Alcohol and the elderly

Alcohol presents more complications as people age: there are more falls and injuries; alcohol’s effects on memory are often mistaken for Alzheimer; older people take medications that interact poorly with alcohol; alcohol worsens the physical problems of old age; because the liver is usually damaged from years of drinking, it doesn’t take near as much alcohol to get an older person intoxicated.

In treatment we’ll often hear from an older person that they have cut down on their drinking, so they don’t know why the family is so concerned. The older drinker hasn’t really cut down, it’s just that it doesn’t take as much alcohol to get the same effect.

Most older alcoholics don’t seek treatment, although there will soon be millions of baby boomers who need treatment for alcoholism. The problem will likely be alcohol plus other mood-altering, addictive medicine. This is another reason older people have a hard time realizing they have a problem — the mood-altering medicine they take reduces their alcohol intake even more, but the combination can still be debilitating. Often alcohol enhances the effects of mood-altering medicine.

I’m not sure what it will take to get older people into treatment. It won’t be so easy to write off all the complications as old age problems when people start living longer into their 90s and beyond. There’s a lot of time living with an alcohol problem from 60 to 90, that is if alcohol doesn’t cause a premature death. The main issue, though, is quality of life. Knowing what we know about alcoholism, it’s not as if the older person is having a party every day in retirement. Alcoholism is a painful and debilitating disease that strips a person of dignity and self-esteem — it creates broken relationships and puts enormous strain on families. Dying from alcoholism in old age is one of the worst endings to life I can imagine. Life doesn’t have to end like this.

The treatment field might have to respond by creating senior-specific treatment facilities. Older people don’t relate to younger people in group therapy as well as they relate to people their age.

The problem of alcohol and the elderly will also become very costly as physical complications from alcohol use fester for years. Healthcare professionals will have to identify alcohol problems earlier and deal with the problems in much more solution-oriented ways. There’s been a tendency to let older people have their vices, but as we all live longer and longer, I don’t think the problems caused by alcohol in the later years can be ignored.