How to talk to M-I-L about excessive drinking?

Hmm, would she listen to a health professional advising her about the problems with excessive alcohol consumption, especially as we get older? Maybe at the same time affirming her for already making such a positive change by drastically reducing the smoking -- that must have been hard, even if it wasn't really voluntary! I hope other people have some ideas.

It would be better for her to smoke than drink at this age. Any way you can swap the vices? My parents entered their 70s in great health but refused to give up their daily wine consumption. Mixing alcohol with seniors' medication creates a mess. Yes, falls and confusion, etc. My parents' downfall was their wine drinking started earlier and earlier each day, eventually moving to 7 am when the local convenience store started daily sales. Maybe you could try to get her to cut her consumption in half, and make sure it starts late afternoon and no earlier. All the advice from myself and various doctors went in one ear and out the other for my parents and I had to let it all run its course. Honestly the doctors didn't really try very hard, it was just sorta like, oh well, they won't stop until they want to.

First you might want to consider what "excessive" drinking is... What size lite beers (12 or 16 oz) over what timeframe? With food? Are there other health concerns (liver/kidney problems, medication conflicts) or is it just your fear of her falling? If MIL is otherwise healthy, even at 88 lbs she should be able to metabolize a pint lite beer(4.2% alcohol) in 1.5 to 2.0 hours. Has she always drunk this much beer or has it recently increased? Try to determine if MIL is self medicating for pain, depression or anxiety. I have a family member who works construction and drinks beer in the evenings at home because (1) he likes beer and (2) it helps with minor muscle pain so he can get a good night's sleep. Maybe MIL is drinking for a similar reason - anxiety over all the recent changes in her life that are out of her control? Her doctor might be able to prescribe something for anxiety but medications have side effects too. If MIL is unwilling to drink less, maybe you could suggest she perform riskier activities (for falls) like bathing in the morning before she begins drinking or use a walker in the evenings. Suggest you begin the conversation with "I'm concerned you might fall and get hurt/end up in the hospital" and avoid the phase "you're drinking too much" at all costs. Good luck.

As an alcoholic with 31 years of no drinking at all since joining AA in 1986, I can tell you that from my experience with hundreds of fellow recovering alkies, you may as well save your breath. I do not say she is an alkie, but my hunch is that she likely is. "Talking sense" to a person who drinks that much is a no-win situation.

I do not write to percolate an argument with anyone...

(We long term recovering problem drinkers know what we are talking about..)

Grace + Peace,

Bob

She wouldn't use a taxi account you set up. She sent away companions. Somehow this doesn't sound to me like a woman you can talk out of doing what she intends to do, or to do want she doesn't want to!

It is wonderful the smoking has decreased! (And that didn't occur because someone asked her to reduce the smoking.) If MIL drinks while she watches television, if she gradually finds other activities she likes in the IL complex perhaps she will watch less television and therefore drink less. We can hope.

If she takes medications you can ask the pharmacist if alcohol interferes with any of them. If it does you could send a note to her doctor. Of course, you don't want to sound like you are telling the doctor what to do, but you can express your concern.

In some locations beer was drunk with breakfast and all day long, even by children, in colonial times. It was often safer than drinking the local water. I'm not justifying it in this day, but just trying to put it in perspective. It is not like she is snorting heroine.

I don't drink any beer because of medication interactions, but I could never drink 5 - 6 beers a day (light or otherwise) because I would have to pee every 10 minutes and miss a lot of my programs, and I would be asleep after the fist 2. I'm impressed that your 88 pound MIL can do this! Does she get drunk on this routine? Is she less steady on her feet? Now that she is being served real meals the beer drinking may gradually decrease because she just won't have room for all those extra calories. You might buy some near-beer for her, saying it was on sale and you heard that it was less filling, which might be good now that she is eating good meals. She might throw it back at you, of course, but it MIGHT be worth a try.

In short, I don't think you are going to come up with words that will convince MIL to drink less. She might listen to her doctor better than she listens to you (but I doubt it). But her new living arrangement is on your side; it might gradually decrease somewhat if she gets into activities and continues eating well.

How old is MIL, by the way?

