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Mom has advanced dementia. No short term memory at all. Bad balance issues and ankle arthritis. Lives alone next door to my sister, who works during the day. I live an hour away and spend two days a week with her to pay bills, make sure meds are in order, clean, laundry, and take her for doc appointments, grocery shop. Our brother, who lives about 30 minutes away, rarely visits or calls her, and is oblivious of her declining condition. She used to have a couple of whiskey toddies in the evenings (she and her late second husband got into that habit, and she continued it after he died). We thought it was not a big deal for her to enjoy a drink in the evenings to pass the time in her loneliness- but this past year, with her declining mobility, her drinking made her balance issues worse, and she had a fall in December - I found her the next morning after a night on the floor - the empty whiskey drink glass still sitting on the table......so I knew it contributed. No injuries, but that fall increased her cognitive and physical decline tremendously. She's now dependent on a walker, and can barely get around. The day she fell, I told her no more drinking. Poured out the remaining whiskey and told her we would no longer take her to the store to purchase alcohol. She has been mad at us ever since, but we explain that it's for her safety. A couple months ago, we found a bottle of whiskey hidden in a cabinet - our brother had bought it for her at her request. We gave it back to him and said she can't drink - a month later, it was back in the cabinet - he had brought it back to her. We took it again and poured it out. We reminded him that she can't drink. He just doesn't get it. Then I found another bottle yesterday - asked her about it, and she said she asked him to bring it to her - she started crying, because she'd been busted once again - I told her I wasn't mad at her - I'm mad at him for enabling her and not getting it - it's for her safety. He won't answer my calls or texts explaining that she simply cannot drink.....she overpours and drinks too much. He doesn't want to or doesn't seem to understand her decline and safety issues. Are we wrong to tell her no? We have medical and durable power of attorney. We do everything for her - for her health and safety. He does nothing and it angers both of us. Opinions?

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If your mother has "advanced dementia" she should not be living unsupervised.

Therein lies the problem.

You only have control over your own behavior. Not mom's and certainly not brother's.

As long as she lives alone and has not been declared incompetent, she is free to do as she pleases.

Look at the bigger picture. Your mother needs to be in a care situation with 24/7 oversight; either round the clock at home caregivers or a facility suited to her current level of need.
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I'm not going to comment on the whiskey toddies. Or falls or even safety.

It's a safety vs feedom of choice issue. Or quality of life vs quantity.

Just going to ask if you have read this book by Atul Gawande?

Being Mortal: Medicine & What Matters in the End.

Maybe it will help, maybe not with this exact issue but for the bigger picture. Your brother may have a different approach. If you can be curious about his reasons & ask him why it may be interesting. Keep an open mind. All perspectives can be useful.
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Safety v. Doing one of the few things still left in her lonely life that she enjoys.

Maybe you should have an all-sibling meeting and come up with a solution, like she can have in her home every day the equivalent of 1 drink so that she can't overindulge. The sister who lives next door may be willing to manage this. Or, someone goes over there after dinner and enjoys the cocktail hour with her.

Growing up my Italian-American family had a small cocktail before dinner religiously. When I visit we still do it. It's not a lot, 1 drink, but we chat and decompress from the day together. You are worried about your mother's body suffering but in the meantime her "self" is suffering. All the caregivers on this forum understand this quandary.

