What happens when elderly smokers and drinkers move into a carehome?

[Seainasive]

My mother is getting more and more confused. We suspect alcohol related dementia. She drinks every day and going cold turkey would probably kill her. She’s also a very heavy smoker. How would this be managed if she has to move into a care home?

My grandads home had a smoking room but he did pass almost 3 years ago and wasn't a smoker so I don't know how much it goes used.

As for drinking, he was an alcoholic who was admitted into a respite home for 2 weeks when 8 times over the drink drive limit 24 hours after he'd stopped drinking (roughly three bottles of spirits one after the other) and he was vomiting so much we couldn't get any fluids inside him and the hospital literally threw him out once they got the results.

He went cold turkey to the best of our knowledge after that, not helped by the fact that the first time he fell sober he no longer bounced and broke his arm that time badly. He lost his confidence and couldn't get out so had to stop 100 percent then as no one would bring it in to him (not that he asked.... At that time he was more interested in paracetomsl as he thought he could have the doctors 8 and then his 8 😕)

Even with our evidence, the reports from rapid response and the hospitals records of multiple admissions due to alcohol or with it as a contributing factor, his gp did not believe he was an alcoholic (he was... At least a bottle of rum a day) and so no medication was prescribed to monitor it. He had regular fits and further hospital admissions because of them. His doctor was very reluctant to attend at the home too for monitoring as the hospital requested.

The reason I write all the above is to keep on at the doctor for full help if your mother does enter and the alcohol is withdrawn under whatever circumstances (or limited). The care home were great about that and he was not offered any wheh the others had some but his doctor couldn't care less (just the tip of the iceberg there....)

With my 90 year old grandma she stopped smoking because se had to smoke outside. The staff were happy to take her out because if they were smokers they could light up too.

Grandma got fed up of going out so stopped smoking.

I'm not sure about the alcohol. Grandma used to have a swig of brandy every morning, as part of her dementia she would forget and have several slurps. I think in the care home she forgot.

The care home had one evening a week that was 'wine and cheese' as one of the entertainments.

Anyway OP talk to her GP, they should be able to recommend a service for her, usually a community nurse and doses of Librium to stop any side effects of alcohol withdrawal.

My friend was a pipe smoker and a whiskey drinker. They allowed him to have a bottle of whiskey in the kitchen and was allowed to sit in the courtyard and smoke his pipe. When I've taken him out for a smoke recently, he just sits with the pipe in his hand and doesn't smoke it. I think he's lost the ability to light it. But it doesn't seem to bother him. He rarely asks for a drink either.

My DMs care home has a bar. She often enjoys a G&T before dinner. One of the carers told us that a group of them sit together before dinner and request that he bar is opened. She also has a glass of wine with both lunch and dinner.
never noticed any smokers there.
But it’s their home. They should be having a good time

I absolutely agree about not stopping them doing what they want at this point in life, heck I would like a little tipple now and then. The big difference is that the OP says she thinks the dementia and brain problems stem from alcohol use so she must be drinking to excess which you wouldn’t be able to do in a care home bar I wouldn’t have though so her drinking will need to be cut down

Although most of the post I'm about to quote is positive (and I'm sorry for your loss) this is also depressing

Dad was allowed a £25 ‘spends’ budget from his calculated ‘earnings’ that paid for his care, so he did have to reduce the amount he smoked (from 40+ to 4-5 a day).

I pray to a God I don't believe in that euthanasia is an option by the time I need a care home.

I think a lot of this depends not on the care home's rules as such but on the individual's desires, needs and quite importantly, their capabilities.
If they're quite independent and able to express that they want a drink etc then most will still get it. If they get drunk and cause a danger to themselves, others or their surroundings then it's a situation that needs addressing and it would be something for the whole care team to sort out with the resident. That's the family, care home manager and staff, social workers, healthcare providers and of course, the resident themselves. The ex alcoholics I know were violent, aggressive drunks and now suffer from dementia so the choice to drink has long been assessed by their care team.
If residents are at the stage of needing assisting to eat and drink then alcohol would probably not be the first thing the carers are reaching for, holding a beaker and straw up to make sure they get their whisky with their breakfast but a nip of sherry or brandy in an evening is certainly a possibility.
Having to go into a care/nursing home is shit whatever way you look at it. It's even more shit when you lose the physical ability to take yourself out for a smoke whenever you want. It's shit that staff can't take you out immediately when you ask because they're busy with someone else. I think my residential home is lovely with great staff. Do I ever want to have to go into a home? Hell no. If I had a personal valet to assist me and only me whenever I want then fine but I'd rather stay independent until I shuffle off this mortal coil.

I agree with a PP they should really be allowed to indulge in whatever small pleasures they have left at that stage of life.

