Older Adults: Addiction

1
Older Adults Addiction RecoveryA 6
Dimensional Perspective

• Presented by
• Peter Oesterreich M.A. LADC
• Director of treatment services
• Senior Recovery Center
• St Paul, MN
• .

2
Objectives

• Participants will understand the pervasiveness of
  substance misuse among people aged 55 and older
  and the need for specialized treatment programs
  to meet the increasing demands of older adult
  admissions.
• Participants will be able to distinguish the
  special characteristics of older adults physical,
  mental, social and health conditions and
  complications.
• Participants will be able to identify the
  increased need for non-clinical support services
  linking older adults to community based
  resources.
• Participants will understand age specific
  treatment approaches for older adults.

3
Introduction

• Some interesting facts
• The U.S. Census Bureau estimates that by 2025,
  approximately 35 percent of the nations
  population will be 50 or older.
• Currently in the U.S. there are roughly 8,000
  people turning 60 every day.
• Each year more than 3.5 million baby boomers
  turn 55.
• This year (2012) the number of Americans 50 and
  older will reach 100 million.

4
Introduction

• Some interesting facts, cont
• SAMHSAs Tip 26 Substance Abuse Among Older
  Adults states, As many as 17 of older adults
  struggle with alcohol and drug abuse issues.
• Walk into a nursing home and the number jumps to
  50.
• Hospitalizations for illness/injury have a 11
  chance of being alcohol or drug related.

5
Dimension 1Acute Intoxication and/or Withdrawal
Potential

• Special Characteristics of Older Adults
• For many older adults the process of withdrawal
  can be lengthier, more dangerous and difficult.
• As people age, their liver and kidneys metabolize
  and eliminate the substance more slowly which may
  require a longer detoxifying process.
• Concurrent health related problems.
• Older Adults are more likely to be taking
  prescribed medications that can complicate
  withdrawal.
• Length of use and reliance upon alcohol and drugs
  for coping.

6
Dimension 1Acute Intoxication and/or Withdrawal
Potential

• Treatment Approaches
• Key points to consider
• Establishing rapport and building trust with the
  older adult.
• Information, support and encouragement for the
  older adult.
• Assessment, particularly health and social
  situations.
• Education about withdrawal effects.
• Close monitoring during withdrawal.

7
Dimension 2Biomedical Conditions and
Complications

• Special Characteristics of Older Adults
• Increased sensitivity, lowered tolerance.
• Fall in ratio of body water to fat.
• Decreased blood flow to the liver.
• Inefficient liver enzymes.
• Altered responsiveness of the brain.
• Medication misuse or complications.
• Current or chronic conditions.

8
Dimension 2Biomedical Conditions and
Complications

• Special Characteristics of Older Adults
• Sensory deficits (hearing and sight).
• Physical Disabilities (reduced mobility).
• Same amount of alcohol can increase BAC.
• Medication management.
• Pain Management.

9
Dimension 2Biomedical Conditions and
Complications

• Treatment Approaches
• Key points to consider
• Education on the increased physical effects of
  substance use in older adults.
• Linking/Collaborating the older adult with
  necessary medical services.
• Pain Management Alternatives.
• Accommodate physical limitations/reduced
  mobility.
• Frequent Breaks.
• Provide wheelchairs.
• Provide Health and Wellness education for older
  adults.
• Ex. Pathways to Health and Wellness.

10
Dimension 3Mental Health (Emotional/Cognitive/B
ehavioral)

• Special Characteristics of Older Adults
• Grief, Loss, and Sadness Issues
• Loss of
• Spouse or significant other.
• Friends.
• Family members.
• Social Status.
• Occupation and sense of professional identity.
• Financial setbacks.
• Reduced income.
• Hope for the future.
• Ability to function.

11
Dimension 3Mental Health (Emotional/Cognitive/Beh
avioral

• Special Characteristics of Older Adults
• Outcomes of Grief Loss Issues
• Sense of being a nonperson.
• Social Isolation and Loneliness.
• Reduced self regard and self esteem.
• Family conflict and estrangement.
• Problems in managing leisure time/boredom.
• Loss of physical attractiveness (especially
  important for women).

