Table of Contents

About This Course

1. Introduction to Elder Abuse
2. The Basics of Elder Abuse
3. Substance Use and Other Risk Factors
4. Screening and Assessment
5. Intervention and Treatment
6. Preventing Elder Abuse

Supplements
Case Studies
References
Resources

Out of the Shadows
Uncovering Substance Use and Elder Abuse

Substance Use by Elder Abuse Victims

Conventional culture views "Grandpa" taking a shot of whiskey while watching the news, or "Grandma" enjoying a glass of sherry over a bridge game as harmless indulgences. For older adults, however, such practices require a few warning labels. Health specialists have identified specific concerns that may make alcohol use dangerous to the health and well-being of an older adult.

Alcohol Misuse

An older adult's decision to use alcohol has to take into account the effects of aging, the presence of medical conditions and prescription drugs, and other factors. Too few older adults understand the connection among alcohol, drugs, and the aging process. About one in five older adults misuses alcohol and prescription drugs. ref

Sometimes One Drink Is Too Many

According to research, the use and misuse of alcohol may vary among aging groups and settings. Studies indicate older men are much more likely than older women to have alcohol-related problems. However, women are more likely than men to start drinking heavily later in life. ref

Older people in long-term residential care settings may have preexisting alcohol-related problems. Some nursing home communities may show particularly high rates of problem drinking if they are being used for short-term alcoholism treatment stays. Alcohol abuse may increase in retirement communities where drinking at social gatherings is the norm.

Health personnel may not easily identify a substance problem in older adults. Studies consistently find older adults are less likely to receive a primary diagnosis of alcoholism than younger adults. ref Family and friends may notice the effects of alcohol before a doctor does.

Diagnosis may be a problem in the institutional setting as well. According to a review of studies of drug use in nursing homes, "Alcoholism is consistently underdiagnosed and underreported by health care providers, especially in elderly female patients." ref

Family members also may ignore substance abuse problems in an older adult or confuse signs of alcohol abuse with age-related symptoms. See Warning Signs Related to Alcohol Abuse to learn more.

For more information on screening for alcohol problems, see module 4.