Ask Miriam – November 2025
Dear Miriam,
I am currently taking care of my brother, who is 66 – he has been diagnosed with dementia caused by alcohol use, and just a few months ago, I offered to have him move into our home since he was having a lot of trouble taking care of himself on his own. I live with my husband, Louie, and unfortunately, he and my brother have never gotten along. My brother gets easily upset, he complains all the time, and he picks fights with my husband. Louie still works full-time, and it’s been a lot of extra responsibility for me looking after my brother – doing his laundry, meals, dealing with his frustrations. Not to mention, he doesn’t think there is anything wrong with him. Even though Louie is supportive of me, we are both just really stressed, especially Louie. My brother is still able to walk around our little town, although I worry about that. But the worst part is that he is still drinking. He buys liquor at one of the corner stores. The doctor was pretty clear if he keeps drinking, it will kill him. I am at my wits’ end trying to keep the peace between my brother and my husband, and I am also scared my brother is going to die. Please help.
—Anguished Sister
Dear Anguished,
Caring for someone with alcohol-related dementia, also called Korsakoff’s syndrome, can be very challenging. Korsakoff’s, which is due to long-term alcohol misuse and vitamin deficiency, typically causes a person to suffer memory loss, confusion, and an inability to recognize their illness.
When addiction is combined with dementia, it creates a complex medical situation, and my recommendation is that you reach out to professionals in your community, such as a neurologist, addiction specialist, and/or social worker who understands alcohol-related brain damage. Know that you are not responsible for saving him from either alcoholism or dementia; however, there comes a time when someone with a brain disease needs daily, ongoing supervision to keep him safe. This type of supervision would enable the caregiver to limit the person from spending money or walking to the store independently.
Discuss with your brother’s doctor(s) what their thoughts are and how he can best be cared for. And talk with your husband about whether each of you feels you would be able to provide that supervision ongoingly. You would need to be able to arrange breaks for yourselves and time for the two of you to be alone together, too. Services such as support groups for caregivers or family members of those with addictions, such as Al-Anon, may be a good way to connect with others.
Together, you may decide that you are not equipped to manage ongoing, intensive care. If that is the case, your brother can also be cared for in other residential settings, such as a board and care, or a nursing home. While it is understandable that you may feel a level of guilt and responsibility, it is important to take everyone’s needs into consideration – even yours.
For more information about the various forms of dementia, call the Alzheimer’s Los Angeles Helpline at 844-435-7259.
Best,
Miriam
Questions for Miriam can be sent to askmiriam@alzla.org.