I don’t like who he has become - he was always difficult - now it’s worse. We lost my mom early last year, and it’s been hard on him, and me. I will do what I can but know my own health is important. Thank you.
Grandma1954 Aug 2018
He will not have any concept what those written pages contain.
I am sure he heard the diagnosis when it was given. I doe not remember it or the concept behind "dementia".
All you can do is make sure he is safe.
Not sure how long he will be able to live safely alone. There are a lot of problems that will come, balance, wandering, forgetting that the stove is on, the water is running, these are things that you are going to have to be aware of.
If it makes him feel better for the moment let him keep the idea that he can get his license back when he is better.
Is there an Adult Day Care in your area? He might be better if he can socialize and participate in activities.
But you are going to have to start thinking about other living arrangements if he is in his own home either assisted living, memory care or the possibility of him moving in with you. (please read some of the posts about problems with that arrangement).
Kingsbridge Aug 2018
Thank you for your guidance. Additional question: you mentioned balance as a issue due to Dementia. My dad falls every once and awhile. My concern is that he does not know what caused it sometimes...just that it happened. Why is balance affected with those with Dementia; and what are the reasons for not remembering what lead to the fall? I thought it could be the drinking...it certainly does not help.
JoAnn29 Aug 2018
I agree. You cannot make a Dementia patient understand. They no longer process or reason. They are now like small children. I am surprised with all that is wrong with Dad he is still living on his own. The time will come he won't be able to.

Sunnygirl1 Aug 2018
It sounds like the doctors say that he has anosognosia, which is when the person is not capable of processing the information that they have a certain illness or diagnosis. I'd read a lot about it and discuss it with his doctor more. I've never read of any way to overcome that. While it's frustrating, it's really not the person being stubborn or disagreeable, but, literally a medical condition that prevents their brain from processing it. Continuing to try to convince him or continuing to confront him about it, may just make him angry and uncooperative. I might focus on who is going to be watching over him and make the decisions on his behalf when the time comes. And, what good would it do if he accepts what he has? It might just make him feel more sad and hopeless. I'd try to keep him as happy and safe as possible, for as long as possible.
Kingsbridge Aug 2018
Thank you for this...I have never heard of Anosognosia...it certainly fits this situation it seems!

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