How to talk to M-I-L about excessive drinking?

Doctors are not likely to be too proactive with a drinking senior. That was my experience - both parents drinking, all manner of doctors, even when each ended up in the emergency room due to over consumption of alcohol. The only doc who cared was a neurologist who finally wrote my dad a "Dear John" letter because of the drinking. Damage to internal organs is bad but, you're gonna die of something anyway. The real problem is falls, because a bad fall can render someone miserable for the years they have left. Alcohol magnifies the negative side effects of Benzos like lorazepam. These drugs affect balance on their own. If she's got lots of bruises she may be bumping into things and/or falling because of prescription drugs and/or the alcohol. If the beer is not affecting her motor skills and she's not driving, its probably not a problem (yet).

According to the National Institute on Alcohol Abuse and Alcoholism (NIAA): "For women, low-risk drinking is defined as no more than 3 drinks on any single day and no more than 7 drinks per week."

The NIAA defines binge drinking as: "..binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours."

The NIAA defines heavy drinking as: "...as binge drinking on 5 or more days in the past month."

RhondaR, based on what you've said in your question, you have reason to be concerned that your MIL does have a problem with alcohol. The first thing I would do is write a letter to her primary care doctor and time it to arrive about 3-5 business days before her appointment. This information is significant, for the doctor will order tests to detect health problems associated with heavy drinking, including liver function tests and perhaps an ultrasound of her liver. Her doctor needs to know about this, because alcohol does affect how other medications are metabolized and alcohol does affect the effectiveness of certain medications. When you write to the doctor, be as specific as you can about her drinking--and if you can give the doctor dates, times and what you saw, that will be even better. That way, her doctor will look for problems associated with alcohol abuse, will take this into consideration when prescribing for her and hopefully will refer her for addiction treatment and appropriate mental health care.

Now, what can you do? Set ground rules / boundaries. If she's been drinking, we go home. She can't drink in your home. Period. Continue to express concern for her drinking, where it's appropriate. Write down your concerns and send a letter to her doctor. Don't enable her drinking. That's all you can do.

Here is a link to a booklet produced by the National Institute on Alcohol Abuse and Alcoholism that discusses alcohol and women: pubs.niaaa.nih.gov/publications/brochurewomen/women

The habits of a lifetime will not lessen in our old age only because all of a sudden we care to respect our higher nature and change. At that age our habits drive us, especially when our ALZ's mind begins to override our logic and our present ability to remember what may be best for us.

I would risk saying here not to venture into making any one change, but to offer love and understanding. In the case of an addicted personality this may be hard, I know. But it may be the one and only feeling that will get through to them.

Many times those addictions have arisen from a feeling of not being wanted, loved or being not good enough. What if they now felt wanted, loved and respected? Little by little that energetic may create the change you seek. And if not, pad yourself on the back for approaching it in a way that may have honored the person rather than judged them.

Just offering a possible new approach.

If she won't use a taxi account....how is she getting the beer? We had the same problem with my mom (with vodka, which we would secretly cut with water), and asked the living facility NOT to buy her alcohol (had the doctor back us up, as it was a fall risk and a lilability issue) . She didn't want to go out, we wouldn't buy it, and she ended up quitting. Of course, other residents could buy for her, but sometimes the inconvenience will stop them. Also bought her diet cokes, flavored waters, etc so she would have SOMETHING with taste to drink. Actually, her favorite was Perrier, as it has that mineral "bite" which somewhat duplicates the "texture" of the beer.

Another agreement with Old Bob. An alcoholic will not stop drinking until s/he decides to do so, until s/he wants to quit. Being the child of an alcoholic, I totally understand that. At least she is not smoking as much now, which is wonderful. My sister recently died (at 72) from emphysema caused by her smoking.

I switched my husband's wine to non alcoholic (on advice of doctor) but he has dementia a doesn't know the difference.

I agree with Old Bob too. A person is not going to stop drinking because you tell them to, even if the words are spoken with kindness and love. If a person has a problem with alcohol, it doesn’t matter what anyone, even a doctor, says. It’s a VERY powerful addiction. One can be pulled over for DUI, be in an auto accident and suffer great embarrassment and hurt when people tell them they have an issue...and still not stop drinking or admit they have a problem. At least your mom doesn’t drive. But I worry she may fall. Mom has to WANT to quit and it doesn’t sound like she does. Probably the best you can do is get her one of those “Life Alert” necklaces if she’ll wear it. But don’t tell her it’s for if she falls while she’s drunk.

How old is your MIL? If she's up in years, what do you expect to gain from her cutting back on drinking? If she's competent, I'd likely let her doctor say if her health is in danger and then, if she's competent, that's her call if she wants to make any changes. If I were a senior, I'd like to live my life as I wanted, as long as I don't hurt others. So, I'd eat what I want and drink my beverage of choice.

I agree with OldBob1936. Your MIL is not going to to listen to anyone because she is probably an alcoholic though she will not think so. If you want to learn to deal with an excessive drinker like this, go to Alanon meetings - not just one meeting either. Get involved. Then, you will learn from others that you cannot convince your MIL with reason. My experience with a stubborn set of parents is that they will do whatever they want as long as they can - even if they die from it. My dad has diabetes and has eaten mostly what he wants for 30 years.

Since your MIL does not use the taxi service, how does she get the beer? My Mama is "Miss Jesus drank wine" lol. I love her and she has dementia. Since coming home from rehab and simply forgetting, she has slowed down on the drinking wine. I also buy smaller jugs. She cannot remember what you said 2 minutes ago but she can ration the wine if not much is left and it's a Sunday. This is an old habit and as long as they don't start drinking more than before then it's okay. Pick your poison.

