Executive Summary
This paper primarily delves into the issue of alcohol abuse among the elderly, its potential short and long term implications, understanding the origin of the problem as well as what are the current methods that are being utilised in order to resolve the issue. Based on the information that has been analyzed, it was determined that alcohol abuse among the elderly was often due to its use as a coping mechanism or due to long term ingrained habits. The end result is that the excess consumption of alcohol creates the very real threat of creating medical complications due to its interaction with the various medications that the elderly have been prescribed. Another factor that should be noted is the fact that a body’s capacity to process alcohol efficiently deteriorates with age and, as such, the older a person is the longer alcohol remains in their system.
This prolonged state of inebriation can manifest in the form of a variety of social, psychological and physical problems which can lead to increased isolation, depression and even death in some cases. It is based on these issues that this paper examined the various methods that could be utilised in order to help the elderly population that has been identified as having an alcohol abuse problem. However, after examining the aforementioned methods, it was determined that there is significant room from improvement. One of the reasons behind this is connected to the low success rates related to the strategies for helping elderly patients who have been consuming alcohol for decades. It is expected that through this paper, new recommendations can be developed to address the issue of alcohol abuse among the elderly. By doing so, the devised strategies would go a long way towards reducing the number of deaths among the elderly that are connected to the overconsumption of alcohol or complications from its consumption with medication.
Introduction
Alcohol abuse among the elderly is an issue that has raised concern among the medical practitioners and the society in general. According to Ham (2007), abuse of alcohol by the aging individuals may pose serious health problems to the victims because of the reduced ability of the body system to manage the toxic substance in the alcohol. It is important to note that the abuse of alcohol by the elderly also affects people around them both socially and economically. When such an individual becomes physically or verbally abusive to the members of the society, the effect of the alcohol abuse will be felt by many people. Sometimes members of the family are forced to clean soiled clothes of those who abuse alcohol, something that many consider demeaning. When their health deteriorates because of the alcohol abuse, members of the family will be forced to spend money in order to treat them. For this reason, it is important to treat this problem before it can bring a series of negative effects on the victims or their families. In this research, the focus will be to identify some of the best ways through which alcohol abuse among the elderly can be treated.
Background of the Study
The importance of this study is directly connected to the potential negative effects of alcohol on the long term health and well being of the elderly. The first issue that should be taken into consideration is the impact of alcohol on medication and the resulting adverse consequences it may have. The study of Sinclair, Chick, Sørensen, Kiefer, Batel & Gual (2014) which examined the result of alcohol consumption and medication on numerous cases within hospitals showed that alcohol can either reduce the effectiveness of medication or bring about unintentional side effects. For instance, drugs related to epilepsy and diabetes have been noted as losing their effectiveness when consumed at the same time as alcohol. The end result is that the conditions that these drugs were supposed to address get worse over time due to the lack of effectiveness of the medication that they are taking. This makes an elderly patient worse off as compared to when they were taking medication without alcohol.
Other issues in relation to medication and alcohol consumption come in the form of the synergistic effects that alcohol tends to have with sedatives such as Valim or even various types of antidepressant drugs such as Prozac. Consuming alcohol and the aforementioned medications can cause issues such as an erratic heartbeat, brain dysfunctions or even death in cases where the alcohol and medications interact in such a way that it causes the person to develop a stroke or stop breathing altogether. Another factor to take into consideration is the fact that due to the advanced age of the elderly, their capacity to process alcohol actually takes far longer as compared to their younger counterparts. As a result, even if they believe that the alcohol they drank has been “washed away” so to speak from their system, it actually continues to remain for significant portion of time (i.e. 12 hours or 1 day longer depending on the age of the individual in question). The end result is that the period in which it unsafe to take medication increases with the elderly being unaware that they are mixing their medication with significant quantities of alcohol in their system. Forlani, Morri, Belvederi, Bernabei, Moretti, Attili, Biondini, De Ronchi & Atti (2014) explained that situations such as these are all too common and can actually be attributed as one of the leading causes behind medication related deaths for the elderly.
Aside from the negative impact of alcohol on medication, there are also the long term implications of excessive alcohol consumption and its effect on the health of an elderly individual. First and foremost, it is important to note that excessive drinking can cause serosis of the liver (i.e. fatty liver syndrome) to the extent that this can impact the capacity of the organ to properly filter out waste materials in the body. Aside from this, alcohol dependence can result in impaired cognitive functions which, when combined with the deteriorating mental faculties inherent in all elderly individuals, exacerbates the potential development of psychological issues such as depression, excessive anger or even suicidal tendencies. Lastly, it was noted by Geels, Vink, Van Beek, Bartels, Willemsen & Boomsma (2013) that excessive alcohol consumption can also contribute towards an individual gaining weight resulting in potential for obesity. While this is a serious issue for a young individual, it is incredibly deadly for an elderly individual given their body’s declining capacity to work of the excess weight through exercise. After taking all these factors into consideration, it can be seen that sufficient efforts must be undertaken to address the issue of alcohol abuse among the elderly.
