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[nenjin]

So the background. I'm 35. My mother is 65.

She retired from her job about 3 months ago.

We were supposed to go on a camping trip this weekend but she called my brother this morning and basically said "I have a problem."

I've known there's been a problem for years. I've watched it happen, as she got progressively drunker and drunker when I'd see her on the weekends (I live in the same town as her, my brother does not.) I've told her it was a problem, that I didn't like talking to her or dealing with her when she was drunk, for years now. Her house steadily got messier and dirtier and basic things just continued to slip. My father has in the past told me my mother had a drinking "issue" but I think we both wanted to believe it wasn't more than that. That it wouldn't reach the point where she was endangering her own life.

Several times I'd contemplated an intervention but I let the fact she was holding down an important position at her job without problems (that I knew of) convince me she had herself mostly in check. My mother is a proud, independent woman who raised two kids mostly by herself, who easily gets defensive when you try to tell her what to do.

Well retirement came, and it did not come on pleasant terms for her, and it brought all this to a head. She's been very depressed, arguably for the last 25 years or so since my dad divorced her. She never really recovered from it or other traumatic events in life like her father dying slowly in a hospital or her mother succumbing to dementia or her brother drowning in his 40s. Once she retired and lost the routine that kept her functional, she basically let herself go and her depression set in. We talked about the need to stay active, do things, make plans for herself post-retirement. A lot. But she just never went anywhere with it, she just sunk deeper into her depression and the bottle.

So I came to her today to find her almost insensible, the worst I've ever seen her. Despite knowing my brother and his wife and I were coming she drank herself into a stupor nonetheless. She tells me she's been vomiting and dryheaving for months now (so the heaviest drinking I assume started right after retirement) in the mornings and her hands shake uncontrollably unless she has a drink. Which means she's basically been drunk every day for months now, to lesser and greater degrees. She's not eating well, or sleeping well. The animals have probably gone hungry more than once. There were tears, a lot of emotional drama and she told me point blank she needed help. Which is good. The truth is though, she could no longer hide what she'd become due to this trip. There was no way she could function without drinking and a camping trip would make it impossible to hide all this. She essentially backed herself into a corner, and that's why the admission came out. The signs were all there before (shocking amounts of liquor bottles just stacked up on the counter, trash laying around on the counters that was never taken out, filthy filthy dishes in the sink that had been there for weeks.) I guess I just didn't want to believe it. I wanted to believe this was just a rough patch. Ah well. At least now I can know what I've long worried about her.

Her condition is stable, I guess. She sobered up a little later enough to eat something, drink water, walk without falling over and say little other than how embarrassed and ashamed she feels. So I don't think her health is in literally imminent danger. We're still taking her to the hospital tomorrow for a full physical check up, because there's no doubt her body is totally fucked after the abuse she's put it through. I don't doubt she's malnourished and dehydrated and who knows what else. They'll probably want to do a mental health screening as well.

We'll be using the week vacation we'd planned to instead make sure she's evaluated and detoxing, find her a rehab center and start getting her house and affairs in order and just be there for her.

---

So....this is all pretty new to me. I've never had to deal with an alcoholic family member before, and it's the one-two combo of an alcoholic family member who is also beginning to age and is less and less able to take care of themselves as time goes on. Here's what I know:

1. Her alcoholism has been years in forming and the loss of a routine is what drove her depression, and therefore her drinking, into overdrive.
2. Deep depression lies at the root of her drinking, an inability to deal with past problems.
3. She is very alone. Other than me she gets little face-to-face human contact. Any friends she had from work have moved away and she was never a socialable person to begin with. She has a sister and their relationship is often strained. Her sister also long ago came to the conclusion my mother was probably an alcoholic. But like the rest of her family didn't intervene.
4. Up until now I talked to her at least once a week and would see her once every couple of weeks. She's been fighting me on any kind of shared activity for, honestly, years now. Wouldn't let me take her out for her birthday or even to celebrate her retirement. All now I realize not just because of her depression but because of her drinking. It's been increasingly hard for me to want to spend time with her either, which has just further isolated her. I guess in a sense I just buried my head in the sand and hoped it'd go away. I'd offered help so many times, told her I was concerned so many times, that I was worried, that she was hurting me, her self, her life....I guess I was in the process of emotionally shutting down to the problem that was getting worse every day.
5. She is very stubborn and will likely relapse as soon as she's stable enough to get over the shame and guilt.
6. We'll have to get her to a rehab center and likely into counseling.
7. The weight of checking in on her, supporting her and and keeping her sober is going to fall on me. There is the very real possibility of her drinking and falling down the stairs and seriously hurting herself. I already saw at least one large bruise on her chest where she's fallen into something.
8. The question of suicidal tendencies is kind of an unknown. I've never taken my mom for suicidal, I think her fear of death is too strong. But at this point I can't say for surety what I do and don't know about her anymore.
9. Most of this seems to have come to a head in the last three months. The problems were all there before but I only really started noticing the symptoms (tremors which she'd chalk up to nervousness, getting lost in her own town of 20+ years when driving, making me drive her car whenever she could.) The post office cancelled service to the house when the mailbox was too full and it looks like they've got about a month and a half mail in storage for her.
10. I coulda been there more. I coulda taken action but out of respect for her I didn't. And if I'm honest, out of apathy and frustration too. I kept hoping this was something she'd come out of, but acknowledge I didn't put in the time to try and help as much as I could. I've gone around with my mother so many times over the years about her attitude, her behavior, how she was continually letting things slip like the house and basic cleanliness, that I'd gotten into the habit of badgering her but not putting in the time necessary to really help.
11. This isn't to say my brother and I haven't been there for her. Shortly after her retirement we cleaned her house, weeded her garden, tried to get her involved in maintaining the house, talk about the future, make plans. The timing chosen by my brother was pretty short-sighted and the day was full of a lot of point blank unpleasantness as I brought up a lot of these issues and basically went "What the fuck woman?" while my brother played good cop. That cleaning spree we did then made today's cleaning that much easier. It would have been really, really bad had we not done that.
12. This could have been a lot worse but she finally did reach out for help when she really needed it. And that's all that really matters.

So at this point I'm just kinda writing to vent but to also ask advice from anyone who has been through this. What to expect. What to watch out for. What helps keep you patient and sane though all of this. I think the road is going to be pretty hard for both of us, but mostly for her as she tries to put a life back together for herself.

[BorkBorkGoesTheCode]

I'd like to know too.

[ChairmanPoo]

I can't really give much advice as to how to manage the day-to-day business, but bear this in mind: You need actual medical support for alcoholism, as uncontrolled withdrawal can be dangerous. I suggest asking your family doctor whether he can help and/or put you in contact with a specialist.

[martinuzz]

Your plan of getting her into rehab, plus finding her psychological councelling is probably the best thing you can do for her right now. AA might help her at a later stage too. First priority is to stop, or at least limit the booze intake with professional help.

For the long term, all you can do is be there for her when you can. But beware. Most if not all alcoholics will lie. They will make up stories just to make you believe they are staying sober and have things under control, and long term alcohol use will teach people to camouflage not being completely sober pretty well.
You will have to be alert to that, and deal with it. Be stern when you need to, and do intervene when it goes the wrong way.
Learn to make unexpected phonecalls throughout the week, if you can only physically be there at limited times.
Might sound really childish to check on an elderly person like if they were a child that needs nannying, but alcoholics are like small children in that respect.

If it will all boil down on you, as you say, I would advise you to find (semi-)professional councelling for yourself as well, about how to deal with it. There's not just self-help groups for alcoholics, there's also self help groups (and professional councelling) for family members of alcoholics. Sharing your experiences with people who are going through the same thing can be quite helpful.

[Tiruin]

Fully agreeing with the past two folks here, I'd like to deeply emphasize educating yourself too--on a parallel vein, you'll likely be in contact with her for as much as she is in contact with professionals; understand her, as in understand her actions, if they irritate you--any response on your part also matters to her. Counseling should NOT be isolated (ie She gets counseling, everything is OK!), because holistic aspects cover social interactions: These benefit you too, as it can also develop one's own understanding of these things as well as their behavior when under similar scenarios. The family of one in any of these situations are also just as important as the one in need of counseling.