It can be difficult to find a direct non-alcoholic substitute for beer. They're mostly too sweet or taste odd to a beer-drinker's palate. But this might be one option - I am delighted to discover that no fewer than forty-five American breweries produce mild ale, which typically has an alcohol rating of 3% to 3.5% (and sometimes less - Jennings's is about 2.3%, I think). Mild can also be delicious, flavour and alcohol content having absolutely nothing to do with one another, so your MIL won't have to feel she's having her pleasures watered down.

Does the amount she's currently drinking seem to affect her mood or behaviour? Would you say she actually gets drunk as such?

My Mom, age 84, lives with me in her custom build senior apartment. She drank and smoked heavily most of her life and, although she quit smoking at age 81, she continues to demand 5-6 drinks per day (beer and wine), half of her previous use. Her health has suffered from the expected health problems: high blood pressure, cirrhosis of the liver, alcoholic cardiomyopathy. She must use a walker as her balance is poor. She must use oxygen while walking as her blood oxygen levels drop when stressed. The slightest stress and she becomes short of breath. Her medications consist of Timolol for high blood pressure, Lasix (a strong diuretic), Flonase for the constant histamine release due to cirrhosis. Her only entertainment is television drama. For 12 years I begged and showed her the possible outcomes of her addictions, to no avail. Her doctors tell her to stop drinking, to no avail.

Your MIL weighs only 88 lbs. FYI: Regular beer has approx 160 calories/bottle. Light beer fewer calories and is less filling.

In my experience and those of a few of my friends, elders are set in their ways until a crisis...

The worst case scenario--controlling Alzheimer's using alcohol. That is actually elder abuse. 

Since your MIL does not use the taxi service, how does she get the beer? My Mama is "Miss Jesus drank wine" lol. I love her and she has dementia. Since coming home from rehab and simply forgetting, she has slowed down on the drinking wine. I also buy smaller jugs. She cannot remember what you said 2 minutes ago but she can ration the wine if not much is left and it's a Sunday. This is an old habit and as long as they don't start drinking more than before then it's okay. Pick your poison.

I agree with OldBob1936. Your MIL is not going to to listen to anyone because she is probably an alcoholic though she will not think so. If you want to learn to deal with an excessive drinker like this, go to Alanon meetings - not just one meeting either. Get involved. Then, you will learn from others that you cannot convince your MIL with reason. My experience with a stubborn set of parents is that they will do whatever they want as long as they can - even if they die from it. My dad has diabetes and has eaten mostly what he wants for 30 years.

How old is your MIL? If she's up in years, what do you expect to gain from her cutting back on drinking? If she's competent, I'd likely let her doctor say if her health is in danger and then, if she's competent, that's her call if she wants to make any changes. If I were a senior, I'd like to live my life as I wanted, as long as I don't hurt others. So, I'd eat what I want and drink my beverage of choice.

I agree with Old Bob too. A person is not going to stop drinking because you tell them to, even if the words are spoken with kindness and love. If a person has a problem with alcohol, it doesn’t matter what anyone, even a doctor, says. It’s a VERY powerful addiction. One can be pulled over for DUI, be in an auto accident and suffer great embarrassment and hurt when people tell them they have an issue...and still not stop drinking or admit they have a problem. At least your mom doesn’t drive. But I worry she may fall. Mom has to WANT to quit and it doesn’t sound like she does. Probably the best you can do is get her one of those “Life Alert” necklaces if she’ll wear it. But don’t tell her it’s for if she falls while she’s drunk.

I switched my husband's wine to non alcoholic (on advice of doctor) but he has dementia a doesn't know the difference.

Another agreement with Old Bob. An alcoholic will not stop drinking until s/he decides to do so, until s/he wants to quit. Being the child of an alcoholic, I totally understand that. At least she is not smoking as much now, which is wonderful. My sister recently died (at 72) from emphysema caused by her smoking.

If she won't use a taxi account....how is she getting the beer? We had the same problem with my mom (with vodka, which we would secretly cut with water), and asked the living facility NOT to buy her alcohol (had the doctor back us up, as it was a fall risk and a lilability issue) . She didn't want to go out, we wouldn't buy it, and she ended up quitting. Of course, other residents could buy for her, but sometimes the inconvenience will stop them. Also bought her diet cokes, flavored waters, etc so she would have SOMETHING with taste to drink. Actually, her favorite was Perrier, as it has that mineral "bite" which somewhat duplicates the "texture" of the beer.