Rationale for the research
Alcohol abuse among the elderly has affected the society from various perspectives. When an old person consumes a high amount of alcohol, Marshall (2000) says that the body may not be able to eliminate the alcohol content from the body within the required period. The scholar explains that this is so because most of the activities in the body system have been slowed down. It means that the alcohol content will take longer time in the body, especially in sensitive organs such as the liver and kidneys, than is usually the case among the active adults. These organs will be affected by the alcoholic substances, which may lead to a series of medical complications such as liver cirrhosis. Health problems that the elderly people develop will not only affect them, but also their families, and the government. Their families will have to pay for their treatment in order to save their lives. The government will be forced to spend more on the medical sector to meet the increasing demand for healthcare. Socially, alcohol abuse may have a series of negative effects to the victim, the society and members of their families. When one takes alcohol and starts misbehaving, his dignity and that of his entire family will be lost. In some cases, they may become aggressive, and this may affect other innocent members of the society. For this reason, it is necessary to address this problem in order to have a society that is free from such consequences both to the victims and people around them.
Scholars have conducted massive research in this field in order to determine the best ways that can be used to address the problem in order to protect the elderly and people around them. According to Yoshida (2006), this field has been under active research for over two decades. However, it was evident that there are some ambiguities in some of these pieces of research. For instance, it is not yet clear who the real victims in alcohol abuse among the elderly are within the society. The approach to be taken is also not yet clear because different experts are emphasizing on different approaches. Some of the recent researches have been proposing a combination of both counselling and medical treatment as the best ways of dealing with this problem. It is necessary to come up with an approach that would be universally acceptable to the experts, and this is the aim of the research. If this is achieved, then many people stand to benefit from the solution that shall have been developed. The elderly alcohol abusers will be protected from the socio-economic and health problems they have been facing after taking alcohol. Their families will be liberated from the problems they have to face after their loved ones have taken alcohol. The society will be liberated from the problems caused by the elderly alcohol abusers. The government expenditure on health will also be reduced.
The Aim of the review
This research will specifically focus on finding the best treatment to the problem of alcohol abuse among the elderly. The research will not involve a collection of primary sources of data from the individuals who have been victims of the problem, or the experts who have been trying to address the problem from various perspectives. The research will only rely on the secondary sources of data in order to find a solution to this problem. The researcher believes that by the end of this research, there will be clear information on how to deal with the problem. The following are some of the specific objectives that the researcher seeks to achieve from this review.
- To identify any conflicting information in the current literatures on how to deal with the problem of alcohol abuse among the elderly.
- To determine why these conflicts in the existing literatures are arising when experts try to explain how to address the problem.
- To identify any misconception that any of the previous researchers could have had in their study that could have led to differing opinions.
- To identify the level of validity in different pieces of research that will be used in order to determine the reliability of their conclusions.
- To come up with a comprehensive plan, based on the reviewed literatures, on how to address the problem of alcohol abuse among the elderly.
- To identify some of the specific roles that can be done by the society and family members of the elderly in order to help address the problem of alcohol abuse among the elderly.
- Propose a clear approach that should be taken by future researchers who will be interested in advancing knowledge in this field.
Upon completion of this research, it is expected that all of the above objectives shall be achieved. This will not only help in addressing the current problem, but also play a pivotal role in guiding future scholars. It will play an important role in guiding the policy makers and families caring for elderly alcoholics.
Significance of the Study
Based on an assessment of current methods of preventing excess alcohol consumption among the elderly in the form of support groups, family interventions, limiting alcohol consumption and a variety of other methods that will be discussed, it was determined that based on the success rates attached to these strategies (less than 50%), new methods need to be devised in order to address the problem. As medical knowledge and science continue to evolve, new methods of dealing with age old problems have come about. It is based on this that this paper will endeavour in taking the first few steps in devising new strategies that can help address the issue of alcohol abuse among the elderly.
The significance of this paper lies in its potential to develop new methods of intervention that would help to either support the older methods utilised or supplant them as the primary method of alcohol consumption prevention. In order to accomplish this, some possible alternatives to current treatment methods will be assessed. This can include, but is not limited to, the use of new medications to simulate the consumption of alcohol but without the ill effects, the use of new psychological techniques involving positive reinforcement in order to encourage lower alcohol consumption as well as a combination of the older strategies that may hold the key towards long term alcohol withdrawal. While this study cannot guarantee that the results of the investigation will yield a revolutionary new method of addressing alcohol abuse among the elderly, it could still prove to be a sufficient enough stepping stone for further research on the subject by future researchers which would result in an effective solution.
Research questions and hypothesis
Conducting a research is a complex process that involves collecting relevant data, analysing it, and drawing conclusions from the analysis. According to Fink (2010), when a researcher gets into the field to collect data, he or she will be encountered by massive sources of information, most of which may not be focusing on the research topic. Sometimes researchers would be swayed from the topic to other irrelevant information that may affect the quality of data collected from the field. Research questions play an important role in narrowly defining the data that should be collected from the field. This helps in avoiding the possibility that the researcher may get into the process of collecting irrelevant data from the field. In this study, the researcher developed the following research questions to help in guiding the process of data collection.
