Expert Q&A: Alcohol and Dementia - Mon 24th Oct 3-4pm

[Mark_W]

Long term alcohol use can be a factor in the causes of dementia and similar illnesses, which can present unique challenges. Carers can also find they face problems with alcohol use themselves.

In our next Q&A Lauren, from the charity Alcohol Concern will answer your questions on Alcohol and Dementia. The session will be on Monday 24th October between 3-4pm, and will take place on this thread.

If you have any questions you'd like to ask, please feel free to post them here, or if you prefer, you can email your question to us at talkingpoint@alzheimers.org.uk and we'd be happy to ask it on your behalf.

Thanks

 

[nitram]

"If you have any questions you'd like to ask, please feel free to post them here"

OK, to start the ball rolling.

Excluding ARBD (Alcohol Related Brain Damage) is there any evidence that a PWD should do other than abide by current government guidelines on alcohol consumption?

 

[Mark_W]

Sorry but due to illness this Q&A has been rescheduled for Monday 24th 3-4pm. We'll leave this thread open in the meantime if anyone wants to ask any questions for then.

Thanks

 

[Mark_W]

Welcome to today's Q&A on Alcohol and Dementia, I hope you'll give a warm welcome to Lauren our visiting expert from Alcohol Concern who'll be answering your questions today.

 

[LaurenB]

Hello

Thank you Mark.
Lauren here. I'm an alcohol consultant for Alcohol Concern. It's a varied job and I spend my days speaking to alcohol service users or training alcohol professionals or developing projects to help drinkers and their families. I speak to people every day who are struggling with a relative's drinking. It can be very daunting and confusing to those around the drinker, who often see the problem long before the drinker does.

 

[LaurenB]

"If you have any questions you'd like to ask, please feel free to post them here"

OK, to start the ball rolling.

Excluding ARBD (Alcohol Related Brain Damage) is there any evidence that a PWD should do other than abide by current government guidelines on alcohol consumption?

Hi Nitram, Alcohol is a neurotoxin and there is evidence that it is a contributory factor for dementia. It also disturbs sleep and can prevent the absorption of nutrients. However, there are no official guidelines that suggest that the recommended maximum for a PWD should be different than for the general population (I have not been able to find any research on this topic, rather than there being evidence to the contrary), my advice would be to stick to the recommended maximum guidelines - 14 units per week - spread over at least four days and with some alcohol free days each week. By the way 14 units is about 1.5 bottle of wine or 5.5 pints of beer!

 

[Mark_W]

We've had this question from Jo via email:

"My mother, who has Vascular Dementia, has got to the point where she's consuming far too much alcohol. She has also had severe arthritis for 45 years, resulting in serious mobility problems, and the amount of alcohol she's drinking makes her very prone to falling. She's also argumentative and quite nasty when she'd had a lot to drink.

Once the VD set in, she completely lost track of how much she was drinking - would swear that she'd only had one or two glasses when, in fact, she was onto her second bottle. The doctors keep telling her she needs to cut down, but she won't, often starting at 4pm and drinking through the evening. When challenged, she says it's "her only pleasure in life". Do you have any advice on how to persuade her to cut down?"

 

[LaurenB]

We've had this question from Jo via email:

"My mother, who has Vascular Dementia, has got to the point where she's consuming far too much alcohol. She has also had severe arthritis for 45 years, resulting in serious mobility problems, and the amount of alcohol she's drinking makes her very prone to falling. She's also argumentative and quite nasty when she'd had a lot to drink.

Once the VD set in, she completely lost track of how much she was drinking - would swear that she'd only had one or two glasses when, in fact, she was onto her second bottle. The doctors keep telling her she needs to cut down, but she won't, often starting at 4pm and drinking through the evening. When challenged, she says it's "her only pleasure in life". Do you have any advice on how to persuade her to cut down?"

Hi Jo, I wonder whether your mother has any other interests? If alcohol is her ‘only pleasure in life’ she may find that she is less inclined to drink if she has other meaningful activities to occupy her time.

