I sat in on an office visit with an internist several years ago. I wanted to explore opportunities for helping primary care providers better identify patients with mental health and substance abuse concerns. His patient, in his mid-70s, indicated that he had two martinis every night. I asked him if he ever had more than two — he paused, laughed and said, “Sure, who doesn’t?”
Alcohol abuse is a growing problem for older adults. According to public health surveys, older adult alcohol-use disorders (the new name for alcohol abuse) are on the rise.
There may be a variety of causes for this increase. Adults are living longer with a range of health problems. Also, a bumper crop of baby boomers is reaching older adulthood, and there is a more-accepting attitude towards drinking in this cohort.
Retirement can be a huge transition, particularly for men, whose identities are often closely connected to their work. Furthermore, men may be more dependent on the structure that work provides. Having to be somewhere at 9 a.m. each workday may help adults stay on track.
Launched into retirement, men can feel lost, forgotten and disconnected from the world around them. “Happy hour” can start earlier and earlier in the day and last longer and longer. Alcohol use can start to tick up slowly over time. Older women are vulnerable, too.
Alcohol problems that may have simmered in the background during middle age, reined in by work, can start to boil over during older adulthood. A weekend problem can become an everyday concern.
While alcohol-use disorders are defined by having five or more drinks in a day for men and four drinks for women, older adults are more vulnerable to the effects of alcohol. Their aging bodies and brains have more difficulties processing alcohol. They can have sedative effects with fewer drinks. Already, older adults have a greater fall risk than middle-age adults. Balance and strength decline with age. Alcohol can contribute to falls that can be life threatening.
Alcohol-use disorders among older adults can be insidious and hard to recognize. Elders can become isolated and family members may live far away. It’s harder to see the impact of alcohol use when older adults have stopped working and are now spending a lot of time at home.
So what can you do to help aging relatives whose alcohol use is becoming a problem?
Don’t keep your observations to yourself. Mention your concerns to your older adult friend or family member. Let them know what you have observed and how it’s impacted you and others. Be kind, but be honest.
Ask them if they are concerned about their alcohol use. Many adults with an alcohol problem hope their friends and family will notice. But they also hope they won’t notice. Underlying the hope that others will notice is their growing recognition that their drinking has become a problem.
Focus on the impact it is having on them. Alcohol-use disorders aren’t going to effect a retired person’s work, but they can impact their relationships with their partner or adult children. It can impact their health. It also can make depression worse, since alcohol is a potent depressant.
Let your relative’s health care provider know what’s going on. Sending a note to your mother or father’s doctor alerting them to your concern can feel nervy, but it can let their doctor know that family is concerned. While they can’t talk to you about your parent without a release, you can communicate with them. Be prepared — the health care provider will likely let your Mom or Dad know that you communicated with them.
Go to an Al-Anon meeting. These can help you cope better with the experience of having a relative with an alcohol or substance abuse problem.
Dr. Paul Schoenfeld is director of The Everett Clinic’s Center for Behavioral Health. His blog can be found at www.everettclinic.com/family-talk-blog.