Identifying Alcohol Problems Among Seniors
There are many different signs and symptoms of alcohol problems among seniors. These will vary with the person's gender, age, onset of the problem (early life, late life, binge drinker with long periods of sobriety), socio-economic status, and overall health.
The following have been identified by seniors' addictions agencies as ones they commonly highlight in their public education presentations. They stress the need to "Look, Listen, and Ask"
Indicators of alcohol problems among seniors fall into several overlapping spheres (Physical Health, Mental Functioning, Social Well-being, Environment etc).
Identifying an alcohol problem among older adults can be a very easy exercise in some instances, and quite challenging in others. No one indicator is "the sure sign" of a problem. It is more important to look at the clustering of the indicators.
Obviously, many of this indicators can reflect problems other than alcohol, which is why it is important to check it out further, but do not ignore the possibility that what you are observing could be related to alcohol.
Some of these indicators are incorrectly attributed to "normal aging", when they really reflect particular medical conditions that may be more common among older people than younger people.
Look at Health (and Changes in Health)
Is there evidence of...
- Difficulty walking, difficulty with balance
- Frequent or unexplained falls
- Bruises on arms and legs (at furniture level), burns
- Loss of weight, loss of appetite
Are there health problems that do not seem to be improving that could be related to the person's alcohol use (e.g. foot infection for an older person who has diabetes)?
Medical tests may indicate problems with liver function, enzymes.
If the senior goes into hospital for surgery, is he or she suddenly showing signs of alcohol withdrawal 2 or 3 days into the hospital stay?
Have there been frequent trips to emergency?
Is the person not showing up for appointments?
What does the senior say? Is the senior mentioning ...
- Lack of energy, lack of appetite, lack of interest
- Problems sleeping (or sleeping during the daytime)
- Stomach troubles
Look ...at Physical Appearance
Whether the alcohol problem will be apparent in a senior's physical appearance depends a lot on whether alcohol has been a longstanding problem or one that has developed more recently.
- Is the person neglecting him/herself (hygiene, environment)?
- Is there a smell of alcohol on the senior in early morning, is he or she shivering?
Look ...at the Social Environment
Does the senior avoid going out anymore?
Is the senior ...
- Drinking alone with increased frequency
- Becoming isolated
- Dropping favourite activities, turning down outings with family and friends
Or, does the person have drinking buddies?
Are friends/family expressing concerns? What are they noticing?
Look ... at Mental Functioning
Is the senior showing ...
- Difficulty talking and concentrating
- Confusion, loss of memory, feels depressed
- Signs of dementia- you may later find out that these are alcohol or medication related
- Changes in moods (become very aggressive-if previously very passive, very friendly), paranoia, forgetfulness
Look ... at Environment
Do you notice...
- Presence of bottles or many medicines (tranquilizers), though often these may be hidden.
At home, ...
- Does the senior have a "nest" (a favourite chair, ashtray, place where he or she likes to sit and drink)?
Look ... at the Drinking Pattern and Medication Use Pattern
Often a person may feel uncomfortable talking about his or her consumption, particularly if the person feels you are drawing conclusions about them as a person. Introduce the questions about alcohol into a place that works for them. If the questions seem to upset the person, place those questions in the broader context of sleeping, eating, and smoking habits.
- About things that are changing in the person's life- changes in their health, death of people who are important to them, anxiety about other events.
- About how much they are drinking.
- If they occasionally have a drink to help them go to sleep.
- Is the senior denying or minimizing of the use of alcohol, despite contrary evidence?
Do their responses match up with other physical or behavioural indicators, or what others have noticed?
Do not only look at the quantity and frequency of the drinking, but also (most importantly) the impact that the alcohol is having on their life. In other words, it is the effect, not the quantity of the alcohol that is the relevant consideration for seniors.
Other possible indicators of a problem looming...
- Is the person drinking earlier in the day?
- Does the senior start to panic when his or her stock of medicines gets low?
Look ... at the Reasons that the Senior Drinks
Is the senior using alcohol
- As self medication- is alcohol being used to self medicate to deal with physical pain, emotional pain.
- To calm nerves, to help sleep, forget worries or losses.
- Because of loneliness or nothing else to do.
Look... at the Other Parts of the Person's Life
Does the senior frequently complain about a lack of money?
Has there been a
- Deterioration in house keeping habits
- Personal grooming
(1998). Choosing to Change: A Client-Centred Approach to Alcohol and Medication Use by Older Adults. Toronto, Ontario: Addiction Research Foundation. (Now Centre for Addiction and Mental Health)
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