To what extent are the elderly affected socially and economically from their abuse of alcohol?
This question was formulated to help in determining the social and economic harm that the elderly expose themselves when they engage in alcohol abuse. This question was developed based on the findings of Lowinson 2005, p. 56) which revealed that many adults continue to lose their lives because of the abuse of alcohol. The following data was taken from this source.
This information that was taken from CDC data clearly shows a consistent rise in the rate of fatalities among the elderly in cases that is related to alcohol abuse. However, it is important to note that this data shows the trend from 1979 to 1993. This question will help in collecting more recent data. It will help in determining the current trend in order to determine if the relevant stakeholders are making positive progress in order to reverse this negative trend.
What are some of the health consequences of alcohol abuse among the elderly?
The literature reviewed on this topic shows that alcohol abuse among the elderly has some serious negative impacts, especially if it is not properly controlled. Some of the researchers noted that the excessive alcohol abuse may lead to some serious health consequences, top of which is liver cirrhosis. It is important to confirm these claims by analysing other scholarly articles and books in order to get clear information on this topic.
How is the society affected by the abuse of alcohol among the elderly?
This question focused on the effect that alcohol abuse among the elderly has on the society. According to Goldberg (2010, p. 45), the elderly rely on the able-bodied adults for various needs. Some of them are always too weak to undertake some chores on their own. When they engage in alcohol abuse, managing them becomes even more stressful to their family members. This scholar notes that some of them would even become violent after taking alcohol. The table below shows the relationship between violence, drug and alcohol abuse among the elderly.
Lowinson (2005, p. 121) noted that men tend to be more violent after taking alcohol than women, a claim that is supported by the data in the figure above. In this study, the researcher will try to confirm if this is still the case, and what can be done to address the issue.
What are some of the conflicting information about the approach to be taken when addressing the problem of alcohol abuse among the elderly?
This question is very important because it seeks to identify conflicting information about the approach to be taken when addressing alcohol abuse among the elderly. The internet is full of information on how this issue can be addressed, and some of them are very misleading. Through this question, the researcher will be able to identify some of the common misconceptions about the issue and come up with the valid approach that can be taken to discredit some of the leading information that is available through various sources. The society will be informed about these misconceptions, and the need to ignore them in order to avoid negative consequences that they may have on one’s life.
What is the best approach of addressing the problem of alcohol abuse among the elderly?
This question is closely related to the above question. After identifying the misconceptions and conflicting information that is available on how to address alcohol abuse among the elderly, the next important stage would be to identify the valid approach that can be used. This will involve a detailed justification why the approach suggested is considered superior to other existing strategies, and the stakeholders who should be involved in the process.
What are some of the specific roles that should be played by different stakeholders when addressing the problem of alcohol abuse among the elderly?
This last question is related to the question above. In this section, the researcher will investigate the role of various stakeholders in addressing the problem of alcohol abuse among the elderly. It will involve identifying these stakeholders, and explaining their role in the fight against this social problem.
Each of the questions above is expected to direct the researcher into looking for specific information from the sources available in order to obtain specific answers to them. Any information that does not directly respond to the above questions will be considered irrelevant. Based on the above questions, the researcher developed some research hypotheses below.
H1. The elderly alcoholics are the worst affected group by the effects of alcohol abuse.
H2. The society is socially and economically affected by the problem of alcohol abuse by the elderly.
H3. The best way of addressing the problem of alcohol abuse by the elderly should involve both medical and psychological strategies.
H4. Every member of the society has an important role to play when addressing the problem of alcohol abuse among the elderly.
The researcher will use secondary sources of data in order to determine if the above hypotheses are true or not.
Review Strategy
According to Basit (2010), conducting a review requires a proper strategy that would help identifying the right sources of data, determining the validity of the sources, and compiling a comprehensive and reliable report based on these sources. Given that this research will purely involve data collected from secondary sources, it was important to develop a proper strategy that would help to identify the relevant sources of data. The search strategy will be defined from two approaches. The first approach will involve identification of published sources of information on the topic that can be found in their print form. Using the search term, ‘Treatment of alcohol abuse among the elderly’, the researcher will visit the school library in order to search for books, which are relevant to this topic. Some terms may be included or excluded based on the circumstances during the search. For instance, the name of a city may be included to identify some of the cities that are worst affected. The term abuse may also be excluded or substituted by another term during the search. Peer reviewed journals will equally form an important source of information for this topic, and they too will be taken from the school library. The researcher will also use newspapers from some of the reputable media houses in the country to help back up the information that will be available from other print sources.
The researcher will heavily rely on the online sources of information when collecting data. Using online sources of information will be the second approach of collecting information for this research. Some of the relevant books for this research may be readily available through online sources. Most of the journal articles that will be used in this study are expected to come from online databases. Some of the databases that are reliable enough to provide relevant journal articles for this research include JSTOR, Oxford Journals, NCBI Databases, CINAHL, AMED, EMBASE, MDELINE, and EBSCO. These are reputable databases which have reliable peer reviewed journals that may offer the researcher a good source of information for the research. The researcher has also developed a strategy of collecting grey literature. This will be collected from the school or public libraries by directly engaging the librarians and asking for their help in identifying such materials. The researcher will also make direct request to some of the scholars who authored such materials within this institution.
