Care and mobility considerations
General Information
Many people misuse alcohol and experience only minor mental, physical or social disability.
Alcohol dependence, in the absence of chronic complications should not be expected to give rise to significant care and mobility needs.
Episodes of repeated drunkenness on their own cannot be prevented by reasonable supervision, although intermittent intervention by another person at specific times may reduce the risk at those times.
Withdrawal symptoms usually last for a few days and should not require long term help from another person.
Self-neglect in people with alcohol dependency in the absence of chronic complications may require short-term attention from another person. However, such help should not be long term once drinking has stopped.
During periods of rehabilitation the person may require support from others, but this should not amount to a need for attention or supervision
The onset of chronic complications is likely to imply moderate or severe disability. The onset of serious, potentially life-threatening complications is likely to imply severe disability.
The following tables present pen pictures of customers’ likely mobility and care needs at varying levels of functional severity – mild, moderate and severe:
Mild Functional Restriction
| Category | Description |
|---|---|
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Pen picture |
A person with a mild functional restriction drinks to excess and may suffer some of the milder consequences of alcohol toxicity. Many of these individuals do not contact a Health Care Professional or obtain treatment. If help is enlisted or treatment instituted, it is often in the form of “brief interventions” from the Primary Care Health Team. |
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Effects |
Mild psychiatric symptoms such as anxiety and depression Minor physical problems such as gastritis or gout Minor social difficulties including relationship, work related, or minor legal problems, such as convictions for drink drive offences. |
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Mobility |
These people would normally have no difficulty walking and would be able to find their way around outdoors. |
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Care |
People with a mild functional restriction would not normally have a level of functional loss that will result in a reduction of their ability to carry out normal day-to-day activities. |
Moderate Functional Restriction
| Category | Description | |
|---|---|---|
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Pen picture |
A person with a moderate functional restriction is likely to have been drinking heavily for several years and have developed dependence or chronic complications such as peripheral neuropathy or epileptic fits. They are likely to be under the care of the Secondary Alcohol Team for ongoing treatment and are likely to have attempted detoxification They are likely to experience gradual deterioration over several years, with periods of remission and relapse in spite of treatment. |
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Effects |
Effects may include:
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However, people with a moderate condition would not normally exhibit significant self-neglect |
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Mobility |
Many of these people would normally have no difficulty walking outdoors, would be safely and independently mobile outdoors and be able to find their way around outdoors. However, some people’s mobility outdoors could be restricted due to one or more of the complications described above. Refer to the relevant links on the Prognosis & Duration page. |
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Care |
Similarly, many people will not have any care requirements but again, some activities may be restricted or limited as a result of one or more of the complications described above. Refer to the relevant links on the Prognosis & Duration page. |
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Severe Functional Restriction
| Category | Description | |
|---|---|---|
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Pen picture |
A person with a severe functional restriction will have been drinking heavily for several years and will have developed chronic, potentially life threatening complications such as cirrhosis, cardiomyopathy and cognitive impairment. They are likely to be under the care of the Secondary Alcohol Team. They will almost inevitably continue to drink despite treatment and their alcohol related disability will deteriorate. The mortality rate for this group is high. 52% of people with cirrhosis die within 5 years if they continue to drink. Even if they stop, 33% die within 5 years. |
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Effects |
Effects may include:
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Mobility |
Physical complications may make it difficult for the person to walk, but each case will have to be judged on individual merits. For example: Cardiomyopathy may cause severe breathlessness Cerebellar disease may cause gross ataxia [unsteadiness] Physical inertia and apathy may require someone to encourage the person with a severe alcohol related condition to get out and about. |
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Care |
The customer may need:
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If evidence shows that the customer has Cirrhosis as a result of Alcohol misuse, then also consult the Cirrhosis guidance for additional information.
Amended April 2009
