Don't make assumptions about substance abuse in elderly
The symptoms of alcoholism and substance abuse in elderly patients can be mistaken for the natural symptoms of aging, says Eileen McKee, executive director of Toronto's Community Older Persons Alcohol Program.
Confusion, depression, memory loss and loss of interest in activities not only may be signs of aging but also symptoms of abuse. "Don't make assumptions," said McKee, who warned that misdiagnosis can also happen the other way. Don't assume a patient is an alcoholic just because there's alcohol on his breath.
McKee said these patients will not present the normal red flags of addiction: changes in employment, absenteeism or withdrawal from society. "Be suspicious about what you are seeing," she said. "Having gone through the Depression, the elderly are usually very skilled in saving money, so financial problems provide a good clue."
The most important aspect of treatment is reaching out to these patients. "If you wait for them to admit they have a problem, they will die," she warned. "Work to help them see that there is a problem. Raise their awareness of the implications and consequences of their drinking."
McKee warned of myths that makes intervention difficult. One is that the elderly don't do well in treatment. Change happens slowly, she said, but about 70% of patients can be helped to improve the quality of their lives.
McKee also challenged the myth that "seniors don't have many pleasures, so let them drink. That really says a lot about what we consider quality of life. It is important to address this and bring other pleasures into their life -- like helping them join a social club or getting them involved in volunteer activities."