In the meantime, you could suggest that she keep less alcohol in the house so there’s less to tempt her. She could also switch to a lower strength brand – there are lots of low alcohol wines and beers on the market these days or if she prefers spirits, it would help to have a mixer with her drink.

Alcohol may also be impacting on her arthritis and affecting her sleep so maybe you could suggest she to cut down for couple of weeks and see if she feels any better. Dry January is coming up (sign up on the Dry January website) and if you all decided to give this a go as a family – to raise money or just to be healthier – she may be persuaded to join in. Sellling the idea as ‘all of us together’ and ‘just for four weeks’ may encourage her to give it a try. Please bear in mind that if she (or anyone else) starts to experience withdrawal symptoms when they stop drinking, they must seek medical help immediately.

 

[Mark_W]

And here's a question from Adam:

"I have a relative who has moderate vascular dementia and is also an alcoholic. They still lives in their own home and have carers going in twice a day to administer medication and prepare meals, with support given by the family. They live alone and are drinking extremely high levels of alcohol (3 litres of gin and 10 bottles of wine in a week.) They've also had a number of falls around the home, resulting in some minor injuries and bruising. This is as well as fainting episodes, one of which lead to a week long stay in hospital.

While in the hospital they were deemed to have capacity by a social worker so were able to return home. The relative is still mobile so they can purchase their own alcohol and refuses to consider any options of increased support, such as the extra care scheme or residential care. The family are finding this situation extremely distressing and the relative fails to recognise that she has an issue with drinking, so will not accept any help. Any attempts to limit alcohol consumption fail due to the relative being able to access the shops to purchase more alcohol. Do you have any advice that could help in this situation? In particular with regards to the mental capacity act and someone’s right to make decisions that may pose a high risk of danger to their health?"

 

[LaurenB]

And here's a question from Adam:

"I have a relative who has moderate vascular dementia and is also an alcoholic. They still lives in their own home and have carers going in twice a day to administer medication and prepare meals, with support given by the family. They live alone and are drinking extremely high levels of alcohol (3 litres of gin and 10 bottles of wine in a week.) They've also had a number of falls around the home, resulting in some minor injuries and bruising. This is as well as fainting episodes, one of which lead to a week long stay in hospital.

While in the hospital they were deemed to have capacity by a social worker so were able to return home. The relative is still mobile so they can purchase their own alcohol and refuses to consider any options of increased support, such as the extra care scheme or residential care. The family are finding this situation extremely distressing and the relative fails to recognise that she has an issue with drinking, so will not accept any help. Any attempts to limit alcohol consumption fail due to the relative being able to access the shops to purchase more alcohol. Do you have any advice that could help in this situation? In particular with regards to the mental capacity act and someone’s right to make decisions that may pose a high risk of danger to their health?"

Hi Adam, For some information on the legal aspects, please see Alcohol Concern’s factsheets on the Mental Capacity Act, Lasting Powers of Attorney and Advance Decision Making. These can be found on the Alcohol Concern website. Please bear with us, we’re updating the website at present so these may not be available for the next couple of weeks.

Whilst your relative is not able to change their drinking, I would suggest harm reduction measures. In many areas the Fire Service offer a free home safety check – this will reduce the risk of fires and they’ll be able to identify other home hazards. Check for loose flooring, make sure they have adequate lighting etc. It will also help to ensure that they are eating regularly as good nutrition will, to some extent, have a protective effect on the body. Rather than encouraging them to stop, your relative may benefit from cutting down a little to begin with. You can contact your local alcohol treatment service for further suggestions.

Close relatives would also benefit from contacting a local service that supports families and carers of drinkers. The local alcohol treatment service will often provide such support or will be able to put you in contact with any local support groups.

 

[Mark_W]

A question from L via email:

"My wife is obviously suffering from dementia but has the brain checks by MRI and the consultant is pretty certain that it is not Alzheimer's . She is now going for a more advanced MRI to check for any extra information but has indicated to me that the dementia may be caused by alcohol. We are both regular drinkers but I was shocked as I do not think that we drink to excess!
Do you know where I could get more information about this as info on the net is rather sketchy."

