elderly

How to Recognize Geriatric Substance Abuse

~ Linda Leier Thomason ~ Leave a comment

Alcohol and drug abuse, particularly prescription drugs, among those 60 and older, is one of the fastest-growing health problems in the United States.

Many consider substance abuse to be a mounting public health concern.

True Story

Ruth retired 12 years ago. Her husband of nearly 50 years died a few years back. Her children and their families live in other states. Many of her friends have died or have moved nearer their children. Some reside in an assisted living facility. Others are in nursing homes. She rarely sees them or even hears from them.

Ruth’s doctor has her on several medications for health issues associated with aging. Most days she remembers to take them.

She’s isolated and feels very alone. In the evening Ruth has a glass or two, sometimes a bottle, of wine to “help her sleep” and cope with all of these big life changes and the overwhelming feeling of loneliness.

Before going to bed, she takes aspirin for a headache.

Is Ruth abusing alcohol?

Could grandma really be an alcoholic?

Maybe.

Substance Abuse Facts

  • While illicit drug use typically declines after young adulthood, nearly 1 million adults aged 65 and older live with a substance use disorder (SUD), as reported in 2018 data.1 
  • Alcohol is the most used drug among older adults. It is often used for physical and emotional pain.
  • The total number of SUD admissions to treatment facilities between 2000 and 2012 differed slightly; the proportion of admissions of older adults increased from 3.4% to 7.0% during this time.2
  • Little is known about the effects of alcohol and drugs on an aging brain.
  • As one ages, physiological changes in the body lead to increased sensitivity and a reduced tolerance to drugs and alcohol. And, medical complications may interfere with the way alcohol or drugs are broken down in the body.
  • Herbal remedies, dietary supplements and over-the-counter medications can interact with drugs and alcohol in unpredictable ways.
  • Older adults metabolize substances more slowly. Therefore, their bodies and brains are more sensitive to drugs.3 
  • Elderly often unintentionally misuse medications. They take them too often, forget to take them or take the wrong amount.
  • According to the National Council on Alcoholism and Drug Dependence (NCADD), widowers 75 and older make up the majority of people suffering from alcoholism in the USA. They use it to medicate their grief.
  • Nearly 50 percent of nursing home residents have a problem with alcohol.4
  • Older adults are hospitalized for alcohol-related problems as often as they are for heart attacks.5
  • Doctors are often confused whether a patient is misusing substances or is showing symptoms of aging like dementia, frailty, lethargy, chronic health conditions or reactions to stressful, life-changing events in their patient’s lives. Many physicians do not screen for substance abuse. Instead, they focus on the more common medical problems of the aging.

Causes of Substance Abuse

Aging is not easy. Older adults, who struggle with the challenges of it, look for ways to self-medicate.

For many, retirement often means a loss of social connection and purpose. Children relocate and are busy with their own families and careers. Health issues become debilitating and disheartening. A lot of the things that once defined adult life are lost.

Causes of drug and alcohol abuse in older adults can include:

  • Loss of a loved one. Many elderly people use drugs and alcohol to comfort themselves following a major loss.
  • Loneliness. A trip to the local bar may be the only way seniors feel connected. They are isolated by circumstance. Maybe the children have moved away and do not remain in regular contact. Or, they’ve lost their spouse or best friend. They no longer have a daily routine since retirement. Alcohol and drugs help them feel less alone.
  • Health challenges. These can come on like a blizzard. Mobility issues mean loss of independence.  Vision challenges may affect one’s ability to drive and lead to social isolation. Cancer, strokes and heart problems make seniors feel hopeless. Health problems can feel overwhelming and drugs and alcohol allows one to escape from the rigors of them.
  • Chronic Pain. It’s very common for those with chronic pain to become addicted to prescription drugs.
  • Financial Challenges. This is a risk factor for substance abuse at any age but especially for the elderly who may not be prepared for medical and nursing home bills.
  • Sleep Problems.  Sleep can be a struggle for many. Maybe it’s caused by age, health problems, loss of a partner or purpose, family conflict, relocation, or anxiety. Doctors are often quick to prescribe medications to help people fall asleep. But certain sleep pills can be addictive. Some elderly choose to self-medicate with over-the-counter sleep aids, prescription painkillers or alcohol.
  • Unintended Abuse. Memory challenges and cognitive decline make it hard for older adults to keep track of medications. They take them too often or in a larger dose than prescribed.  It is common to inadvertently take medications incorrectly, increasing the risk of developing an addiction and dependence.

