Advocacy

 

A Role for Everyone

Here's just a sample of roles that we can encourage many different community members, government bodies, and private organizations to take to reduce the likelihood of alcohol problems developing in later life and to appropriately help if a problem does occur.


 

A

Addiction Services can help by

-         training staff to understand the needs of older adults and the most appropriate approaches for working with older adults who have alcohol use problems

-         recognizing where attitudinal and service barriers exist throughout the addiction treatment and rehabilitation continuum, and actively address those barriers

-         directly acknowledging existing program/service limitations (for example, not self identifying as serving "all adults" when in reality they have little or no contact with older adults)

-         working in conjunction with mental services and other community services to see that older adults' mental health and other needs are being met

-         drawing on harm reduction strategies, as opposed to focussing exclusively on abstinence before offering help

-         developing and using appropriate tools to assess the level of drinking and the extent of other related problem affecting older clients

-         developing links with geriatric services and geriatric specialists to be able to have a better assessment of older clients’ circumstances in order to offer appropriate types of help

-         understanding the ways in which long term alcohol use can cause memory damage, leading to clients who appear as “non-compliant”, and knowing how to assist clients in these circumstances

-         identifying  the ways in which alcohol problems continue  to be stigmatized, and actively countering those stereotypes and misconceptions

 

 


Ambulance personnel can help by

-         working with community and health services to look at ways of  preventing crisis interventions among older adults, avoiding having “revolving door clients”, and exploring ways to address the underlying problems that  lead to these situations



 

Apartment Managers and Public Housing Societies can help by

-         recognizing that sometimes a tenant may have or may develop an alcohol use problem;

-         providing basic training for managers and other staff on aging, better understanding of older adults' needs

-         identifying and eliminating house rules that isolate or hinder support of older tenants

-         permitting addiction or other related services to be offered in the building

-         permitting seniors to be safely detoxified in their apartments

-         talking about alcohol and medication issues in a non-stigmatizing, non-judgmental manner

-         developing non discriminatory entry and leaving policies

-         providing education to building managers and boards about alcohol issues affecting older adults in a way that helps them respond openly and non- judgmentally to potential and existing alcohol/ risk problems in the building

-         developing supportive housing alternatives, using staff who understand the nature of alcohol problems and are able to work with tenants from a harm reduction approach

 


C

Caregiver Groups can help by

-         providing non judgmental information and education on alcohol issues in caregiving materials

-          letting people giving care know that alcohol use is much more common than people might think, and alcohol misuse can easily happen

-    acknowledging that people receiving care can sometimes have past or current alcohol use problems, and that can affect how others respond to them now

-         getting people giving care to look at their own level of drinking. Asking non-judgmental questions related to alcohol, such as:

o “How many of you here occasionally take a nightcap to help you sleep?”

o “What about after a really bad day?”

 


 

Colleges and universities can help by

-         developing and promoting courses on addictions and counselling that focus on aging issues, recognizing that older adults will be the largest and fastest growing age group in Canada

-         integrating aging issues into the curricula of medicine, counselling, psychology, health promotion, health policy,  communications and many other fields


Community Health and Wellness Programs can help by

-         integrating alcohol use issues into existing health promotion materials, such as falls prevention, dealing with emergencies, in a non-stigmatizing way (e.g. the FOCUS Falls Calendar)

-         developing information for families on how to talk about alcohol issues in the family throughout the lifespan in non-threatening ways, recognizing the fact that alcohol is the most common drug used in Canada


Continuing Care/Long Term Care Managers can help by

-          recognizing that some Continuing Care clients will have alcohol problems

-          having assessors who understand the effects of alcohol on the older individual

-          developing non discriminatory policies to meet these clients' needs

-         knowing the available community resources for addictions (beyond self help groups).

-          knowing the available resources for counselling, bereavement, pain, home care, respite etc.

-          talking about and dealing with alcohol issues in a non-stigmatizing, non-judgmental manner

-         advocating for increased community resources that can help older adults who are experiencing problems

-         understanding the ways in which long term alcohol use can cause memory damage, leading to clients who appear as “non-compliant”, and knowing how to assist clients in these circumstances


 D

Detoxification (alcohol withdrawal) services can help by

-         having appropriate alcohol and drug withdrawal protocols that take into account age-related differences in withdrawal

-          training staff to understand the specific safety, health and stigma issues of alcohol use and alcohol withdrawal for older adults

-          having  staff who take a positive, non judgmental approach to the long time user

-          having good  links to  appropriate community  and  addiction services in order to have good “after care”, to help prevent relapses


E

Elder Abuse services can help by

-         recognizing the roles of alcohol and drugs in some abuse cases, and recognizing it may be an issue for a victim  or a perpetrator

-        developing cross training with addiction services so that both types of organizations have a better understanding of appropriate ways to best help the person

-    understanding the ways in which an alcohol use problem, and the related health and social problems often associated with it can be part of "self neglect"

-    understanding how alcohol use problems can affect self determination, ability to assess personal risk etc.

