Six Common Community Misconceptions 

Around Seniors and Alcohol

1. It Doesn't Happen in Our Community.

On many occasions, people have said to me "But seniors don't have those problems, do they?" 

It is still quite common for physicians and nurses, staff in seniors housing, at seniors' centres, and for other service providers in some communities to state in no uncertain terms that alcohol problems don't occur among  "their seniors". Often there is an underlying message being expressed that

The reality is, it is very rare to find a community with seniors that does not experience alcohol problem to some degree. 

Part of the "it doesn't happen here" attitude may simply reflect the common stereotypes people have about who develops an alcohol problem in later life. It can easily be 

- the retired high school principal, 

- the retired miner or truck driver,  

- the widow with seven grandchildren, 

- or almost any other senior who currently consumes (or previously consumed) alcohol.

Alcohol problems in later life is an urban, suburban and rural problem.  Wealthy communities, poor communities and all the communities in between  who have seniors living there can have  older members who are struggling with alcohol  and other drug dependence problems. While the problem may be hidden, it is there, if you look.

One of the reasons that people may not recognize that some seniors in their community may be experiencing alcohol-related problems is that they are only considering situations where there is a chronic problem.  It is easy to overlook the earlier stages of alcohol problems. People may not recognize that many medications in combination with moderate alcohol use can also lead to problems for a senior or that moderate use can be come problematic use for some people, simply because the body changes as people grow older.

2. " Why Do Anything? It's Too Late in Life. Besides, It's Their Last Pleasure" or 

"You Can't Teach an Old Dog New Tricks".

When expressing the first statement, people may not understand the nature of alcohol problems in later life. Problematic alcohol use is not a pleasure for the individual, it is causing significant difficulties in the senior's life.

Alcohol is seriously interfering with the things that older adults often hold nearest and dearest-- 

• remaining as independent as possible; 

• feeling and being  part of the community; 

• remaining as mobile as possible; and 

• being able to think clearly and make their own decisions as long as possible.

The second statement is not only inaccurate, it is extremely ageist and condescending. 

In spite of the fact that an alcohol problem has been a long standing problem for a significant number of seniors, research indicates that seniors do as well if not better than younger persons when they receive appropriate support and assistance in their lives for the alcohol problem.  It is true that the longer that a problem goes unrecognized or ignored, the more likely an older person's physical, mental, and social health will deteriorate, reducing their chances to improve. Waiting for a senior to have a crisis or "hit rock bottom"  is often a death sentence.

3. The Alcohol Problem is Too Complex

It is easy to feel overwhelmed by the number of complex medical and social problems that seniors who have had long standing ("early onset") alcohol problems may be experiencing. This feeling of hopelessness is quite common among service providers in the community (and even addiction specialists who do not have significant experience working with older adults).  

Even in seniors who are  experiencing alcohol as a recent ("late onset") problem, conditions more common with growing older can complicate a person's personal  and social resources.  

That is one of the reasons why it  is so important to recognize the problem earlier and  to have resources to address the problem... before it develops into a long standing problem or before it reaches a crisis.

When there are many problems occurring simultaneously, people may see these and freeze, thinking "But where do I start?" The answer often is "start with what the older person is identifying as his or her most pressing problem". 

This is also one area where it is very helpful to take a team approach, drawing from the skills of several different people in the community, particularly if each of them has a common understanding of the goals. It is very easy for service providers to inadvertently undermine each other and sabotage a senior's recovery by not talking to each other, and by sticking with  inflexible rules or policies that do not meet the senior's needs. 

4. Seniors Won't .....

There are many generalizations made about seniors, and particularly in the area of seniors who are experiencing alcohol problems.  Here are two common ones-- that seniors don't like to talk about their feelings and that seniors don't like to use support groups.

The Generalization that ..."Seniors Don't Like to Talk About Their Feelings".

Reality is more complex.  Certainly, today's seniors have been raised in generations where people often did not openly express their feelings. However, when an older person is approached in a non-confrontational, caring, and trusting manner, and when the person is given sufficient time to talk, he or she often does let others know about those feelings.  Often these are being expressed for the first time in the person's life, and that can feel frightening and overwhelming.