BarbBrooklyn makes good points about her being alone and unattended. In a care facility she will at least have people to talk to and activities and events to attend and no one will be needlessly orbiting around her and fretting. Who has PoA for her? This person can read the document to see when their legal authorities are activated and can then start making decisions in her best interests. If she has no PoA, this needs to be accomplished sooner rather than later, but with all the siblings so that there's transparency and no one can later say, "I didn't know _____". I wish you family harmony and much success in helping her have a better quality of life.
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You're saying that your brother who lives 30 minutes away rarely visits. If you're averaging finding a bottle of whisky once a month, then he's coming by. He might visit during the day when your sister is at work.
You did ask for opinions on your mom's situation, so I'll give you mine.
Yes, it would be wrong to completely cut your mother off having her whisky. What else does she enjoy at this point in her life?
You can restrict how much she can have though. Your sister lives next door. Would she be willing to keep the whisky bottle at her house and let mom have one dram in the evening and no more?
Then make your brother aware of this new arrangement. Tell him that if he's going to leave a full bottle then he can stay there while mom gets lit to make sure she doesn't get hurt.
I'm pretty sure he's not willing to do that and will probably agree to stop bringing by a bottle for her.
If he refuses to stop leaving off a bottle for mom, the next time she's drunk put her in the car and drop her off at his house no matter what time it is. Let him deal with it. That will stop his whisky delivery service for sure.
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I have had a similar situation in the past with my mom. Mom is a fall risk and on blood thinners. We went through months and months of discussions (arguments) about alcohol consumption because visiting family thought it was cute to see her tipsy and started encouraging her to drink when she normally doesn’t. One day I found her outside, by herself, stumbling around in the concrete and gravel backyard, in 104° heat, and a half- empty glass of whiskey on the patio table. She was “weeding.” My family says “she’s 83, let her have some fun.” They live elsewhere and apparently have no idea how much work caregiving is (on a good day!) or how dangerous alcohol is for an elderly 104 pound woman. They said I was being “controlling.” It took almost a year of battles before she finally started managing herself and would only have a little bit and only when we were having a special evening with friends. I am so grateful she eventually came around. I thought I would lose my mind for a while. I’m so sorry for how your brother is disrespecting you. I wish I had some words to help!
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It's hard to break a habit of having a drink or two in the late afternoon or evening, especially if she has dementia and can't remember if she had a drink or not.

There are meds that you can't mix with alcohol.

Or you can choose like your brother did and let mom enjoy doing whatever she wants to do during the rest of her life.

If something happens she'll end up in the Hospital and or Rehabilitation.

I know it's hard, but put yourself in mom's place, what would you want your kids to do?

Juse because you think to pro long your mom's life you decide what she can or can't do but in the end which is better do what makes you happy even tho you may live a shorter life or live unhappy and exist a little longer?

I think for myself, I'd take the happy route.

Alsi, if she can't remember about the drinking like if she already had a drink or not then you would have to worry that she would obverse dose on her meds.
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disgustedtoo May 2021
"...let mom enjoy doing whatever she wants to do during the rest of her life."

"Juse because you think to pro long your mom's life you decide what she can or can't do but in the end which is better do what makes you happy even tho you may live a shorter life or live unhappy and exist a little longer?"

This ISN'T about trying to prolong her life so much as preventing premature DEATH. Do you think it makes her mother happy to spend the night on the floor?

"Alsi, if she can't remember about the drinking like if she already had a drink or not then you would have to worry that she would obverse dose on her meds."

With advanced dementia and no short term memory, she likely isn't going to remember she had one, two or twenty drinks and won't remember to take her meds or will forget to have taken them and take more.

If she didn't have dementia, I might concur that letting her make her own choices is the way to go, right or wrong for her health. We can't force those who still have their faculties to do what we think is right. But that's NOT the case here:

"Mom has advanced dementia. No short term memory at all. Bad balance issues and ankle arthritis."

"We thought it was not a big deal for her to enjoy a drink in the evenings to pass the time in her loneliness- but this past year, with her declining mobility, her drinking made her balance issues worse, and she had a fall in December - I found her the next morning after a night on the floor - the empty whiskey drink glass still sitting on the table......so I knew it contributed. No injuries, but that fall increased her cognitive and physical decline tremendously. She's now dependent on a walker, and can barely get around."

Thinking one or two drinks is harmless when clearly there IS an issue and suggesting they leave mom to her own devices and decisions is just plain wrong. Allowing a small drink, under supervision might be okay, esp if you can start watering it down. Allowing her to have a bottle to do as she wishes is asking for BIG trouble!

I can attest to this. My grandmother liked her wine. Sadly the parents and aunts never really discussed this with us, even though we were on the cusp or over the age of consent/adult. I'd heard them whisper about it, but had NO clue how bad it could be. One long weekend, mom and dad took YB (10 years younger than me) away to old friends/neighbors. They left Nana with us, like WE needed a sitter? We were both in college and of legal drinking age at that time. I went to the store to get some food items and was going to pick up some beer for myself. She wanted to go along. On leaving the grocery store, I wavered about the liquor store - go now or take her home and make another trip? I decided to go now. She questioned the turn away from home and was happy to go pick up a bottle of wine.

