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The Do’s and Don’ts of Alcohol Intervention for Seniors

The Do’s and Don’ts of Alcohol Intervention for Seniors

There’s a specialized way to address an older adult’s drinking problem.

U.S. News

By Anna Ciulla, Contributor

July 16, 2018

IF YOU’RE WORRIED ABOUT an elderly parent or grandparent’s substance use, you’re not alone.

Americans over the age of 65 should limit their weekly alcohol consumption to no more than seven drinks, according to guidelines from the National Institute on Alcohol Abuse and Alcoholism. Yet some estimates suggest that as many as 15 percent of older adults in this country exceed this healthy limit (above which drinking is associated with various alcohol-related issues and constitutes “at-risk drinking”).

For this at-risk population, even a brief, more informal alcohol intervention (as opposed to a formal intervention facilitated by a certified professional) can be effective. Both the approach and level of advance preparation, such as familiarity with senior-specific treatment considerations and options, can be critical to ensuring a successful intervention. Here’s how to express your concerns in a way that’s helpful – not overbearing.

How to Address an Older Adult’s Drinking Problem – What and What Not to Do

When an older adult is engaging in problem drinking, family members and caregivers often have trouble broaching the issue. In these situations, consider the following guidelines for what and what not to do:

Choose an appropriate time to talk. Choose a time when a loved one is sober and experiencing the negative effects of a drinking problem, such as a hangover, alcohol-related injury or symptoms of withdrawal. They will not be as receptive to discussing how their habit is hurting them when they are drinking.

Avoid the use of labels. Charged terms like “addiction” or “alcoholic” carry a negative stigma that’s often felt strongly among older generations. Where there is stigma, there is shame – and the risk that labeling the problem will only further alienate the person who needs help, setting them on the defensive and in attack mode. The result can be a lost opportunity to connect in a loving and supportive way, which will be much more persuasive.

Labels are also premature diagnoses that only an addiction professional is qualified to make. Leave the diagnosing to people with the right credentials (like an addiction-certified psychiatrist or therapist).

Adopt a tone of love and respect. Ageism is a common pitfall. It can serve as an excuse to ignore at-risk drinking in someone older, claiming that because of their seniority, they can drink as much as they want. Or, it can manifest as condescension and “talking down” to an older person, as if they need to be treated like a child and don’t deserve the same respect that a younger adult is entitled to. Love and respect are more effective at achieving the ultimate goal of getting a loved one the help they need.

Ask questions that invite self-reflection. One tangible way to show love and respect is to ask questions that invite a loved one’s self-reflection. Don’t just talk at them – allow your loved one to participate in the process of addressing a drinking problem. For example, you might ask them to share their goals about health, independence, mobility, hobbies, relationships and financial stability; and invite them to consider whether their current drinking levels are helping or hurting the effort to achieve these goals.

Talk honestly and concretely about alcohol-related concerns. It’s perfectly appropriate to share concerns when these are grounded in concrete observations about the physical, social or financial consequences of a loved one’s drinking habit. For example, maybe a loved one has become more withdrawn and depressed lately, or maybe he or she ended up in the ER after mixing alcohol with medication. Maybe their savings account has taken a hit. Airing these observations honestly and directly communicates love and care.

Be sure to mention that alcohol treatment is an option and that recovery outcomes for older people are in fact better than those for younger populations. Research shows that seniors are better at complying with a plan of treatment. They also “have more positive experiences to draw upon and tend to be more disciplined about recovery,” according to a 2013 Hazelden report.

Alcohol Treatment Options to Consider for Seniors

Seniors often have alcohol treatment needs that are unique to their particular stage of life. Some common issues include decreased mobility, increasing dependence on others for care, greater social isolation and grief over the death of a spouse. They can all give rise to loneliness, boredom, depression and other addiction triggers.

Effective treatment should be tailored to address these individual needs, along with other medical, psychiatric, safety, legal and cultural needs specific to the individual. There is no cookie-cutter approach that will work for every senior. However, the best treatment program will offer a comprehensive array of the following evidence-based therapies and interventions for older people with addiction:

  • Cognitive-behavioral therapy, which teaches seniors how to rebuild their social support network and manage emotions like grief, loneliness and boredom
  • Marital and family therapy, which reportedly increased treatment compliance in older men by involving close loved ones in the treatment process
  • Group-based and individual counseling
  • Medically supervised detox and inpatient treatment

Research has also revealed that older adults with multiple chronic health conditions and depression are nearly five times as likely to be problem drinkers as older adults with the same conditions and no depression. Consider looking for dual diagnosis treatment, which treats mental illness and addiction side-by-side.

Finally, many rehab facilities now offer “senior-specific” alcohol treatment, although the jury is still out as to whether these programs achieve better recovery outcomes. As with any prospective treatment program, it’s important to inquire about the therapies they offer and how these will address the specific treatment needs of an elderly loved one.