It is very important to assess the quality of the literature before including it as part of the sources in the research. The validity of the literature will be determined using a validated checklist by analysing the method used in concluding, the sample size used, the authority that the authors command in that field, and what other scholars say about the particular literature. The plan that will be used in the synthesis of the information from the identified studies will be defined by the objectives above. The plan must lead the researcher into achieving the above objectives. It means that it will start by identifying the relevant literatures using the search term identified above, determining the validity of the literatures, and then conducting a comprehensive review of the selected literatures. Of interest will be to identify the strategies proposed by each, any conflicts, the reasons for the conflicts, and the way forward in addressing the issue. Although a meta-analysis may be necessary at this stage, it would not be included in this research.
Analysis and Synthesis of Data
The research will only rely on the data collected from books, journal articles, newspapers, and other relevant online sources. The analysis of this data will involve careful analysis of the findings of these authors, identification of any conflict of the information they present, the validity of their research process, and the ethical procedures they followed. When synthesising the information from these sources, this research will be keen to base conclusion on the studies valid and reliable.
Resources required
According to Fink (2010), it is always necessary to define all resources that may be required before starting the implementation process in order to determine the feasibility of the project. It is always common for such projects to fail along the way because the project’s needs were not clearly defined. The research will need some specific resources that will need to be used in order to achieve the desired result from this project. The first resource that will be needed for this research will be time to conduct the research. There are stages that will be involved in collecting data, and at each stage, it will be important to define time needed to complete all the activities. This is defined in the Gantt chart below. Books, journal articles, and magazines found in the university library will be among other resources that will be needed in this study. Stable internet connectivity and a personal computer, most preferably a laptop, will be necessary in data collection and compilation of the report. The researcher may also need an amount of money not exceeding £450 in order to subscribe to some of the databases mentioned above, and to complete some of the tasks that may need some form of payment. This will include printing and binding services once the document has been finalised. The researcher will also obtain the necessary permission from relevant authorities at different stages of this research. This is not only meant to maintain ethics in the research, but also to ensure that the researcher gets relevant guidance from the authorities whenever it may be necessary.
Work plan
It is important to understand the work plan that will be used in this research process in order to help in defining its feasibility. The research will involve a series of activities which will be conducted in a systematic manner. The Gantt chart below shows the specific activities that will be carried out in this research process. Each of the planned activities will have a specific timeframe within which it has to be accomplished. This will help in determining the total time that will be needed to complete the project.
The first activity will be proposal development. The researcher will develop a research proposal that will define all the activities that will take place in this research process. Given the nature of this research, development of the proposal may take one month because it will also involve identifying all the resources that will be used in the research. Approval of the proposal is expected to be completed within 14 days, after which the researcher will start collecting the needed data. The next activity will be reviewing of the literatures which will then be followed by compiling the report. Typing and proof-reading of the report will take approximately 30 days and a week long.
Ethics
According to Dening (2013, p. 54) it is important to maintain ethics when conducting a piece of research. The research will be used by various people for different purposes. This informative report will be valuable to the policy makers in understanding some of the pertinent issues concerning alcohol abuse among the elderly. The report will identify the stakeholders and their roles in addressing alcohol abuse among the elderly. For this reason, the information presented in this document must be credible. It must be founded on factual information from authoritative sources. This will ensure that the information does not mislead people who may rely on it to take various actions. It means that the researcher will need to maintain ethics at every stage of this research. This section will critically evaluate how this research upheld ethics in various stages.
One way of maintaining ethics will be to avoid bias when collecting information. According to Goldberg (2010, p. 34), some scholars always ignore literatures that seem to go contrary to their values. This is an unethical behaviour because it ignores the importance of such contrary opinions. In this study, the researcher was keen to analyse conflicting views in order to have a holistic view on this issue. This way, it was possible to explain where the scholars with conflicting views went wrong in coming up with their conclusion. This also helps in addressing some of the controversies that may confuse policy makers and other stakeholders.
According to Dening (2013, p. 78), it is always ethical to identify some of the weaknesses of a research in order to help the users of the report to understand the extent to which they can apply to the document. There are cases where the consumers of such information require a high level of accuracy because of the consequences associated with their decision. They need to know the level of accuracy of a report, and the sources of data that led to the conclusion made in the report. In this study, most of the data will be collected from relevant literatures and other secondary sources found online. For this reason, the researcher identifies the main weakness of this report to be the fear that some information in the report may not reflect the exact events happening today. However, the researcher tried to address this problem by collecting data from current newspapers and journal articles to capture the most recent information available in online sources.
Understanding the Origin of the Problem
When examining the case of alcohol abuse among the elderly, it is important to determine the origin of the problem in order to devise an appropriate solution. It is based on this that the work of Barrick & Connors (2002) is essential since it delves into the attitudes that lead to alcohol abuse among the elderly and how it initially comes about. Barrick & Connors explains that one of the first reasons behind alcohol abuse in the demographic being examined in this paper is connected to the concept of alcohol acting as a coping mechanism. Senior citizens, by virtue of their advanced ages, are often subject to a variety of stressful situations that people from younger demographics are not impacted by (at least until they reach the same age) (Barrick & Connors 2002). These stressors can be categorized under the following:
Feelings of Loneliness
People of advanced ages are often not included in the same social activities that they once were a part of when they were younger. This is in part due to health concerns, the inability to be as physically active as well as current social predilections regarding interactions with the elderly (Millard & McAuley 2008). Senior citizens often feel left out and, as a result, they turn towards alcohol as a means of coping with the loneliness that they feel. This is often one of the most common reasons behind alcohol abuse among the elderly since, in one form or another; most elderly individuals encounter such a situation (Millard & McAuley 2008).
Death of a Spouse
Af the reasons behind alcohol abuse can be connected to the subsequent death of a spouse. This is another common reason behind the use of alcohol as a coping mechanism since spouses of advanced ages have often developed a very deep emotional connection with one another (Livingston & King 1993). Experiencing the death of their significant other, especially in cases where it is drawn out due to a debilitating illness, can often result in a considerable level of emotional turmoil which can drive an elderly individual to using alcohol as a means to “dull the pain” so to speak. It should be noted though that such behaviour is understandable to a certain extent since coping with the death of a loved one, especially one that has been with you for a prolonged period of time, is a harrowing experience, however, the problem with utilising alcohol as a means of coping with death is that it becomes habit forming over time (Livingston & King 1993).
Fear and Anxiety
Aside from loneliness and the death of a spouse, another of the issues that causes elderly individuals to turn to alcohol as a coping mechanism are feelings of fear and anxiety. Simply put, the elderly are often subject to a variety of treatments, medications and life sustaining procedures that places a considerable level of stress on their mind. This is due to the fear of their impending death as well as the anxiety that develops as a direct result of such thoughts. The end result is that they turn towards the use of alcohol as a means of “deadening” the fear and apprehension that they are dealing with.
Aside from the use of alcohol as a coping mechanism, other factors that cause the elderly to turn towards alcohol abuse consist of the following:
Long term habits
While not necessarily applicable to all elderly individuals, there are some that have been prolific drinkers for decades. These ingrained habits results in alcohol abuse later on in life as they succumb to alcoholism. The inherent problem when it comes to dealing with alcohol as a lifelong habit is that drinking has become such an ingrained aspect of their lives that treatment for alcohol abuse among such individuals is often incredibly difficult given the decades in which their system has grown dependent on alcohol. It should also be noted that despite various means of treatment, ranging from interventions, support groups, psychological counseling, etc. the success rate has been relatively low for elderly individuals that have such an ingrained habit.
One of the reasons behind this can be seen in the work of Livingston & King which explained that while standard methods of alcohol intervention can have a modicum level of success on younger individuals, elderly alcohol abusers have a sense of “finality” in that they believe that since they are going to die anyway then it would be fine to imbibe alcohol in the manner in which they choose since they have already lived a long and fulfilling life. Of course the inherent problem with this way of thinking is that it causes havoc on their health and can react negatively with the various prescription drugs that they already take resulting in them dying several years or even a decade earlier than they should due to kidney problems and damage to their liver.
Admitting that they have a problem
Through the work of Blondell (1999), it was seen that the elderly are less likely to seek professional help early on which makes the problems associated with alcohol abuse even worse. Blondel explains that the social stigma associated with alcohol abuse is just as prevalent among elderly communities as it is in younger ones. As a result, people are often reluctant to admit that they have a problem and seek professional help. It should also be noted that Cummings, Bride & Rawlins-Shaw (2006) discovered that the elderly develop their own biases regarding their “problem” which is similar to that of many alcoholics. This bias effectively create the idea that their problem “is not so bad” and that it is relatively minor as compared to the assortment of issues that they have to deal with (i.e. the death of a friend, the expense of medications, their impending death, etc.) (Alcohol abuse hidden among elderly population 2001).
When taking all the factors that have been mentioned into consideration, it can be seen that there are a plethora of reasons that can cause an elderly individual to develop an alcohol abuse problem. As such, it is only by addressing the root causes in the following section that they can truly be resolved in the long term.
Addressing the Issue
After going over everything that has been stated so far, the following strategies have been devised to address the issue of alcohol abuse among the elderly. Do note that this in no way does this encompass all possible methods of addressing the problem, rather, it focuses on those most pertinent in resolving the problem based on origins that have been stated in this paper.
How to address Alcohol as a Coping Mechanism
The inherent issue with alcohol as a coping mechanism is that, it does not address the underlying psychological turmoil that come about through feelings of loneliness, the death of a spouse or the fear and anxiety that the elderly feel at times. From a certain perspective, alcohol can be compared to placing a band-aid over a deep puncture wound. On the surface everything may seem fine; however, it does not address the underlying problem and in effect makes it worse over time. It is based on this perspective that Caputo, Vignoli, Leggio, Addolorato, Zoli & Bernardi (2012) state that psychological counseling in the form of one on one therapy, group therapy or simply having an outlet for the problems an elderly person faces on a daily basis can do wonders in resolving the need for alcohol to cope with the problems they encounter. Psychological counseling, as explained by Krach (1998), involves addressing the underlying problem by bringing it to the surface. All too often people bury their problems and state that they can take care of it alone.