My DM was in a care home and had put on a lot of weight due to being fed properly and not moving much (used to chuck her meals on wheels on her lawn when she lived alone).

Her care home rang me one day to say they were not going to allow her to choose a cake from the afternoon trolley due to her weight increase … she was 92!! And she was paying over £1K a week in that place. I soon told them they absolutely wouldn’t be doing that …. it was the highlight of her day ffs.

This is such a depressing post.
It should be enshrined in law that when you go into a care home you can smoke and drink and have as many takeaways as you like.
It is literally God's waiting room, they are waiting to die, why the fuck can't they do as they please.

Yes this is as bad as schools trying to force water only rules on children.
Are these rule makers failed Traffic Wardens, useless and interfering in trivia to avoid real work?

I think when our generation is older ie the generation of uber eats and deliveroo it will be easier to maintain autonomy over what we eat and drink.

Carers and nurses cannot legally stop us from ubering as much gin and cake to our room as our hearts desire.

That's assuming any of us can still afford to eat and drink.

Note to DS when looking for my care home in the long distant future,hopefully please make sure I'll be allowed a glass of wine/gin and tonic in my twilight years.

My mum's husband (note, not my stepfather, vile man) went into a care home with alcohol related dementia. He had a beer allowance the carers were permitted to give him but he declined pretty quickly and now has no perception he used to drink, his brain is so addled. So he was effectively weaned off in the home and is now dry. It is such a strange illness, drinking was one of the last bits of him to go but it has gone. He is effectively a shell with no sense of who or where he is.

Gosh, what would be the point in putting a person through the pain of withdrawal at that age and stage of life? What's the worst that can happen? I'd rather die happy and relaxed.

Yeah, alcoholics aren't generally happy and relaxed. They don't enjoy drinking, it is an addiction and a compulsion that has destroyed their relationships, their bodies and their brains. That being said, the care staff would give him tins of beer if asked, but he was a secret drinker so it is not in his nature to ask. Whether he drinks or not is an irrelevance now, in any case.

@HeadNorth this is the point I was trying to make, I’m unsure she would be allowed to drink to the levels she has been drinking therefore will need something to help wean her down

@AlaskaThunderfuckHiiiiiiiii I can only speak from my experience, through the lengthy downhill process prior to being admitted, the level of his drinking was known to his GP and consultant. When he was admitted the staff said he had a beer allowance, which mum was to supply but they would give him on request up to a certain amount. He went downhill so rapidly he stopped asking so I guess he was weaned off that way. So in my experience, there is an awareness that alcoholics need to drink a certain amount to remain stable and this needs to be tapered - your mum is far from the first drinker with dementia they will have dealt with, sadly it is all too common.

in my Nans care home they had wine with the evening meal if the wanted it and a scotch or brandy after the meal, it a cafe home not a prison. I suspect they can smoke it their room but not in public spaces.

My friend’s mum, heavy smoker, who had dementia went into a care home. The care staff use to take her out to the smoking shelters regularly. After a while, she deteriorated and eventually forgot she was a smoker.

thank goodness for such common sense and compassion.

After a while, she deteriorated and eventually forgot she was a smoker.

It is an amazing disease, unless you have lived close to it you can have no idea. My mum's husband's life was defined by alcohol. Now his physical body walks about but he has no awareness and apparently no craving for drink. I have heard about other heavy smokers that forgot they smoked by the time they had deteriorated sufficiently to require residential care. Dementia really does strip the person of every scrap of personhood and yet they remain 'alive'. It makes you question what being alive really means.

The staff at the care home appear to be full of common sense and compassion by the way, but I think it is hard to grasp how far gone some people in residential care can be. It is not about 'allowing' them to drink and smoke and have fun. Those concepts have gone completely for many people. Admittedly some may deteriorate slower and can have some quality of life, but it by no means a given.

I work in a care home. Smokers are taken outside for a cigarette. Maybe not as often as they want but a few times a day.
We don't provide alcohol but family can bring it in for residents if they want
To be honest most of the dementia residents are happy with the non alcoholic beer or wine .

Horrified at some of these care homes that are being so restrictive to their residents! I run a nursing home. We have a smoking room and outside areas available for smokers (fire risks have to ask for their lighters). They can have alcohol whenever they want it, mostly bought by themselves but we always provide a good selection for events/birthdays/Christmas. It is their home and they are human beings with rights.

I also regularly take my residents to pubs/cafes etc. I'm even taking one to bongo bingo next weekend. Shes in her 70s but will absolutely love it. They should be seen and treated as adults with adult interests and hobbies.

I’m so confused about this. When I read the thread title my first thought was - well they’ll probably have a great time with each other. But then someone mentioned medication and now I’m confused. I’d so love people in a care home to smoke and drink and eat what they want if that’s what they’d like to do but what about their medication.

Phew! I’m so pleased to hear it.