In this article, we shall discuss the issue of alcoholism amongst the elderly. Alcoholism amongst the elderly is often an issue that’s hidden or overlooked. Alcohol abuse often goes undiagnosed because elderly people are often less social. Doctors may dismiss symptoms of alcoholism as ‘signs of ageing’ such as a fading memory, sleeping problems and depression.
The extent of alcoholism amongst the elderly
According to the National Council on Alcoholism and Drug Dependence, 6-11% of elderly people admitted to hospital exhibited symptoms of alcoholism. 20% of elderly patients admitted to psychiatric treatment also exhibited symptoms of alcoholism. 14% of elderly residents admitted to emergency rooms also exhibited signs of alcoholism. Around 49% of elderly people living in nursing homes were thought to suffer from alcoholism.
Why the elderly turn to alcohol
Elderly people often drink alcohol to relieve pain, to help them calm down or to experience short term happiness. Like the rest of us, the elderly may lie about the extent of their drinking and may become upset if questioned on the issue.
Some seniors are irritable or resentful when sober. Many elderly people face social and/or financial problems as a result of their drinking.
The #2 categories of alcoholism amongst the elderly
Alcoholism amongst the elderly may be split into two broad categories. The first category has been termed early-onset alcoholism. This term is typically used to describe people who have a life-long pattern of alcoholism. People in this group have suffered from alcoholism for most of their lifetime. These people are most likely to suffer from poor relationships with family, a decline in socio-economic status and a history of alcohol abuse in the family. Experts believe around 75% of elderly people suffering from alcoholism sit in this category.
The second category of alcoholism amongst the elderly is termed late-onset alcoholism. Many of these people begin to suffer from alcoholism much later in life, typically during their 40s or 50s. Many of these people are highly educated and have attained high socio-economic status. These people often suffer from alcoholism due to some traumatic event they have suffered from during their lives.
The dangers of retirement
Retirement is clearly a major life change for most of us. Unfortunately, retirement is a difficult transition for many elderly people. For these reasons, retirement is thought to be a key cause of late-onset alcoholism. During retirement, elderly people are likely to feel bored or less fulfilled as a result of their retirement. These negative feelings arising during retirement are thought to increase the risk of alcoholism.
The dangers of experiencing a significant loss
Elderly people who have suffered a significant loss such as the death of a spouse are also at a heightened risk of developing alcoholism.
Signs of alcoholism in elderly people
If you suspect an elderly relative is suffering from alcoholism, you may be able to confirm your suspicion by taking note of the below signs of elderly alcoholism:
- Experiencing gaps in memory
- Hiding alcohol or lying about their drinking
- Becoming confused
- Unexplained bruises
- Being unwilling to discuss their drinking
- Making excuses to drink alcohol
- Neglecting their appearance, personal hygiene or home
- Depression and anxiety
- Not paying their bills
- Neglecting their pets
- Poor diet
- Suicidal ideation
- Frequent car accidents
- Being aggressive or abusive
- Withdrawing from social activities
It is important to remember that some of the symptoms associated with alcoholism are easily mistaken with the symptoms of natural ageing, for instance falling down or prospective memory loss.
9 Health consequences of drinking alcohol for the elderly
One of the main concerns regarding alcoholism amongst the elderly is that many of these people are unaware of the damage they inflict on their physical and mental health as a result of their drinking.
With age, the same amount of alcohol can have a greater and more damaging effect on an elderly person’s body compared to a younger person’s. This is because older people have a diminished ratio of body water to body fat. This means as we grow older, drinking alcohol in our 60s will cause far more damage compared to drinking the same amount of alcohol in our 20s.
When seniors drink more than the recommended number of alcohol units, the below problems may occur:
1. Reduce cognition
When an elderly person drinks an excessive amount of alcohol, this will reduce the person’s judgment. This is known to cause falls, fractures and car crashes. These symptoms could be confused with symptoms of Alzheimer’s disease or dementia.
