In older adults, the signs of a drinking or medication problem overlap heavily with other conditions, so a doctor comes before a conclusion. Lead with the health concern rather than the drinking, get every medication reviewed in one place, and involve your parent in decisions rather than announcing them.
You went to visit and something was different.
Maybe it was the recycling. Maybe a fall they explained away, or the fact that they seemed confused in a way they were not last year. And you have been turning it over since, unsure whether you are seeing a drinking problem, getting older, or something else entirely.
I am Chris Howard, and that uncertainty is the hardest part of this. I want to help you think about it without jumping to a conclusion.
Why this is harder to read than with a younger person
With an adult child, the signs are usually recognisable. With an older parent, almost everything overlaps with something else.
Unsteadiness. Memory trouble. Sleeping oddly. Low mood. Falls. Confusion in the evening.
Those can be a drinking problem. They can also be a medication interaction, a thyroid problem, an infection, early cognitive change, grief, or several of those at once.
This is why I would steer you to a doctor before you steer yourself to a conclusion. Not as a formality. As the actual first step, and the one that most often changes what the family thought was happening.
I have been called into situations that turned out to be a sedative prescribed years ago and never reviewed. The family had spent six months convinced it was drinking.
What often sits underneath it
In the situations I have been called into, the drinking usually was not new. What changed was everything around it.
Retirement removed the structure that kept it contained. A partner died. Friends moved away or passed away. Driving stopped, and with it most of the week’s reasons to leave the house.
That is not an excuse and it does not make it less serious.
But it does change what help looks like, because a plan that addresses the drinking and leaves the isolation untouched tends not to hold. If the only thing that changes is that somebody takes the bottles away, you have removed a coping strategy and replaced it with nothing. The Family Support Services page describes the parallel work that usually needs to happen alongside anything the parent does.
Prescription medication, and why it’s easy to miss
Older adults are often taking several medications prescribed by several different people, sometimes over many years.
Add alcohol and the interactions can be significant. Add a sedative that was appropriate when it started and was never reviewed, and you can get an effect that looks exactly like decline.
The most useful thing a family can do here is unglamorous. Get everything in one place, including anything bought over the counter and anything a neighbour recommended, and have one doctor or pharmacist look at the whole list together.
That single step resolves more of these situations than families expect, and it costs nothing but an afternoon.
How to raise it without losing them
Lead with the health concern, not the drinking.
“Dad, I want you to see the doctor because you have fallen twice” is a conversation most parents will have.
“Dad, I think you are drinking too much” is a conversation many will refuse outright, particularly a generation that tends to regard it as a private matter and a character question rather than a health one.
Both routes can get to the same place. One of them keeps the door open.
Pick a time when they are rested and the house is quiet. Describe what you have seen rather than what you have concluded. And ask rather than announce: “what do you think has been going on?” gets you further than any statement.
The dignity problem
Adult children often handle this as though they are now the parent, and it goes badly almost every time. The same pattern comes up in reverse on the parents and adult children page, and the dignity question is the common thread.
Your mother or father has been an adult for considerably longer than you have. Being managed by your own child is a particular kind of indignity, and most people resist it even when the help itself is entirely reasonable.
Involve them in decisions rather than announcing them. Ask what they think would help. Keep as much of the arrangement in their hands as you safely can.
Where something has to be taken away, say so directly and explain why, rather than arranging it quietly and hoping they do not notice. They notice.
Where siblings come apart
This is where families most often fracture.
One child lives nearby and sees it daily. The others visit occasionally and see someone having a good day, because people rally for visitors.
The one nearby gets accused of overreacting. The ones further away get accused of not helping. Both are usually partly right, and the argument absorbs the energy that should be going to the parent.
Get on the same page before anyone speaks to your parent. Share what each of you has actually seen, with dates, rather than conclusions.
If you cannot agree, that is the first thing to fix. A family that arrives divided gets refused.
When to act faster
Some things do not allow for a slow, careful approach.
Driving. Repeated falls. Medication being taken wrongly or not at all. Any sign of a medical emergency. Any situation where they cannot manage basic daily needs safely.
In those cases, the health route becomes urgent rather than diplomatic, and a doctor needs to see them sooner rather than at the next routine appointment. Where confusion, agitation or a sudden change in behaviour is involved, the mental health crisis page covers what else to consider.
If the situation is an emergency
If there is immediate danger to life, or you believe a medical emergency is happening, call 911. The Crisis Interventions page describes what a planned response looks like when the situation is urgent but not immediately life-threatening.
For a mental health crisis that is not immediately life-threatening, the 988 Suicide and Crisis Lifeline is confidential, available at any hour, and carries no cost to the caller.
Los Angeles County residents can reach the Department of Mental Health ACCESS line on 800-854-7771, which can dispatch a mobile crisis team.
Frequently asked questions
How do I tell the difference between drinking and dementia?
You generally cannot from the outside, and the two can occur together. That is a question for a doctor, and it is the main reason a medical appointment comes before a family conversation about drinking.
My parent refuses to see a doctor. What now?
Try a reason that is not the one you are worried about: a routine check, a repeat prescription, a fall. Getting them in front of a clinician matters more than how you got there.
Can I speak to their doctor?
Privacy rules limit what a doctor can tell you, but there is usually nothing stopping you passing information to them. Write down what you have seen and send it.
Should I take the alcohol out of the house?
I would be careful. Removing it without any conversation tends to relocate the drinking and damage trust. If somebody has been drinking heavily, stopping suddenly can also carry medical risk, which is another reason to involve a doctor.
They say it’s their life and they’re entitled to a drink.
That is a fair point and worth acknowledging rather than arguing with. The conversation usually goes better when it is about the falls or the confusion rather than about the right to drink.
Is an intervention appropriate at this age?
Sometimes, and it looks different. Fewer people, gentler, and usually with medical involvement rather than a treatment placement as the goal.
What if my siblings and I disagree?
Resolve that before anybody speaks to your parent. A divided family produces a refusal, and it damages the relationships between you as well.
If you’re not sure what you’re looking at
Most families in this situation are not dealing with a crisis. They are dealing with a slow change nobody can quite name and a growing worry about what happens next. It is worth talking it through before anything becomes urgent.