A few weeks ago I had an appointment with a patient. It was quite comical. So picture this: a nearby assisted living center(I am omitting the name for HIPPA) decided that they wanted to serve alcohol at their holiday party. They are required to offer alcohol to all of their residents and then get clearance from their doctors before they allow them to drink. This patient was brought in by her daughter-in-law to talk to me. The patient was an 84 lb lady who is hard of hearing and has some dementia...I will call her LOL (little old lady). The daughter-in-law (DIL) explained the situation when I walked in and interjected that the family did not want the patient to drink because they were concerned about her balance. I wasn't even certain LOL wanted a drink, so I commenced to yell the following conversation, because she couldn't hear me:
Me: Did you want to drink?
LOL:What?
DIL: Do you want to drink alcohol?
LOL: What? Now?
Me: No, at the assisted living center. They may serve alcohol, are you interested in having a drink?
LOL: (confused look at DIL) What?
Me:They may serve alcohol, are you interested in having a drink?
LOL:(confused look at DIL continues)
DIL: They may serve alcohol, are you interested in having a drink?
LOL: Did somebody say I have a problem??!?!?!
Me: No. It is for a party. If they serve alcohol, do you want some?
LOL: They don't serve alcohol at the assisted living center.
DIL: They are planning on serving it at the holiday party, do you want some?
LOL: Well I suppose if somebody handed me a drink I would want to drink.
LOL: I don't have a problem.
At this point in the conversation I am realizing what her dementia would be like with alcohol on board. Then I reviewed her med list and saw she was taking percocet and lorazepam which don't mix well with alcohol.
Me: I know you don't have a problem, but with your medications I think it would be best if you didn't drink.
LOL: (Indignantly and nearly screaming) I am 84 years old, I can have a drink if I want to.
Me: I am concerned that your balance would be off with some of your other medications and alcohol.
LOL: I can have alcohol if I want to!!! What medications!?
Me: The medication for your hip pain and the one for anxiety?
LOL: I don't take any medications!
Me:I have it listed that you do and I think that it would be best if you didn't drink.
LOL: (slamming her little old lady hand on the table) I am 84 years old, I can have a drink if I want to.
Me: I understand, but I don't think it would be best.
LOL: I haven't had a drink in 15 years, I can have a drink if I want to.
DIL: If you have gone that long, it wouldn't be any different.
LOL:They don't serve alcohol at the assisted living center.
LOL: I don't have a problem!! I should be able to drink if I want to.
Me: (in a normal tone to DIL-pt couldn't hear this) Maybe one small glass of wine wouldn't be that big of a deal.
DIL: (through gritted teeth) Stay strong doctor.
Me: (yelling again so the pt could hear me) Well let's send you to the lab and I'll make a decision about it later.
LOL: I am 84 years old, I should be able to have a drink if I want to.
We helped her out of the room and as we are walking her down the hall to the lab she continues to yell: I am 84 years old, I can have a drink!!
Me to DIL: Thank you very much assisted living center...hope you have a nice party.