| As a society, we share a complicated history with | | | | public health problem. It is an increasingly important |
| alcohol. During the later part of the 19th century, | | | | concern because the elderly is the fastest growing |
| politicians, women's groups, and churches banded | | | | population today, and is expected to continue this trend |
| together to convince lawmakers to outlaw alcohol. In | | | | well into the next decade. There are two forms of |
| 1919, the U.S. Congress passed the 18th Amendment, | | | | alcoholism that can be distinguished in the elderly: |
| making the sale and distribution of alcohol illegal. Alcohol | | | | alcoholism beginning before the age of 65 years and |
| consumption declined but did not prevent illegal use and | | | | continuing, and alcoholism beginning after the age of 65 |
| distribution. In 1933, Prohibition ended and as a result, | | | | years. As stated before, alcoholism in the elderly is |
| millions of Americans have made alcohol an important | | | | often difficult to diagnose, especially since health |
| part of their social activity. In the 1960s, researcher E.M. | | | | problems due to alcohol may be attributed to old age. |
| Jellinek reported that excessive and abusive use of | | | | Also, in the case of alcoholism, elderly patients, taking |
| alcohol was a disease. Within 10 years, a public effort | | | | multiple medications, present an increased risk of |
| was launched in the United States to educate people | | | | medication/alcohol interactions, especially with |
| that alcoholism was an illness.In 1980, the American | | | | tranquillisers and sedatives.At the beginning of this |
| Psychiatric Association's Diagnostic and Statistical | | | | article I suggested that Americans have a complicated |
| Manual 3rd refined the definition of alcoholism by | | | | relationship with alcohol. Well, to a certain extent, the |
| differentiating between alcohol abuse and dependence. | | | | same can be said about society's relationship with its |
| However, people continue to use the term | | | | elderly citizens. In America we often don't value our |
| "alcoholism" when they discuss all forms of | | | | elderly individuals, we sends a double message, some |
| "problem drinking," when in fact alcoholism | | | | may call it a love hate relationship with our elder |
| and abuse have specific clinical definitions. Alcoholism, | | | | population. As a result, some people tend to ignore or |
| also known as alcohol dependence, is a chronic, | | | | shun older people with drinking problems. For example, |
| progressive, and potentially a fatal disease. The | | | | to ease our own internal conflicts, we say things like |
| symptoms are: drinking excessive amounts frequently, | | | | "after all they are not hurting anyone. Let them |
| inability to control drinking despite medical, psychological, | | | | enjoy the time they have left...Who cares?" |
| or social complications, increased tolerance for alcohol, | | | | Often, therapist may be reluctant to work with older |
| and serious withdrawal symptoms when the person | | | | alcoholics due to unconscious counter-transference |
| stop drinking.On the other hand, alcohol abuse is a | | | | issues. For example, the elderly client triggers the |
| chronic disease in which the individual refuses to give | | | | therapist's own fears about aging. Older clients are |
| up drinking even though it causes the person to | | | | often accused of being rigid and unwilling or unable to |
| neglect important family and work obligations. | | | | change. In which case therapists may feel that they |
| However, abuse, left untreated, can become | | | | are wasting their time working with these individuals. |
| dependence. The symptoms are: drinking when it is | | | | However, researchers who study the science of aging |
| dangerous (drinking and driving), frequent excessive | | | | understand that these myths, assumptions and |
| drinking, interpersonal difficulties with family, friends, and | | | | stereotypes are unproven and often harmful to the |
| coworkers caused by alcohol, and legal problems | | | | elderly individuals who can benefit from proper |
| related to alcohol use.The National Institutes of Health | | | | treatment or intervention.One's later years does not |
| (NIH) estimates that in 1998, alcoholism cost society | | | | have to be a time of loneliness, depression, or a life of |
| $184.6 billion in lost productivity, medical care, legal | | | | alcoholism. Many individuals find happiness and even |
| services, and cost from traffic accidents. However, | | | | adventure in their advanced years. Those who age |
| these statistics does not address the cost, to society, | | | | successfully tend to have a strong sense of life |
| or the problem of alcohol dependence among the | | | | achievement, high self-esteem and positive attitude. |
| elderly the "hidden population."It seems that | | | | Older individuals who achieve a sense of ego integrity |
| alcohol abuse among older adults is something few | | | | are able to view their past history with a sense of |
| wish to talk about, and a problem for which even | | | | satisfaction. While older individuals who look back with |
| fewer seek treatment on their own. Too often, family | | | | regret and believe that it is too late to make significant |
| members are ashamed of the problem and choose | | | | changes may experience a sense of despair and |
| not to confront it head on. Health care providers tend | | | | depression.Those who age successfully is able to |
| not to ask older patients about alcohol use if it wasn't | | | | adjust to the loss of a spouse and other significant |
