Case Study IV - Arthur

CLIENT NAME: Arthur

AGE & GENDER: 72 YO; Male

OCCUPATION: Retired business owner & NAVY Veteran

DIAGNOSIS: Alcoholic 

TREATMENT: 30 days of residential treatment Older Adults Program

CURRENT STATUS: Recovering 

South Florida Intervention was contacted by Arthur's daughter seeking help for her father’s alcoholism and declining mental health. Arthur retired to Florida three years earlier from New York following a successful career as an executive in the garment industry. Shortly after retiring, Arthur’s wife, Marsha, unexpectedly passed away, which left Arthur alone with few structured activities. 

Throughout his life, Arthur was never considered a drinker, except for the occasional glass of wine at restaurants. Similar to other men whose wives were in charge of making plans, Arthur now found himself often home and lonely, during times he normally would have been out with his wife. In time, he grew more depressed and isolated.

Somewhere along the line, Arthur discovered the solace provided by a late afternoon drink. The daily drink helped him get through the twilight hours, which were some of the worst for Arthur and he naturally liked the relief this provided. Given his accomplishments and his reputation as a solid contributor to his family and the community, nobody would fault his newfound tradition.

Soon Arthur found his drink time coming earlier and earlier with the passing months, which left room for a second drink before getting ready for bed. On some occasions, Arthur would find himself exceeding his self-imposed two-drink limit. 

Arthur’s daughter became increasingly more concerned when her nightly check-in telephone calls were met with discombobulated conversations and slurred speech. Her immediate reaction was surely her father had a stroke. Naturally, she insisted on taking Arthur to the hospital to be looked over. When his examination revealed a clean bill of health she dropped the investigation.

It wasn’t until a couple of weeks later when Arthur’s daughter decided to surprise her father, with bringing him dinner, when the truth was revealed. When she entered his apartment she discovered her father passed out on the couch with an empty scotch bottle at his side.

Not wanting to confront her father she carefully woke him up as if nothing was wrong and set the table for dinner. Later that evening she told her husband and younger brother what she had discovered earlier. 

Having found South Florida Intervention through a friend she reached out for help. We discussed her father’s situation and I shared with her that alcoholism and addiction are so prevalent among older adults that many treatment centers now offer programs designed for this demographic.

After discussing this at length we agreed an intervention and residential treatment are the appropriate next steps. Because Arthur would be going to rehab locally, I met with his family to tour the facility and make sure they were comfortable with the recommendation. Seeing the rehab center was a huge relief to them. Now they could confidently tell their father about the great place they were sending him.

Despite carefully planning the intervention it kicked off unexpectedly when Arthur showed up forty-five minutes early. Some interventions are less elegant than we hoped for, but only so much can be controlled.  

Unlike other interventions, Arthur wasn’t quite sure what was happening and required an explanation of the forthcoming events. Arthur immediately protested and denied the possibility of him being an alcoholic. He said the idea of him being a problem drinker is preposterous and insulting.

I prepared the family in advance that Arthur’s first reaction would most likely be denial driven by shame and embarrassment. We knew this intervention would require patience and it would be better to help him conclude on his own terms that he needed help.  

Arthur is the kind of man that responds to reason, so we provided him compelling facts. For instance, up to fifteen percent of the population doesn’t start drinking until they are what is considered an older adult. The number of Americans diagnosed with alcoholism is estimated to reach over 5.5 million by 2020. 

According to one source drinking problems among those entering their golden years are sometimes overlooked or even misdiagnosed. The symptoms of depression – insomnia, mood swings, and anxiety – can mirror the warning signs of alcoholism. Substance abuse screenings are rarely part of annual physical exams, making it more challenging to detect the early signs of a potential drinking problem.

Recent studies suggest women may be more susceptible to alcoholism later in life than men, and seniors, in general, are more prone to life-threatening conditions such as heart disease, diabetes, cardiovascular problems and certain types of cancer when combined with excessive drinking.  

I explained the insidious nature of addiction to Arthur and I could see him nodding his head in agreement as I continued on. We talked about the effects of alcoholism on family members, especially his six grandchildren. The idea he could be doing his grandkids such a disservice softened his demeanor and ultimately provided him a reason to accept treatment. 

After agreeing with nothing left to hide, Arthur admitted how lonely he had been feeling these last couple of years.  “Ever since Marsha died I just haven’t had much to look forward to,” he acknowledged. “I started seeing my own death as a near term reality and not something way out in the future like I used to,” he continued. 

Arthur's transition into the rehab center was smooth and he was happy to see other men his age. This is a big consideration when placing older adults in treatment; you can’t put a 75-year-old Navy veteran with alcohol use disorder with a 21-year-old heroin addict or perhaps even a 35-year-old professional who has been fighting the old guard her whole career to get ahead. The placement has to make sense for the patient, or it’s another barrier to get over or another excuse to use not to get sober.  

Arthur’s time at the rehab center was productive as he came to realize many things about himself. He attended grief counseling and talked about his late parents and of course Marsha. There were feelings he had suppressed deep inside himself years prior.

His children and their spouses attended a week-long family program, which helped them understand the disease of addiction.  Further, this assisted in healing some repressed memories from his childhood, which included his mother’s sudden death. Addiction is a family disease that affects far more than just the victim, so this work is necessary if real recovery is to take place. 

After being discharged from treatment Arthur fell in with a group of older men in recovery. Many of which shared similar paths as Arthur.  Many grew up in New York or New Jersey, and had parents who immigrated to the United States from Europe during World War II.  

Being an active member of Alcoholics Anonymous gave Arthur purpose and being part of something positive. There he was able to do service and help others starting their journey in sobriety. Seldom does Arthur eat dinner alone or not have an AA related activity requiring his attention.

“It’s the fellowship of Alcoholics Anonymous that gave me life in sobriety; treatment just prepared me for that life,” Arthur likes to say nowadays. His only regret is that Marsha isn’t there to see how well he’s doing and the families he’s helped along the way.