retirees

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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©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.

Become a Consignment Shopping Beast

~ Linda Leier Thomason ~ 2 Comments

8 Tips: Furniture Consignment Shopping + 1 Superstar Shopper

 Here’s a true story. One of a “senior citizen” with more courage, determination and smarts than most decades younger than her.

20160709_150125In September 2016 Brenda relocated from upstate Maine to Des Moines, Iowa. That in itself deserves applause, regardless of age. Similar climates. Similar people. Yet, major geographical change.

All last summer, together with her retired sister and brother-in-law, they sorted, donated and sold not only her accumulated items but also those of her parents whose house she was living in after her father’s recent death. [Years before, when Brenda’s husband died, she sold their Louisville, Kentucky home. Then, she moved herself to Maine to care for her aging parents. Care-taking became her life. So had becoming self-sufficient.]

After sorting and selling the Maine house, the trio loaded a moving trailer. They hitched it to a pick-up truck and caravanned three vehicles half-way across the country. All were relieved when they arrived.

Brenda purchased a condo prior to the move. Therefore, she had a sense of what would travel to Iowa with her. Yet, letting go of decades-old heirlooms is not easy. Some were taken by a brother remaining in Maine, making the letting go less painful. Others she photographed as a way to remember.

Mom’s Got Decorating Style + Smarts

What she did when she got to Iowa surprised all, mostly her children and grandson. She expertly and smartly furnished her “new pad,” combining items that made the trip with pieces purchased at a high-end consignment store. The first time her daughter saw her mom’s newly furnished home she exclaimed, “Mom, I just never expected you to furnish and decorate your place like this.” Well, she did. She used the opportunity to smart-size (a trendy word for downsize) and to create a space that fit who she saw herself as today.

For the first time in decades, she had no one to care for but herself. It was time to start over. She deserved a place she was proud to call “home.”

Tips for Furniture Consignment Shopping

  • Keep photos of room layouts and measurements on your phone. They’ll be handy for quick purchases. Most consignment stores have a no-return policy.
  • Find a consignment store that chooses well-cared-for pieces, timeless or trendy. Buying secondhand and re-purposing are now trendy. However, you’re not looking for torn or smelly upholstery or rotted wood. There are some outstanding furniture consignment stores. Find them and patronize them.
  • Get to know the consignment store staff. Make sure they have your contact information and know your style and vision. Have them contact you when a piece comes in they think is an ideal fit for your space.
  • Visit your favorite consignment store often. Inventory turns quickly. Know if the store accepts cash only,or if you can use a debit or credit card.
  • Do your own price research. Comparison shop online to guarantee you’re getting a great price at the consignment store.
  • Understand that some pieces require a bit of work. Did you find a well constructed, designer brand dresser or sofa? Be willing to upholster or refinish the piece. Make sure neither costs more than purchasing new.
  • Have any of the pieces been recalled? Do they have lead paint? Ask. Work with a reputable consignment store that doesn’t sell dangerous items.
  • Visit the store with a vehicle large enough to haul away your purchases. Some stores charge a holding fee.

Brenda purchased a new sofa and two side chairs, but nearly everything else, including wall hangings, came from consignment stores.

Take a look.  Would you know the difference?

She did an outstanding job!

Leave your comments and questions below.

All but glasses from consignment shop
All but glasses from consignment store

Table, chairs and centerpiece from consignment shop
Table, chairs and centerpiece from consignment store

Vase adorns fireplace ledge. It from consignment shop.
Vase adorns fireplace ledge. It’s from consignment store.

Wall hanging, lamp and chest, which doubles as file cabinet..from consignment shop
Wall hanging, lamp and chest, which doubles as file cabinet..from consignment store.

 

 

 

 

 

 

 

 

Consignment shop chairs
Consignment store chairs

 

 

 

 

 

 

Flower vase from consignment shop
Flower vase from consignment store.

Plant from consignment shop
Plant from consignment store.

 

 

 

 

 

 

 

 

 

Dresser being primed for painting.
Dresser being primed for painting.

Painted dresser
Painted dresser

 

 

 

 

 

 

 

 

 

 

Is it time for you to down or smart-size? Check out tips for doing this successfully on the “Real Estate” tab above. And, good luck with the move.

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© Copyright. August 2016. Linda Leier Thomason

All Rights Reserved.