Projected Population Growth

Transcription

1

2 Objectives Learn recommended drinking guidelines for older adults Identify physical changes in older adults that affect alcohol tolerance Recognize signs and symptoms and risk factors of alcohol misuse in older adults Learn potential dangers of alcohol and medication interactions in older adults Identify barriers to detection and treatment of substance abuse in older adults Obtain Resources on substance abuse in older adults

3 Projected Population Growth Currently 35 million over 65 12% of U.S. population By million over 65 20% of U.S. population One million Americans reach 60 each month. (AARP)

4 Responsible Drinking The National Institute on Alcohol Abuse and Alcoholism (NIAAA) Recommended Drinking Guidelines for Older Adults over 65 yoa: No more than 7 drinks per week (one drink per day) Maximum of 2 drinks on special occasions Somewhat lower limits for women

5 5

6 Drink Demonstration What is a Standard Drink?

7

8 Changes in Aging Body Which Increase Effects of Alcohol Older adults have higher body fat, less body water. Lower total body water results in a smaller fluid volume for alcohol to distribute into. Decreased metabolism by liver. Older adults get higher BAC levels than younger adults after consuming the same amount of alcohol. 8

9 Changes in The Brain Aging results in changes in the brain resulting in a decreased ability to compensate for the effects of alcohol. Older adults are more susceptible to sedation and impairment when consuming alcohol. Combining sedative medications with alcohol can result in excessive sedation, impaired motor skills and increased risk of injury. 9

10 23% of men aged years of age admitted to binge drinking (4 or more drinks on 1 occasion); 9% of women reported binge drinking (3 or more drinks on 1 occasion). Duke University Medical Center study Alcohol and medication misuse among older adults is one of the fastest growing health problems facing our country. Almost 1 in 5 older adults misuse alcohol and medications.

11 Why are Older Adults at Risk to Abuse Substances and/or Medications? -Bio -Genetic -Psychological -Social -Multiple Medications -Uncoordinated Care 11

12 Risk Factors -Functional Limitations/Declining Health -Physical Pain -Depression/Low Self Esteem -Feeling Like a Burden -Changes in Living Situation -History of Substance Abuse -Co-occurring Psychiatric Disorders -Decreased Social Support/Isolation/Living Alone -Care Giving Role -Living in a Health Care Setting (Blow, 2004)

13 Who Becomes an Older Adult Alcoholic -Early Onset - 2/3 of older alcoholics have been chronic abusers who have used alcohol heavily throughout their life. -Late Onset - 1/3 of older alcoholics begin excessive drinking late in life response to situational factors, life changing events. 13

14 Life Changing Events Addiction experts estimate 15% of Americans over 65 will develop an alcohol problem when they retire or their partner dies. 14

15 Widowers over age 75 have the highest rate of alcoholism in the country. 15

16 Alcohol Suicide Correlation After age 65, drinkers are 16 times more likely to commit suicide. 16

17 Signs & Symptoms of Alcohol Abuse in Older Adults -Loss of interest in activities -Change in sleep pattern -Abrupt changes in mood -Decline in grooming, housekeeping, routine chores, and eating habits -Unsteady gait -Declining health -Trembling hands -Increased accidents

18 Signs & Symptoms of Alcohol Abuse in Older Adults -Smoke burns on clothing and furniture -Increased use of medicine, tobacco, or alcohol -Slurred speech -Isolating from family -Smell of alcohol on breath -Memory loss or confusion (not dementia)

19 Adverse Consequences for Older Adults Adverse Drug Events Falls Fires Automobile accidents Death 19

20 Mixing Alcohol with Drugs + = Potential Danger! 20

21 Alcohol-Medication Interactions in Older Adults 19% of those taking alcoholinteracting drugs reported alcohol use 60% of older adults referred for prescription drug abuse showed evidence of alcohol use 77% of older adult prescription drug users were exposed to alcoholinteracting drugs (Dr. Patricia Slattum, VCU School of Pharmacy)

