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Alcoholism and Aging
A New Growing Problem
by Rabbi Joel Dinnerstein
Rabbi Joel Dinnerstein, MSW, MS, NCAC is
Founder and Director of Ohr Ki Tov’s Jewish Alcoholism and
Addiction Counseling Center. An expert Pastoral Counselor and
Clinical Social Worker, Rabbi Dinnerstein in the first Rabbi in
the United States to become a Certified Addiction Counselor.
According to recent studies, the number of
people above the age of 85 has risen 38% since 1990 and will
probably grow another 50% by the year 2010, making it the
fastest growing demographic group in the nation.
The century of the frail elderly seems to be upon us. Now, add
alcohol and drugs, and America has a major new health crisis on
its hands.
Unfortunately, the issue of aging and alcoholism is often
under-recognized, misdiagnosed, and poorly treated. However, it
is estimated that as many as 15 percent of those age 65 and
older suffer from alcoholism or alcohol abuse. In addition,
approximately 70 percent of all hospitalized senior citizens and
up to 50 percent of nursing home residents suffer from alcohol
related impairment. This is rapidly become a life-threatening
epidemic for America’s graying population.
In the course of time, normal social drinkers can easily become
problem drinkers. As people age, their body’s metabolism
changes, and they are not able to process alcohol as efficiently
as they once did. The same amount of alcohol consumed with
little effect at an earlier age can create faster and more
frequent intoxication later in life. The longer the drinking
goes on, the more likely a person is to develop alcohol
dependence.
Older people can usually hide their alcohol abuse
more successfully than their younger counterparts because they
tend to have fewer regular routines and less social
interaction. Since they are often retired and living alone,
they are not seen daily by employers, co-workers, family
members, or friends. Consequently, there is no one to observe
their normal pattern of behavior or their deviation from it.
Nevertheless, there are warning signs, and
anyone who has contact with the elderly should be aware of what
they are. These signs, especially when present in a cluster,
include: withdrawal from friends and relatives; loss of interest
in hobbies; bruises, bumps, and scars from falls; difficulty
with shopping, housekeeping, and other activities of daily
living; erratic behavior and mood swings often characterized by
aggression, irritability, anxiety, and depression.
The problem with these symptoms, however,
is that they can easily be attributed to other physical or
psychological conditions, or simply to the natural process of
aging itself. Therefore, they should be viewed as a potential
warning, to be followed by further observation and, if
necessary, professional intervention.
People who have been drinking socially or
abusively for much of their lives are considered early-onset
alcoholics and account for approximately two-thirds of the
elderly alcoholic population. The other group, referred to as
late-onset drinkers, consists of individuals who begin drinking
later in life, often in response to a stressful situation, such
as a decrease in income or status, the deterioration of health,
or the loss of a loved one.
Initially, alcohol may have been used in
order to ease the pain. Drinking is often turned to as a means
of self-medication, but it can gradually accelerate, spinning
out of control when a crisis occurs. And the road back is not
an easy one. As an old timer in A.A. was fond of saying, “Once
you’re a pickle, you’ll never be a cucumber again.”
In general, alcohol impairs judgment,
alters mood, slows down alertness and brain
activity, causes both long-term and short-term memory loss, and
reduces physical coordination. These are symptoms which, in an
older person, can mimic the early stages of dementia or
Alzheimer’s Disease. When taken with prescription medication or
over-the-counter drugs, alcohol can produce even more severe
side effects.
Excessive drinking can also lead to medical
conditions that are extremely debilitating and potentially life
threatening, especially to those with a compromised immune
system. Some of these disorders are gastrointestinal bleeding,
cardiac arrhythmia, urinary incontinence, cirrhosis of the
liver, and high blood pressure which does not respond to
medication.
Enabling is the word used to describe those
who, knowingly or unknowingly, help the alcoholic to continue
drinking. An adult son or daughter or a caring home attendant
who purchases alcoholic beverages for an older person may think
that he or she is simply performing an act of kindness, but may,
in reality, be facilitating a self-destructive behavior.
Denial, shame, and guilt are the hallmark
of alcoholics in every age group but these responses become even
more pronounced among seniors. Reluctant to admit the problem
to others, and, often, even to themselves, the elderly are the
population least likely to seek help. Therefore, everyone
involved in the life of an elderly person must learn to
recognize the warning signs of substance abuse. All caregivers
and gatekeepers need to know what they are looking at and where
to get the proper assistance.
Different professionals will, of course,
view the situation through different lenses. Physicians will
identify the medical factors; psychologists and social workers
may perceive age-related adjustment issues; clergy might see
distress in the spiritual dimension. In most cases, however, a
trained addiction counselor is essential to the healing process.
Treatment is available, and the good news
is that treatment works.
You can find the help you are seeking at Ohr Ki
Tov’s Jewish Alcoholism and Addiction Counseling Service at
954-480-6230 or at
www.ohr-ki-tov.org or
www.rebyankel.com.
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