CHALLENGES IN CAREGIVING FOR PARENTS WITH SUBSTANCE ABUSE

A goal of Senior Loving Care is to cover a wide range of perspectives and challenges that family caregivers experience. No matter what you are facing, knowing that you are not alone may offer comfort. I sat down with a fellow family caregiver who is taking care of his eighty-year-old mother who suffers from alcoholism. This is his story. 

About seven years ago, I decided to find a senior facility for my mother. Her health was declining, and she was not doing a great job caring for herself, which includes a host of health issues, such as COPD, heart disease, and other ailments. Living in her apartment alone was risky for her as well as those around her. Residents in her complex and property management were also getting fed up with her alcoholic behavior pattern, which caused disturbances in the community where she resided. 

Finding a suitable facility takes a lot of trial and error

Finding the ideal senior living facility to accommodate my mother’s needs took quite a bit of trial and error. The first error was thinking my mother could live with extended family members. She stayed with two households. These failed experiences taught me that family members did not have the proper accommodations, backbone, or skills to care for her. She was not eating properly nor taking her medications regularly. In fact, she was actually living in an environment that led to more drinking.   

A big obstacle I faced during the transition of my mother to a facility was convincing her that moving was for her own good. My mother believed she could care for herself and was doing fine at her old apartment complex, although the family, myself included, could plainly see that her health was spiraling downhill, so the effort to find her a facility was worthwhile. 

An assigned social worker helped us find a small private nursing home that was run by an individual. The facility housed up to six seniors and accepted Medicaid. While there is a wide range of assisted living options, our financial situation and my mother’s requirements limited our choices. Our list of available facilities was narrow because my mother requires an oxygen tank to help with her COPD. 

The first few months at the home went well. It was a 4-hour drive from my house, and I visited a few times. Things ended abruptly when the facility shut down because it was discovered that the director was running the facility illegally. Unfortunately, so many operations in the U.S. are committing fraud in an attempt to get a hold of Medicaid dollars.  

Because of the shutdown, my mother was placed in a small boarding home for seniors.  Although they had the proper licensing, this place was a disaster. It was also privately run by an individual much like the director at the previous facility. My mother was not cared for properly, and they did not offer her required services. She could not get transportation to scheduled medical appointments, her prescribed medications were not managed, and general oversight was poor. 

Because managing her care long-distance was stressful, I purposely made sure that the next facility I was placing my mother in had to be a large nursing and rehab center close to me. In actuality, the next facility was approximately 24 miles from where I lived. The facility was highly rated, had been in business for many years, and offered a wide range of services. 

Unmanageable behaviors of substance abusers make caregiving more stressful

The convenience of having my mother in the same area provided peace of mind, but challenges still persisted. Problems began to surface when my mother stopped following the rules. The facility had a no-smoking policy, and alcohol was not allowed on the premises. My mother was caught breaking both rules on more than one occasion. Cigarettes and bottles of alcohol were found in her room, and the nursing staff detected the smell of smoke coming from the bathroom in her room. Thus, I had to find another place for her to live after the facility terminated her housing agreement. 

I accepted that my mother’s addictions were out of my control and that breaking her smoking habit of over 60 years is not likely. She was putting others at risk so I began searching for a place that allowed smoking. 

I was lucky enough to find one of the few facilities in the state that allowed smoking with rooms available. The facility is a large nursing home that houses over 100 residents. My mother appears to be settled now, and I am happy that she is in a place where she feels comfortable. Social interaction and medical services (oxygen therapy) are a big part of what she needs. Given the larger resident population, my mother was able to make friends, which eased the anxiety of living in a new facility. The facility is also staffed well, and thus far, they are doing a good job managing her respiratory issues.  

Over the past seven years, I have learned a great deal about family caregiving. Here are my biggest takeaways for anyone in a similar situation. 

Five things I’ve learned from caring for a parent with substance abuse 

1. Research, Research, Research

You simply cannot research these facilities enough. What they tell you and reality don’t always agree. There is a lot of money to be made in the industry, and not all facilities are on the up and up or care about your parents’ general well-being. Making sure that you understand the costs, policies, and services can prevent you from moving abruptly or too frequently. 

2. Build a rapport with staff

Building a close relationship with the staff is helpful if you are a caregiver of a parent with an addiction. By coordinating with the team, you can determine the real issues and not be manipulated into unknowingly violating policies. In my mother’s situation at the nursing home, I wanted to be notified of problems immediately so I could do my best to address the matter. Understanding the rules and restrictions of each facility enabled me to reiterate the guidelines to my mother and encourage her to comply. While staff will eventually identify patients with substance abuse, informing them in advance helps them to prepare. 

At my mother’s nursing home, they had the right to search the room and discard items that were not allowed. I have always been in favor of room searches given my mother’s history at previous facilities. She was able to convince visitors of other residents to buy her alcohol and cigarettes. Despite the restrictions, people can be bribed into doing things that are harmful. When you suspect this type of activity, inform facility management so that they know what to look out for and when a room search is warranted.  

3. Communicate consistently

Staying in close contact with your parent is also good, especially if they are accustomed to living around family. My mother always grew up around lots of extended family, and she felt lonely and isolated at the nursing home. When she moved closer, I could visit at least once a week, and I called her a few times in between. 

4. Find ways to manage stress 

Juggling a 9-5 job when you are a caregiver for an aging parent or aging parents with substance abuse requires PATIENCE. Recognize when things get overwhelming and take time out to decompress. Situations will always get complicated, and you will not get your parent to cooperate easily despite your efforts. But you should not feel guilty about taking some time off from caregiving and setting boundaries to maintain your sanity. I found that internalizng what I was going through caused stress that negatively impacted my health.  

5. Take advantage of family support if you have it 

If you have siblings or other family members, don’t hesitate to make them aware of what you are going through. Caregiving can be taxing on you as well as your immediate family. Sharing the responsibility of caregiving, like shopping for personal items and going to doctors’ appointments, lessens the burden on any one person or a small majority of primary caretakers. In my case, most family members have cut ties with my mother, and I am the only consistent caregiver that she has. 

Finding the ideal place for my mom was a very bumpy process, and I am relieved that she is finally comfortable and receiving proper medical attention. While I wish the behavior associated with alcoholism would end, with each year, I am better able to accept her illness and continue to care for her despite the frustration. In hindsight, it would have helped if there had been a transition coach to counsel my family. It took seven years for my mother to fully understand that her health conditions required ongoing care and that the nursing home she lives at is the best alternative. 

Alcohol is the most used substance among adults age 65 or older. The effects on the body are more adverse in the elderly and abuse often goes unrecognized, unreported, and untreated. I hope that you will take steps to find peace if you are struggling with managing caregiving issues involving abuse of alcohol, prescription meds, or recreational drugs. Please comment or share your story with our community of family caregivers.