Relative with Korsokoff’s back in hospital after drinking. What can I do?

[sunglasses]

My brother was admitted to hospital in Oct 2020 with symptoms related to alcohol abuse. He went through a managed withdrawal and thiamine supplementation but was assessed as having Korsokoff’s 4 weeks later. He was discharged to a care home ,as homeless ,where he was for 12 months initially not drinking but towards the end of his stay had started again. He had a care worker who seemed to us not very useful and did very little to support him. She told us she thought he was fine to go and live in a council property on his own and helped him to do this. His family did not agree this would be wise without support but it happened and he has been living alone for about 5 months now. In that time his drinking has become more and more of a problem. He is also a gambling addict and has gone into debt fuelling the gambling and drinking. He had a fall and was admitted to hospital a couple of months ago and is now back in hospital again as was lethargic and yellow( a friend called an ambulance) He has been detoxing again and waiting for scans etc to get a full picture of his health. He is still gambling! From his hospital bed. Is there anything we as a family can do? His Korsokoff’s means he cannot take stock and decide not to drink or gamble. He seems to exist in a Groundhog Day scenario and has limited short term memory as well as confabulations. If and when he leaves hospital he will be back to square one. He cant take care of himself, doesn’t eat properly, lives in a mess, gets confused about his medication- tablets found lying all over the floor. Whenever we as a family raise concerns we are just told that no one can do anything as this is how he wants to live. Surely given his Korsokoff’s diagnosis there is some help and support he can get? Can we have any control over his finances etc to stop him getting into financial difficulty? Should he be living alone with just limited contact from the care services? Any advice would be very much appreciated.

Talk to the social care people at his hospital.

Before he leaves hospital he will have an assessment that will help decide whether he can live independently or needs to go back into residential care. That’s going to depend on his capacity.

I assume you don’t have POA over his finances? If not and if his capacity is permanently diminished it might be possible to apply to the Office of the Public Guardian for guardianship.

But sadly, everyone has the right to make decisions that other people might consider unwise or eccentric. So if he has capacity to choose to live that way then yes, there is little you can do to stop him.

Thanks. I know the alcohol and gambling is something that he has to want to stop himself. It’s just that with his Korsokoff’s diagnosis he is never going to make that decision. Does anyone know wether that medical diagnosis means anything in a legal sense? I.e would be by definition of not have mental capacity? Is this what the assessment you mention will assess? We don’t have POA but I do feel that someone should be speaking up on his behalf. We just all feel so powerless to help.

I’m really sorry this is happening to your relative. It is not unusual for vulnerable alcohol users to be discharged to unsafe situations because they are seen as making the choice. Alcohol Change UK has a couple of good documents on this. Would quote them to professionals if you are being fobbed off.

In terms of advice, you need to request formal cognitive testing and also a test of mental capacity around the decision about where to live and what support to have and whether to gamble. Ordinarily people with korsakoffs are not in touch with their current reality so collateral (including from family) is key to the capacity assessment. Advocate for your relative. Preferably ask for a liaison psychiatrist at the very least if not a neuropsychiatrist to assess and do the capacity assessment. Then the ward should be arranging a best interests meeting with you and social work and other professionals to agree how to proceed in their best interests.

There are cdedicated cognitive rehabs for people with korsakoffs. The Upstreet Project in Kent and Serenita in Somerset are two I know of. It may be worth calling them for advice. In my experience local authorities tend not to want to pay for them but sometimes families do. The key with korsakoffs is that with a decent period of abstinence people can get a lot better.

For the gambling suggest calling the National Gambling Helpline. They will have suggestions about how to block stuff.

You don’t say where you are but in the devolved nations the care pathways are much better. Wales has launched a pathway for Alcohol related brain damage (which includes korsakoffs) so have a look at that to see what care should look like and use that to advocate. Good luck.

That’s amazing- great advice and exactly what I was looking for. I do feel a sense that we have been fobbed off in the past and want to try and change that but didn’t know where to start. Whenever I have tried to make headway with social care they always say they can’t discuss things as it’s confidential but we are his family and want to try and help him. They previously advised my parents to go no contact with him and they would deal with everything but didn’t give much indication of what that meant which just left them in the dark wondering what was going on.