At Any Age, It Does Matter:
Substance Abuse and Older Adults
(for Professionals)
Promising Prevention Programs for Older Adults
Healthy Aging Program
The Healthy Aging Program integrates substance abuse and alcohol education and prevention, screening, and referral into its overall programs. Programs include clinical screening, disease prevention, health promotion and education, and referral to treatment and followup. The program serves older adults who attend senior centers, live in senior housing, or are referred.
The program encourages participants to recognize unhealthy behaviors and adopt healthier lifestyles. Program participants attend weekly classes that address lifestyle factors such as diet and medication. The program teaches English and life skills for older persons who immigrated late in life. The goal is to help them avoid the problems that can result from isolation.
A key to program success is the education and empowerment of older adult clients. Cultural competence is also critical. The program serves not only the primarily Scandinavian long-term population but also the growing numbers of older adults who have emigrated from Russia, Bosnia, Vietnam, and elsewhere.
Contact: Carolyn Scharffenberg, Program Manager
Salt Lake County Aging Program
2001 South State, #S-1500
Salt Lake City, UT 84190-2300
(801) 468-2473, fax (801) 468-2679, E-mail cscharffenberg@co.slc.ut.us
Health Enhancement Program
The Health Enhancement Program helps older people recognize health improvement opportunities, adopt healthy behaviors, and minimize unhealthy behaviors. The program is highly client centered and client driven and produces documented results. It is one of three complementary programs that make up the senior wellness program. The others address exercise and chronic disease self-management.
The Health Enhancement Program is designed to prevent functional limitations and reduce unnecessary or inappropriate health care use. Keys to program success include:
- Significant partnerships with universities and the health care community
- The ability to connect programs and resources within one organization
- The range of offerings
- The use of trained volunteers
Contact: Susan Snyder, Director, Senior Wellness Project
Senior Services of Seattle/King County
1601 Second Avenue, Suite 800
Seattle, WA 98101
(206) 727-6297, fax (206) 448-5766, www.seniorservices.org
Little Havana Health Program
Little Havana offers mental health services tailored to the specific needs of older adults identified through a comprehensive health and social assessment. The assessment includes targeted questions for mental health screening. It is conducted with participants in the nutrition program, senior centers, and other agency services.
Keys to program success include:
- Cultural competence and sensitivity
- Transportation for all who need it
- A comprehensive assessment for all clients
- An integrated array of services
Contact: Ariela Rodriguez, Ph.D., L.C.S.W.
Director, Health and Social Services
Little Havana Activities and Nutrition Centers of Dade County, Inc.
700 S.W. 8th Street
Miami, FL 33130
(305) 858-0887, ext. 238, fax (305) 854-2226
Gatekeeper
Gatekeeper is a communitywide system of proactive case finding to identify high-risk older adults. The target population includes persons experiencing:
- A serious and persistent mental illness
- Emotional or behavioral problems
- Poor health
- Substance abuse problems
- Abuse or neglect
- An insufficient support system or social network
Gatekeepers are nontraditional referral sources trained to identify high-risk older adults. Gatekeepers include postal workers, meter readers, bank tellers, pharmacists, and others who come into contact with older adults through their work activities. After a referral is made, a multidisciplinary team conducts a comprehensive assessment and develops a service plan.
Contact: Julie E. Jensen, Ph.D.
Washington Institute, Western Branch
9601 Steilacoom Boulevard, S.W.
Tacoma, WA 98498-7213
(253) 756-3988, fax (253) 756-3987, E-mail jjensen@u.washington.edu
PATCH
Psychogeriatric Assessment and Treatment/Teaching in City Housing (PATCH) serves older adults living in high-rise public housing sites throughout Baltimore. It combines elements of the gatekeeper model and the mobile treatment model. Mobile treatment brings treatment to older persons at places that are convenient for them.
Staff working in congregate public housing are trained as case finders. They refer individuals they are concerned about to a nurse who visits each site weekly. An assessment is conducted and an individualized treatment plan is developed. PATCH focuses on assessments, psychotherapy and medications, and "connecting services," such as transportation to medical appointments.
PATCH involvement ends when a system to provide needed resources is in place. The program has succeeded because of the trusting and supportive relationship the nurse has built with residents.
