HEALTHY LIVING: The Doctor Is In

By DAMON RASKIN, M.D.  |  Special to the Palisadian-Post

Q: My father is in his late 70s and we lost my mother almost eight months ago. We are all coping in our own way, but I have noticed my father’s drinking habits increase. A man who used to have an occasional beer is now keeping hard liquor in the house and is openly drinking a drink or two each day (from what I can tell). Should I let my father have his vice or is my concern warranted and need to be addressed?

From my experience treating older patients, you have every right to be concerned about your dad. Not only is alcohol abuse more common in the elderly than you might think, it is often a very under-recognized problem by medical personnel as well as our society in general. Studies have shown that alcohol and medication misuse may affect up to 19 percent of older Americans.

I had an elderly patient come see me a few months ago who thought he was just fine. But his wife brought him to me because he was losing his memory and had new troubles with balance. She was clearly worried about Alzheimer’s disease or something more sinister. After a full work-up including blood tests and brain scans, he finally admitted that he had begun to drink vodka around noon and didn’t stop until he passed out after dinner. The diagnosis became much clearer at that point.

Your dad is still mourning the loss of his wife, and his drinking patterns seem to have shifted. This is a big red flag. Because you are probably leading your own busy life, what you are seeing may only be the tip of the iceberg. He may be using alcohol to numb his feelings, and he may not even realize the implications of his actions. I have seen too often the combination of alcohol and falls in older people, leading to hip fractures and head trauma. Liver disease, heart disease and sleep disorders can all be brought on by excessive alcohol consumption.

The key is early detection. The elderly can often hide their drinking behaviors, so you may not truly know the extent of the problem.  For example, it may be harder to detect a problem in your dad when there is not an issue of him showing up on time for work or making excuses to miss social activities. We often give the elderly a “pass” if they say they are tired or do not want to go to social events. We may blame their arthritis or just “slowing down” when that may not be the case. That may be compounded with the fact that they may have some age-associated memory impairment and may not realize or remember how much they are drinking.

Many older people may also be on medications, which should not be mixed with alcohol. Sleep medicines, anti-anxiety medicines and anti-seizure medications may all intensify the effect of alcohol. In addition, common chronic conditions like high blood pressure and diabetes may also be worsened with excessive alcohol use.

The National Institute on Alcohol Abuse and Alcoholism recommends that any person over 65 consume no more than one standard drink per day or seven standard drinks per week. Since 12 ounces of beer is equivalent to 1.5 ounces of hard liquor, it is of less significance what your dad drinks. It is the fact that you are noticing a change, which leads me to believe there may be a problem.

My best advice is to have a
respectful, non-confrontational discussion with him, which hopefully leads to a more open understanding of how he is doing. If he does
need help, take him to a medical professional who understands elder addiction.

Palisadian Damon Raskin, MD, is a board-certified internist who offers preventative medicine, concierge services and addiction medicine to patients in and around the Palisades. Contact: 310-459-4333. To submit your medical questions, email john@palipost.com.