DEMENTIA FROM ALCOHOL AND THE FAMILY IN DENIAL

Long before experiencing dementia from alcohol, the alcoholic has spent a life time trying to hide his alcoholism from family, friends and even medical professionals. So when the illness progresses to the dementing stage the  family who is in denial, now takes over not only the feelings of guilt and shame the alcoholic experienced. But also the active role of concealing the real cause of the dementia.  Dementia from alcohol doesn’t come on rapidly, but after a long time of alcohol abuse.

During those years of alcohol abuse the family maintains a code of secrecy, looking away and in so doing gives the abuser little reason to seek help. Family and friends are referred to as “co-alcoholics” due to their role in maintaining the alcoholic’s excuses, thereby promoting continued abuse.

Enabling, references the families efforts to protect the alcoholic from the consequences of their drinking. Supporting statements of needing “something to unwind,” ignoring odd or inappropriate behavior, and not identifying times when the alcoholic is not physically or emotionally available, are ways in which families protect the drinker. By not addressing the abuse the family gives the alcoholic little reason to seek help.

The alcoholic most likely, because he is enabled, will not seek help until he hits rock bottom. However more often than not, the abuser experiences dementia from alcohol and long term placement becomes necessary before he has the opportunity to make that choice. Once in long term placement the family and friends then continue the charade by finding a diagnosis of Alzheimer’s disease more acceptable than dementia from alcohol abuse.

The true numbers of persons with dementia from alcohol will most likely never be know because of the family continuing their role of “co-alcoholics.”  While healthcare professionals avoid questions about alcohol consumption so they are not seen as being “intrusive.”

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing

ALCOHOL RELATED DEMENTIA – THE DR. JECKEL & MR. HYDE STORY

Howard was a particularly difficult new patient in the dementia unit. Howard was young – only in his mid fifties, strong and very fit at least physically, not mentally.  Howard was easily upset, especially if a staff member told him “No”. And Howard presented us with many opportunities for saying no, as he literally ran through the unit. Having seen other patients like Howard, I asked his wife if Howard had had a drinking problem. She looked very surprise at the question, and yes Howard had been in the habit of drinking daily.

I then asked her if Howard had shown a significant change in personality when drinking, yes he did.  His demeanor changed and she remembered him having almost a “day and night personality change”. Eventually a Dr. Jeckel and Mr. Hyde personality switch was going on. Howard being normally a happy person, when starting to drink would soon become excessively friendly and happy to the point of being obnoxious. He would be very social and then become almost celebratory in his mood. When guest were over frequently jumping into the pool fully clothed.

After a seemingly shorter and shorter time of drinking,  Howard would literally check out, having a flat expression and appearing somewhere else.  His expression would then become very dark and scary while his vocabulary became suggestive and often he was vulgar.

Fortunately  Howard hadn’t been the drinker who becomes immediately angry, aggressive, rage-full and ready to fight. Of the two personality shifts the happy drinker is easier on the family, but maybe makes it harder for them to identify a drinking problem earlier.

So how much is too much, when it comes to drinking? Moderate consumption of alcohol is considered 1-2 drinks a day. A significant history of drinking is 35 or more drinks a week for a man and 28 a week for a woman.  Alcohol is quickly absorbed into the blood stream and goes directly to the neurons in the brain. Alcohol causes an increased release of dopamine in the brain (the pleasure/reward neurotransmitter), and over time you need a larger and larger amount of alcohol to realize the same effect.

When caught early, brain damage due to alcohol can be reversed. Alcoholism is caught too late when long term excessive consumption has been a toxin to the brain, resulting in neurological damage and changes to the brain including brain shrinkage.  Drinking to the point of drunkenness is particularity harmful to the brain.This was Howard’s story, and is he now is at the point where Dr. Jeckel is gone and all that is left of Howard is Mr Hyde.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing