Matua Raḵi August 2016 newsletter

We don’t tend to think about alcohol and drug use as an older person’s problem. But perhaps we should know better. After all, we do know that addiction is no respecter of persons. It can affect anyone – be they male or female, rich or poor, young or old.

Shirley McKinney is a nurse specialist employed by Odyssey in Burnside, Christchurch which receives four or five over-65 AOD referrals a month. She says there are a lot of myths and assumptions around what can be a hidden and taboo subject.

“We should remember that older people were once younger people,” Shirley says.

“In some cases older people have just carried on with the drinking they did when they were younger. In other cases they have started heavier drinking later in life, perhaps due to loneliness or boredom, having lost loved ones, or because of an underlying mental illness.”

The issue for older people is often exacerbated by the fact that in many cases they are taking medication that can make the effects of alcohol or drugs worse. Even over-the-counter medications like cold and flu tablets or cough medicines can potentiate the effects of alcohol. Medicines like Losec can react with prescribed benzodiazapines.

“There’s also the fact that metabolisms change as we age,” Shirley says. 

“Organs become less efficient at processing substances and it can be hard for older people to recognise alcohol has become a problem for them because they’re drinking the same amount and not expecting the results to be any different.”
It can be a hidden problem because when an older person is having issues with alcohol or other drugs, it isn’t always obvious. If they’re beginning to fall or becoming forgetful, leaving a pot on the stove, we tend to think that’s just what happens with older people and we may not suspect the real cause. 

Symptoms from the use of substances can also mimic those of a lot of medical conditions so Shirley says it’s really important that doctors and family members start asking the right questions when older people are having events or symptoms that could have been caused by alcohol or other drugs.

Another issue with older people is that we may be reluctant to do anything about it when we do recognise a problem, especially with regards to alcohol. 

“The thing is we may not want to talk to grandma or grandpa about their drinking because we think that may be the only pleasure they have left,” Shirley says.

“But that’s such a limited way of seeing things, and by the time older people are referred to us they are certainly experiencing negative consequences. Problems around drinking tend to accumulate with age and most of the people we see are starting to fall over because of alcohol.”

Chris Sinclair is one of Shirley’s colleagues. She is also a specialist nurse at Burnside and runs a therapy group for older people in the area called 65 Alive. As the name suggests, participants must be at least 65, but the oldest person currently attending is 90. The group is facilitated by Veronica Higgins, also a specialist nurse now retired.

“We started the group because we were finding that many of these people are feeling pretty isolated,” Chris says. 

“There’s a lot of shame, guilt and embarrassment when people this age have problems like this. A lot of them have done Alcoholics Anonymous and found it difficult – fitting in, getting transport, being able to hear, or the age range was too wide. So they like this group because it has a more intimate feel to it and there’s a real camaraderie. In fact it’s one of the most rewarding groups I’ve worked with.”

Typically about ten people attend the group each week and sessions are centred on mutual support and sharing and caring. Occasionally speakers are invited, but usually it just involves discussion about issues raised by members.

All three nurses have worked with the elderly in the past and Chris says she first became aware of the problem of older people and substances when she was working at psychiatric services for the elderly at Princess Margaret Hospital in the 1990s. She says there was just nothing there for them and that’s even more of an issue now. 

“Recent research is pointing towards a real influx when the baby boomers start coming through. There are plenty of people in their 60s already who are on the methadone programme, for example.”

But she says it’s also a sad fact that people with alcohol and drug issues often don’t make it to old age. Many die along the way through diseases like cirrhosis or hepatitis C or because of an overdose. 

Chris and Shirley do a lot of work with people in rest homes but say they would like to do more, because rest homes will increasingly begin filling as the baby boomers age. In particular falls are a big issue with people because of their problems with alcohol. They’d like to set up a programme specifically to address this.

They also work closely with older people in the Māori community, who are often not very visible, making referrals to kaupapa Māori groups who run services for kaumatua.

“In the future it would be good to see a geared facility for residential care for people because there’s a real vacuum there, and older people’s needs are quite different to those of younger people,” Chris says.

Elva

Elva is 76 years old and lives at St Nicolas care home in Christchurch. She regularly attends the 65 Alive group and was in fact a founding member.

She enjoyed alcohol when younger and out dancing and socialising with her husband and friends, but her drinking slowly got heavier during her 40s. By her 50s she was drinking during the day and this was when she knew it had become a problem. 

It became even worse after she and husband Ray lost their uninsured business to a fire in the late 1990s. She started having blackouts and couldn’t go to any family gathering unless she was “completely blotto”. This really hurt and upset her children, who became angry, and the consequences of this still linger today.

Ray also drank heavily and Elva says it eventually killed him.

“One night he just gave in; drank whisky and went to sleep – and never woke up.” 

Elva sometimes feels lonely in the home and this can be a temptation to drink.

“You can live with a lot of people and still be lonely,” she says. 

She still drinks a bottle of wine on occasions, but never more than that. She says if she has more she’ll probably have a blackout.

When she was living in another home Elva had a fall while drunk. A doctor referred her to Chris at Odyssey House and Elva joined 65 Alive which, she says, is marvellous.

“In group I have people my age and we can all talk – we’re all in the same boat. We can call other members if we’re struggling, and a lot of us don’t have much else besides the group. And like me, most of us just don’t seem to fit in with AA.”

She says now that she has better control of her drinking she can think and talk more clearly and she no longer has blackouts. She has 10 great grandchildren and says life is what you make it. 

“Living is really important to me and life is so much better now that I don’t drink so much. And this group really helps!”

She’s really grateful to Chris and Shirley and says they’re doing a wonderful job.

“If only others knew about 65 Alive, because there are a lot of older people like me out there drinking on their lonesome.” 

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