Contact: Peter V. Rabins, M.D., M.P.H.
Johns Hopkins Hospital
Meyer 279, 600 North Wolfe Street
Baltimore, MD 21287-7279
(410) 955-6736, fax (410) 614-1094, E-mail pvrabins@jhmi.edu
Geriatric Regional Assessment Team
An interdisciplinary mental health team, including a nurse, geriatric mental health specialists, and a psychiatrist, provide the following services:
- Assessment
- Crisis intervention and stabilization
- Referral and linkage to providers
- Consultation
- Guardianship evaluations
- Care planning
- Education for professionals, families, and other care providers
Keys to success include:
- Free services
- Flexibility
- Experienced clinicians
- Quick response to those making referrals
- Creative approach to initial encounters
Contact: Karen Kent, Clinical Supervisor
Geriatric Regional Assessment Team
Evergreen Healthcare
5701 Sixth Avenue, South, Suite 502
Seattle, WA 98108
(206) 215-2850, fax (206) 215-2890, E-mail kkent@evergreenhealthcare.org
Kit Clark Senior Services
Kit Clark Senior Services offers outpatient treatment programs for older adults with addictions or mental illness. The Kit Clark programs are part of a continuum of services. Most clients come in for individual or group sessions and to socialize in the senior center, have a meal, and receive other services. Kit Clark strives to offer a community that accepts and values its participants while helping them decrease social isolation and loneliness.
Each senior is offered a comprehensive health and social needs assessment. During initial intake, a complete social and health history is taken. Clients undergo screenings for mental status, gambling addiction, and substance abuse. If a problem is detected, a more detailed assessment is completed.
Kit Clark mental health and addictions programs provide individual and group therapy, outreach, and psychoeducation. These services are also provided through home visits for persons who cannot come to the center. Self-help recovery groups meet regularly at the Kit Clark senior center. Its primary key to success is its comprehensive service program.
Contact: Anita Shipman
Kit Clark Senior Services
1500 Dorchester Avenue
Dorchester, MA 02122
(617) 288-5991, E-mail Ashipman@fdnh.org
Over 60 Health Center
This community health center integrates mental health and substance abuse services with primary health care. It also provides referrals to community mental health and substance abuse services. Through an interdisciplinary team approach, Over 60 Health Center sites offer "one-stop shopping" for a full range of services. These include health promotion, disease prevention, screening, diagnosis, and treatment.
Over 60 offers assessments, individual and group counseling, medication management, Alzheimer's disease diagnoses, and behavioral health services. Over 60 uses a consumer-directed approach to mental health services, which is reflected in:
- Age-specific treatment
- A focus on coping with depression by addressing loneliness and loss
- A focus on family and caregiver involvement
- Treatment in a manner and at a pace that is comfortable for older adults
- Emphasis on staff training
- A strong emphasis on working with other community-based services for older adults
Keys to success include status as a Federally Qualified Health Center. The sponsor, Lifelong Medical Care, is a community health service charged to provide a range of services in a medically underserved area. Another key is consumer direction. Consumers make up the majority of the board of directors. A third key is cultural competence.
Contact: Marty Lynch, Ph.D.
Lifelong Medical Care
P.O. Box 11247
Berkeley, CA 94712-2247
(510) 704-6010, ext. 261, fax (510) 883-1667, E-mail martyl@lifelongmedical.org, www.lifelongmedical.org
Elder Substance Abuse Outreach Program
The Elder Substance Abuse Outreach Program began as a cooperative project between Hawthorn Services and Brattleboro Retreat, an inpatient substance abuse treatment agency. It offers a community-based approach to substance abuse treatment for older adults. The program:
- Identifies older adults at risk
- Uses an experienced clinician to initiate contact with older adults in their own homes
- Offers the support of weekly therapy and peer support group meetings
Program components include outreach, counseling, group counseling, socialization, peer support, and education.
An element that program staff have deemed important is that the program does not insist on sobriety as a requirement for participation. Some reduction in drinking and some improvements in self-management are acceptable for continued involvement.
The staff's holistic approach to clients has been an effective philosophy. Staff believe that one must really have a different approach for older adults. The approach the program uses allows outreach workers to establish rapport and learn about the person's whole life and circumstances before attempting to deal with substance problems.