I had an old TV in my room, so I went there with my drink and left her in the LR with hers and the TV there. When I was preparing for bed, I could hear the TV blaring away. I crept down and peeked. No sign of her, just the TV on. Uh Oh. The parents had closed off the "breezeway" between the house and garage, and this had a bed/couch for her to sleep on. I found her passed out on the floor. Oops. I managed to disturb her enough for her to crawl into the bed (couldn't lift her dead weight.) Next day was a cookout planned at my aunt's house. I woke her and told her to get dressed. Oh, no feel ill (she had barfed into a paper bag overnight.) Long story short, I got her to dress, we drove about 45-55 min to aunt's, got her through the house, into the back yard, seated in a chair and she puked all over herself. Aunt changed her clothes (they took turns caring for her, so there was spare clothing) and put her to bed.

So, bottom line is she WAS okay if you gave her a glass. She was NOT okay with a bottle. She also did NOT have dementia. Add dementia into the equation, you have a recipe for disaster.
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There are so few things your mother can enjoy at her stage of life and condition. Is it possible to allow her to have a drink in the evening? Try not to be mad at your brother. He may not be doing things the way you'd like them to be done, but is it worth having a family feud over this? Can you hire an aide to help your mother at the end of the day with bathing and getting to bed? At least this way you'll know that she is safely in bed after her drink every night. Or perhaps your sister can drop by just to check, every evening. Usually you wouldn't expect a person with advanced dementia to be living alone.
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It truly sounds like your mom should NOT be living alone.
Check all the medications she is taking, I bet at least 1 of them will state that she should avoid alcohol while on the medication. If so it may not have been just the drink that caused her to fall but the combination of alcohol and medication.
If she is living with someone, someone living with her or if she is in Memory Care AND if is alright with the medications she is taking there should not be a problem with a small "controlled amount" of a drink in the evening.
I am sure your brother is fully aware of her decline.
I am sure that he finds it difficult to say "no" to mom.

There is also the possibility that your mom is an alcoholic and you will not get her to stop drinking. The concern would be when the drinks get stronger, start earlier in the day. (next time you take her to the doctor and they do lab work ask if they can add a BAC (blood alcohol content))

Next time she ends up in the hospital it might be a time to assess if she is safe to be discharged to her home if she is there alone. (that is if she is found in time and is able to be discharged to home or rehab.) **hate to be a downer on that but it is realistic**
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disgustedtoo May 2021
"I am sure your brother is fully aware of her decline."

This may not be the case. If he isn't spending time with her, he won't be aware of how bad it really is. Getting a call to pick up a bottle of booze and going there to drop it off, he isn't going to experience the whole thing. It's like a doctor, who is reality only sees you for maybe 10 minutes during a check up. So much can be missed and/or the person can briefly put on the show.

If he is truly aware, then he is like a few who have posted here who think it is fine to let her do what she wants without considering the repercussions. As I noted in response to one of these comments, this isn't so much about prolonging her life or making quality of life better (does alcohol even do that???), but preventing serious illness, injury or premature death!
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The drinking compounds an already existing issues - balance and ability to think through issues, dementia itself. It is not a question of letting her enjoy. She probably doesn't enjoy it so much as it is a habit. My mom was a wine drinker. As her dementia got worse, so did her drinking. I don't think she realized how much she was drinking. It became a safety issue - related to falls, her use of the oven, and on top of it, she smoked cigarettes.

First off we turned the oven off, so she could no longer use it. It was not safe. She forgot and left it on with a pan on the oven. She used it to light cigarettes, and wiped off the hot range.

Then, we began watering down her wine so that eventually it was nothing but water and juice. And delivered less and less until she forgot about it. I did the same with the cigarettes, by delivering fewer and fewer.

Both worked - she falls much less, has less incontinence, no longer drinks wine and no longer smokes. It was not to take away her last pleasure - It was to keep her safe from an even worse event. Just like I took away her car and her driver's license. It was not just a matter for her safety, but for all around her.

The idea that this is some kind of enjoyment seems to make sense on the surface, but it is just a habit. And in too many cases, it creates unnecessary dangers. Now it has been nearly a year past and she rarely, if ever, thinks about drinking and never brings up cigarettes.
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disgustedtoo May 2021
"Both worked - she falls much less, has less incontinence, no longer drinks wine and no longer smokes. It was not to take away her last pleasure - It was to keep her safe from an even worse event. Just like I took away her car and her driver's license. It was not just a matter for her safety, but for all around her."

Thank you for this post. It is a good example that backs up what I've tried to say - it isn't about denying her pleasure or extending life, but preserving what she does have left and avoiding unnecessary illness, injury or worse!

