Drug or Alcohol Intervention for Your Elderly Loved Ones
When it comes to our parents or older adults in our family, we often have blinders on. On the one hand, we tend to think of our parents as having their act together. After all, they raised us and have years of accumulated wisdom. But we may also be preoccupied with our own lives and unable to recognize signs of drug or alcohol abuse that may be going on with them.
What are some of the signs that we should be on the lookout for? How do we know when and if an intervention for our elderly loved ones is appropriate or necessary? Let’s look at this issue in a little more detail.
We already know that our parents have a keen sense of privacy. They’re also pretty adept at keeping things secret that they don’t want others to know about, including us. It should come as no surprise, then, that our parents may cloak their growing abuse of alcohol and drugs, including prescription drugs and maintain an outward demeanor that everything is just fine.
Should there be slight glimmers of misuse of various substances, often our parents will cleverly cover it up by saying they’ve just got a bug or engaged in a little too much celebration. No big thing, they may say. There’s nothing for you to worry about.
That’s just about the time when your radar should sense that there might be more to the situation than your parents are letting on.
It isn’t that your parents want to lie to you, at least, not in most cases. But if they’ve become dependent upon drugs or alcohol, or any combination thereof, they may not be able to help themselves. Telling a falsehood becomes necessary in order for them to be able to continue their surreptitious consumption of drugs and/or alcohol undetected.
So, while we can forgive them their outright lies, this doesn’t mean that we should allow the situation to continue.
But how do we know if there really is a problem? Maybe it is true that they’re only drinking now and then, or took prescription medication in conjunction with alcohol only once. On the other hand, the problem may already be quite severe. In fact, only about 37 percent of substance abuse cases are recognized in people over the age of 60, compared with 60 percent among those under the age of 60.
The only way we can be less than clueless is to know and watch out for warning signs of drug or alcohol abuse.
Warning Signs of Prescription Drug Abuse in the Elderly
It’s easy to dismiss certain signs of prescription drug abuse in the elderly as just normal aging. Forgetfulness and irritability are two common behaviors that often go hand-in-hand with advancing years.
Here are some of the typical behaviors that are associated with drug abuse, including abuse of prescription medications. If any of them are present, it may be time to think about an intervention for your elderly loved ones.
- Changes in sleeping patterns – including sleeping too much or inability to sleep
- Changes in eating habits
- Poor personal hygiene
- Inability to concentrate
- Unexplained chronic pain
- Unsteady gait, tendency to fall frequently
- Lapses in memory
- Sadness, depression or irritability
- General loss of interest in life and activities that used to bring enjoyment
- Increased isolation from family and friends
- Has bottles of tranquilizers on hand and often takes the medication at the least sign of any disturbance
Before launching into a confrontation with your loved one, however, it’s a good idea to know a little more about what your elderly loved one may be dealing with. First of all, take an inventory of the prescription medication your loved one is taking.
Does your loved one take a drug that has addictive potential, such as benzodiazepine or opioid painkillers? These are drugs such as Valium, Xanax, Librium, OxyContin, Dilaudid, Demerol, Vicodin, Lorcet and others. If so, any deviation from taking it exactly as the doctor ordered, including how much to take, how often to take it and for how long, could be problematic.
What sometimes happens is that an elderly person doesn’t think he or she is getting the expected benefit from the medication and doubles up on the amount taken, or takes it more often than recommended. It’s also easy for older adults to forget that they’ve already taken the medication, if they don’t use a pill minder or organizer. And combinations of medications, perhaps prescribed by different doctors who aren’t kept informed of other medications your elderly loved one takes, can also be harmful. Interactions, side-effects and complications can ensue.
It might be time to accompany your elderly parent or loved one to the doctor and ask about the possibility of prescribing a safer alternative drug. This is especially important if your loved one has a past history of addiction.
Remember that it isn’t ever advisable for a patient to just stop taking a medication that the doctor prescribed for them. So, while you may be concerned about your older loved one’s misuse of a variety of prescription drugs, he or she may have become addicted to one or more of them. Quitting cold turkey is not only difficult, but can be extremely dangerous or even fatal. Withdrawal symptoms, such as seizures, for example, in the case of addiction to benzodiazepines, mean that safely detoxing from the drug needs to be carried out under the supervision of the doctor or a medical professional, often in an inpatient rehabilitation facility.
Warning Signs of Alcohol Abuse in the Elderly
Abuse of alcohol is dangerous for everyone, regardless of age. But it can be especially dangerous for older adults. Medical experts say that older adults usually need less alcohol to become intoxicated than individuals who are younger. An older person stays drunk longer due to the fact that the human body processes the alcohol more slowly with increasing age.
Older adults may have vision or hearing problems, or both. They may also have reaction times that are considerably slower than they once were. This means that use and misuse of alcohol can exacerbate these problems, causing more incidents of falls, alcohol-related vehicle crashes, as well as other types of accidents.
When an older adult mixes alcohol and prescription medications or over-the-counter (OTC) drugs, the results can be dangerous or even fatal. And the fact is that as adults get older, they are more likely to be prescribed multiple medications for a variety of medical conditions, everything from high cholesterol and high blood pressure levels, to diabetes, blood, lung or other illnesses.
Watch out for the following signs that may indicate alcohol abuse in your elderly loved one. Note that some of these warning signs are similar to or the same as those for prescription drug abuse.