| a problem in their lives in earlier years. This may explain | | | | relationships, adjust to retirement and reduced income, |
| why so many of the alcohol-related admissions to | | | | accept and deal appropriately with declining health and |
| treatment among older adults are for first-time | | | | get involved establishing a satisfactory living |
| treatment.Recent studies indicated that between 1.1 | | | | arrangements.Unfortunately, not everyone ages |
| and 2.3 million elderly citizens use alcohol to alleviate | | | | successfully. Some individuals cannot accept the |
| grief and loneliness. What has been called the | | | | physical changes that come with advanced age. |
| "invisible population" is now being discovered | | | | Others can't handle the loss of a spouse or friends, or |
| and measured. Most individuals tend to restrict their | | | | they find it difficult adjusting to retirement. And, too |
| alcohol intake as they advance in age, mainly because | | | | often, many of these individuals turn to alcohol.Many of |
| of poor health or reduced social activities. However, | | | | these individuals never had a drinking problem prior to |
| society has begun to recognize that the incidence of | | | | this time in their lives. This is called late onset |
| alcoholism among older individuals is on the rise. | | | | alcoholism. The bad news is that this type of |
| Despite the numerous studies being done on this | | | | alcoholism may go unrecognized. The good news is |
| subject it is difficult to find reliable statistics on today's | | | | that individuals with late onset alcoholism have a much |
| elderly alcoholics. However, some research suggested | | | | greater chance of recovery. This is due primarily |
| that as much as 10% to 15% of health problems in this | | | | because these individuals have a history of handling |
| population may be connected to alcohol and | | | | problem successfully.On the other hand, early onset |
| substance abuse.One fact is clear: alcohol-related | | | | alcoholics are those individual drinkers who have been |
| problems among the elderly are much greater than | | | | drinking excessively for many years. As a result, they |
| perceived even a decade ago. It is also clear that the | | | | may have more difficulty in recovery because of |
| common individual's response remains devoted to | | | | health complications from years of excessive alcohol |
| treating their symptoms briefly and directly, rather than | | | | abuse.Finally, elderly alcoholics have a wide range of |
| getting to the core of the drinking behavior and treating | | | | treatment options. After detoxification, when |
| the alcoholism. The general practitioner is without doubt | | | | necessary, the elderly client can receive further |
| the person with the most opportunity to identify | | | | treatment from inpatient programs, day treatment, |
| alcoholism in an elderly patient, whose social and family | | | | outpatient therapy, or community-based groups. |
| isolation is relatively common. However, the practitioner | | | | Completion rates appear to be modestly better for |
| is often confronted with denial of the problem, by the | | | | elderly-specific alcohol treatment programs compared |
| patient and especially by the family. One reason may | | | | with mixed-age programs. Some seniors find that |
| be because the effects of alcoholism may mimic | | | | Alcoholics Anonymous (AA) meetings offer them |
| those of aging. Making diagnosis of alcoholism difficult | | | | strength and support to overcome drinking problems. |
| because many symptoms, including aches and pains, | | | | While other seniors feel these groups are stigmatizing |
| insomnia, loss of sex drive, depression, anxiety, loss of | | | | and find it more comfortable to seek support from |
| memory and other mental problems are often | | | | their age-peers at senior citizen programs. What is |
| confused with normal signs of aging or the side | | | | important to know is that the most effective programs |
| effects of medications.Another concern is that, too | | | | treat the "whole person," making sure that |
| often, when families or professionals try to get help for | | | | their health, housing, financial, and social needs are met. |
| their love one, identification of a drinking problem may | | | | This is an important concern because late-onset |
| be difficult. For example, many of the criteria | | | | alcoholism is often associated with stress, isolation, loss, |
| necessary to make the proper diagnosis of alcoholism | | | | and loneliness. Therefore, effective substance abuse |
| are more appropriate for younger abusers. These | | | | treatment for the elderly should address these |
| traditional criteria may not be appropriate for elderly | | | | underlying issues.Dr William Smith is a psychotherapist |
| individuals who may be more isolated or solitary, is less | | | | and personal consulttant with over 30 years |
| likely to drive and most likely to be retired. In fact, some | | | | experience working with individuals and groups. Dr. |
| researchers suggests that the diagnosis of alcoholism, | | | | Smith specializes in working with: Adult Children of |
| for the elderly, be focused on biomedical, psychological | | | | Alcoholics, Survivors of Incest and other Childhood |
| or social consequences.Although the prevalence of | | | | Sexual Trauma, Rape Survivors, Depression, Anxiety, |
| alcohol consumption and alcohol abuse decreases with | | | | Self-Esteem, and Relationship problems, Smoking |
| age, alcoholism in elderly people remains a significant | | | | Cessation. For a FREE initial consultation Dr. |