CONTENTS

Table of Contents
Introduction

1. Overview
2. Alcohol
3. Prescription and Over-the-Counter Medications
4. Barriers to Recognizing Problems
5. Signs and Symptoms of Misuse
6. Talking About Sensitive Issues
7. Assessing a Problem
8. Preventing Misuse
9. Intervention and Treatment

Supplements
Resources

Alcohol, Medication and Older Adults
For Those Who Care About or Care for an Older Adult

Module Content Introduction Intervention Treatment Summary

Intervention

Intervention can be a discussion with a friend or family member about your concern for his or her health. It can be a call to the doctor of someone you care for to share what you observe. Sometimes talking might be enough. Other times, more may be needed.

Intervention can be a doctor tapering the dose for the drug causing the problem. It may be one or more short counseling sessions with the older adult to provide education on the problem and set goals for change.

The rule is to start with the least intensive options first. Treatment can be tailored to the needs of individuals.

Brief Interventions

A brief intervention is one or more counseling sessions, which may include:

• Educating on the effects of drinking or drugs
• Asking direct questions and giving feedback
• Establishing goals and a contract for a change in behavior

The goal of a brief intervention is to motivate the older adult to change problematic behavior. Personal goals can be flexible, allowing the older adult to choose between reducing use and stopping completely.

Trained clinicians, home health care workers, social workers, and professional counselors can conduct brief interventions. These interventions can be done in a doctor's office, clinic, hospital, or at home.

The following challenges are unique to older adults, making them particularly vulnerable to alcohol problems:

• Many older adults are ashamed about their drinking. Others may be unaware of the problems caused by alcohol. Therefore, interventions need to be nonconfrontational and supportive.
• Chronic medical conditions make it difficult to see how alcohol contributes to a decline in functioning and quality of life.
• Older adults are more sensitive to the effects of alcohol. Even small quantities of alcohol can be dangerous to their health and well-being.

Pretreatment Interventions

If brief interventions don't help, a pretreatment intervention may be needed. Several people who are significant in the older person's life speak to him or her. They confront the person with firsthand experiences of drinking or drug use.

Generally, a professional counselor meets with the family before the session to gather facts and emphasize the importance of remaining emotionally neutral. The goal of an intervention is to get individuals to recognize the effects of substance use on those they love.

Older adults present certain challenges with this method:

• Often the impact of the alcohol or drug misuse is difficult to detect.
• Denial is strong, particularly with prescription drugs originally prescribed for a legitimate medical condition.
• No more than two people should be present with the counselor, as it can be confusing and emotionally overwhelming for an older adult.