My grandmother was into the wine - I related how it was for her in a comment. In our case, my parents and aunts were old school and didn't discuss all this with us, despite two of us being more or less adults in college! Had they bothered, I would NEVER have taken my grandmother with me to buy wine OR I would have known to just give her a glass and hide the bottle!!!
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As my uncle reached 90 the Dr told my aunt that he probably should stop drinking. My Aunt was 20 years younger and had worked in health care. He was an off-the-boat Italian and made his own wine in an old whisky barrel in the cellar. His daily routine was a morning drink that included an egg, strong coffee and his wine (Yuck, but he liked it), a tiny glass of wine with lunch & dinner and at 8:00 he had a beer and went to bed. My Aunt told the Dr "the man is 90 years old, how much longer do you expect stopping his routine would add to his life and what enjoyment would he have?"
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disgustedtoo May 2021
That's also a very different scenario. He clearly had a "routine" and a drink with meals, one before bed, etc. Leaving a full bottle with a person who can't control themselves (my grandmother, no dementia) and/or has dementia is asking for trouble! Certainly if she enjoys a drink in the evening, mostly out of habit, that could be allowed/controlled. There's no way this woman should have access to a full bottle of whiskey with no supervision (I also question why she is living alone.)
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Sounds like your mom has no business living alone.  If she were around other people and not sitting alone, maybe she wouldn't even think about the nightly drinks.  Your brother is very typical in his denial of your moms situation.  Like I told my moms brothers....your inability to accept her illness and limitations does not change her situation.  She still has dementia and still needs assistance.

Your brother is giving her the booze for the "pat on the head" he has probably gotten from her his entire life.  You are more than likely not going to be able to change the dynamics of their relationship.

Focus on the bigger issue.  Mom needs more care and should not be left alone.  Your brother is not going to be of any help, so don't expend any emotion or energy being angry at him.  He is a speed bump...move past him and focus on how to care for mom.
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RedVanAnnie May 2021
Spot on
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Her short term memory is evidently better than you think if she is remembering and arguing about not having her alcohol. And if you really believe her short term memory is gone, there's no way she should be living alone next door to a sister who works all day. Short term means she forgets she turns the stove on and other potential disasters. You're too far away to monitor and brother not participating. It's beyond time to allow her to live alone. You say you and sister do everything for her health and safety, but this woman is alone all day. While brother may not be helping - mom does not really have any kind of oversight during the day. Not to mention her fall during the night where she wasn't found until the next day.

I say all that because if you are having a conversation with her to tell her no more booze and it would appear you expected, or she did, understand that chat. So, I kind of got mixed message in the post.

Aside from that, drinking mixed with old age is definitely not a good mix. I have a feeling that all three of you allow mom's tears to determine her living arrangement. Perhaps you and sis know she should no longer be at home alone, but tears and arguing allow it to continue. Brother gets the booze for the same reason

If there is money - it's time to hire in home caregiving or move to assisted type living facility where someone is available 24/7 when needed. If there is no money, she needs to be evaluated by a doctor to determine if her medical needs meet those required for nursing home care and start the process. OR she has to move in with one of you. Tell brother no more booze because it doesn't mix well with meds and she already fell one time. If she asks him for it - he can blame both of his sisters. Or if he brings a bottle, he needs to move in with her for safety sake.

If she's really more competent than related in this post, she does have the right to drink if she wants and live where she wants. So maybe that is a discussion to have with her: When you drink, fall and break a hip - what nursing home do you want to go to?
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disgustedtoo May 2021
"Her short term memory is evidently better than you think if she is remembering and arguing about not having her alcohol."

"She used to have a couple of whiskey toddies in the evenings (she and her late second husband got into that habit, and she continued it after he died)."

This sounds much more like a LONG term memory/habit. Also, just because short term memory is compromised doesn't mean nothing sticks. I was amazed that my mother very quickly learned how to clear the LCD display I got to help with her hearing loss. It needed just a button press and it only took maybe once or twice for her to figure it out and clear it after reading what I wrote! Other times, OI! She'd have a sales flyer in hand and repeat over and over how much she liked these slip on shoes and how they were only $20. For whatever reason, I couldn't dislodge that, probably because she had the flyer in hand, so would see them and it would repeat.