The problem with such a strategy is that this actually causes their inner turmoil to increase and often brings about a state of depression. To address such an issue, it is advisable to transition an elderly subject into a state where they are willing to talk about their problems and from there help them to realize that alcohol is not the best method that they can use in order to cope with the problems that they feel they are going through. This can be achieved by placing the individual in question into a comfortable setting where it is emphasized that sharing their life, their problems and their fears will not be met with ridicule or contempt. Such a strategy can often be done through the use of support groups in elderly communities or through the placement of an in-house therapist within a nursing home in order to talk to the patients through a schedule of meetings (McInnes & Powell 1994). What is important, as indicated by Saunders, Copeland, Dewey, Davidson, McWilliam, Sharma, Sullivan & Voruganti (1989), is that a sense of normalcy and regularity is implemented into their daily schedule through these counseling sessions. Trevisan (2014) delves deeper into this by explaining that “going through the motions” so to speak of having a scheduled existence that also has the benefit of addressing their underlying fear, anxiety and depression would do wonders in terms of removing the root causes of their alcohol abuse problems.
Simply put, Trevisan states that the addition of emotional turmoil via the root causes of alcohol abuse creates an unscheduled existence that actually enticed further disruptive behaviour (i.e. depression) which results in even more alcohol abuse. It is only when people are properly “grounded” so to speak that they are able to get their emotional and psychological state in order to the extent that they no longer need to depend on alcohol as a means of coping with their problems. This particular approach is actually effective in addressing the other problem with alcohol abuse wherein the elderly do not want to admit that they actually have a problem when it comes to their alcohol consumption (Onen, Onen, Mangeon, Abidi, Courpron & Schmidt 2005). An open and accepting environment often lets people become more introspective and, as such, helps them to come to an understanding regarding what they are doing to themselves. Do note that the aforementioned strategy is not as effective when it comes to alcohol abusers that have been drinking heavily for decades since it has become more of an ingrained habit for them rather than a coping mechanism for something that they are only recently experiencing.
Addressing Alcohol as a Long Term Ingrained Habit
Through the work of Cummings et al. (2006), it was seen that addressing alcohol abuse in the elderly is made more difficult if it has been going on for decades. Cummings et al. pointed to the fact that alcohol consumption within various regions such as the U.S., UK and Russia has become such an ingrained aspect of the local culture that it is more surprising to find someone that does not drink alcohol than someone that does. One of the reasons behind this is the social aspect connected to alcohol consumption wherein people often drink alcoholic beverages when they are with their friends in a friendly setting (i.e. a bar). This enables a person to develop a predilection towards alcohol consumption resulting in them going for items that either have a higher alcoholic content (i.e. hard liquor such as tequila) or drinking alcohol in large volumes (i.e. consuming a six pack of beer in a single day). While such behaviour is tolerated and even considered acceptable to a certain extent within society, the fact remains that long term alcohol consumption in excessive amounts is not only bad for an individual’s health, it also becomes habit forming.
The end result is that the “withdrawal symptoms” associated with stopping one’s long term consumption of alcohol actually begin to resemble those associated with drug addicts or smokers. This can manifest in “shakes” (i.e. the individual in question sometimes involuntarily twitches), becoming feverish, an increase in irritability, some form of physical pain that does not actually have a specific origin but it felt in some areas of the body, lack of energy as well as issues related to adverse psychological behaviour (i.e. violence, depression etc) (McInnes & Powell 1994). It is when taking these symptoms into consideration that weaning an elderly individual off of a long term habit becomes far more complex since, given their advanced ages, the aforementioned withdrawal symptoms can place a considerable amount of stress on their body to the point that it may cause strokes, cardiac dysrhythmia (i.e. the irregular beating of the heart), extreme depression leading to suicide and other such manifestations of long term alcohol withdrawal. On the other hand, Cummings et al. stated that simply allowing the habit to continue to avoid such symptoms from manifesting also causes issues in the form of liver and kidney damage as well as the fact that the various medications that help to sustain an elderly individual (i.e. keep them alive) do not react well when mixed with alcohol.
It is based on this that in order to address alcohol abuse as a long term ingrained issue among the elderly, what is necessary is to focus on an equally long term view regarding the treatment procedure. What is necessary is to simultaneously enrol the elderly individual in group sessions of other elderly alcohol abusers while slowly reducing their alcoholic consumption. This type of treatment can take up to 3 years depending on the level of addition, however, by slowly reducing their dependence on alcohol over a period of several years, this helps to mitigate the symptoms associated with alcohol withdrawal while at the same time helps the elderly individual adjust to living a life without alcohol (Onen et al. 2005). One way in which the individual in question can also be transitioned from their long term habit into something less damaging is to introduce them to social activities that would take away their need to consume alcohol. While physically taxing activities are not advisable, gaming in the form of Play station and Xbox One consoles as well as PC gaming have proven to be effective pastimes that the elderly can take on that helps them find some form of alternative to their alcohol habit.
