Advocacy

 

Book Reviews


June, 2004

"Caring for someone with an alcohol problem" by Mike Ward, Age Concern (UK), (2003).

Length: 118 pages and is written in a good size print. It was first published in 1998, and this is the third reprint.

From the back cover jacket: "More people drink alcohol, than smoke, gamble or use illegal drugs. When drinking becomes a problem, the consequences for the carer can be so physically and emotionally difficult to see any way out of the problem. This book will be invaluable help to anyone who lives with or cares for a problem drinker, with a particular emphasis on the problems of caring for an older problem drinker."

Scope (from the book jacket): "The book is divided into two main sections: It begins by considering the causes and types of drink-related problems that can occur, then looks at ways of working for change. It discusses the practical steps that can be taken to get the problem drinker to change, and provides advice on the help that is available from support services and specialist agencies. Finally there is a chapter for "caring for the carer- looking at the carer's own, often neglected needs."

The book answers common questions and concerns such as "do you buy alcohol for a problem drinker"; "do you permit alcohol"- the risks of prohibiting; dealing with drunkenness; protecting the drinker (e.g. fire risk and drinking); and protecting others. Throughout, it relies on a number of harm reduction techniques.

It uses vignettes (case studies) to illustrate key ideas such "caring for someone who does not want to change"- (Chapter 7)

Chapter 2 explains who becomes a problem drinker, identifying the purposes of drinking and common reasons why older people drink- to kill pain; to help wit sleep problems; to alleviate loneliness and boredom; to replace meals; to cope with loss; because of their former professions; because they have fewer and different constraints on their lives; to keep warm.

Chapter 3- facing a crisis talks about how much a carer can do and finding out what help is available. The role of ignorance (lack of knowledge) and irrational beliefs.

Chapter 4 "Working for change" talks about

It also covers talking about the problem- what not to say; use of drink diary and thinking about the effects of drinking; as well as setting personal boundaries.

Chapter 5 focusses on making the change- which makes sense for this person--attempting to give up drinking completely or try controlled drinking, and who is more likely to succeed with each approach; changing the way someone drinks; making a contract. It explains alcohol withdrawal and that relapse is not a disaster.

Drawing from UK resources, Chapter 6 identifies a variety of resources. It notes "any professional working in a caring capacity ought to be able to respond positively to someone with a drinking problem. GPs, social workers, other health professionals, human resources staff and employee welfare officers should all have the capacity to recognize such a problem and know what to do when they recognize it. This is not always the case."

The identified services include:

(a) Community based alcohol services: These include

(b) Others.

These include Self Help groups, explaining they way they function and whether they work for everyone. AA, Al- anon; and Adult Children of Alcoholics and Dysfunctional Families; Inpatient treatment; and Other sources of help- services for homeless people, women and people from ethnic minorities; telephone helplines; drugs; health education advice

Understanding Fears: "Older people in particular may believe alcohol treatment involves locked wards and invasive psychiatric treatment. Other may recollect hearing about aversion therapy techniques that were used in the past".

Chapter 8 covers combining alcohol with other drugs. It provides a simple table identifying drugs taken for common conditions and what happens when combined with alcohol

Chapter 9 covers prevention and Chapter 10 addresses" caring for the carer" explaining that alcohol does not simply harm the person who is drinking. In many ways those closest to the drinker suffer even more.

It emphasizes the message that "whatever else you do as someone caring for a problem drinker, you must make sure you look after yourself." This chapter includes "problems encountered when drinking ends". There is even passing coverage of "abuse of older people".

Strengths: The book on the whole has a positive tone, with a considerable amount of useful information for people caring for and about older adults. It describes older adults' fears, and many of the stereotypes and mistaken assumptions people have. It helps service providers and family members move to positive change in helping.

Limitations: North Americans may feel a little awkward about or unfamiliar with some of the language use, e.g. terms like "warden" [A warden is basically the building supervisor or administrator of a seniors' housing or retirement community]. The Canadian equivalent of "carer" would be "caregiver".

Cost: 6.99 UK Pounds + approximately 6.00 UK Pounds for shipping and handling (so about 32$ Canadian)

 


"Taking Care of Parents Who Didn't Take Care of You. Making Peace with Aging Parents". By Eleanor Cade (2002). Length, approximately 160 pages, with an index. Distributed through Hazelden. www.hazelden.org


People are often unsure about how best to give emotional support and practical assistance, and how much to offer  as parents age. These issues can become even more complex when there are alcohol issues or other family stressors involved.  The publication, "Taking Care of Parents Who Didn't Take Care of You. Making Peace with Aging Parents" is a good starting point.


Scope: This book for family members is divided into four sections with twelve chapters.

In Section one, "They Fallen and Can't Get Up: Our Parents Need Help", the author offers caregiver stories, discusses returning to help aging parents, talks about what losing independence looks like and means (personal hygiene, nutrition, medications) and estate issues.

Section two, titled --"I Can't Cope: Re-engaging the Past" explores family issues, such as "what kind of family did I grow up in"; family myths and scripts, and family roles. It also covers coping issues for the adult child- such as how families handle emotions, caregiver emotions, personal rigidity, and people's own core values.

Section three is the longest. Titled "Time for Action: Choices and Compromises", it covers finding a new role (expectations, choices, priorities, being taken for granted, setting boundaries, dealing with our siblings, creating freedom). The chapter on decisions and plans tackles making decisions; reliability: who is saying what; getting siblings to help; caregiving from a distance; helping the primary caregivers; and talking to our parents.

The chapter on living arrangements looks at a range of alternatives and presenting a plan to parents in a way that may increase its likelihood of being accepted; taking care of caregivers-including self pity, setting boundaries, support groups, physical response to stress, letting off steam, nutrition, and meditation. It even acknowledges that elder abuse can occur in the course of giving care.

Section Four is titled "Honour Thy Parents: Acceptance and Healing. It covers "making peace"- communicating with parents, listening to our parents, making connections, interviewing our parents, silence and respect, finding freedom, gratitude, letting ourselves off the hook, grieving, and death and dying. The final chapter is called "Breaking the cycle".

Strengths: While the title may put people off a bit, the book is balanced, and very compassionate in understanding both family needs and parents' needs. It has much less of the patronizing tone that sometimes crops up in books written for caregivers. There is a focus on improving communication, particularly hearing and understanding what aging parents say and how they feel.

Limitations: Because this book is much better than others I have read, it is hard for me to point out many limitations. By keeping any specifically American content to  a minimum, it is useful to people living in other countries.

Cost: Cost is $16.00 US dollars, plus shipping and handling.

Source: Hazelden is an American treatment agency that takes a 12 step approach. Unlike other Hazelden publications, this particular book does not promote any particular approach (and raises alcohol issues as part of the broader context of potential problem areas). As a result, the book would apply to almost anyone giving care.

 

*The Usual Caveat:  The opinions expressed in this book review reflect only my views, and do not necessarily reflect the views of any organization or project with which I am associated.

 

 

Page last updated 31/10/2004.

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