Be continuous in your behavior with her. Show love and understanding; if anything 'bad' is done to you--respond in kind. Always keep in contact with them, even in the least once a week. Also keep in contact with the medical professionals helping her. :O

[Harry Baldman]

Show love and understanding; if anything 'bad' is done to you--respond in kind.

That last set of words probably isn't the one you're looking for there, since responding in kind means responding with the same.

Also, alcoholism - it's not all screwed in your case, nenjin. While she is depressed, she isn't part of an environment filled with alcoholics. My mother is also an alcoholic, as is my father, and pretty much every last one of her siblings (recovering or current) as well as at least a few of her acquaintances, which makes getting her sober once she gets going nearly impossible.

If you can get her to, say, live with somebody else in your family or perhaps yourself, you could potentially shape her environment into a more positive one. Sociable or not, nobody likes to be alone. Keep her around. Contact her. Have her do stuff for you, do stuff for her in return to have a perceived equitable arrangement.

[MetalSlimeHunt]

Prepare for failure. Both of my parents have been "functional" alcoholics to greater or lesser degrees for as long as I've known them, and there's nothing that's ever so much as put a dent in their habitual drunkenness or bad behavior while drunk. It can practically be put on a clock.

I'm not saying it's hopeless, but don't go into this wide-eyed. Most never reform, and your actions will be more appropriate if you accept that coming out of the gate.

[Tiruin]

Show love and understanding; if anything 'bad' is done to you--respond in kind.

That last set of words probably isn't the one you're looking for there, since responding in kind means responding with the same.[...]

Ah! ...Oops. I didn't read it that way when I typed it. Sorry!
Also emphasis on the understanding part--even if failure occurs; the scenario is upon years of experience and thoughts, rather than just a short-term event. People's memories are also affected by how they feel in comparison to what is said, although all these being said here should be in context and best given by those there.

[nenjin]

Thanks for the replies all.

Took her into the hospital today. They basically did nothing besides give her meds for her tremors and nausea, do blood and urine work to tell us what we already knew (her liver is shot), and tell us they couldn't detox her, and the separate detox center they ran at the hospital had 3 beds and they were all full. The doctor stopped short of saying she was well on the way to killing herself. I point blank asked him what the likelihood of liver failure would have been had she kept going the way she was and he refused to speculate.

So we took her to an in-town detox center. It's a weird experience to leave your parent at a place where you're not allowed to visit, they're not allowed to have cellphones or media or even books, and they can only call at set times of the day. It's like dropping your own parent off at the saddest summer camp ever. They said they may keep her anywhere from 24 hours to....as long as it takes, I guess. Or until she says she wants to leave (which I'm guessing will be within the next day or two at most.) She called. Said the people were nice and they'd given her meds for the shaking and they'd put her to bed. The guy we met at the reception area for admission was himself a former alcoholic who had been through the place....twice, and now worked there. He said he'd take care of her and that put me at ease...because honestly the whole experience felt like putting her in prison.

She didn't try to resist any of it and, other than I think overplaying how shaky she was at times, seems to be facing this frontally...if a little meekly. Part of me can't help but wonder if she's going to just go along with it until the attention is off of her, then go right back to drinking. It'd fit her MO. I'll need to find out how seriously she says she's taking this...and then I'm going to have to verify it, constantly.

Prepare for failure. Both of my parents have been "functional" alcoholics to greater or lesser degrees for as long as I've known them, and there's nothing that's ever so much as put a dent in their habitual drunkenness or bad behavior while drunk.

Well here's the thing. I've known my mom is a functional alcoholic for probably 6 to 7 years now. This is beyond that. She has become a non-functional alcoholic. I'm talking shut in, living in squalor, wearing torn up clothing that is three days old, babbling crying insensibility, falling and/or crawling to get around the house and still reaching for a drink. Someone who can't be arsed to clear out the filth surrounding them but can still get into the car and go to the liquor store. She was into the death spiral and this was a cry for help. I realize that I'll probably spend the rest of her life fighting to keep her out of the spiral at best. True sobriety seems pretty far away for her. But I'm trying to keep a positive attitude because I'm typically the "hard truths guy" in my family, and I need a little more to sustain me than that. So I'm going to try some good old fashioned sunny optimism.