Signs & Symptoms

Substance abuse in the elderly is often hard to identify, especially if the person is always homebound.

Some of the signs of substance abuse mirror signs of aging, making it difficult to recognize if there is an issue, or its extent. Also, medications that many elderly take may mask or mimic substance abuse symptoms.

General health and mental conditions increase as one ages, creating the need for greater prescription drug usage. The Psychiatric Times estimates that a quarter of all prescription drugs in the USA are sold to the elderly, and close to 11 percent of this group may abuse these medications.

Those with abuse issues feel ashamed and try to hide their addiction.

Their adult children ignore the issue, disbelieving mom or dad could be an alcoholic or drug addict at this point in their adult life.

Elder substance abuse then nearly becomes an invisible problem.

Experts say these are the most common indicators of substance abuse in the elderly:

  • Secretive and solitary drinking habits
  • Slurred speech and repeated falls
  • Sudden and drastic change in appearance and hygiene
  • Hostile and aggressive behaviors, irritability
  • Unexplained burns and bruises
  • Drinking despite warnings on prescription containers
  • Onset of depression or anxiety; panic attacks
  • Fatigue or weakness; sleep problems or sleeping during the day
  • Memory loss, confusion and forgetfulness, especially of date, time and place
  • Giving up interests and hobbies once enjoyed
  • Chronic health complaints not linked to obvious health problems
  • Loss of appetite or changes in eating habits
  • Losing touch with loved ones
  • Unable to complete activities of daily living (ADLs)

Consequences

Drugs and alcohol worsen lung and heart problems and exasperate memory issues and mood disorders.

Alcohol abuse puts older people at greater risk for diabetes, high blood pressure, congestive heart failure, liver and bone problems and memory and mood disorders.

Impaired judgment, reaction time and lack of coordination resulting from drug and alcohol use often result in accidents like falls and vehicular crashes.

It leads to greater isolation. The one abusing substances self isolates or (s)he offends family and friends, causing greater isolation.

What to Do

Little research exists on the best models of care for older adults abusing substances.

Research that is available shows that even a brief intervention by a physician or other healthcare provider can reduce drinking levels.

If you are concerned about a loved one who may be suffering from elderly alcoholism or addiction, talk to them about their habits. Be prepared. They may be embarrassed by their problems and refuse to admit they have an issue. Because of the stigma of addiction, they might believe it’s a private matter and not be willing to openly talk to you about it.

Since many older adults do not recognize the need for addiction treatment, an intervention from family, treatment professionals and/or medical professionals is vital.

Research does show

  • Treatment with others their age is most effective.
  • Older adults are compliant with treatment and have better outcomes than younger addicts.
  • Longer duration of care for this population results in better outcomes.
  • A focus on re-building support networks is vital to preventing relapse.
  • Since detox and withdrawal are very hard on the body, elderly addicts with serious medical conditions are best treated in a local hospital before transferring to a treatment center.

If you or a loved one is struggling with substance abuse and needs help, please contact   Contact – Craft Lifestyle Management (craftlifestylemgt.com)

They are there to listen in a non-judgmental way and to guide you to the best treatment available.

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You never know who may be helped by doing so.

©October 2021 Craft LifeStyle Management.

All Rights Reserved.

Written for Craft LifeStyle Management by Linda Leier Thomason.

References

  1. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
  2. Chatre S, Cook R, Mallik E et al. Trends in substance use admissions among older adults. BMC Health Services Research. 2017; 584(17). doi: https://doi.org/10.1186/s12913-017-2538-z
  3. Colliver JD, Compton WM, Gfroerer JC, Condon T. Projecting drug use among aging baby boomers in 2020. Annals of Epidemiology. 2006; 16(4): 257–265.
  4. National Council on Alcoholism and Drug Dependence. (2015). Alcohol, Drug Dependence and Seniors.
  5. National Council on Alcoholism and Drug Dependence. (2015). Alcohol, Drug Dependence and Seniors.

