Why is Enabling a Common Response to Addiction?

Question

After spending some time at my mom’s house over the holidays I am convinced that she needs to get some help. My dad died 2 years ago. She has always liked to drink but he really kept her under control. Now that he is gone she has been drinking more and more. She is 74 but she has aged incredibly in the last year and I am not sure if it is because she is always a little bit drunk or not but she is not nearly as sharp as she was just a couple of years ago. Her house was always well kept but now it is dirty and messy and she always used to like to socialize quite a lot but now when I ask her about how she spends her time and who she sees she gets very vague. I get the feeling she doesn’t leave the house all that much other than to go to the grocery and liquor stores. I asked her about her drinking but she got very defensive and angry about it so I dropped it. My brother doesn’t seem to want to get into it with her but my sister agrees with me that something needs to be done. The question is what to do? As it stands right now I do not think she should be living alone. I don’t think she is eating well or taking care of herself, but I do not know how much of her neglect is related to her drinking or if there is maybe some other cause for it. My sister says we should consider asking her to move to a retirement community and that within an assisted living environment she would probably do well and with increased social opportunities she might have more to do each day than get loaded.

Dr. James Strawbridge · Accepted Answer

For women who drink heavily, the affects are most apparent to family and friends. You mentioned that your mother, age 74, has aged substantially in the last year; is not nearly as mentally sharp as she was a couple of years ago; her house is now in disarray; she isolates; becomes ambiguous when asked how she spends her time; and defensive and angry when asked about her drinking.

Talking one-on-one with your mother can be a difficult proposition. You begin with high hopes but soon find yourself outmaneuvered. To keep defenses down, refer to your mother's addiction as chemical dependence, alcohol dependency. Use statements such as “how alcohol has turned on you” and “it's not your fault that you have this disease” Keep in mind that you are talking about a disease, not a moral failing.

When families ask what they should do about elder adult addiction problem, they are usually referred to their family doctor. However, most doctors, including psychiatrist, have little or no training in addictions and know very little about diagnosing and treating the disease. To find a doctor certified in addiction

medicine, contact the American Society of Addiction Medicine by calling 301-656-3920 and asking for the membership assistant. To request a referral by e-mail, visit its Web site at www.asam.org. Ask for a referral to a gerontologist with a specialty in addictions in the your area. If the older adult refuses to see a doctor, ask the primary care physician to consult with a specialist.

Putting your mother in a retirement community before her addiction to alcohol is addressed is like putting the cart before the horse. Read about Interventions in the 1960s book by Dr. Vernon E. Johnson, an Episcopal priest who developed the techniques family interventions. It is a mainstay in the Interventions Field. Tour the Older Adult Treatment program at Hanley-Hazelden (www.hazelden.org). You can call 1-800-257-7899 to talk with a professional.

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