While she is depressed, she isn't part of an environment filled with alcoholics.

While I guess this is true, she's arguably in a worse position: alone in an environment of her own making. She's very sensitive to social stigmas and people's perceptions of her. People keep her worse half at bay for a time. Alone? There's no one to check her impulses and she can go into excess in private. I always wondered why she never seemed to smoke around people as often as I'd see her smoke at home, or why she didn't seem to drink socially hardly ever, only to go home and immediately pour herself a drink. I realize why, now. If she started smoking, she'd chain smoke and she didn't want people to see her doing that. If she started drinking, she'd get shit faced and she didn't want people to see that either. She's always been a loner and somehow I think being around a lot of other drinkers would actually keep her from drinking to some extent...because it's her private vice that she doesn't share with anyone else, because deep down she's ashamed of how much she craves getting annihilated and how it makes her look.

If it will all boil down on you, as you say, I would advise you to find (semi-)professional councelling for yourself as well, about how to deal with it. There's not just self-help groups for alcoholics, there's also self help groups (and professional councelling) for family members of alcoholics. Sharing your experiences with people who are going through the same thing can be quite helpful.

I've already got the brochures for the AA meeting nights, the Al-Anon meeting nights. all that stuff. To be honest I'm not big on therapy, professional group or otherwise. My mom has seen therapists several times over her life and me a couple, and I've never seen them make a dent in our problems. I'll probably need someone to build me back up after she starts fighting me on staying sober and going to her meetings. Because I know myself well enough to know it will erode my compassion for her and my patience with her. The last thing I want to do is have to call the cops because she's gone on a bender and needs to be involuntarily detoxed. That's the kind of public embarrassment and airing of her dirty laundry she'd likely never forgive me for. But I'll do it if that's what it takes.

[DeKaFu]

I will say about AA in particular: Something that's not necessarily obvious until you look into it is that AA is a religious (or at least "spiritual") organization. Approximately half the steps in the twelve-step program involve examining and improving your relationship with god.

No idea if this is relevant to your situation, but I once had an acquaintance who attended AA meetings while trying to overcome their alcoholism. As a hard atheist, they found the religious tones of the meetings and material distressing and alienating, since they felt they were being indirectly pressured to change their beliefs (or else "fail" the program).

I think there is certainly value to programs like that, but evidently they are not one-size-fits-all. That person was able to find success once they sought out more secular options. I'd recommend doing some research into local options before committing to any one group.

[nenjin]

She was raised Catholic. She's not practicing but she's always held on to something of it. I imagine it has the potential to drive her away, I know it would me. The faith-based recovery angle has always annoyed me too. Almost feels like they're going after people who are the most vulnerable.

[gimlet]

Best wishes for you, her and your family.  I just have one thing I wanted to throw in: how to ask the "what are the chances" question of doctors.    They'd all refuse to answer when I phrased it like that.   I forget where I got the tip, but if you phrase it as "Out of 100 patients in approximately that condition, how many would be expected to X?" Where X is survive/recover/need surgery/whatever.   I gather in the 1st case you're asking them to predict the future for a specific patient, I dunno, I wish they'd have met us laymen halfway and rephrased it themselves with "Well, it's impossible to predict the course of X in any one patient, but out of 100 patients with X we've experienced Y% survival rate/whatever" but noooooo....

[nenjin]

Yeah, when I had my sinus surgery that's how the surgeon talked about scenarios. "X patients of mine out of Y blah..."

Well today was pretty bad. 15 minutes after dropping her meds off at the treatment center we took her to yesterday, they called me and said "she is so completely infirm we can't help her, she needs too much care."

Since she's been in detox she has gone from shaky to basically crippled. She fell last night trying to get to the bathroom and grazed her head right near her eye. On a lamp she said. A very close call. My understanding is two guys were trying to help her even.

The nurse there told me "She needs physical therapy. Her body is absolutely wrecked." It's crazy to me because just three weeks ago she was with me and seemed, more or less, normal. The people at the treatment center told me to take her BACK to the first hospital I took her to, to the ER, because they thought she was that bad off after a night with her. (I'm guessing it's also true they didn't want to take the liability for her either.)