 


Employers can help by

-         helping older employers plan for and “graduate”  into a successful  retirement, recognizing the significant psychological impact retirement can have on many

-         developing flexibility in employment, eldercare, and retirement policies to adapt to the different circumstances of  people, some of whom are giving care to aging parents, so that they do not have to jeopardize their own physical, psychological  and financial wellbeing  to give care

-         assuring there are age appropriate services  for employees who have alcohol use problems


G

Provincial and Territorial Governments can help by

-          allocating adequate resources to the treatment of older adults, recognizing that this is a growing population and recognizing the adverse physical and mental health impact on the population

-          recognizing the benefits of prevention and health promotion, as contrasted with ongoing crisis interventions

-          recognizing the cost effectiveness of providing addiction and other services for older adults - to help keep them healthier longer

-          looking at ways to meet the health needs of older people in rural  areas

-          promoting non-discriminatory policies in health and socials services so that older adults can have their needs met fairly and equitably

-         understanding the interrelationship of various addiction issues for older adults and allocating resources in a way that meets their pressing needs

-    understanding and responding to the underlying factors that lead to alcohol use problems for older adults

-    understanding and responding to alcohol use problems as an issue that affects successive generations as they grow into old age

 



 

Federal Government can help by

-          promoting the development  of moderate drinking guidelines that better take in to account age-related health changes

-          promoting research on the efficacy of common herbal medications to better educate consumers

 


H

Health-Related Organizations can help by

-          incorporating alcohol-health information into public education materials on diabetes, cancer, liver disease, lung disease, heart disease and stroke, and other key health conditions negatively affected by alcohol misuse

-          tailoring the information to older adults‘ education levels

-          presenting different types of education messages in light of the different education needs of those without an existing problem, and those with an existing problem

-         identifying the ways in which alcohol use problems continue to be stigmatized, and actively countering those stereotypes and misconceptions in public and professional education

 


Home Care/ Home Support services can help by

-          recognizing that some clients will have alcohol problems

-          developing non discriminatory policies to meet those clients' needs

-          know how to talk with clients and families talk about alcohol issues in a non-stigmatizing, non-judgmental manner

-          developing fair policies to respond to problem situations

-         advocating for increased community resources that can help older adults who are experiencing problems

-         understanding the ways in which long term alcohol use can cause memory damage, leading to clients who appear as “non-compliant”, and knowing how to assist clients in these circumstances


 

Hospitals can help by

-         having staff in all departments (including emergency), trained to recognize and appropriately respond to alcohol problems,

-         having staff trained to recognize alcohol and drug (e.g. benzodiazepine) withdrawal in hospital patients, and deal with it appropriately

-          having age-appropriate protocols for alcohol and benzodiazepine withdrawal based on the best current information (e.g. slow tapering for benzodiazepines)

-          recognizing and addressing existing stigmatizing and judgmental attitudes and practices that occur in some hospitals (such as "GOMER, Get Out of My Emergency Room")

-          having staff who are aware of the existing community resources to help older adults with alcohol use problems in order to make appropriate referrals

-         providing good discharge planning when the older adult has a substance use or other health problem

-          developing  skills among all  hospital social workers to be able to talk comfortably with older patients about getting help for difficulties stemming from their alcohol use, to help link them to appropriate community resources

-          developing geriatric assessment services to help better determine the level of functioning of older persons experiencing problems in order to help others in the community better plan to meet the person’s needs



 

Housing Authorities can help by

-         understanding the links between alcohol and substance use problems, mental health problems and people’s risk of losing their housing

-         assuring there are  supportive alternatives in housing to help those who have special needs because of their alcohol use, mental health difficulties, or cognitive impairment

-    providing training for housing staff to help them understand and appropriately respond to the needs of and the real life issues affecting older adults


M

 Medical Associations can help by

-          promoting the development of better understood practice standards on pain relief, recognizing the fact that a significant number of older adults in the community and in nursing homes are inadequately having their chronic and terminal pain addressed. In part, this currently reflects a lack of understanding among some physicians about the important differences between pain medication tolerance, pain medication dependence and pain medication addiction.

-         working with the federal government departments and drug enforcement authorities to assure physicians can  better meet the needs of older adults experiencing pain, without fear of having their prescribing practices unnecessarily challenged

-    promoting continuing education (particularly geriatrics education) for physicians so that they can better understand the medical and social needs of their older patients

 


Media (television programs, newspaper and magazine journalists) can help by

-          covering the issue of seniors and alcohol

-    avoiding stigmatizing language to talk about the issues (such as "Seniors' Secret Shame") that reinforce the negative perception of the issue

-          not reinforcing misinformation (for example, by depicting "interventions" as portrayed in popular programs such as "Seinfeld" or "Touched by  an Angel". The approach has been discredited for decades, and is not considered as an appropriate responses for helping people seek help)

-    providing a balanced perspective in alcohol and health articles, by identifying both risks and benefits to health as they relate to older adults

-        informing people about the range of approaches available in the community to help with alcohol problems, above and beyond Alcoholics Anonymous

-    including messages of encouragement and helping people understand that older adults often do well when appropriate help is given

 


 

Medical Services can help by

-          having billing that adequately compensates physicians for taking the appropriate amount of time with older adults, recognizing older adults more complex needs



 

Mental Health Services can help by

-          recognizing and removing existing barriers to mental health services (such as when mental health service require that the alcohol problem be under control first)

-          recognizing that alcohol and mental health problems often develop concurrently, and addressing the issues together

-          knowing which anti-depressants are less likely to cause an adverse reaction if the person continues to drink, and recommending the use of these.