Long-term alcoholism amongst the elderly is also known to cause a conditional known as Wernicke-Korsakoff syndrome (WKS), or alcohol-related dementia. This syndrome is caused because long-term exposure to alcohol damages the body’s ability to produce thiamine. Thiamine or vitamin B1 is an essential fuel for the brain. Without thiamine, the brain is unable to store new memories. This gives rise to global cognitive impairment.
2. Agitate osteoporosis
Osteoporosis is a metabolic bone disease causing bones to become brittle and fragile due to a loss of tissue. The condition is common amongst elderly people due to hormonal changes and a deficiency in vitamin D and calcium.
Since alcohol is a diuretic, it will agitate osteoporosis. Furthermore, alcohol decreases osteoblast numbers (bone-forming cells). An agitation of osteoporosis is known to increase the risk of hip fracture.
3. High blood pressure
Elderly people who drink an excessive amount of alcohol are more likely to suffer from high blood pressure as a result of their drinking. Hyper-extension (high blood pressure) increases the risk of stroke.
4. Reduced quality of sleep
Elderly people who abuse alcohol will reduce the quality of their sleep as a result of their drinking. Many of these people may experience insomnia and a reduction in rapid-eye-movement (REM) sleep. A lack of quality sleep is known to cause a number of physical and mental health problems, including depression.
5. Liver damage
Expose to alcohol elevated liver enzymes. This causes alcoholic hepatitis, fatty liver or cirrhosis. Studies say around 50% of elderly people diagnosed with liver cirrhosis die within a year of diagnosis.
Furthermore, the liver of elderly people is not as efficient as the liver of younger people. This means a fixed amount of alcohol is far more likely to damage the liver of an elderly person when compared to a younger person.
6. React badly with prescription medications
Many elderly people consume over-the-counter and prescription medications. Since alcohol is a drug, alcohol may react with other prescription drugs you may be taking. For instance, when alcohol is mixed with aspirin, it is known to cause bleeding in the stomach. Liver damage is possible when alcohol is mixed with pain killers such as acetaminophen.
These problems are increased because elderly people often take more prescription medications than their doctor recommends. This is because elderly people often forget they have already consumed their medication or may take more to elevate ‘breakthrough’ pain.
7. Increase the risk of infection
Alcohol abuse amongst the elderly causes immunosuppression since alcohol weakens the body’s ability to produce white blood cells. Thus elderly people who abuse alcohol are more likely to suffer from infections such as pneumonia due to a compromised immune system.
Furthermore, if the elderly person suffered from tuberculosis during childhood, this damage to their immune system could trigger reactivation of the disease.
8. Damages the brain
Since alcohol is a neuro-toxin, alcohol is capable of ageing and damage brain cells. Furthermore, alcohol consumption causes the brain to release stress hormones. Exposure to these hormones is known to cause nerve cell damage in the hippocampus region of the brain.
9. Increases the odds of a poor diet
Many elderly people suffering from alcoholism will consume a diet deficient in calories and nutrients. This is because many of their calories are being consumed via alcohol. This may lead to a nutritional deficiency in thiamine and folate.
8 Steps to Helping an elderly person suffering from alcoholism
Below we outline a number of steps you may take to help an elderly person who suffers from alcoholism and thus help slow down or reverse the above damage your elderly relative is inflicting on his or her health by virtue of their alcoholism.
Step #1: Acknowledge the problem within your family
If the elderly person who suffers from alcoholism is a family member, it’s essential your family members acknowledge a problem exists. Enlist the support of as many family members as possible.
Step #2: Know how to approach your elderly relative about his or her drinking
When you confront your elderly relative about his or her drinking, it should not feel like a confrontation. First off, wait until your relative is sober before you discuss his or her drinking. Avoid labels such as ‘alcoholic’ and be sure to mention your elderly relative’s good qualities.
