I hope that I am posting this in the correct forum.

My mother was diagnosed with early stage AD about a year ago. To this point it seems that only her memory has been impacted.

She has always enjoyed the occaisional glass of wine and shortly after being diagnosed she reduced her alcohol intake to a glass or two of wine per week.

Her primary caregiver has repeatedly berated her for her wine consumption and has told her recently that it has the effect of making her hallucinate and that she would shortly have to be institutionalized because her AD was so severely impacted by the wine.

Neither of my sisters or I have witnessed anything other than a slight impact on her memory shortly after a glass of wine.

Her caregiver has accused her of violence against him.

Can anyone tell me if her wine consumption may indeed be escalating her AD and causing her to become violent and hallucinagenic?

I appreciate any and all insight.

CharlesC: This is the perfect forum for your question. The Care Consultant may be able to give you a more definitive answer regarding whether 1-2 glasses of wine a week could trigger hallucinations and/or violent behavior. I wouldn't think so, but I'm not an expert.

A more important question is whether this particular caregiver is the right one for your mother. I would be worried about the fact that he is berating her. And it seems very inappropriate for him to be telling her she will have to be institutionalized.

I'd be afraid that his accusations of violence on her part might actually be masking hostile feelings (and perhaps actions?) on his part.

Dear Charles C,

It wasn’t clear on your post on whether you are a long distance caregiver. Since the caregiver accuses mom of violence, it would be important to monitor /investigate the situation to assess if it’s true. It is possible for someone with AD to get physically and verbally aggressive, especially toward their caregivers (the people that control them or try to keep them safe). It might be helpful for you or another family member to spend a few nights to see how mom responds to the caregiver. If mom is violent, it would most likely be difficult for her to mask it when you are present. However, if it is true that the caregiver is violent, it may not be as evident when you visit. Either way, as Nickie suggested, it might be a good idea to find out who is being aggressive towards whom.

It might not be necessary for your mom to give up occasional alcohol just because she is diagnosed with dementia. However, there are several reasons on why she shouldn’t be drinking. Dementia may reduce the brain’s ability to withstand the effects of alcohol. It is possible that mom may not remember how much alcohol she consumed and would increase her use (this may cause the dementia to progress faster). Alcohol use may limit the usefulness of some medications prescribed for Alzheimer’s disease or other illnesses. It is possible that a person with AD who stops drinking may experience some improvement in their functioning if the drinking contributed to their problems with thinking and memory.

Alcohol is a drug that affects the brain at any level of use. As people age, the brain is less able to withstand the toxic effects of alcohol. The same amount of alcohol may have a much greater affect on an older adult than on a younger person. Alcohol can cause impaired judgment and reasoning and a lack of self-awareness. Alcohol use can cause problems with coordination, which can lead to falls. Alcohol itself can interfere with learning and remembering, and can cause the loss of social inhibitions, leading people to say or do things that they would not ordinarily consider appropriate. Alcohol can also cause problems with regulating a person’s emotions-feelings of depression, anxiety, anger, and frustration. The person using alcohol may eat poorly, resulting in poor nutrition and vitamin deficiencies. With all the information we know about alcohol, it might still be best to consult with mom’s doctor on whether mom should be allowed occasional social drinking of wine. If it is confirmed by the doctor that there wouldn’t be any adverse effects, there is nothing wrong with mom drinking wine with supervision.

I hope the above information was helpful for you. Please call our 24-hour helpline if you would like to speak with a Care Consultant for further questions or concerns. You are welcome to continue to post your concerns, questions and updates on our Message Boards. Thank you for using the Alzheimer's Association Online Community.

Sincerely,

Mini V.

When my Mom was in earlier stages of dementia she could not tolerate wine. Her behavior would change drastically with just one glass. We eventually changed to serving her 'fre' brand wine which is alcohol free. She has a vision impairment so we "fibbed" and told her it was the real stuff she insisted upon. I think that for some even a small amount of alcohol can change their behavior.