Addressing the Issue of the Elderly not admitting they have a Problem
Through the work of Millard & McAuley (2008), it was seen that the elderly are often in denial when it comes to admitting that they have a problem with their alcohol consumption. One of the reasons behind this is connected to their advanced ages wherein they assume that since they have already lived for so long; their consumption of alcohol should no longer matter. It is with this attitude in mind that a class means of resolving alcoholism is needed: an intervention. This can often come in the form of friends and family members telling the elderly individual in question that he/she has a problem with their consumption of alcohol. While the method is not 100% effective, it has proven to create some form of self-introspection in the individuals involved resulting in some of them lessening their consumption of alcohol to some degree (Trevisan 2014).
Discussion
When examining the success rates involving the methods that have been presented so far, it was noted that the average rate of alcohol intervention success was 40%. This is despite a combination of the different methods that have been mentioned or utilising each method individually as a means of addressing the issue. While 40% may seem like a significant statistical figure it is important to note that it actually decreased based on the age of the individual (Geels et al. 2013). For individuals 55 to 60 years in age the total statistical significance of their recovery period was noted at 40%, however, in each successive 10 year age range, there was a 5% statistical drop (on average) in the effectiveness of alcohol intervention. For example, for individuals that were 65 to 75 years old the statistical range for successful recovery was 32 to 35 percent (Geels et al. 2013). Individuals that were 80 to 85 were at 28 to 30 percent. This was indicative of a diminishing level of treatment effectiveness based on the age of the individual in question (Geels et al. 2013).
One way of understanding this aspect of alcohol abuse treatment among the elderly is from the perspective of Geels et al. (2013) who explained that ingrained habits get harder to treat the longer a person has been exposed to them. Aside from this, there are also issues related to psychological dependence and the fact that at advanced ages people seemingly stop caring about the long term ramifications of their drinking habit since they have already aged considerably. It is based on this that the issue that is immediately apparent is the fact that the methods that have been utilised thus far to treat alcohol abuse among the elderly are simply not effective enough. McInnes & Powell (1994) explained that the effectiveness of medical treatments should be between 75 to 85 percent effective to be classified as being medically viable. This takes into consideration complications associated with the various types of treatment methods out there. While it is true that 100% effective medical treatments are available, they will not be discussed in this paper given the sheer amount of treatment methodologies that have been developed. Suffice it to say, based on the assertion of McInnes & Powell (1994), the current 40% intervention success rate is far from viable and is indicative that the current methods utilised are not effective enough to actually handle the issue. It is based on this that this section will delve into potential alternative methods that can be utilised in order to help address the issue of alcohol abuse among the elderly.
Chemical based therapy
One of the methods that could be potentially utilised as an effective alternative was developed by Professor David Nutt who created a pill that selectively activates the GABA receptors in the brain in order to replicate the effects of alcohol. This particular method shows a considerable level of promise when it comes to addressing the issue of alcohol intervention since it can be combined with regular alcohol consumption in order to lessen the amount that people drink yet still give them the same psychological effect. Based on the work of Geels et al. (2013), it was noted that one of the reasons why alcohol intervention programs have a low success rate is due to the psychological dependence people have towards alcohol consumption and the “buzz” that it gives them. As such, by replicating the same effect through the pill and combining it will normal alcohol consumption, people would be able to drink less alcohol and yet get the same full effects.
It should also be noted that the effects of the pill are also fully reversible which would allow a person to enter into a state of minimal inebriation within a relatively short period of time. The potential ramifications of this when it comes to treatment methods are massive since the pills would help to lessen the amount of alcohol consumed without causing negative manifestations (i.e. withdrawal symptoms) that are normally associated with reducing alcohol consumption in individuals that have a considerable level of alcohol dependence due to their long term abuse of the substance. Doctors can start prescribing the pills to elderly individuals who have been noted as having an extensive history of alcohol abuse. By instructing them on the appropriate dosage levels and the method that they should utilise in order to properly use the pills, it is expected that this should result in a reduction in the amount of alcohol related issues (i.e. necrosis of the liver) that are normally associated with alcohol abuse. Another factor that should be taken into consideration is the fact that utilising these pills helps to address the issue of alcohol as a coping mechanism in the elderly since instead of drinking large amounts of alcohol; they can merely take large quantities of these pills which do not have the same adverse impact on the body.
Taxation
One potential avenue of approach that could help in reducing alcohol abuse among the elderly is to focus on increasing the tax associated with alcoholic beverages. The best method of resolving this issue is not to target the state of alcohol abuse directly since there is no way to prevent a person from drinking, instead, a more effective method would be to discourage the process of drinking large quantities of alcohol by making it prohibitively expensive. Taxes have always been a way in which governments have controlled the flow of imported goods into the country in order to give local producers a chance against cheap foreign imports, an enacted policy that levels a specific type of tax on foods identified as being the cause of health problems among the elderly would raise their prices sufficiently so as to limit their consumption.