22 If We Mix Alcohol with Medications: Medications can lose effectiveness Most have no effect whatsoever Medications can turn deadly 22

23 Meds Interacting w/ EtOH to Cause Dizziness/Fainting/Falls, Cognitive Impairment Nausea: Pain: Allergies/Cold/Flu: Angina: Anxiety/depression: BPH: Cough: Diabetes: Heartburn: Herbs: Hypertension: Muscle pain: Sleeping pills: Claritin Nitroglycerin Paxil Prozac Flomax Robitussin Cough Glucophage Zantac Kava Kava Minipress Soma Dramamine Vicodin Ambien Harmful interactions: Mixing alcohol with Medicines Pamphlet 23

24 Fatal Vision Goggle Demo Goggles and pill vial Indicates how alcohol can affect older adult taking medications.

25 Over the Counter Pain Meds Liver damage Alcohol worsens acetaminophen (Tylenol ) effect Abstain from EtOH while taking Tylenol Alcohol and stomach bleeds Aspirin Ibuprofen (Advil, Motrin ) The Merck Manual of Geriatrics, 3 rd ed. Updated online 25

26 Lack of Diagnosis Studies consistently find older adults are less likely to receive a primary diagnosis of alcoholism than younger adults Alcoholism is consistently under diagnosed and underreported by health care providers, especially in elderly female patients 26

27 Barriers to Older Adults Seeking Treatment May deny they have a substance abuse problem May rationalize they are old and let them enjoy life May not seek help for fear of losing independence May mistrust or resist services If caregiver abusing substances, older adult may deny for fear of retribution or abandonment 27

28 SA Difficult to Detect and Treat in Older Adults Symptoms/adverse events mistaken as part of normal aging or other health problems Stigma-not an attractive issue Family/others ignore or enable Lack age specific programs Overall health complications Co-occurring disorders Transportation Support systems lacking Shortage of professionals with specific training to work with older adults

29 An Individualized Approach Volunteers should use an individualized approach to alcohol use in older adults, and if welcomed, help these individuals establish, as appropriate, safe drinking habits that will augment health and quality of life. 29

30 Be Objective Important to be objective about alcohol use. Avoid making judgments based on personal beliefs. Being objective means Observing and reporting the facts NOT our opinion 30

31 The Role of Volunteer Be aware of client s alcohol and medication intake Assist with education regarding alcohol and medication misuse Observe/report signs and symptoms of adverse reactions to alcohol use and medications Stay up-to-date on alcohol and medication misuse by reading available resources Watch, listen, talk, and report to supervisor. 31

32 Motivational Interviewing Non confrontational Deemphasizes labels such as alcoholic Emphasizes personal choice/responsibility Focuses on client s concerns Uses reflection to meet resistance 32

33 Resources Available AAAG Website AAAG Resource List Best Is Yet to Come brochure referral sources 211 & SeniorNavigator

34 AAAG Web Based Training Partnership with Virginia Association of Community Service Boards 3 web based training sessions launched May 2010 Complimentary Pre/post tests, videos, and power points CEUs and Contact Hour certificate available

35 Screening Tools Used to Identify Problem Several brief practical screening tools available to help diagnose substance abuse problems including: 4 question CAGE 24 MAST-G (Michigan Alcoholism Screening Tool Geriatric version) Audit 35

36 Get Connected Toolkit SAMHSA developed with NCOA and U.S. Administration on Aging OlderAdultsTAC/docs/Get_Connected_ ASA_NCOA_% FINAL.pdf can be pre-ordered by contacting SAMHSA s Health Information Network at SAMHSA-7 and referencing GCKIT. Get Connected Tool Kit information is available for download

37 Sample Resource Matrix Area of Expertise Name of Organization Contact Person and Phone How to Request Assistance What the Organization Can Provide Medication Outpatient addiction treatment Geriatric medicine Social work Chemical dependency Mental health issues Support groups Health education Training

38 For additional information, contact: Regina Whitsett VA ABC Education Coordinator and AAAG Chair

39 Here we come, ready or not! Boomer 39