More Information

Substance Abuse in Aging and Elderly Adults (psychiatrictimes.com)

Facts About Aging and Alcohol | National Institute on Aging (nih.gov)

Substance Use Treatment for Older Adults | SAMHSA

A Guide to Drug Abuse & Addiction Recovery for the Elderly

Substance Use in Older Adults DrugFacts | National Institute on Drug Abuse (NIDA)

Retirees: How to Plan for Next Pandemic

~ Linda Leier Thomason ~ Leave a comment

Covid-19 Wake Up Call

©www.lindaleierthomason.com

Many rejoiced! Covid was over. Life was getting back to ‘normal’.

Or, so it was thought until the recent Delta variant crept back into the everyday news cycle.

For a few brief months, when all believed this nasty virus was tamed with vaccines, Americans delighted in seeing families coming together again to celebrate and reconnect.

What Will We Do Differently?

While we all tepidly approach our public lives again it’s time to pause a bit and ask what was learned during the pandemic.

At Craft LifeStyle Management we see children finally getting back into their parent’s homes. Grandchildren into grandparent homes and neighbors into older friend’s homes.

Some of what is found and reported is heartbreaking.

Real Life Story

Recently we were asked by an out-of-state family member to enter their father’s local home. Of course, they’d been frequently visiting with him via telephone during the pandemic since he was unable to manage other modern communications.

He always sounded good on the phone-laughing, joking and openly reporting what he’d eaten. He claimed he had no problem getting up and down the stairs and that his laundry was being done. Much laughter was had when he told a story about stained clothing from all of the cooking he’d been doing.

The out-of-state family had groceries delivered. A family friend about their dad’s age regularly checked on him by calling and driving by.

Everyone was doing their best to keep dad safe since he has cancer and COPD.

Here’s what was really going on during COVID times.

Dad lied. Or, perhaps didn’t want to alarm, or bother, anyone.

The Truth

The family received their vaccines and confirmed dad had his. “Yup, all taken care of.”

They came to visit-all excited to hug and see each other.

To their dismay and heartbreak, when they arrived at the family home, it was nothing like their anticipated “Norman Rockwell family gathering.”

It was pure sorrow.

He was not washing clothes or cleaning. He was depressed and lonely.

He was not eating well.

Sure, the groceries were delivered; however, he didn’t want to cook. Instead, he ate all processed food and snacks. Thank goodness he had access to these even if they were mostly unhealthy.

Dad was unable to get up and down the stairs where his bed was. Instead, he was sleeping, eating and basically surviving on the couch.

The family took him directly to the emergency room 40 minutes away. He was not admitted but was given liquids and sent home.

Outcome

Dad is now living with his out-of-state family. He is not happy about having to abruptly leave him home, causing another level of depression.

The family is trying their best to figure this out.

What Learned

  • Telephone calls, Zoom meetings and Facebook messages cannot take the place of in-person interactions. The pandemic highlighted the fact that many older people are not familiar, or comfortable, with the latest technology and struggle to make meaningful contact with loved ones.
  • Parents have a habit of sheltering their children from bad news.
  • There is an increased awareness of taking care of one’s mental health. Globally, the impact on mental health from the pandemic has been devastating. There will be no “normal” way to adjust and re-acclimate to life after the events of this past year. A Kaiser Family Foundation poll reported that up to 45 percent of adults experienced negative mental health effects due to the pandemic – and an even higher percentage in those who serve as family caregivers for older senior loved ones.
  • Retirees are experiencing a role reversal. During the pandemic parents were getting instructions from their children. “Don’t leave the house. Order groceries online. Watch church services on your computer, etc.” Many are trying to understand what these roles look like post pandemic.
  • Easing back into the real world can be hard. Regaining physical strength and emotional resilience are necessary to thrive in this new post pandemic world. Most were living in fear and isolation for so long it’s hard not to want to emerge fully confident and active. However, after months of inactivity and diet changes, and likely lost muscle mass, it’s best to take it slow to adjust to this still uncertain world.
  • Adult children gained insight about their own retirements and how they want to age. Where would they want to live during a pandemic? Are they financially prepared? Would they be able to support themselves in an economic downturn?
  • Families are discussing adapting their houses and lifestyle to have their parents share a home with them.
  • Senior-living industry is adapting to this upheaval, planning for the future. Some have moved isolation units to the main floor instead of upper floors, allowing for access to the outdoors for fresh air and sunshine. Many placed clear panels in doorways so residents could see and talk safely to visitors. Future buildings will likely have smaller groups of units in the building rather than several dozen units down a long hallway. Even the HVAC systems are being re-thought-circulating air over smaller areas. And, communal dining and group activities will now likely be reinvented and done in smaller groups.