The habits of a lifetime will not lessen in our old age only because all of a sudden we care to respect our higher nature and change. At that age our habits drive us, especially when our ALZ's mind begins to override our logic and our present ability to remember what may be best for us.

I would risk saying here not to venture into making any one change, but to offer love and understanding. In the case of an addicted personality this may be hard, I know. But it may be the one and only feeling that will get through to them.

Many times those addictions have arisen from a feeling of not being wanted, loved or being not good enough. What if they now felt wanted, loved and respected? Little by little that energetic may create the change you seek. And if not, pad yourself on the back for approaching it in a way that may have honored the person rather than judged them.

Just offering a possible new approach.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAA): "For women, low-risk drinking is defined as no more than 3 drinks on any single day and no more than 7 drinks per week."

The NIAA defines binge drinking as: "..binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours."

The NIAA defines heavy drinking as: "...as binge drinking on 5 or more days in the past month."

RhondaR, based on what you've said in your question, you have reason to be concerned that your MIL does have a problem with alcohol. The first thing I would do is write a letter to her primary care doctor and time it to arrive about 3-5 business days before her appointment. This information is significant, for the doctor will order tests to detect health problems associated with heavy drinking, including liver function tests and perhaps an ultrasound of her liver. Her doctor needs to know about this, because alcohol does affect how other medications are metabolized and alcohol does affect the effectiveness of certain medications. When you write to the doctor, be as specific as you can about her drinking--and if you can give the doctor dates, times and what you saw, that will be even better. That way, her doctor will look for problems associated with alcohol abuse, will take this into consideration when prescribing for her and hopefully will refer her for addiction treatment and appropriate mental health care.

Now, what can you do? Set ground rules / boundaries. If she's been drinking, we go home. She can't drink in your home. Period. Continue to express concern for her drinking, where it's appropriate. Write down your concerns and send a letter to her doctor. Don't enable her drinking. That's all you can do.

Here is a link to a booklet produced by the National Institute on Alcohol Abuse and Alcoholism that discusses alcohol and women: pubs.niaaa.nih.gov/publications/brochurewomen/women

Doctors are not likely to be too proactive with a drinking senior. That was my experience - both parents drinking, all manner of doctors, even when each ended up in the emergency room due to over consumption of alcohol. The only doc who cared was a neurologist who finally wrote my dad a "Dear John" letter because of the drinking. Damage to internal organs is bad but, you're gonna die of something anyway. The real problem is falls, because a bad fall can render someone miserable for the years they have left. Alcohol magnifies the negative side effects of Benzos like lorazepam. These drugs affect balance on their own. If she's got lots of bruises she may be bumping into things and/or falling because of prescription drugs and/or the alcohol. If the beer is not affecting her motor skills and she's not driving, its probably not a problem (yet).

I can certainly relate to the challenges of addiction, in addition to all the other challenges of old age. I've been trying to get my dad to stop smoking since I was 10 years old, and not even watching my mom die from cigarettes has made a dent in his addiction. The only thing that's helped is that, as with your MIL, he is in a place now where he can't smoke inside--though not even that would stop him if he could get to the store on his own.

But working in our favor is the fact that he can't, so when we go to the store with him I have to actually physically restrain him from going to the cigarette counter. We did allow him to buy two liters of whiskey though last time we were with him, not knowing that most of it would be gone in a week! So its another thing we have to be more careful with.

Just as we now give him his cigarettes to smoke as a special treat when he's with us, and don't let him bring any back with him, can you provide MIL with her booze supply? As has been suggested here, maybe you can be her supplier and only provide nonalcoholic or low alcohol content beer. I think you said you live 2 hours from her; maybe there is a Beer-of-the-month club that carries a low-alcohol version that you can sign her up for. Maybe she'll enjoy not having to spend money on it herself, and getting it for free will make her not mind not getting her favorite brand.

You can save your breath trying to reason with her; the only thing you may be able to do is change her environment to prevent the problem behavior. As we say in positive dog training, "set her up for success." Good luck.

