End stage Liver disease ?

Hi All,
My 62 year old female relative is alcohol dependant. She drinks about 1 litre of vodka a day and has done for quite a long time. She has always drunk quite a lot of spirits since being in her late teens. For the last 12 months she has been quite unwell and will not tell me what the doctors have said. All she tells me is that she is anaemic and has blackouts. She also said she had a burst ulcer last year, vomiting and passing blood and hospitalised for 5 days, having transfusions. But after an endoscopy earlier this year I did overhear them say she has not got an ulcer. I moved away in June when she seemed alright and she has just moved closer to me as I am her only living relative. I cannot believe the difference in her. She is so thin, her cheekbones are sticking out, she gags at the slightest thing, she cannot take her medication without gagging and nearly being sick, she doesn't eat (she has had 1 cracker today with a bit of cheese), she has to run to the toilet and doesn't always "make it" therefore soiling herself, she has muscle wastage, cannot walk properly, is very frail and the other day she had a fit and I took her to the hospital where they gave her an x-ray, blood tests and drips, I think they were saline, potassium and electrolytes. She had a second fit at the hospital and they kept her in. When I went to pick her up the next day I found out she had discharged herself, and all I found out was that she was supposed to stay in for another few days because she was on detox and her liver enzymes were elevated. I settled her at home before leaving her but did notice the next day when I went to visit her she had drunk over 1 litre of vodka in less than 20 hours. She also bruises very easily, she is covered in bruises due to falls. Her hair is thin and she does have a pale yellow hue to her face. She is taking thiamine (strong dosage) prescribed by her GP along with other medication including an anti-depressant and a statin. I am convinced she has cirrhosis of the liver, she does keep hinting that she won't be here for much longer. As I am her next of kin and obviously now looking after her I would like to know what to expect. I cannot get an explanation from her she just keeps saying she's ok. She looks like she is dying to me. I really need to know what to expect next as she will not tell me anything and I am also looking after my Dad who has dementia and suspected lung cancer. I think the next few months are going to be very hard and any information on prognosis will be much appreciated. I know she has no intention of abstaining from alcohol, therefore a liver transplant is out of the question.
Thank you.

Alantra, welcome to the forum. Sorry for the late reply...I just saw your post. It certainly sounds to me that she has ESLD and is dying. She will surely die within months if she doesn't stop drinking entirely. It doesn't sound like she is motivated to do so. In which case, it's best to contact Hospice.

She should be seeing a hepatologist (liver specialist) or at least a GI doc...not a GP. They know next to nothing about liver disease.

Hugs,
Connie

Thank you Ziff, Connie and Mae,
Sorry for the late reply.
You have confirmed my fears, but I do think I will be facing an uphill battle with my cousin...she has no intention of getting any help at all, she is even irritable with me when I try to help her, I suppose this is the toxins in her brain affecting her personality.
I have read and re-read everything I can find out about ESLD and she does have most of the symptoms but as far as I know she has not had any fluid removed, nor does her abdomen look particularly large. All I can do is try and get her to eat as much as possible but it would be fair to say that a mouse eats more than she does. She has had about 10 mouthfuls of salmon today and maybe two cups of tea and far too much alcohol.
I suppose I will have to play it by ear with her and hope she decides to tell me herself what the doctors have said, but I doubt that will happen, I just hope in time she will accept more help, or maybe she will not be in a position to argue ? The most frustrating thing about all this is that I am completely in the dark as to how long she has had this illness and how long she may have left. Could anyone tell me if it would be possible to care for someone with ESLD right to the end or will she have to go into a hospice ?
I know I will be asking for advice again before very long and am so pleased I have found this forum. I will post updates if that is ok.
Thank you again for your support.
Alantra.

Well Alantra, it all depends on how much free time you have. She WILL be close to a full-time job...not just the actual personal care, but the running for meds, groceries, then cooking, seeing to the meds 3 or 4 times a day, laundry galore (as there will be many BM accidents) and a lot of disinfecting around the home, help with bathing, even walking sometimes.

She will have to be monitored closely for edema, life-threatening bleeds, HE, etc. etc. and you say you are also caring for your dad, well I guess it depends on your priorities but I couldn't take on both, myself, unless maybe if they were in the same house and I didn't have to work.

If you ever have her in the same room while the doctor is there, say to her "cousin, that reminds me, now that the doctor is present could you give him or his staff permission to give updates to me?" Then you can honestly tell personnel down the road that "you have her permission", best to get a signed form though.