©August 2021 Craft LifeStyle Management.

All Rights Reserved.

Written for Craft LifeStyle Management by Linda Leier Thomason.

Home Modifications to Age in Place

~ Linda Leier Thomason ~ Leave a comment

More seniors are choosing to age in place than ever before. This is partly due to long-term care costs. In addition, the Baby Boomer generation has been privileged to have a more active lifestyle than generations before them, allowing greater health in older years.

Technology and availability of more services, like home care, are also making it easier for older adults to independently remain in their own homes.

Definition

Home modification means materially changing a senior’s home to make it easier for them to safely move around. It also involves removing potential hazards to support independent living.

Falls, often resulting in broken bones, are the #1 reason seniors lose their mobility, thus their independence.

To avoid this, home modifications, supporting aging in place, typically address three areas.

• Safety

• Accessibility

• Convenience

Help is Available

Craft Lifestyle Management and Craft Homes http://craftlifestylemgt.com/craft-homes/, supported by a team of professionals like occupational therapists, have years of experience with home modifications.

We can assist you, or a family member, in creating a safe space for those choosing to age in place.

We will walk through the home with you and make suggested modifications.

We’ll also introduce you to products and services that will make you and your loved ones feel safer in the home while aging in place.

Our Craft Homes team can make the physical upgrades on your schedule and within your budget.

BONUS: Peace of Mind-Family members who cannot be with their aging loved ones all the time can have peace of mind knowing these modifications will create a safer place for their aging family member.

Basic Modifications

You Can Do

Clear Excess In Rooms

Remember, falling is the #1 reason seniors lose their independence.

Ensure each room, including the front door entryway, has plenty of space to maneuver around, especially if your loved one relies on a mobility aid like a cane, walker or wheelchair.

Remove unnecessary furniture. Clear pathways and hallways. Leave plenty of space to move around without bumping into anything.

Remove or Fix Trip Hazards

Rugs beautify space; however, they often are trip hazards. Remove area and other floor rugs or secure them to the floor to avoid slips and falls.

Are there extension cords running across floors? Find another way. Cords are definite trip hazards.

Level uneven areas of flooring throughout the home. Minimize height differences between flooring types to avoid tripping hazards. NOTE:1/8” or more is a trip hazard.

Assess Lighting

Not enough light can increase tripping, thus falls. Too much light creates glare. Make sure the home is well lit, always.

By age 75, most people require twice as much light as the normal recommended standard, and nearly four times as much as a 20-year-old, to see satisfactorily (Dementia Services Development Center – The Importance of Lighting).

Consider putting nightlights in hallways and in bathrooms. Use table or floor lamps in sitting areas and put adhesive countertop lights under cabinets.

NOTE: Changing light bulbs is often risky for seniors. To avoid having to change lights frequently, switch all lights to LED bulbs. Most are rated up to 50,000 hours.  

Raise the Toilet Seat

Low toilet seats are a major hazard for falls. Install a raised toilet seat with handles and/or grab bars next to the toilet.

Change the Shower Head

Install a handheld shower head. These are easier to use while seated or while holding on to a grab bar.

NOTE: Craft Homes can help you install grab bars and other safety equipment and tools to avoid slips and falls.  If someone in your family does the installation, for your safety, make sure the grab bar holds up to 250 pounds or more and that it is installed by screwing it into wall studs, not just the sheetrock.

Replace Door Knobs

Arthritis or other conditions that limit motion make using round doorknobs challenging. Replace these with lever-style ones, which are much easier to grip since they don’t require a twisting motion.

More Involved Modifications

Contact Craft LifeStyle Management for an In-Home Assessment

Remember any modification that ensures safety and helps you or your loved one live independently for as long as possible is well worth considering.