N

Nursing homes and other long term care facilities can help by

-          recognizing that sometimes a resident coming into a facility may have or may develop an alcohol  use problem;

-         providing education to staff about alcohol issues affecting older adults in a way that helps them respond openly, fairly and non- judgmentally to potential and existing alcohol/ risk problems in the facility

-         talking about alcohol and medication issues in the facility in a non-stigmatizing, non-judgmental manner

-         developing non discriminatory policies and protocols, particularly for entry and leaving (recognizing that alcohol problems are a recognized disability under provincial human rights legislations)

-          permitting support groups to be offered in the facility


P

Pharmacists can help by

-          talking about alcohol issues with customers in a non-stigmatizing, non-judgmental manner

-          asking customers about over their counter and herbal medication use

-          monitoring customers' drug use & identifying potential interactions

-          providing reliable information to customers on interactions (improving the information sheets currently being used)

-          having medication information sheets written in everyday language, with information that is most likely to be relevant to seniors

-          alerting physician to potential medication problems with a specific person

-          helping physicians identify and prescribe less harmful medications, when they know that the person is drinking

 


Pharmaceutical Companies can help by

-         providing plain language information on key medication interactions for common medications used by older adults, in the context of the types of situations older adults are likely to be facing

-         providing plain language information on alcohol-medication interactions placing less emphasis on generic information in

-         testing current materials being used in drug store chains (which usually buy  the information from the United States) to see if existing packaged  and printed information is understood by older consumers

-         developing software that can describe medication interactions, based on the specific medications that a consumer is using, with plain  language cautions when there are potential problems



 

Physicians can help by

-          asking older people about drinking and medication use, including over the counter drugs and herbals

-          listening to and taking the time for their older patients

-          assessing older patients for pain and providing adequate pain management

-          carrying reliable information on how alcohol affects seniors' health (benefits and risks)

-         continuously enhancing their medical knowledge about alcohol and drug medical treatments suitable for older adults (for example the need for slow tapering in benzodiazepine withdrawal)

-         knowing the available community resources for addictions (beyond self help groups).

-         referring older patients with alcohol use problems  to these resources

-          knowing the available resources for counselling, bereavement, pain, home care, respite etc.

-          being alert to the signs of depression among older clients

-          taking time to properly assess the older adult's situation, including alcohol and medication, over the counter drug, and herbals use

 


Police can help by

-         being able to talk with intoxicated older adults in a non-threatening way

-         knowing and being able to offer the available community resources for (geriatric) addictions and mental health services

-         understanding how some older adults’ alcohol use can lead to financial exploitation by others, and understanding how alcohol affects capacity to consent

-         target some community education in low income areas to the types of financial exploitation and other crimes that older adults are likely to experience



 

Prevention Resources can help by

-         carrying age appropriate information on older adults and alcohol issues

-         addressing any inequities in the  amounts of material  they carry  for older adults, compared to other age groups


R

Researchers can help by

-         developing age sensitive and age appropriate survey tools to gain a better understanding of the extent of the problem among older adults

-         integrating gerontological information with addictions information in their research

-         researching the effectiveness of different kinds of treatments for older adults

-         critically analyzing existing research information, in light of age differences


S

Seniors Centres can help by

-          normalizing the issue of drinking by carrying reliable information brochures about alcohol for seniors & for family giving care; integrating it into caregiving, retirement, life changes and health information

-          carrying reliable information on how alcohol affects seniors' health (benefits and risks)

-          having volunteer services (such as friendly visiting, telephone reassurance,) that can help the person deal with underlying problems of isolation

-          training specially trained volunteers who will feel comfortable helping older persons who have more complex needs

-          look at whether there are any internal barriers that make it less likely that some seniors will feel comfortable using their services or resources


Seniors can help friends by

-       recognizing alcohol problems can easily happen at any age

-       being supportive of and not condemning friends who have a problem

-       encouraging these friends to seek help

-       learning more about how alcohol problems develop

-       helping community resources understand older adults' needs better, and helping identify some of the barriers that can create  isolation for older adults


T

Taxis and bottle delivery services can help by

-         recognizing that some staff may try to take advantage of older customers, and having appropriate policies in place to avoid and deal with that potential problem


V

Veterans Affairs can help by

-         helping veterans and families link to appropriate community resources when alcohol use is a problem

 

 


 

 

This page was last updated October 1,  2002. Webmaster: cspencer@shaw.ca

 

 

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