Should you give alcohol to someone with dementia?

Today, I want to talk about a topic that I have seen many Careblazers struggle with: substance use, particularly alcohol use in their LOWD.

Before I jump into this, I want to clarify that today we are talking about alcohol USE not ABUSE. There is a big difference between someone who occasionally enjoys having a few alcoholic beverages and someone who, even prior to developing dementia, had problematic alcohol consumption. Both of these topics are important and I plan to address alcohol (or other substance abuse) in a future video; however, today we will be focusing on things to consider when your LOWD would like to have an alcoholic beverage.

If you would rather watch a video on this topic, click here. 

I have heard a wide variety of opinions on individuals with dementia consuming alcohol. I am not here today to tell you what is right for you and your LOWD. My goal today is to give you several things to consider when this situation comes up if this is something that you struggle with. If this is something that comes up frequently, having thought about these things ahead of time can ease any decision you may have to make as well as relieve some of the stress you may feel in these situations.

Ok, let’s jump into 4 things to consider when deciding if you want to influence your LOWD’s decision about consuming alcohol: 

1. Before even really considering this, it would be good to know what health concerns are there? Is there any reason that consuming alcohol could be dangerous for you LOWD? Does your LOWD have any medical conditions that could flare up from alcohol use? Are they taking any medications that might interact with alcohol? Has their doctor recommended they stay away from alcohol or introduced a limit? Knowing the type of precautions that should be taken due to medical conditions can help further guide your decision as you think about the next three points.   
2. The next question that is worth knowing the answer to is: Why does your LOWD want to consume alcohol? Is it that you are at a party and everyone else is consuming alcohol and they want to fit in with everyone? Do they want to have a good time? Are they feeling uncomfortable? Knowing the reasoning behind wanting to consume alcohol can change your response. For example, if it is because they want to fit in and there are serious medical concerns, are there other ways that you could make this happen? Is there a non-alcoholic beer or mixed drink option? If they are feeling nervous or become anxious in social situations, are there things that can be done to prepare for this ahead of time? If they are spending time with old friends and want to enjoy the beverage they all used to drink together and there are minimal medical concerns, you might have less stress about contributing to that choice. You can see how the answers to each of these questions start to interact.   
3. Ok, next question: How does your LOWD respond to alcohol? Do they become unsafe? Does it increase confusion? Agitation? Increase relaxation? If there is a big change in their behaviors or emotions, even with small amounts of alcohol. This may have a large impact on your decision  
4. One of the last questions that may be one of the most important is: What is most important to your LOWD at this phase in their life? Often as Careblazers, we are so focused on ensuring our LOWD is healthy and safe that we can often forget about quality of life. It is, of course, important that your LOWD be as safe and healthy as possible, AND we also want to consider their feelings of wanting to make independent decisions. Of the fact that they may value quality of life over sticking strictly to everything that is recommended. We often forget about the importance of being allowed to make a choice. This is as true in this situation as it is in other situations. Think about if you were simply told, no. No, you can’t eat that piece of cake. No, you can’t drive. No you can’t go outside by yourself. No, you can’t have a drink. How would you feel if all of your choices were taken away. If you were to think about speaking with your LOWD prior to them having developed dementia, what would they have said about this? Would they have told you they want to stay as healthy as possible, no matter what? Would they have told you they want to have the best quality of life possible given the situation? Understanding the importance of choice and the impact of knowing what they value is incredibly important. 

Before I end for today, I want to leave you with two other bits of information: 

You may not have control in the situation! As much as you may want to, you may not always be able to control the situation. So often I hear the question, “Should I allow my LOWD to have a drink?” How successful have you been when you have simply told your LOWD No? There are situations where your LOWD may already be consuming a beverage, what then? Asking if you should allow them to consume alcohol can be compared to asking should I allow them to eat sweets or watch TV that upsets them? While there are things you can do to limit the chances of these things happening, it is likely that you are not successful in this 100% of the time. Your chances of successfully avoiding these things likely drops if you simply tell your LOWD that you do NOT want them to do something. Remember telling someone what to do can automatically lead someone to feel defensive and argumentative. You are much more likely to be successful if you plan ahead. In the case of sweets, not to have any in the home or storing them in hard to reach or different places. In the case of alcohol, placing barriers to obtaining alcohol: not having alcohol in the home, or again, storing it somewhere they will not think to look. Avoiding eating places that serve alcohol or speaking with the server ahead of time and request that they not discuss the drink options. There are so many ways to try to set the situation up ahead of time for success. Think through the situation you are going into and what some of the barriers may be.   

Also...

Other people may judge your decision. Be prepared for this. One way or another, everyone seems to have an opinion about the decisions you make as a caregiver. Be prepared for how other people may respond and know that you have thought through all of the important aspects to help guide your LOWD in making this decision.