Contact: Jim Callahan or Maureen Perreault
Hawthorn Services, Inc.
93 Main Street
Chicopee, MA 01020
(413) 592-5199, fax (413) 594-8693, E-mail hawthorn99@aol.com
Center for Older Adults and Their Families
The Center for Older Adults and Their Families provides comprehensive geriatric mental health services for people age 55 and older and their families. The Center uses a family-centered approach and emphasizes cultural competence. Program components include:
- An elder outreach team conducting home visits for assessment and engagement
- A clinic program offering assessment, evaluation, therapy, and case management
- A day treatment program with all clinical services plus activities in a therapeutic milieu
- Psychiatric consultation for the Gouverneur Nursing Facility
Comprehensive mental health and substance abuse assessments are conducted. Based on the assessments, treatment plans are developed. Referrals are made when the Center cannot handle a particular problem. Although the Center has no licensed substance abuse treatment program, it often continues to support patients with such problems by including them in recovery and support groups.
Keys to success include:
- Cultural competence and multicultural organizational development
- Consumer empowerment
- Community education and outreach
- Use of natural settings
Contact: Gouverneur Department of Behavioral Health
Center for Older Adults and Their Families
Edgar Velasquez, MD
227 Madison Street, #397
New York, NY 10002
(212) 238-7384, fax (212) 238-7399
Older Adult Outreach and Education Service
The Older Adult Outreach and Education Service provides inpatient and outpatient substance abuse and mental health treatment, counseling, and outreach. Its collaborating agencies are its sponsor, Chelsea Community Hospital, the University of Michigan Turner Geriatric Clinic, and Neighborhood Senior Services.
The program trains its partners and providers of services for older adults to recognize potential substance abuse and mental health problems among persons they serve. Outreach services are provided to individuals who are unable or unwilling to accept a referral to substance abuse or mental health services.
Outreach is the key to serving older adults. It is essential to reach older individuals who are resistant to recognizing a problem. Other keys to success are the linkages to partners and the availability of community resources.
Contact: Jeff Smith
Older Adult Outreach and Education Service
Chelsea Community Hospital
955 West Eisenhower Circle, Suite H
Ann Arbor, MI 48103
(734) 665-5070, fax (734) 665-6487, E-mail jsmith@cch.org
Adair Elder Care
This adult day health program addresses substance abuse and mental health needs of older adults. The center provides counseling and support groups and makes sure that appointments are kept.
An interdisciplinary team conducts an assessment and develops a plan. The team includes a nurse, a social worker, a recreation therapist, certified nursing assistants, master's students, and a psychiatrist if needed. In addition, the client or a client's representative participates fully in developing and implementing the care plan. Adair's services include assistance with daily activities, nursing services, stimulating and therapeutic activities, personal care, advocacy services, and meals.
Keys to success include:
- Public support
- Active efforts to keep the program in the public eye
- Commitment on the part of local elected officials
Contact: Dr. Lynda Wilkerson
Adair Elder Care
127 N. Reed Street
Columbia, KY 42728
(270) 384-5351, fax (270) 384-6971
Alcohol and Drug Services Prevention for the Elderly
The Alcohol and Drug Services program uses an integrated program of interagency cooperation and collaboration. The goals are to raise public awareness, educate professionals, and conduct prevention and outreach programs. Activities include:
- Community networking to identify older adults who may need substance abuse and mental health treatment
- Case consultations by phone, on staffing teams, and in person
- Prevention and outreach, such as home visits and home calls
- Education and Training, including:
-
- A Wellness Discussion Series for Seniors
- Training for human service professionals
- Booths/exhibits at senior fairs and the county fair
- Distribution of public information materials
- Sponsorship of a substance abuse awareness campaign involving as many as 15 to 20 workshops a month
- Promotion of Older Americans Month in May to build public awareness
Keys to success include a responsive local government and agencies that are committed and open to collaboration. The team demonstrates cultural competence by working with members of different groups. For example, they collaborate with the Korean Community Center and with the Center for Multi-Cultural Services, a nonprofit organization through which interpreters can be contracted.