Having already been found on the floor in the morning, assumption is she was there all night, clearly speaks volumes about her ability to live life on her terms. She needs supervision (who can also intercept the booze deliveries) and rather than eliminating the alcohol, allow a drink in the evening, for now. As dementia progresses further, the alcohol may have to go, so start now with limit of 1/night and water it down, a little at a time until it's mostly water.
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Let her have the bottle. Just replace 3/4 of it with water and food coloring.
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NeedHelpWithMom May 2021
MJ,

Interesting idea! How do facilities handle a resident who drinks moderately? Do they do these clever tricks?
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I can see how much you care about your mom. You help with so many of her needs but I am afraid that she needs more care at this point in her life.

Would she enjoy the company of others? Is she drinking out of habit or loneliness?

As far as your brother goes, he sounds like a guy who doesn’t want to make waves and goes with the flow. He isn’t clued into her needs like you and your sister are because he isn’t involved in her day to day needs. Plus, he is obviously swayed by your mom’s feelings.

Your brother may not even be interested in having a closer relationship with her. He may be preoccupied with his own life and has issues that you aren’t even aware of.

Your brother obviously isn’t taking her drinking seriously, even though you have discussed your concerns with him. I doubt if you can sway him to see your side. So, leave your brother out of the equation and make plans for her care on your own. You say that you have POA, so your brother may feel that you are capable of handling everything. Holding onto all of the responsibility isn’t always the best answer. Let others care for your mom. Don’t place your focus on your brother, instead use your energy on finding the best care options for your mom.

Do you have any objections to her being placed in a facility? You are concerned about her safety and the best situation would indeed be 24/7 care. Best wishes to your family.
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You state that she drinks too much, that it’s a habit, that she cries when she gets caught... Well she’s an alcoholic. Age is no respecter of addiction. She needs help from a doctor who understands this. You cannot just take it away from her, she could develop a dangerous spike in her blood pressure from the withdrawal and have a stroke. She will need help to detox. Please take this seriously, she cannot do this without help.
But at her age just dilute the whiskey and let her have the two toddies she’s used to. Leave only enough in the bottle for the toddies and refill it daily. Elderly folks fall for many reasons and I question that the alcohol she’s been used to drinking for years caused her fall. It does sound like she should not be living on her own.
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My mother used to have a modest glass of brandy, topped up with very hot water and brown sugar. Yeuchh! Yeuch anyway, and a terrible thing to do to VSOP Cognac, but actually the point is that the modesty declined as her ability to judge measures did. The last time I saw her do it my eyes almost popped out of my head - woah there!

Get your mother a decorative cocktail measure. Or, maybe your sister could make up the evening's toddy and put it in an insulated flask for her, something like that? But I wouldn't insist on changing her very longstanding habit.

Has she been given any of the simple, basic balance exercises to do, by the way?

Your brother is being a - I won't say the word. But you're not going to change his mind. Instead, let your mother see both that you're on her side and that you're right.
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Imho, perhaps your mother, who has "advanced dementia" can NO longer live alone, e.g. it may be time for facility living for her. I am really not surprised (but should be) that the only function that your brother is adept at is being your mother's alcohol enabler. So if she moved to a facility, perhaps this would end, albeit someone who is used to consuming alcohol is going to perchance have a difficult time ceasing such habit.
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Hi there, lisah. Alcohol is one of the few things I've ever heard doctors and caregivers say shouldn't be cut suddenly. If your mother is an alcoholic and her body is used to the alcohol, having her stop cold turkey may not be the best option for her health. I would bring this up with her doctor and tell him the amounts and length of the habit, and then go from there. You and your brother can hopefully agree on whatever the doctor's advice is, too, and it doesn't put you at odds with each other over this.
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You are right - no drinking under any circumstances. Your brother drinks and won't give it up and refuses to see what is going on. He may be incapable of seeing it with his drunken mind. And she wants to drink. Unless you can totally separate them so she has no access to drinking, you won't be able to stop it or get through to him. I see only one solution - she has to be put somewhere that she simply cannot drink - it does not exist. You could also ask Social Services to step in and do their thing but I think for her safety, you know what you will have to do.
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disgustedtoo May 2021
"Your brother drinks and won't give it up and refuses to see what is going on."

Where did you get this from, a magic mirror? There was no mention of OP's brother drinking, only her mother and the mother's second husband. I rechecked all replies to be sure I didn't miss anything and checked the profile as well.

RIF!
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Your mother obviously has a problem with alcohol. She probably would do better withdrawing from alcohol if it was in a facility - people have died of withdrawal.

Your brother has a problem as well with enabling her alcoholic behavior. I suggest you talk to a lawyer that specializes in elder law about steps to take in regards to your brother.
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