My MIL passed away almost a year ago. She was a widowed former nurse, creative, competent, lots of fun, very social, and loved being in control of life's adventures and activities. As she approached 90, she lost those controls and developed vascular dementia. Confined to a wheelchair, going blind, with hearing impairment, and breaking bones consistently. She fought the aging and deterioration of her physical abilities tooth and nail. She took her frustration out on her youngest daughter - her caregiver. She lived in a granny flat attached to SIL's home, with accessible door between their living rooms.
She was a remarkable woman and we had been great girlfriends since my entry into the family about 50 years ago. On opposite ends of the country, we talked by phone almost daily. One problem that arose: her love of wine and a good Manhattan contraindicated daily doses of OxyContin and Vicodin. Eg., one day she had a Manhattan, fell out of her wheelchair, broke another bone, was hospitalized. Her tale to me, "I had a drink, that's the last thing I remember, and I woke up in the hospital." She had two part time caregivers during the week (Angel SIL worked full time outside the home) and as a very strong personality, convinced one to buy wine and help her hide it from SIL. When she started accusing SIL of stealing the bottles, we discovered her deceit and realized she totally forgot SHE had finished them off.
Ultimately, gathering from across the country, my husband, his brother, SIL, and her husband held an intervention. (Another daughter was not included because she bought into her mom's anxieties and false beliefs, and continually sabotaged her sister's efforts at maintaining as best a quality life for her mother as she could). During the intervention, we recognized how she felt that drinking was the one big pleasure she had left, but how she still enjoyed socializing and having visitors, going to church, on outings. We talked about how the medications mixed with alcohol could cause more falls, possibly a stroke, and how she would not want to be locked into a body which couldn't move or speak. It was an emotional tearful meeting. She agreed to stop drinking. Two days later, we gathered with her caregivers, explained the problem, asked that they not facilitate her manipulations, and show us where the bottles were hidden. Both were relieved to have our support. MIL got on board reluctantly, obviously feeling trapped by the open communication. With time, she became accepting and stopped mentioning how she wished she could have a drink. Sadly, she passed away several months later, and is missed so very much.

Save your breath (and the stress). It will do no good.
Write a letter (not a phone call or email) to her doctor. State how many drinks she has a day (don't underestimate). Explain that she will not stop drinking and ask the doctor to adjust her medications accordingly. The letter must become part of her medical record and that makes the doctor treat it seriously. You are so right. If she has a serious fall, it's off to the SNF and drinking there can be a challenge (something you might use in your argument to MIL - if you get into one dispite your best efforts).
If you are buying the beer, make the next batch some brand of non-alch beer that you're pretty sure she's never heard of. If she drinks it and says nothing, WIN-WIN. If she does say something, just say 'sorry, I didn't notice'. You'd be surprised how many heavy drinkers I've seen who have (sneakily) been switched to non-alch beer or wine and never noticed. It doesn't feel right, but if everybody's happy and healthy, I can sleep at night.

If she doesn’t get rides from a taxi service, how does she get the beer?
Unfortunately, it’s terribly unlikely that she’ll quit. She sounds like she’s going to continue to do exactly as she pleases.
Unless she’s getting into trouble where she lives, I’d try not to worry about it.😑.

HI Rhonda,
I am so sorry that you are worried about this with your Mother in Law. I have many dysfunctional drinkers in my life, some sober, some not so much. I agree with Bob that there is not likely a talking solution.
It sounds as if she is dependent on the alcohol. She is a grown woman doing what she wants to do. You can have a gentle loving conversation stating that it concerns you that she is drinking a six pack a day. But only do that with the knowledge that you cannot change her behavior. You can plant the seed, but it's her garden and she will determine what to do with it.
If she were 50 years old and drinking/smoking etc. in this way what would be your reaction? Our parents being elderly doesn't necessarily give us any more sway over them than over any other adult we love.
Good luck
Margaret

5-6 light beers over a 24 hour period is really not that much and she certainly won't listen to reason. At least some of the smoking has stopped which is a step in the right direction.
she is getting regular good meals which is another good thing.
it certainly would be a good idea to let her Dr know about the drinking but don't expect him to be able to stop her. Short of a court order sender her into rehab and even then she would start up again as soon as she was released. Just be thankful she is not using hard drugs and don't enable her. I would not labor the point at this point just make sure MIL is properly taken care of and when and if and when the worst happens all you can do is deal with it. I don't drink or smoke yet my hip broke six months ago. It won't stop me doing things I want to do even if there is some risk involved. i am just extremely careful. Let MIL enjoy however many years she has left on her own terms.