Craft LifeStyle Management will work with your time schedule and budget. We will schedule a convenient in-home assessment and begin any modification work when you are ready.

Contact Us. http://craftlifestylemgt.com/contact/

Widen Doorways

Doorways must be at least 32” wide for a wheelchair to move easily through it but 36” wide to accommodate a turn, like from a hallway into a room.

In addition to the actual widening construction, sometimes light switches and electric wires must be moved.

Pocket doors may be recommended instead. Using pocket doors has two advantages: doors are no longer in the way when open and wheelchairs don’t get caught on hinges.

NOTE: Sometimes just flipping a door to open to the other side is all that’s needed. Every option to create accessibility and contain cost will be explored with you.

Adjust Kitchen Countertops

Regular countertops stand about 34 inches off the floor. Adjusting countertops to 30 inches makes it easier for someone in a wheelchair or scooter to enjoy daily activities like cooking.

Cabinetry with pull out drawers is a real bonus for those wanting to enjoy working in their kitchen longer.

NOTE: Simply lowering a microwave makes a huge difference for independence.

Install Slip-Resistant Flooring

Choose flooring that is soft so bones are less likely to be broken if a fall happens. Also consider installing flooring that is easy to clean and stays clean.

While hard surfaces like wood and stone floors are easier to clean and more sanitary, they have less traction and are just that-hard. Carpet is softer and warmer and provides more cushion if there’s a fall. Yet carpet is more challenging for mobility aids like walkers and wheelchairs.

Engineered vinyl planks may be an ideal option for those wanting a hard surface. They are both easy to clean and hold up well to liquid spills. This flooring looks and feels like hardwood floors. They also have texture so they’re less slippery than real hardwood floors.

NOTE: If you don’t want to replace bathroom tile that’s in great shape, buy ADA approved anti-slip coating and roll it on with a paint roller.

Build a Wheelchair Ramp

If the home is not zero entry, meaning it has zero steps and a minimal threshold, you may need to have a wheelchair ramp built and installed.

The most obvious use of the ramp is for wheelchair accessibility but ramps also eliminate the need to navigate steps, which is often difficult for those with balance issues.

If the home is zero entry, ensure there is a covered entryway to protect you from snow and rain. Regularly have your drainage systems checked. Don’t allow rain to puddle or ice to form by the entryway.

Change Faucets

Replace twist faucet handles with levers. Or, install touchless faucets on the kitchen and bathroom sinks for those with arthritis or other grip issues.

Install anti-scald faucets in the bathtub or shower. These prevent sudden bursts of hot water when cold water is diverted due to a toilet being flushed or the washing machine being filled.

NOTE: A simpler way to avoid scalding is to lower the water heater temperature to 120 degrees or less. 

Replace the Bathtub

A walk-in shower provides much easier and a safer entry than a bathtub. It makes showering independently possible.

If space or budget don’t allow for a walk-in shower, definitely have a safety bar added to the tub and install safety strips.

You can also purchase a bathtub transfer bench. https://makedisabilityeasier.com/how-to-use-a-transfer-bench-for-the-bathtub-and-shower or use a bathtub chair. Transfer benches are safe and affordable and highly recommended.

A walk-in or siting tub option is also available, though much more costly. These serve as a stand-up or sit-down shower as well as a deep soaking tub.

Move the Bedroom

The bedroom should be on the main floor of the house.

Craft Homes can definitely help you redesign your space to make this happen.

Contact Us. http://craftlifestylemgt.com/craft-homes/

NOTE: Alternatively, you may want to install a chair lift or elevator.

More Information

Click to access RT-Aging-in-Place-Safe-at-Home-Checklist.pdf

Written by Linda Leier Thomason for Craft LifeStyle Management.

© August 2020. Craft LifeStyle Management. All Rights Reserved.

Denise Craft founded Craft Lifestyle Management in 1988 to ease the burden for families of aging, veterans, special needs adults and those in rehab during times of transition. She understands what’s involved in transitioning any individual from their personal home to their next home and to the end of life. Her seasoned knowledge of available placement services, housing options, eligible benefits and payor sources, and community resources is endless. 

Please contact Craft LifeStyle Management for all of your transitional needs.

