When Dad’s memory started to slip and his confusion set in, it was difficult for us to notice. Was this just old age, or was he drunk? In fact, it turned out it was something else entirely. It was alcohol-induced dementia.
Alzheimer’s disease, dementia and other cognitive impairments pose huge health risks for seniors, but those brought on by extensive alcohol use, which are referred to under the umbrella term “alcohol-induced dementia,” or “alcohol-related dementia” are the most complicated and difficult to manage. It’s also an increasingly common form of dementia.
A recent study published in JAMA Psychiatry estimates that one out of every eight Americans struggles with an alcohol disorder and the group of Americans that saw the highest increase in alcohol abuse over the last decade were seniors.
CNN reports that between 2003-2013, the number of Americans aged 65 and older with an alcohol use disorder increased by 106.7%.
For seniors like my Dad, alcoholism takes a huge toll on the body, mind and spirit. In his case, he’s lost strength in his legs because of a serious vitamin B deficiency. It’s likely that he has Korsakoff syndrome – a form of alcohol-induced dementia that is related to low thiamine (vitamin B-1) levels. According to the Alzheimer’s Association, “Korsakoff syndrome is most commonly caused by alcohol misuse.” In other words, long-term alcohol abuse can deplete the body’s thiamine, causing this form of dementia.
Sometimes Korsakoff syndrome is preceded by an episode of Wernicke encephalopathy (also known as Wernicke-Korsakoff Syndrome), which the Alzheimer’s Association says is an “acute brain reaction to severe lack of thiamine.” Symptoms of these two related diseases include “confusion, lack of coordination, staggering, stumbling” and “problems learning new information, inability to remember recent events, and long-term memory gaps.”
Confabulation is another common symptom, where someone with the syndrome may make up information that they can’t remember. According to the Alzheimer’s Association, “they’re not actually lying, but believe their invented explanations.”
Considering that these symptoms are interspersed with moments of clarity, where the person can carry on coherent conversations, it can be difficult for family and friends to differentiate some of these symptoms of dementia from intoxication.
The Bitter Pill
In my Dad’s case, we felt like something was wrong, and he did too. Still, it took a long time to convince him to see a doctor. He finally went to a memory clinic and was diagnosed with alcohol-induced dementia. Support in terms of counselling and rehab was offered by our local Alzheimer’s Association to my Dad and to our family.
Unlike most forms of dementia, alcohol-induced dementia is in some cases reversible. How wonderful that, unlike many other dementia diagnoses there’s a ray of hope. Yet, at the same time, how frustrating.
“Individuals who have recovered from Wernicke-Korsakoff Syndrome were only likely to stay episode-free if they abstained from alcohol,” says Sunrise Senior Living. “Convincing a long-time drinker that his or her behavior is destructive to themselves and to loved ones is an extremely delicate matter.”
Even with the support of your local Alzheimer’s Association, helping someone with alcohol-induced dementia is a challenge. The first problem is the most glaring, and that’s the addict themselves.
“How do you convince an alcoholic to get help?” I asked one of the doctors treating my Dad. “That’s the million-dollar question,” he replied.
It’s a bitter pill for families to swallow — seeking treatment for an addiction must be voluntary. You can’t help someone who doesn’t want help.
The Stigma Behind Alcohol-Induced Dementia
The second problem is that it’s not easy to talk about alcohol-induced dementia because there is a stigma associated with addiction and with mental health. In my own family, my Dad’s alcoholism was something that growing up I desperately tried to hide from friends, coworkers, teachers and extended family.
Now, when I tell people my Dad has dementia, I tend to leave out the alcohol part. When we talk to the doctors treating the unique element of this form of dementia – knowing that there is some accountability on his part – complicates treatment.
But, once you begin talking about it, it becomes easier. You eventually meet other people who are going through something similar. Remember those statistics about Americans and alcoholism?
While scientists have yet to determine why some alcoholics develop alcohol-induced dementia and some don’t, there’s no doubt that this health issue will continue to grow as alcoholism amongst American seniors continues to skyrocket.
A Gap Between Support Services
The third problem that I’ve personally encountered is a lack of formal support in place to help my Dad. He seems to fall into a gap in support services – addiction and mental health programs aren’t equipped to help with his ongoing health concerns and the support he needs for his addiction isn’t necessarily available in the palliative care settings he’s been in. The result of this gap is that, except for the Alzheimer’s Association, we’ve had little success in getting formal support.
Geography has complicated matters for us. There aren’t any in-patient addiction rehabilitation facilities in our area. We were referred to another city only to find that they could not accept patients outside of their catchment area.
Upon further investigation, we learned that many in-patient addiction rehabilitation centers require that participants are healthy enough to engage in the treatment process. These programs are not necessarily equipped to manage some of the health issues that my Dad has – including mobility challenges, or a catheter that’s a complication of the prostate cancer he had over a decade ago.
What about a nursing home or retirement community? We’ve learned that not all are equipped to manage alcohol-induced dementia because it requires a level of mental health and addiction services that is beyond the “norm.” This means that if you’ve got a family member with alcohol-related dementia it’s important to search for a retirement community or nursing home well in advance of a crisis.
Managing the care of any senior with ongoing health issues is complicated enough, and when you add to the mix the need for addiction support and advanced memory care, finding the right care becomes excessively difficult. Appropriate care is out there, but you’ll need time to find a community with the right balance of memory care and addiction support.
So, What Can You Do?
If you think your loved one has alcohol-induced dementia talk to your family doctor and ask for a referral to a memory-clinic. Remember, you’re not alone!
The Alzheimer’s Association has counseling available for family members whose loved ones have alcohol-induced dementia. My advice is to accept that counseling. Seeking counseling for yourself is one thing in this situation that you can control.
When you’re looking for formal support networks for your loved one tell people right away that they are a senior. Seniors dealing with an addiction are at a higher health risk than people who are younger, and as such they’re often made a priority for rehabilitation services which means they may be fast tracked into addiction programs.
Be up front with any retirement community or nursing home about your loved one’s alcohol-induced dementia. Not every community is aware of this condition, nor will they have the resources in place to provide proper care. If they can’t provide the necessary support, ask them to help you find a place that can.
Visit the National Council on Alcoholism and Drug Dependence for tips on how to have open discussions with your loved one. It’s important that they know they’re supported.
Are you or someone you know dealing with alcohol-induced dementia? Please help end the stigma by sharing your story.
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