Thank you all. I am in Texas and my mother is in Canada so it is difficult for me to get all the details straight and I certainly want to know as much as I can before making any judgements either about my mothers' violence and related wine consumption or about the nature of the interaction between my mother and her primary caregiver.

I do have sisters in the area who are able to assess her situation more closely. Mini V, I really like the idea of one of them staying a couple of nights with Mom. She seems, at least, to those of us not in everyday contact to be functioning at a very high level - she owns and operates her own business and is doing well there - her employees tell us aside from some memory gaps she has not shown any signs of anger or delusions etc. Certainly we appreciate that she is likely to function better during the day but it seems important to collect information from every person who has sunstantial interaction with her.

Our hope and goal is to assist her in maintaining her independence as long as is safely possible but we are not being given ALL the information from her primary caregiver and that is cause for concern.

Nickie, we ARE concerned about her PCG and how he approaches her AD. He is constantly reminded her that she has forgotten something and undermines her independence by forcing diet restrictions and "herbal" treatments that she is not comfortable with. So, yes, we are concerned about his impact on her but I am hesitant to say that he doesn't have her best interests at heart. I pray that he is simply misguided.

Karen, thanks for the suggestion of non-alcoholic wine...I can't for the life of me understand why we hadn't already considered that.

Charles: When a caregiver berates an individual and attempts to force his personal beliefs for treatment and diet on someone, that is NOT excellence of care. That is abusive behavior. Verbal abuse is absolutely not acceptable from an aide. Giving her medication (herbs or not), which may affect her other medication or worsen her condition is abuse. Ignoring her requests for meals and forcing unwanted foods upon her is abuse.

There is your Mother, stuck with this fellow who harangues her on a daily basis. Sounds as though he is pretty overt about it.

Your mother is helpless against him - no wonder she may possibly act out. Why is she still being subjected to this?

She may be forced into a diet she cannot abide, she is disrespected, baited and verbally abused; she has herbal medication thrust upon her, (which by the way can be potent and cause very deleterious effects on a person with dementia).

What I see, especially with the feedback from the employees, is perhaps this is a caregiver induced problem. Your mother should be given the benefit of the doubt and have this explored.

This is not about expediency. The caregiver may be convenient for the family and be dependable to be at work; BUT this does not constitute good care or a good quality of life for your mother.

And believe me, it is all about quality of life. If this were you, and someone came into your home and berated you, perpetually brought up every little inconsistency of yours, refused you your meals as you wished them and demanded you take herbal products, and threatened to have you put away, and you had no way out and were forced to live with this day in and day out, day after day after day and it relentlessly encompassed your entire life, and you had no power and no way out - how would YOU feel?

Whew! Exhausting writing that last paragraph!

While your sisters would be in the house for a few night, the caregiver would be on best behavior and truth would not out. Nanny cams would do the trick, but that's not the easiest route to take.

And, why does she have a male caregiver? Would she be more peaceful with a female?

Who cares for her on the weekends when the primary caregiver has days off? Does that aide report the same behaviors?

Non-alcoholic wine is a good idea. In fact, some folks pour it from the alcohol free bottle into the "real" bottle.

It would be interesting to see if the caregiver were given two weeks or so off, and a daughter or someone else stayed with her, if the situation improved. That would tell you a lot.

My dear, this goes beyond being, "misguided". He is "undermining her independence", he baits her by inappropriately pointing out her shortcomings, he threatens her with placement and FORCES her into unnecessary dietary restrictions and probably contraindicated herbal medication! What part of this does the family NOT think is abusive?

This cannot continue. Yes, it will take a bit of doing to find a reliable care giver, but we do this all the time for our loved ones.

It's about the quality of your mother's life and not permitting abuse.

There is no room for, "warning" the aide, he has far overstepped his boundaries, has poor judgment and common sense and this is his self-immersed value system. Shame on him. For me, this cannot be remediated, it would be time to sever his employment.

One person's opinion.