Greg Craft founded Craft Homes in 1980. Since then, he’s been involved in home building, redesign and modification.

Contact Craft Homes at PHONE: 402.578.5911 or Crafthomes.greg@gmail.com or denise@craftlifestylemgt.com

5 Ways You Can Combat Loneliness for Aging Parents

~ Linda Leier Thomason ~ Leave a comment

Stay Connected & Engaged

Isolation and loneliness are serious problems for older adults.

Sadly, 43% of people over 60 are reporting that they are suffering from loneliness. 

It may be due to

  • Loss of a spouse
  • Physical decline like decreased mobility, hearing and vision, resulting in loss of driving ability
  • Death of peers
  • Reluctance to make new friends
  • Limited social outings and interactions
  • Unfamiliarity with technology

Remaining in one’s home is often a goal but it can result in extreme social isolation. Even if caregivers stop-in to check on the aging person, life often lacks fun and excitement.

Geographically distant family members become overwhelmed with guilt and uncertainty of how to help combat the loneliness from afar.

It becomes worrisome when they hear aging relatives express enthusiasm about social connections in offshore countries and optimism about winning lotteries.

While contests and social media platforms can be fun, they can also cause multiple problems, especially if your loved one begins sending money to unscrupulous ‘connections’ from afar.

Loneliness is linked to disease and even death. Those who feel isolated and alone are sicker and often die sooner.

It’s important to build safe social networks, in person or digitally, at all ages, but especially for older adults living alone.

5 Tips

1. Stay in Touch Frequently & Regularly

Put yourself in their place. Imagine living alone and never speaking to or connecting with anyone other than a retail clerk or medical staffer.

Make it a point to call or visit regularly. Maybe you check-in with a phone call every day at a certain time or every Sunday, for instance, you meet for lunch. Your senior will look forward to each of these contacts.

Increase your contact volume and keep a regular schedule.

While you’re there in person, go through the mail.

Do you see anything that looks suspect, like phony offers of prizes from lotteries and sweepstakes or envelopes from foreign countries? If so, talk about this and remind them of the possible risks of these sorts of activities.

Remember, anytime you’re asked to send money to collect a prize, it’s not legitimate.

2. Introduce & Teach Technology

People of a certain age may not own or even use technology like those younger than them.

This doesn’t mean they don’t have the ability to learn.

Investing in a computer or tablet with a camera is a great way to help an aging relative feel connected.

Let the grandchild teach them how to use it, establishing a memorable bond.

Check out community education classes for seniors.

A whole new world can open up to an aging relative willing to learn how to use technology.

3. Attend Events Together

Few older adults want to learn a new craft or be pushed into an activity they never enjoyed or participated in while younger.

Instead, go down memory lane with them.

Ask what activities they fondly recall from day’s past. Maybe it’s the annual fall festival or the church fish fry, or even the Christmas concert at the elementary school. Whatever it is, make plans to attend together.

Be sure you get the tickets and make the travel arrangements so the event is worry-free for them.

4. Relive the Old Times

Make a date to sit with them a look through family scrapbooks, home movies and photo albums to relive memories. You may be amazed what new information you learn.

Or, pull out a favorite recipe to make together. Or find a card or board game and play it.

Let them take the lead and tell you what activity from their past brought them the greatest joy, and then do it together with patience.

Doing these beloved activities with grandchildren will only heighten the experience.

5. Community

Maybe your aging loved one was never a “joiner” but it doesn’t hurt to try and encourage them to participate in the many community events for senior citizens.

Get online and research availability and maybe even join them for an activity or two to ease the transition.

It’s proven that social interaction and activity extends one’s life span. This is a great, easy way to start them getting more social interaction.

© May 2020. Craft LifeStyle Management. All rights reserved.

Written by Linda Leier Thomason for Craft LifeStyle Management.

Denise Craft founded Craft LifeStyle Management in 1988 to ease the burden for families of the aging, veterans, and special needs adults during times of transition. She understands what’s involved in transitioning any individual from their personal home to their next home and to end of life. Her seasoned knowledge of available placement services, housing options, eligible benefits and payor sources, and community resources is endless. 

Please contact Denise Craft LifeStyle Management for all of your transitional needs.