Above all, do not impose your help on your relative. If your relative is not ready for help, do not force it upon him or her. Furthermore, do not dig up painful events in the past that you attribute to your elderly relative’s drinking. This will only serve to hurt your relative rather than help.
However, treat your elderly relative like an adult and not like a child. This means being direct and to the point. Be specific and offer up tangible evidence about why you feel your relative has a problem with his or her drinking.
Step #3: Talk to a doctor or a local health department
Seeking the assistance of a doctor or other health care professional may motivate your elderly relative to cut down on his or her drinking. Many elderly people respect doctors, and so will listen to their warnings concerning excessive alcohol consumption.
However, your elderly relative may deny he or she suffers from alcoholism. This will mean you may need to collect evidence of your relative’s drinking habits before you approach a medical doctor.
When you seek the help of a doctor, ask your elderly relative to consent to a blood test. A blood test will help strengthen your case that your elderly relative suffers from an addiction to alcohol. A blood test helps reveal how much alcohol your relative is drinking because his or her gamma-GT (an enzyme in the liver) levels will be high if alcohol is being abused.
Step #4: Consider enlisting the help of a local support group
There exist many support groups for people suffering from alcoholism. The most popular organisations offering support groups include Alcoholics Anonymous and SMART Recovery. These organisations require participants to have abstinence as their ultimate goal. We recommend you visit these organisations’ website and search for a support group taking place in your area. You can find the web address of these organisations in the footer of this article.
Many elderly people may resist the idea of joining such a group because they may not ‘fit in.’ We recommend you take your elderly relative to more than one group to ensure he or she locates a group he or she feels accepted. Try to locate a support group made up of participants who are the same age as your elderly relative.
Step #5: Try to keep track of the number of alcohol units your relative consumes
This step may be difficult to implement, particularly if your elderly relative is not completely honest about his or her drinking. You may only be able to implement this step if you live with your elderly relative.
However, even if you do not live with your elderly relative, you may still be able to estimate how many units of alcohol he or she consumes each week. You could do this by searching your relative’s bins for bottles and cans that contained alcohol.
If you discover many empty bottles and cans, you will gain valuable evidence concerning the existence of your relative’s alcoholism. This evidence is particularly useful when persuading other family members that your elderly relative suffers from alcoholism.
Step #6: Make sure your relative receives nutritious meals and is well hydrated
If you suspect your elderly relative is suffering from alcoholism, you should assume this person is neglecting his or her diet. To combat this lack of nutrition, ensure your elderly relative is eating good food and drinking lots of water by offering to prepare his or her meals at least three times a week.
Alcoholism coupled with poor nutrition is a recipe for disaster for elderly people. This is because the calories in alcohol are empty and a lack of vitamins and minerals causes memory loss, fatigue and a loss of cognition.
We also recommend you help your elderly relative engage in social/physical activities and avoid people who encourage their drinking.
Step #7: Send your elderly relative to rehab
If your elderly relative suffers from acute alcoholism, a medically assisted detoxification programme will be needed. This typically takes place at an alcohol rehab centre. During this detox, a benzodiazepines drug will be used to reduce alcohol withdrawal symptoms such as hallucinations and a possible seizure. These withdrawal symptoms are more severe for elderly people when compared to younger patients. We recommend detoxification should take place in a residential rather than an outpatient basis due to these risks.
Detoxification should be followed by a programme of rehabilitation. Rehabilitation incorporates a significant element of psychological treatments such as counselling and cognitive behaviour therapy.
Step #8: If abstinence is not possible, encourage safe levels of drinking
In the US, the National Institutes of Health recommends that people over age 65 should have no more than seven drinks a week and no more than three drinks on any one day.
Below we list a number of organisations capable of assisting you with your elderly relative who suffers from alcoholism:
- Short Michigan Alcohol Screening Test-Geriatric Version
- Alcoholics Anonymous
- SMART RECOVERY
- AGE UK
- NHS locater for alcohol services in your area