As drinking rises among older Americans, we can take many steps toward recovery

Dear Sage:

 

My Dear Bride is 68 years old and appears to be hitting the bottle pretty heavily. She swears that she has just one or two glasses of wine each night, and that’s what I witness. But recently I discovered a huge trash bag full of empty wine bottles – perhaps three or four dozen – in the trunk of the car. She laughed and said that she was going to the recycling center after helping a friend clean up after a recent wine and cheese party. But I wonder if she is grossly underreporting the amount she is consuming. Maybe the stuff she’s sipping in that insulated water bottle isn’t water after all. She rarely slurs words and insists that she’s simply a social drinker. Nevertheless, she has become increasingly moody, confused and forgetful. She’s eating less and is avoiding socializing with friends. I fear that she may have a serious drinking problem. Where should I turn?

 

                                                                           – Scared in Savannah

Dear Scared:

 

   Particularly as drinking increases among older Americans, this is not a funny issue, though many recovering alcoholics will relate stories that they can now look back on with humor (more on this below). The Sage is not a doctor. Many of the symptoms you mention can be attributed to other disorders, including everything from dementia and Alzheimer’s to neurological or biological diseases. First off, a visit to your doctor would certainly seem to be in order, with honest input from you, as alcoholics are notoriously good at denial and at covering up the extent of their drinking. If this is an alcohol disease, it could be eminently helpful – if not life-saving – for you to insist on accurate reporting to medical personnel.

    Otherwise there are countless risks, from overdose to coma, liver damage, brain damage, stroke, heart problems, dementia, debilitating falls, depression and pancreatitis, to name a few – not to mention highway tragedies and cancers of the mouth, throat and other parts of the body. People also can become belligerent, irresponsible in sexual habits, eat very little, neglect their physical appearance and become verbally or physically abusive.

   Then again, many people who define themselves as alcoholics never reach such a point, recognize that they have a problem, and seek help from counselors and 12-step programs, notably AA.

 

   According to the National Council for Aging Care, ‘Addiction can come in all shapes, sizes, and amounts. There are people who could be high or drunk and continue to function in their public and working lives but become secluded and distant in their private lives. The opposite remains true, too, as those addicted to a substance can have their public and working life destroyed by substance abuse, and it could severely impact their performance at work.’

   Some people don’t hit bottom until they’ve lost everything – jobs, family, house, money. Some may be in rehab a dozen times or more and may never acknowledge that they have a drinking problem. Others are much luckier.

    In any event, the council says that 10 to 15 percent of people ‘don’t start to drink heavily until they are older.’ At that point, alcohol is harder to absorb in part because we have less muscle as we age, and it takes longer to digest, which can damage organs and interact dangerously with medications. It also can lead to serious dehydration.

   Medical experts also say that a decrease in brain receptors makes a person more sensitive to the effects of alcohol—it takes less to have the same deleterious effect, as with prescription medication. Additionally, alcohol consumed later in the evening tends to disrupt sleep.

   Let’s assume, Mr. Scared, that drinking is the main problem. Chances are, your wife has not reached the point – as many alcoholics have – where they will employ all types of stunts to satisfy their cravings, such as:

   •  Hiding vodka in a hose outdoors– with a cork at the end – and frequently going out to ‘water the garden.’

   • Reading the news for wedding and funeral dates and showing up either at a reception or a cemetery, with appropriate emotions – either celebration or grief – and drinking on the house to either the bride and groom or to the deceased (the Sage encountered such a person, who can laugh it off today – he professed to be a fine actor, and if anyone asked him, he was either on the groom’s or bride’s side or knew the deceased from work or from a fraternal organization or from a bridge club, whatever he could glean from the newspaper notices).

   • A 75-year-old woman would hide three or four ounces of alcohol in small glasses on window sills behind curtains in various rooms and confound her husband by cleaning the house pretty much every day. He would tell her that she was overexerting herself because she typically ended up taking a four-hour nap afterwards – until he had to call an ambulance one day because he couldn’t wake her (she survived and has been in recovery for five years).

   • A man, fearful that his wife would know the full extent of his drinking, would hide a bottle in the bathroom and use food coloring with the booze in a mouthwash bottle. He had his own bathroom, so he got away with this for several weeks, until his wife noticed that the liquid level varied markedly day by day – and then she tried the mouthwash. Surprise!

    Others have kept bottles in very unusual spots – at the bottom of hampers, inside safes, in the basement – you name it.

   Regardless of the manifestations, alcoholics typically agree on one thing once they begin recovery: Living sober is a lot easier than being out of control and unable to manage their lives. That can be a living hell of regret, depression, guilt, anxiety and humiliation and affects not only the individual but the rest of the family, many of whom face similar emotions as well, along with fear and anger.

   The alcohol problem among older Americans has gotten worse in recent years. The National Institute on Alcohol Abuse and Alcoholism reported that problem drinking was rising quickly among older Americans, according to a report in the New York Times.  

   “More troubling,” the article reported, “the proportion of older adults engaged in high-risk drinking jumped 65 percent, to 3.8 percent. That’s roughly 2.5 million seniors, according to various agencies.

   The National Council on Alcoholism and Drug Dependence says that high-risk drinking is responsible for 20 percent of admissions of seniors to psychiatric hospitals and 14 percent of seniors’ admissions to emergency rooms.

   This disease is not something to take lightly. If you or someone you know may have an issue, please contact your doctor, an addiction counselor, a psychiatrist or psychologist who specializes in addiction disorders, or Alcoholics Anonymous.

 

   The road to recovery will have a lot of bumps, but it’s a heck of a lot easier and more rewarding than a dead end – sometimes literally.

   As for Mr. Scared, The Sage would suggest that you confront the situation directly. Don’t engage in what is known as ‘secondary denial’ – by a partner of an alcoholic. Tell her you are very concerned about her health and insist on going with her to talk to her physician. Do not be accusatory, as this is a disease, after all. Be loving, supportive, sympathetic, kind and diplomatic. Show your concern for her. You may also find support and valuable advice in Al-Anon – an organization that helps people who are worried about someone with a drinking problem – on how to cope and how to address the situation with her. There are meetings everywhere.

   In addition, interventions often work. These typically include a physician, an alcohol counselor or an intervention specialist, plus relatives and perhaps friends.

   “Professionals who conduct formal interventions focus on helping family members and friends hold up a mirror to their loved one’s behavior, revealing the need to confront their addiction before hitting bottom,” says the Hazelden Betty Ford Foundation. If you choose this route, you will need a counselor to help direct the process.

   It is possible that your wife is still in denial. It’s also possible that she’s ready to acknowledge the problem and take the first step – admit that she’s powerless over alcohol.

   Good luck to you. Let’s hope that one day she’ll be able look back on these years and offer humorous anecdotes as others have. Twelve-step meetings are educational and deadly serious in helping one another get through each day – but they also have many light moments.

   Here’s to lots of those.

   Humbly,

   The Sage