Since your last meeting with Mr. Moore, you have come to be aware that because he is home so infrequently, he does not spend much quality time sober with his children. He recently missed his daughters' national gymnastics championships in San Francisco, CA. The girls excel at gymnastics and are among the best in the country at their level. Mr. Moore has been to one gymnastic meet 3 years ago. His son, Jeffrey, plays hockey and is on a travel team. Mr. Moore has never been to one hockey game. Mr. Moore has never missed work due to drinking, although you have come to be aware that he sleeps only 4-5 hours per night and is typically hung over the next day after being out drinking the night before. He has very little patience, chain smokes, and has many regrets in his life (although drinking is not yet one of them). When asked about his children, he appears to know very little about them. He is unable to tell you who each child's best friend is, what each child's favorite color is, what television shows they like to watch, what music interests them, or what foods they like to eat. He cannot recall ever doing any activity with any of them individually or together. He is not sure of their schedule, and he has never been to a school parent/teacher conference or any doctor or dentist appointments. However, he is very vocal in his expectation that his children excel in school and get all As. He did disclose that he reviews their report cards to be sure they are getting all As. When asked about his children's apparent athletic ability, he is apathetic. He truly believes that he cannot attend such events because it interferes with his business.

Mr. and Mrs. Moore travel frequently as a couple with different retail groups, and these trips are paid for by the manufacturers of the furniture that Mr. Moore carries in his stores. The children do not come on these trips. There are about two per year, each lasting for 1 week. When asked about these trips during an interview, Mrs. Moore's face elongates and she looks down. She is very guarded in her responses to you as the probation officer. You learn that these trips are a source of great stress for Mrs. Moore because all decisions are left up to her. She decides and plans for the child care for the children when they travel, she does the packing, and she even has to pick out all of Mr. Moore's clothing. During these trips, Mr. Moore is intoxicated most of the time except the mornings, and Mrs. Moore is left to deal with his intoxication, embarrassing behavior, and other antics.

Mr. Moore has an early diagnosis of cirrhosis of the liver. In addition, he has had an inflamed liver. He takes numerous medications for this condition and has needed different treatments in the past. The doctors have clearly articulated to him that his cirrhosis is caused by his excessive drinking. They have advised explicitly that Mr. Moore must stop drinking if he wants to live. Despite this medical advice and his diagnosis of cirrhosis, he continues to drink and smoke excessively. His wife and children have spent numerous days and nights at the hospital while he recovered from different medical problems as a result of his drinking.

Sheila, age 10, is the youngest. She is a comedian in the family, always trying to lift the mood and make light of the situations that involve her father's drinking. She is immature and does not do well in school. She is, however, ranked second in the country at her level of gymnastics.

Jeffrey, age 11, is quiet, withdrawn, and introverted. When he is physically home, he retreats to his room and becomes engrossed in reading or in playing video games. He is an excellent hockey player and is on the travel team, which gives him some relief from his chaotic home environment. No one knows that Jeffrey has an eating disorder, which he began to suffer from at age 9.
Wanda, age 13, is the child that her sister says can do no wrong. She is aligned with her father and is constantly appeasing him. She is an overachiever who not only excels at gymnastics (she is ranked first in the country at her level of gymnastics) but also at school. She is a gifted learner who is taking college-level courses in the 8th grade.

Given the additional information that you have learned about the Moore family during your interviews, do the following:

Explain how Mr. Moore's alcohol-related medical condition has impacted his children and his wife.

Use the facts and your knowledge of alcohol abuse to specifically address the impact of the medical condition on each member of the family.