- Increased incidents of falls
- Inability to make it to the bathroom in time, a condition known as incontinence
- Increased headaches and/or dizziness
- Poor personal hygiene
- Changes in eating habits, for example, not eating enough or eating poorly
- Increased problems with money or finances
- Losing touch with or ignoring family and/or friends
- Thoughts of suicide
- Mood swings, frequently feeling sad or depressed
- Seems more hostile than usual or more resentful
- Loss of interest in activities that previously were enjoyable
- Difficulty in focusing and making decisions
- Worsening memory
- Feeling anxious most of the time
- Drinks alcohol despite warning labels on prescription drugs
- Often appears intoxicated, slightly tipsy, exhibits slurred speech
- Suffers from shakes and tremors
- Drinks in solitary, hidden from others
- Is drinking more than before
- Has drinking rituals, like drinking before, during or following meals, and is upset when this ritual is disturbed
- Suffers from alcohol-related health problems
- Often hides empty beer and liquor bottles or surreptitiously attempts to dispose of them
- Makes excuses to keep beer and liquor in the house
- Has the smell of liquor on his or her breath, attempts to disguise it with mouthwash or by chewing gum
- Falls asleep during conversations
- Calls you at odd hours or in the middle of the night
If any of the abovementioned warning signs are present, it doesn’t automatically mean that your elderly loved one is abusing alcohol. Some of these are warning signs that accompany other health problems that adults may have as they age. Some behavior changes are the result of stress, which may have prompted a sudden increase in alcohol consumption as a means of coping.
In addition, retirement, if recent, the loss of a spouse or other loved one, loss of the family home, and being recently diagnosed with a disease can all trigger substance abuse, whether that substance is alcohol or drugs or both.
Getting Help: Arranging for an Intervention
After careful analysis of the situation with your elderly loved ones, if you determine that there’s good reason to be concerned about drug or alcohol abuse, the first thing to do is to have a frank and loving conversation with your loved one about what you have observed.
This may not go as you had planned, however, due to the fact that your elderly parents may deny that a problem exists, promise to quit drinking and/or taking too many drugs, or ask you to mind your own business. You should not give up in the face of resistance, though, since the life of your loved one could depend on his or her getting professional help.
Maybe you will be able to convince your parent to see his or her doctor and you could accompany your loved one for the visit. This isn’t always practical and your parent may refuse to either go to the doctor or to allow you to come along. Again, it may be considered an invasion of privacy, a desire to remain independent, or a denial of any problem, or all of these.
What should you do if problems continue to exist and your elderly loved one refuses to get help to correct them? Consider an intervention by a professional.
Why not do the intervention yourself? For one thing, unless you’re a professional drug and alcohol interventionist, you aren’t properly equipped to handle the emotional aspects of the intervention. You may be swayed by tears and angry outbursts, feel a sense of shame or guilt about confronting your elderly loved one. Worst of all, you may back down and allow your loved one to continue behaving as before.
With a professional interventionist present, however, you can be assured that the meeting will take place according to evidence-based procedures. There will be a pre-meeting for family members and possibly close friends where everyone meets with the interventionist to go over what will take place during the actual intervention.
During the intervention itself, the interventionist’s sole purpose is to get your elderly loved one to acknowledge that his or her abuse is a problem and to accept and be willing to go into treatment. During the meeting, family members and close friends read aloud statements that they have prepared ahead of time, telling the loved one how his or her drug or alcohol abuse has impacted them, that they are here out of love for the individual and only want him or her to get the treatment they need.
It’s also critically important that your elderly loved one realize that there will be no more enabling of the drug or alcohol abuse by family members. Excuses will no longer be tolerated and there will be no further support unless and until the individual accepts treatment.
Once the individual agrees to go into treatment, the intervention is over. Arrangements for admission to a drug or alcohol rehab facility should already have been made and the interventionist often accompanies the individual directly to the facility. There’s no downtime, no delay to give the individual an opportunity to back out. This is striking while the iron is hot, so to speak.
When looking for a professional interventionist, search for one that is board registered and certified by the Association of Intervention Specialist Certification Board (AISCB).
Prognosis for Recovery
Look upon the professional intervention as an important part of the healing process from drug or alcohol addiction. It is true that older adults, over the age of 55, often take longer to recover, and they also often need greater support during treatment, but it is also true that their overall long-term recovery success rate is higher than any other age group.
Remember, age sometimes does have its benefits. While your elderly loved one may have been quick to dismiss that there was a problem with his or her alcohol abuse, once they enter treatment and commit to sobriety, they often embrace their new sober lifestyle with gusto.
Of course, one time in rehab for drug or alcohol abuse may not be sufficient to overcome chronic addiction. Your elderly loved one may relapse, requiring further counseling or treatment one or more times in a rehab facility or private counseling. This does not mean the original rehab was a failure. It only means that there may be more time required for your elderly loved one to understand the disease of addiction, learn more about how to recognize triggers and learn and practice coping strategies for dealing effectively with cravings and urges.
Participation in 12-Step groups such as Alcoholics Anonymous, Narcotics Anonymous or other self-help groups is also strongly encouraged following completion of drug and alcohol rehab.
With continued support and encouragement from family and peer support groups, your elderly loved one will have a much better chance of maintaining sobriety and living a more fulfilling life. Don’t shortchange your parents who may be in trouble with drugs and/or alcohol. The time to act is now if you believ