Contact: Margaret Kollay
Alcohol and Drug Services Prevention for the Elderly
County of Fairfax
3900 Jermantown Road, Suite 200
Fairfax, VA 22030-4013
(703) 934-8772, fax (703) 934-8742, www.co.fairfax.va.us/service/csb/ads/adsmain.htm
Elders Wrap-Around Team
The Elders Wrap-Around Team is a coordinated effort that develops individualized services and support. Because of the complex needs of older adults, many clients are involved with several community agencies. Coordination of services prevents redundancies and service gaps.
A wrap-around intervention is developed and approved by an interdisciplinary team. The intervention is centered on the strengths, needs, and desires of the older person and family. Services include education, training, screening, and treatment.
A core group of representatives of 12 agencies meets each month to review specific cases and discuss community issues. Professionals from another 40 agencies are invited, as well as consumers and families. Other efforts include family education and support and community educational programs for older adults and agency staff.
Keys to success are the willingness of all agencies and representatives to abide by two rules:
- Always act in the best interest of the client.
- Leave turf issues behind.
Contact: Jeanne Duford, Elders Community Coordinator
Riverbend Community Mental Health
P.O. Box 2032
Concord, NH 03302-2032
(603) 228-2101, fax (603) 228-2100, E-mail jduford@riverbendcmhc.org, www.riverbendcmhc.org/
Mental Health and Aging Coalition
This regional mental health and aging coalition offers cross-training in the fields of aging, mental health, and substance abuse. The region covered by the program includes multiple counties in Ohio, Kentucky, and Indiana. The coalition's mission is to promote education, advocacy, and access to behavioral health services. It also provides support services for older adults, their families, and caregivers.
A major project of the coalition is ElderReach, which conducts four kinds of presentations for four types of audiences:
- Cross-training for professionals
- Public education for staff of other organizations or groups that might be in contact with individuals in need
- Presentations to elected officials to secure ongoing support
- Presentations to other networks—such as the Inclusion Network, which represents those who serve older persons with disabilities—to advocate integrating the networks.
Keys to success include cultural competency. Service providers recognize the increasing numbers of immigrating individuals who are African, Asian, Russian, and Hispanic. The challenge now is to address the specific cultural needs as well as language barriers. Staff capacity in other languages is not readily available. However, translation is provided for several languages through the assistance of the Jewish Community Center and Travelers' Aid.
Contact: Jessie Thomas, Program Specialist
Hamilton County Community Mental Health Board
801 A W. 8th Street, Suite 500
Cincinnati, OH 45203
(513) 621-3045, fax (513) 632-7160, E-mail jessiet@hamilton.mh.state.oh.us
Barbara Gunn, Executive Director
Senior Services of Northern Kentucky
1032 Madison Avenue
Covington, KY 41011
(606) 491-0522, fax (606) 491-4590, E-mail bgunn@fuse.net
Marietta Cappelletti, Project Director
ElderReach
5837 Hamilton Avenue
Cincinnati, OH 45224
(513) 541-7577, fax (513) 541-5895, E-mail cappellettim@corebhc.org
Texas Interagency Seniors and Substance Abuse Workgroup
This State-level interagency workgroup develops plans for integrated delivery of aging, mental health, and substance abuse services. The workgroup collaborates to raise awareness and promote a statewide integrated service delivery approach. It includes staff from all State health and human service agencies as well as advocacy groups and providers.
The workgroup was established to address:
- A lack of awareness of the substance abuse problems of older adults
- A lack of information and educational opportunities for service providers
- A need for special programs for older adults
Objectives include shared policy and process guidelines, public education and awareness activities, education and information on available services, and expansion of treatment options. This involves:
- Designing and promoting an interagency continuum of care
- Researching best practices to identify model programs
- Providing training and technical assistance to providers of other services to encourage additional prevention, intervention, and treatment options
Staff commitment and agency awareness and support are essential. One of the biggest lessons learned is that committed staff can do a lot to educate and raise awareness, but program funding is essential to accomplish real and lasting systemic change.
Contact: Galen Brewer
Coordinator of Older Adult Services
Texas Department of Mental Health and Mental Retardation
P.O. Box 12668
Austin, TX 78711-2668
(512) 206-4854, fax (512) 206-4784, E-mail galenbrewer@mhmr.state.tx.us
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Last Updated: 07-03-2002
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