What can you do to care for an alcoholic aging parent, who is otherwise fairly fit?

My boyfriend’s mother is 78 years old. She is actually in pretty good shape--she drives, goes to church, goes grocery shopping, bathes and dresses herself, can still cook (although she is often too tired to), and maintains basic household chores. She prefers to spend her days watching television or reading, so she’s not in the best of physical fitness, and she walks with a shuffle rather than picking up her feet. She’s lucid, but forgetful, and sometimes seems to have a little trouble with good judgment, though thankfully in innocuous ways.

The trouble begins at night--usually around 5 pm or so, when the drinking begins. First, a couple of classes of wine or so, then she starts the bourbon. She drinks herself into a drunken stupor every night. She refuses to give up the upstairs bedroom she shared with her husband, so she staggers up to bed in varying states of drunkenness every night. Sometimes she makes it upstairs and gets herself to bed just fine. Other times, she falls at some point on the way up the stairs. Once, were it not for my boyfriend, she would have fallen backwards, head-over-heels from a little more than midway up the stairs. Sometimes, she gets upstairs fine, but in her drunken state, she falls down in her bedroom or in the bathroom, and can't get back up--whether from drunkenness, or weakness, we don't really know. She is often bruised or scratched, her glasses are broken, or her room is all torn apart--all tell-tale signs that she's taken a tumble. But she's as likely to deny/not remember the fall, as not.

On Saturday night, she called my boyfriend (thankfully we were staying there for the night) to ask for help. When he got upstairs, she was lying, half-naked, on the floor, with bedding, a lamp and some other things on top of her. We have no idea how she even managed to get the phone...

It’s a small town, where jobs are scarce, so my boyfriend –who is her primary caregiver, works part-time far from home. The stress of worrying about her is really taking its toll. He’s sometimes irritable and abrupt in his dealings with her. He’s depressed and he feels trapped. Clearly he’s getting burnout from this arrangement. But his three sisters (two of whom live and work nearby) are too busy with their own lives to help with her care or with looking for options for care. Since they only see her drunkenness on holidays or at family functions, (and at those times, Mom is on pretty good behavior, so it’s not too bad), it’s seen as a cute little eccentricity on mom’s part. They generally shrug their shoulders, and accuse him of being overly dramatic, or tell him to move out because it’s not his responsibility to care for her, or it will be her own fault if she falls and is badly injured—or worse. They chastise him for not being “nice” enough to her when they hear him snap at her; and they become defensive when asked for help. While I don’t condone the abruptness he displays sometimes, I understand the stress he’s under because I’ve been there to witness many of the things that happen when no one else is around.

I’ve been looking around the web, to see if I can find any resources for elderly parents who are in pretty good shape for the most part, but who require care at night when no one is around. I know this may be more of an alcoholism issue than a standard elder care question. But since I haven’t found anything so far, I wanted to see if anyone else has been in a similar situation and how you might be handling it. Mom wants to continue to live independently. But for her safety, and for my boyfriend's sanity, we could really use some help.

Thanks very much.