My wife with dementia is covering up her alcohol use, what shoud I do?

A fellow caregiver asked...

My wife has early dementia. She is doing very well except for memory. The problem is that she will drink whatever alcohol is available but denies having done so when I discover that some is missing. She does not drink to excess but we both enjoy sitting together for a drink before dinner and I am concerned that the drink she has out of my presence and when we are together is or may be more than she should have. I have tried talking to her about it but she denies that it happens. She even adds water to the bottle trying to cover up the use.

Expert Answer

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

I'm sorry you're facing such a daunting challenge. I'll assume that your wife's dementia was diagnosed after a formal assessment by a skilled neurologist or geriatric physician.

Assuming that to be the case, it appears that what you're dealing with here is a multi-disciplinary medical problem, and there are no easy answers or solutions. Your wife is demonstrating classic signs of being an alcoholic, and combined with her dementia, it becomes a monumental task to discuss and subsequently deal with these problems.

The first thing I believe you should do is a very honest personal assessment regarding how long you've known that your wife has been abusing alcohol. It's quite possible that before her dementia, she was very skilled at hiding or covering up her drinking, or perhaps her tolerance for alcohol was such that you either didn't see it or you may have denied it as a being a problem. This will give you both a timeline of how long the problem has existed and an honest picture of how bad the problem may actually be for your wife.

Because you may be dealing with both dementia and alcohol abuse, the one thing you could do to attempt to reduce the situation to a single issue, is rid the house of everything that has alcohol in it "“ liquor, beer, wine, mouthwashes with alcohol, cough syrups containing alcohol and any other similar products in the house. You may even want to remove any pain medications, particularly prescription narcotics that may be in your medicine cabinet.

This also means that your shared cocktail hour before dinner is about to become a thing of the past. If your wife still drives, you will have to monitor everything she buys and brings into the house. If she is addicted to alcohol she will buy it and if necessary sneak it into the house and begin hiding it. If she is an alcoholic, she will deny that is what she is doing if caught, and because of the dementia, may not remember having done it. This is a terrible combination of problems to be faced.

In addition to the above mentioned steps, I recommend that you make an appointment for a complete neurological work-up for your wife, and be absolutely certain to tell the neurologist of her problems with alcohol including any history that your own honest assessment turned up regarding the length of time that the problem with alcohol has been ongoing.

Because I don't have very much information to go on, and you didn't ask a specific question, I will provide some additional information based on possibilities and assumptions that I am making without any basis, but just to round out a more complete picture of potential outcomes:

  1. If your wife has early onset Alzheimer's disease, the speed at which the disease will impact her is much more rapid than late onset Alzheimer's. Her decline will accelerate.

  2. If your wife is diagnosed as also suffering from alcoholism, standard treatment programs are not likely to be effective for her due to her memory loss.

  3. Over time, if her drinking is not fully curtailed, it will exacerbate the memory problems and due to her early onset dementia, her behavior may change to a point where she can no longer be left alone.

  4. There is also the possibility that the early onset dementia may require that you consider placing her in a facility if her care needs exceed what you can adequately provide.

Your situation is extremely difficult for you, your wife and your family. You need to have a multi-disciplinary team of professionals to help her and you deal with her dementia and her alcohol abuse issues.

I wish you the best of luck on this difficult road.