Consuming alcohol is very dangerous for an elder because of the following:
#1 They're addicted.
#2 Mixing meds with alcohol is a huge NO NO and protocol is given NOT to by their doctor.
#3 It presents a greater fall risk.
#4 It's harder for them to stop the consumption.
#5 It's very damaging to the liver and other organs.
#6 Present this scenario to her, else she's going down a deeper hole.

As a grown child of alki parents as well as an abuse survivor of those same parents, I can honestly say there's no talking people out of drinking when they drink excessively and live as constant drunks. Sometimes it takes them hitting rock bottom and being forced to realize what they are doing and how it's affecting them before they decide to get help. Sadly, I don't recall my parents ever getting help, and furthermore they never made it right with me. All too often those kinds of people like my parents were normally don't change. They're the ones who must face the consequences, especially after they die and must face God and give an account an answer for everything they ever did wrong. When someone has made up their mind to live drunk, you can't change their minds. You can't even convince them of what's going to happen to them as a result of alcohol. Alcohol dissolves many things, believe me! It dissolves family, relationships, jobs, bank accounts, and assets unless you're one of the very few who happens to have loads of money, which my dad actually had much to my surprise. He worked his whole life for Ford and always drove drunk to work. I don't know how he kept from being fired, all I know is he must've been a very high functioning alcoholic. I know he also had some other things he was doing on the side but I don't know how many of them he may have been earning money for but by time he died he still had his house and a life insurance policy. Sometimes people who live as constant drunks go broke just like when people gamble but other times you just have a money reserve, which can keep drunks going as was the case with both of my parents, dad was the only provider. Sometimes people go broke but other times they amaze us when they happen to have a money reserve somewhere to keep themselves going

In your specific case, I must honestly say when dealing with a full-blown drunk, you'll never a very good relationship with them and I'll explain why: 

They do stuff drunk they won't do sober and then when they're sober they either don't remember it or they downright deny it out of fear or embarrassment. Alcohol affects people a little bit differently depending on each person. Something people do crazy things, some may seem sane and become violent where as others may just lay down and sleep it off. Sleeping it off is actually better than anything else because you're really of no use anyway when you're drunk nor are you that good of company. Instead of kicking someone out if they're one of those kinds of people who would sleep it off, you may as well accommodate for those kinds of people. Instead of kicking someone out if they're one of those kinds of people who would sleep it off, you may as well accommodate for those kinds of people and permit sleep. As long as they don't become violent or start doing crazy stuff, then it's no problem if they need to lay down and sleep it off. If you kick them out, they're going to find somewhere else to sleep and it may not be safe. Therefore, if something bad happens to them, it's your fault for not seeing to their safety. Finally, you would be just as bad as allowing that person to drive drunk and another area I frown on is those who take advantage of an incapacitated person such as a drunk female. I don't condone the abuse of drugs or alcohol by no means but I do seriously frown very heavily on those who would take advantage of those who are incapacitated by such means. 

If you want a good relationship with your mother-in-law, don't go poking your nose into her business. Let her live out her rest of her life, the way she wants. Either you accept her for what she's or move her out. Trying to modify someone else's character or habit patterns, even if it's for their own well-being, never works. That's how relationships begin to sour!

Your have gotten some very good answers here (except the one from cetude). They vary somewhat in what they advise, but they are all worth considering and thinking about. I hope you are still with us, RhondaR. We'd love to hear what you decide to do, and how it works out for you.

My mom is 87.. and she drinks 2 glasses of port wine a night. Always has, always will, and even in rehab for CHF she had her wine ( dr had to OK it) That old adage about wine being good for your heart! It is what it is,,, and it makes her happy at 87 so I;m not having that fight! If she is not unsteady,, this is a fight you may not win. I worked for awhile in a AL, they had wine with dinner if you wanted it, and cocktail parties weekly. She is not in MC,, so she has say in her behavior. But I do agree with idea of trying "near beer" ..

There are medical treatments that will deal with alcohol dependence, but you have to look to find them, that have a better success rate than AA. Maybe going to lite and then fake beer might be a start.