Older adult alcohol abuse, a growing problem
I sat in on an office visit with an internist several years ago. I wanted to explore opportunities for helping primary care providers better identify patients with mental health and substance abuse concerns. His patient, in his mid 70’s, indicated that he had two Martinis every night. I asked him if he ever had more than two—he paused, laughed and said, “Sure, who doesn’t?”
Alcohol abuse is a growing problem for older adults. According to public health surveys, older adult alcohol use disorders (the new name for alcohol abuse) are on the rise. There may be a variety of causes for this increase—adults are living longer with a wide range of health problems, there is a huge bumper crop of baby boomers entering older adulthood, this large group of over 65 adults is retiring, and there is a more accepting attitude towards drinking in this cohort.
Retirement can be a huge transition for older adults, particularly men, whose identities are often closely connected to their work. Furthermore, men may be more dependent on the structure that work provides. Having to be somewhere at 9 a.m. creates an external structure for the day and week that may help adults stay on track. Launched into retirement, men can feel lost, forgotten, and disconnected from the world around them. “Happy hour” can start earlier and earlier in the day and last longer and longer. Alcohol use can start to tick up, slowly over time. Older women are vulnerable too.
Alcohol problems that may have been simmering in the background during middle age, reined in by work, can start to boil over during older adulthood. A weekend problem can become an everyday concern.
While alcohol use disorders are defined by having five or more drinks in a day for men and four drinks for women, older adults are more vulnerable to the effects of alcohol. Their aging bodies and brains have more difficulties processing alcohol. They can have sedative effects with fewer drinks. Already older adults have a greater fall risk than middle-aged adults. Balance and strength decline with age. Alcohol can result in falls that can be life-threatening.
Alcohol use disorders among older adults can be insidious and hard to recognize. Elders can become isolated and family members may live far away. It’s harder to see the impact of alcohol use disorders when older adults aren’t working and spend a lot of time at home.
What can friends’ and family do to help their aging relatives whose alcohol use is starting to become a problem?
Don’t keep your observations to yourself.
Mention your concerns to your older adult friend or family member. Let them know what you have observed and how it’s impacted you and others. Be kind, but be honest.
Ask them if they are concerned about their alcohol use.
Many adults who have an alcohol problem hope that their friends and family will notice. But they also hope that they won’t notice. Underlying the hope that others will notice, is their growing recognition that their drinking has become a problem.
Focus on how it may be impacting them.
Alcohol use disorders aren’t going to effect a retired person’s work! But they can impact their relationships with their partner or adult children. It can impact their health. It also tends to lead towards worsening depression, since alcohol is a potent depressant.
Let your relative’s health care provider know what’s going on.
Sending a note to your mother or father’s doctor alerting them to your concern can feel nervy. But it can also let their doctor know that family is concerned. While they can’t talk to you about your parent without a release, you can communicate with them. Be prepared—your parent’s health care provider will likely let your Mom or Dad know that you communicated with them.
Go to an Al-Anon meeting.
These meetings can help you cope better with the experience of having a relative with an alcohol or substance abuse problem.