 

[LaurenB]

A question from L via email:

"My wife is obviously suffering from dementia but has the brain checks by MRI and the consultant is pretty certain that it is not Alzheimer's . She is now going for a more advanced MRI to check for any extra information but has indicated to me that the dementia may be caused by alcohol. We are both regular drinkers but I was shocked as I do not think that we drink to excess!
Do you know where I could get more information about this as info on the net is rather sketchy."

Hi L, Alcohol affects different people in different ways - some can drink a lot more than others with seemingly no adverse health effects. The government guidelines recommend no more that 14 units of alcohol a week for adults, which isn't a lot (one and a half bottle of wine, for example) so both of you may be drinking in excess of this without realising it.

Please see the factsheets on the Alcohol Concern website on: What is Alcohol Related Brain Damage, Signs and Symptoms and Treatment and Diagnosis. These are a good starting point for you. There is also a carers’ manual which gives some practical tips on how you may be able to support your wife. Why not both give Dry January a try next year? You can sign up on the Dry January website for free and get tips and support thoughout the month. It's a great chance for both of you to save money, feel better and take a pause in your relationship with alcohol. It's possible that your wife's symptoms will improve if she cuts down or stops drinking. As before, however, I must stress that if she has any physical symptoms on stopping drinking, she needs to see a GP urgently.

 

[Mark_W]

Thanks Lauren, we have another question from Ellie via email:

"My mum was diagnosed with early onset Alzheimers 2 years ago and just recently she has started to drink more and my dad is concerned. He has found cups full of neat whiskey near my mum and she has obviously been drinking before he gets home from work. He has now removed all alcohol from the house but we are concerned that she will go out and buy more. She is still driving and we are obviously concerned that she will drive whilst drink and hurt herself or someone else. My poor dad is really feeling the strain at the moment and I really want him to access some support but he is too proud to do so. I think he needs to speak to other people who are going through similar things and to talk through strategies on how to cope with these new challenges. Do you have ideas on how to access support for my dad without him feeling bullied into it?"

 

[LaurenB]

Thanks Lauren, we have another question from Ellie via email:

"My mum was diagnosed with early onset Alzheimers 2 years ago and just recently she has started to drink more and my dad is concerned. He has found cups full of neat whiskey near my mum and she has obviously been drinking before he gets home from work. He has now removed all alcohol from the house but we are concerned that she will go out and buy more. She is still driving and we are obviously concerned that she will drive whilst drink and hurt herself or someone else. My poor dad is really feeling the strain at the moment and I really want him to access some support but he is too proud to do so. I think he needs to speak to other people who are going through similar things and to talk through strategies on how to cope with these new challenges. Do you have ideas on how to access support for my dad without him feeling bullied into it?"

Hi Ellie,
It must be very worrying for your family if your mum may be driving whilst under the influence and you may want to consider whether an assessment under the Mental Capacity Act would be appropriate and/or to suggest to her that it would be better for her not to drive. You can contact the DVLA for information about when it would be appropriate for, for example, her licence to be revoked.

I can imagine that this is putting a lot of pressure on your dad and you’re right, he would probably benefit from some support. Could you suggest that, rather than support for him, it’s a way for him to find out new ways to help your mum? Support groups aren’t just tea and sympathy, they provide a vital link to others who’ve been through similar situations and have some practical ideas for how to improve the quality of life for the person with dementia. If not a dementia support group, there are also support groups for people caring for someone who is drinking excessively.

Your dad may feel daunted by the idea of a support group and prefer one to one support. Contact your local alcohol treatment service for information about what is available locally. Your dad might also find some useful tips in the carers’ manual on the Alcohol Concern website.

 

[Mark_W]

That's all the time we've got for questions today so I'd like to thank Lauren for her time today and all her help. Her answers are very much appreciated.

Thanks

 

[LaurenB]

That's all the time we've got for questions today so I'd like to thank Lauren for her time today and all her help. Her answers are very much appreciated.

Thanks

Thank you Mark,

It's been a pleasure. Please do check out both the Alcohol Concern website (for information about alcohol and dementia) and Dry January (for trying a month off booze - you'll feel the benefit, I promise!).

Best wishes all,


Lauren