So for the second time in two days I took my mom to the ER. And this time I told the staff I was not fucking around. I told them I brought her in on Sunday and the staff had more or less written us off. They did labs, gave her a few pills and told her to hit a treatment facility. The lady on staff who pointed us to the treatment facility in the first place essentially walked in, handed us a printed out sheet with a couple notes and said something to the effect of "we can't officially endorse any of these places and that's all I can really tell you." She was very nice and sympathetic to mom, but essentially useless. I could have gotten that shit off of Google.

The people at the hospital had no idea that, as soon as she really started detoxing, she would fall completely apart. Like I said, she can't even hardly walk by herself right now, only by leaning into a wall and banging into everything along the way. The fact they sent her off on Sunday......infuriating. She basically has like no muscle mass left at all so she's just jelly and shaking like a leaf to boot. She's sick in every goddamn sense of the word and they wanted to tell us to get lost.

So when we went back I raised a little hell. Told the doctor point blank that if the refused to admit her for detox, monitoring, recovery, hydration, nutrients, vitamins, drugs and everything else she desperately needs they would fucking hear about it in more ways than one. He calmly told me it wasn't his decision to make, it was the hospital administrator's. And I told him that if they refused us, I wanted their name. Because I already had his.

Amazing what putting your foot down will do. Within the next three hours I had not one but two doctors come in and deal with her, she was on a nutrient-rich IV drip within 10 minutes and about six nurses came through to do this, that and the other thing. Doctor #1 realized that after seeing all her bruises and hearing that she'd at some point hit her head in the last few weeks (news to me of course) that she should have a CAT scan. (Which we never heard the results of. I'm not sure if that's good or bad.) After the second doctor came in and said they would admit her (and actually took detailed notes, something Sunday's ER doctor did not) we got her into a real hospital room out of the ER and started getting her some help.

The stupidest thing is this: this hospital has an in-house treatment center especially FOR detoxing. It's the place everyone in the city says to go to...but it only has three beds. Three beds for an entire county. And there's a waiting list. They want to refuse to detox people and send them off to some other clinic in town, and have them come to their place for recovery after they detox. Three beds....and this damn place costs $200 A DAY, and that's with Medicare covering the other costs. I had the people at the treatment center I'd taken her to earlier tell me to fight the hospital if they tried to refuse to admit her to the normal hospital for detox, that they could absolutely medically detox my mother if they needed to, that simply putting her in a bed and feeding her some pills and regular food wasn't going to cut it. And then I had nurses at the hospital telling me the people at the treatment center often overreact in their recommendations. Shit, we're a middle class family with good educations all around and enough money, and finding actual, legit treatment for this has been fucked. What is a poor person with little to no education supposed to do if they find themselves in real trouble? Hope someone gives a shit enough about their plight to take them seriously?

It's practically fucking negligence that they were going to send her away. No treatment center would handle her in her condition, she needed real medical attention, and the hospital wanted to pass her off because she "couldn't take a detox bed in our state of the art treatment center" attached to the goddamn hospital.

Fuck that though, my mom is literally falling apart in front of my eyes as she starts to detox and I was not going to take no for answer.

Trouble didn't really end there though. I left to get her a care package, and when I got back probably 2 hours later with the rest of the family, we found the door to her room open and the curtain drawn. I kind of immediately sensed something had been going on. Apparently she tried earlier to get up without help to go pee. Tore out her IV part way. Fell. The nurse in her wing barely caught her before she hit the floor, she only knew she was moving because she'd heard her banging around and went into the room to check on her. They've now set up her bed with a really loud alarm if she tries to get up and they're leaving the door open so they can hear what she's doing. *sigh* Of all the times my mother decides to get tough, it's when she's completely incapable of doing whatever it is she's doing successfully. The minute I walked into the room she went "Oh good, you can help me get up to pee" and tried to (unsuccessfully) roll herself out of bed her IV in her, again. We started to help but them decided "yeah, let's not try to do this ourselves" called the nurses in and it took two of them to help her into the bathroom. It was only then that I noticed the bruise forming on her eye and the cut on her head and I'd spent all day with her stroking her head and wiping away tears. The nurse who has been dealing with her since full admittance to the hospital also said she did not see it at first. Since it happened yesterday if there's a problem the CAT scan would have probably caught it but.....still haven't heard what those results were.