The worst case scenario--controlling Alzheimer's using alcohol. That is actually elder abuse. 

My Mom, age 84, lives with me in her custom build senior apartment. She drank and smoked heavily most of her life and, although she quit smoking at age 81, she continues to demand 5-6 drinks per day (beer and wine), half of her previous use. Her health has suffered from the expected health problems: high blood pressure, cirrhosis of the liver, alcoholic cardiomyopathy. She must use a walker as her balance is poor. She must use oxygen while walking as her blood oxygen levels drop when stressed. The slightest stress and she becomes short of breath. Her medications consist of Timolol for high blood pressure, Lasix (a strong diuretic), Flonase for the constant histamine release due to cirrhosis. Her only entertainment is television drama. For 12 years I begged and showed her the possible outcomes of her addictions, to no avail. Her doctors tell her to stop drinking, to no avail.

Your MIL weighs only 88 lbs. FYI: Regular beer has approx 160 calories/bottle. Light beer fewer calories and is less filling.

In my experience and those of a few of my friends, elders are set in their ways until a crisis...

It can be difficult to find a direct non-alcoholic substitute for beer. They're mostly too sweet or taste odd to a beer-drinker's palate. But this might be one option - I am delighted to discover that no fewer than forty-five American breweries produce mild ale, which typically has an alcohol rating of 3% to 3.5% (and sometimes less - Jennings's is about 2.3%, I think). Mild can also be delicious, flavour and alcohol content having absolutely nothing to do with one another, so your MIL won't have to feel she's having her pleasures watered down.

Does the amount she's currently drinking seem to affect her mood or behaviour? Would you say she actually gets drunk as such?

She wouldn't use a taxi account you set up. She sent away companions. Somehow this doesn't sound to me like a woman you can talk out of doing what she intends to do, or to do want she doesn't want to!

It is wonderful the smoking has decreased! (And that didn't occur because someone asked her to reduce the smoking.) If MIL drinks while she watches television, if she gradually finds other activities she likes in the IL complex perhaps she will watch less television and therefore drink less. We can hope.

If she takes medications you can ask the pharmacist if alcohol interferes with any of them. If it does you could send a note to her doctor. Of course, you don't want to sound like you are telling the doctor what to do, but you can express your concern.

In some locations beer was drunk with breakfast and all day long, even by children, in colonial times. It was often safer than drinking the local water. I'm not justifying it in this day, but just trying to put it in perspective. It is not like she is snorting heroine.

I don't drink any beer because of medication interactions, but I could never drink 5 - 6 beers a day (light or otherwise) because I would have to pee every 10 minutes and miss a lot of my programs, and I would be asleep after the fist 2. I'm impressed that your 88 pound MIL can do this! Does she get drunk on this routine? Is she less steady on her feet? Now that she is being served real meals the beer drinking may gradually decrease because she just won't have room for all those extra calories. You might buy some near-beer for her, saying it was on sale and you heard that it was less filling, which might be good now that she is eating good meals. She might throw it back at you, of course, but it MIGHT be worth a try.

In short, I don't think you are going to come up with words that will convince MIL to drink less. She might listen to her doctor better than she listens to you (but I doubt it). But her new living arrangement is on your side; it might gradually decrease somewhat if she gets into activities and continues eating well.

How old is MIL, by the way?

As an alcoholic with 31 years of no drinking at all since joining AA in 1986, I can tell you that from my experience with hundreds of fellow recovering alkies, you may as well save your breath. I do not say she is an alkie, but my hunch is that she likely is. "Talking sense" to a person who drinks that much is a no-win situation.

I do not write to percolate an argument with anyone...

(We long term recovering problem drinkers know what we are talking about..)

Grace + Peace,

Bob

First you might want to consider what "excessive" drinking is... What size lite beers (12 or 16 oz) over what timeframe? With food? Are there other health concerns (liver/kidney problems, medication conflicts) or is it just your fear of her falling? If MIL is otherwise healthy, even at 88 lbs she should be able to metabolize a pint lite beer(4.2% alcohol) in 1.5 to 2.0 hours. Has she always drunk this much beer or has it recently increased? Try to determine if MIL is self medicating for pain, depression or anxiety. I have a family member who works construction and drinks beer in the evenings at home because (1) he likes beer and (2) it helps with minor muscle pain so he can get a good night's sleep. Maybe MIL is drinking for a similar reason - anxiety over all the recent changes in her life that are out of her control? Her doctor might be able to prescribe something for anxiety but medications have side effects too. If MIL is unwilling to drink less, maybe you could suggest she perform riskier activities (for falls) like bathing in the morning before she begins drinking or use a walker in the evenings. Suggest you begin the conversation with "I'm concerned you might fall and get hurt/end up in the hospital" and avoid the phase "you're drinking too much" at all costs. Good luck.

It would be better for her to smoke than drink at this age. Any way you can swap the vices? My parents entered their 70s in great health but refused to give up their daily wine consumption. Mixing alcohol with seniors' medication creates a mess. Yes, falls and confusion, etc. My parents' downfall was their wine drinking started earlier and earlier each day, eventually moving to 7 am when the local convenience store started daily sales. Maybe you could try to get her to cut her consumption in half, and make sure it starts late afternoon and no earlier. All the advice from myself and various doctors went in one ear and out the other for my parents and I had to let it all run its course. Honestly the doctors didn't really try very hard, it was just sorta like, oh well, they won't stop until they want to.

Hmm, would she listen to a health professional advising her about the problems with excessive alcohol consumption, especially as we get older? Maybe at the same time affirming her for already making such a positive change by drastically reducing the smoking -- that must have been hard, even if it wasn't really voluntary! I hope other people have some ideas.