12
Dimension 3Mental Health (Emotional/Cognitive/Beh
avioral

• Treatment Approaches
• Key points to consider
• Group Therapy.
• One to One counseling.
• Monitoring medication compliance.
• Administer Geriatric Depression Screening and
  make referrals as needed.
• Follow up with clients Mental Health
  Practitioners and Professionals, and
• appointments.
• Individualized and Group work assignments.
• Create opportunities onsite for chemical free
  social interactions.

13
Dimension 4Treatment Acceptance/Resistance

• Special Characteristics of Older Adults
• Motivators for Treatment
• Fear
• Physical Health/Falls.
• Financial Insecurity.
• Losing Independence.
• Family Pressure.

14
Dimension 4Treatment Acceptance/Resistance

• Special Characteristics of Older Adults
• Barriers to Treatment
• Stigma/Denial.
• Physical, Cognitive, and Economic
  instabilities.
• Difficulty asking for/receiving help.
• Lack of transportation.
• Lack of family support for motivation.
• Shame and Guilt.
• Lack of age appropriate treatment programs.

15
Dimension 4Treatment Acceptance/Resistance

• Treatment Approaches
• Key points to consider
• Provide education to address stigma.
• Disease Concept.
• Step One.
• Provide Transportation.
• Facilitate Funding/Scholarships.
• One to One Counseling.
• Group work/Peer Interaction.
• Additional Step work.

16
Dimension 4Treatment Acceptance/Resistance

• Treatment Approaches
• Key points to consider
• Provide materials in Large Print format.
• Speak loudly and clearly.
• Certain amount of repetition is necessary.
• Provide materials in multiple formats (CD,
  Cd-Rom, etc).
• May need assistance completing assignments.
• Building relationships Sober Network.
• Self Esteem building and Affirmation exercises.

17
Dimension 5 Relapse/Continued Use Potential

• Special Characteristics of Older Adults
• Medical Problems/Illness.
• Pain Management.
• Loneliness/Isolation.
• Grief Loss Issues.

18
Dimension 5 Relapse/Continued Use Potential

• Special Characteristics of Older Adults
• Financial Stress.
• Situational Depression/Anxiety.
• Interpersonal Conflict/Dysfunction.
• Unwillingness/Inability to engage with other
  people in recovery.

19
Dimension 5 Relapse/Continued Use Potential

• Treatment Approaches
• Key Points to consider
• Monitor cravings, urges, and AA meeting
  attendance.
• Continue to monitor Physician visits and
  medication compliance.
• Referrals for Pain Management.
• Relaxation and Stress management exercises.
• Enhancing relationships.
• Group work and referrals to grief and loss
  specialists.

20
Dimension 5 Relapse/Continued Use Potential

• Treatment Approaches
• Key points to consider
• Referral to community resources including
  financial assistance agencies.
• Referral to Mental Health professionals.
• Interpersonal skills building and conflict
  resolution exercises.
• Provide onsite AA meetings with required
  attendance.
• Provide onsite sober recreational/social
  activities

21
Dimension 6Recovery Environment

• Special Characteristics of Older Adults
• Living Environment.
• Inability to maintain residence.
• Assisted Living/Nursing Homes.
• Safety Concerns.
• Vulnerable Adult.
• Lack of Family and Friends.
• Lack of Sober Support Network.
• Transportation.
• Boredom.
• Isolation and Loneliness.
• Lack of Social Activities.

22
Dimension 6Recovery Environment

• Treatment Approaches
• Key points to consider
• Helping clients engage in structured and
  meaningful activities.
• Refer family members and loved ones to Alanon.
• Enlist the help of family members in creating a
  supportive recovery environment in the home.

23

• End

24

• Senior Recovery Program
• 200 East Plato Blvd.
• St. Paul, MN 55107
• 651-773-0473
• Because the Golden Years are Worth Recovering