She kept saying "I don't want to bother anyone...." when we asked why she KEEPS trying to get up by herself even though she knows she can't make it...and I know that's her pride talking. Having people needing to help you pee in a bathroom is humiliating. She feels shamed and embarrassed enough as it is without that indignity. But she is too damn stubborn to take all the help she needs, she's gotta hold on to that one thing she's going to try to do herself. I mean, on the one hand I'm heartened by her desire to fight for something as simple but vital as getting herself to the toilet. I'd prefer that to despondency and catatonia. But she's hurting herself more every time she tries to do it. Part of me is afraid if it's self-destructive behavior. She's been asked like 8 times now if she's even thought about suicide and said no but.....

I told the nurse straight up "restrain her if it comes to that." And then I told her I told them that. It's shit that I have to be that guy, but I can't risk her falling and bashing her head open. The very thought is terrifying because it's such a real possibility between her infirmity, her disorientation and her twisted sense of pride. Apparently she's having mild hallucinations as well, which I'm told is not uncommon for detox patients.

Anyways, the plan is for her to now detox at the hospital in 24/7 managed care, which she should have had already. The Intervention Nurse comes in tomorrow to do her drug and alcohol evaluation, which is her first step to being admitted to "the best treatment and recovery center in town." I've been told her treatment can last anywhere from 30 to 45 days. So I'm probably going to need to move into her house part time to take care of it and the animals. (At least it will be about 10x more pleasant to live in than it has been after we've been cleaning it.) She's also going to need to add physical therapy to the list of things she needs to do, because even once she's fully detoxed her body is totally wasted away and she needs to build her muscles back up. Without that, she can't even begin to live on her own.

...there's a good chance she may be in treatment or some form of monitored care for months. Depending on how she recovers, how quickly she comes back from this, I may have to move home again just to care for her.

I mean fuck me....I saw her three weeks ago! She was walking fine! Maybe I've just become so inured to her decline that I didn't see the signs that were right in front of me. I just can't square the woman lying in the bed now to the one of just three weeks ago. I want to say I hope tomorrow is better but in truth, it's probably going to be even worse. The more she detoxes the worse and, honestly, crazier she's going to get until she is through it. And that could take weeks before that happens completely. I can see why the hospital was unwilling to take detox patients into general treatment. The process is not pretty and my mom is basically using up three nurses' attention just to keep her safe from herself. And this is just Day 2. But you know what? Fuck the system, she needs real help. The more I think on it, the more I realize how close she came to dying in more than one way. Inconveniencing the hospital is the least of my concerns compared to that.

[MetalSlimeHunt]

It's not necessarily a lack of sight on your part. Dependencies have a tendency to "hold together" so long as the substance is supplied, and conversely it all comes crashing down during withdrawal. And that's just the physical dependency, a person who's getting their addiction fed can ignore a lot of symptoms and pain, to the extent they don't know all that's wrong with them.

The only way out is through, but I'm sure you know that already. Just make sure to keep focused on that, because you probably won't have much else to go on for a while.

[nenjin]

Just sucks ass that detox is the kind of thing that gets worse before it gets better, ya know? Most of the time you take people to a hospital (assuming they don't completely fuck up or give you MERSA or something) and they get steadily better after they're admitted. She's just going to get worse for a bit. She hasn't started getting scratchy yet, getting angry, totally irrational, delirious, combative. Maybe the drugs they're giving her are keeping that somewhat in check. I don't know what's ahead but I'm not sure there can be anything worse in the process than seeing her like this. I tell her there's no shame at all, none, zero. Truth is we don't have any right to say that to her. We're not the ones living through what she is. But we say it anyways in the hope that it will stick. Don't get me wrong, infirmity, sickness, injury, dying, none of them are easy to watch. But to know it's a self-inflicted suffering, quicker and more obvious than lung cancer, and all the knock on effects it's caused, that makes it even harder to watch.