At the same time, there will be some seniors who will not feel comfortable at all and prefer to not open up. 

If a particular  approach does not seem to be working in your practice or your community, ask yourself "Why?" Perhaps it is not the right approach (you  are going down the wrong road with this person).

Before you blame the seniors for what isn't working (often exemplified by that statement "seniors won't"), look carefully and ask "What could we be doing differently?"

The Generalization that "Seniors Don't Like to Use Support Groups".

The reality is that one of the proven methods of reaching and helping many older adults who are experiencing  alcohol problems is to offer them opportunities to meet and talk together with others of their own generation.  Many older adults have not had any experience with talking together in  a group setting. As a result, without support and genuine feeling of being welcome, the group setting can feel alien and threatening to many especially in the beginning. Establishing and maintaining an effective seniors' support group is often a slow process that takes special skills in knowing what appeals most to the persons and understanding group and gender dynamics among older adults.

We have learned that where service providers take the time and don't push, many seniors will consider support groups, especially those groups that take a broader approach to giving people the opportunity to discuss not only their alcohol problems but other important issues happening in their lives.  

The keystones to the successful groups is trust within the group and in the facilitator, confidentiality, support, and encouragement.

For both individual counselling and support groups, one size does not fit all. No one expectation, no one option, and no one resource will meet all seniors' needs.  People will differ in their receptivity to what is being offered. Part of this may reflect their personality, their physical and mental health, their needs, and where they are in terms of "the stages of change".

5. We Don't Have the Resources to Deal with the Problem Effectively.

This is a very common and very understandable response.  Many Canadian communities have been under considerable pressure in the last few years to "do more with less," or in some cases "to do everything with nothing."  

It is hard to plan and develop resources when you do not know whether the person you are planning with will be in that job tomorrow, or for that matter, if you will be in your position. However, be careful that this does not simply become a justification for not acting...

It is often helpful to: 

a. Assume there will continue to be change within the programs and systems.

b. Start some place, particularly by building your own knowledge around alcohol issues  and older adults, and the knowledge of the people you work with directly. 

c. Start with what you have.  Don't assume because you don't have something specifically for seniors, that you can't do anything.

d. Begin and continue to work on the attitudinal and systemic barriers that affect seniors' ability to access what is available  in your community. Often that does not take more resources, "just" joint action, more understanding of the problem, more understanding of seniors' needs, less stereotyping, and more consideration.  

e. Actively address the stigmatism in this area, particularly when it takes the form of seeing seniors with alcohol problems who reach crisis after crisis as "bed blockers".

6. We Have to Be the Experts on Addictions Before We Can Do Anything.

The reality is there are many components to helping, including reducing the factors that can lead to an alcohol problem developing or worsening in later life.

Recognizing an alcohol problem, knowing what to say to the person, and knowing how to support the person who is stop drinking or trying to the amount that he or she drinks are all important aspects that can be met by many different people in community. Addictions specialists have a special understanding of how addictions develop. Some have a good understanding of issues related to aging, but some others may not. Some service providers may have a good understanding of issues related to alcohol misuse and abuse, but others may not.

The community goal is for people to build up their knowledge as well as share their own expertises, so that seniors' needs are being met better in ways (and that usually means, in ways that make sense to them).

Helpful Resources:

(1998) Choosing to Change: A Client-Centred Approach to Alcohol and Medication Use by Older Adults. Toronto, Ontario: Addiction Research Foundation. Available through the Centre for Addiction and Mental Health.

www.camh.net/resources/counselling_resource_mat.html#Choosing%20to%20Change

This practical publication is written for non-addiction service providers who are in contact with older adults experiencing problems related to alcohol and/or psychoactive medications, and who are looking for ways to reach and help them. It gives concrete examples of "what do I say to the person", at different stages of change.

Page last updated April 9, 2002.

Contact Webmaster: cspencer@shaw.ca

This information has been developed by Seeking Solutions: Canadian Community Action on Seniors and Alcohol Issues, a national project funded under Health Canada's National Population Health Fund. © Charmaine Spencer, Gerontology Research Centre, Simon Fraser University, Vancouver, B.C. To put it simply, you are welcome to use this material as long as you cite the source and do not use it for commercial purposes.