The advantages of this method are simple, the elderly have a limited amount of income which they can use to purchase particular products; by having an alcoholic product that leads to health issues cost more and the elderly would only be able to drink a specific amount of that particular type of beverage due to limitations in income. Other policy initiatives have focused on dealing with the problem of alcohol abuse among the elderly when it has already occurred; this policy initiative specifically targets the cause of alcohol abuse and ensures that it has a limited impact on how it is consumed. While there would be a definite backlash from various companies and consumer groups, the fact remains that should such a policy be put into practice, the rate of alcohol abuse among the elderly would definitely decrease. It should also be noted that this could also create a substantial reduction in the amount of people who develop a dependence on alcohol from an early age since the prohibitively high costs would discourage them from buying such a product. This can result in positive long term societal implications since this would reduce the amount of individuals that have alcohol dependency issues when they enter into old age.
Policy Initiatives to Lower the Rate of Advertising
When it comes to the consumption of any form of good or service, basic economics dictates that so long as there is a demand for a product there will always be someone willing to supply it, regardless of the apparent ethical implications associated with it sale. On the other hand several policy initiatives that have been attempted such as preventing certain advertising campaigns from being aimed at alcohol consumers have resulted in a certain degree of resistance from various manufacturing companies. The inherent problem is that companies such as Jack Daniels, Johnny Walker, etc., do not perceive their products as actually causing harm to people. Such companies state that if drank in moderation their products would not result in the prevalence of alcohol issues among the elderly today and that it is up to the consumer to rein back their level of consumption.
Such arguments have actually been effective in preventing policies that would in effect limit the access of such companies to various markets by deflecting the responsibility of the proper consumption of alcohol to the people who buy it in the first place. As for what government agencies are directly relevant to the proposed policy, the health sector in government operations is the most likely set of agencies needed to ensure that any proposed policy in reducing adverse alcohol consumption is carried out. The only inherent problem with this though is that fact that many of the necessary methods of response needed in order to ensure compliance are outside of the control of the health sector which creates problems in ensuring that policies are effectively carried out. It is based on this that the most effective policy that could potentially be enacted in order to lower the rate of alcohol consumption among the elderly is to prevent targeted advertisements that specifically focus on elderly alcohol consumers. What must be understood is that the capacity for advertising to influence the demand of consumers is considerable and, as such, by creating policies that prevent specific target advertising campaigns, this helps to at lower the rate by which alcoholic beverages are bought by this specific segment of the population.
Early Onset Psychological Intervention
One of the earlier issues that was mentioned in this paper was related to the elderly utilising alcohol as a “crutch” so to speak in order to deal with a variety of different emotional situations such as their friends or family members dying due to old age. It is based on this that in order to resolve the problem and “nip it in the bud” so to speak, one method that could be utilised is to implement early onset psychological intervention. This method focuses on providing psychological care and assistance to an elderly individual after they have experienced the loss of a loved one. By doing so this helps to considerably lessen the psychological burden that they have and should lessen their potential dependence on alcohol as a means of addressing their emotional issues.
Alternative Treatments
This failure to add some form of effective preventive method for relapse when it comes to alcohol abuse among the elderly has been noted by various researchers as being due to the fact that even an assortment of external preventive programs have very little in the way of a sufficiently effective preventive capacity when the origin of the problem is the internal decision making process of a patient. It is often the case that patients need to develop their own internal realisation backed by psychological reasoning when it comes to abstaining from alcohol abuse. What is necessary is the development of sufficiently strong internal reasoning mechanism and support system to ensure that the factors that caused a particular individual to turn to drugs in the first place do not manifest.
Religious Spirituality as a Possible Solution
One possible alternative method that has been gaining a considerable degree of traction in a variety of alcohol abuse treatment programs has been the use of religious spirituality. It was determined in the article “Patients consider spirituality and self-help approaches vital in TC” that religious spirituality can not only aid in the process of alcohol abuse rehabilitation but can even act as a preventive measure to ensure that relapses do not occur. The reason behind its effectiveness is quite simple, religious spirituality acts as a means of altering an individual’s perception in such a way that they view their life as not just their own but rather being connected to an almighty external creator (i.e. God). Not only that, spirituality in certain cases involving religious groups and organisations helps to instill a sense of belonging on patients with the religious community that they are involved in often acting as a support group to prevent drug related relapses from occurring.
What you have to understand is that a large percentage of current alcohol abuse cases are often related to individuals who feel depressed, worthless, and alone in life. Such behavioural symptoms are often correlated with a lack of sufficient support and social interaction which makes the use of alcohol seemingly more ideal since it acts as a form of escape from such situations. By adding religious spirituality to alcohol abuse treatment programs this creates the initial foundation by which addicts could find an alternative to using drugs by immersing themselves in the feeling of being in a community and belonging to a greater whole. Such a solution would prevent the potential for patients to relapse since it addresses the internal psychological state that must be addressed in order to ensure that patients develop their own realisation regarding the ill effects of alcohol abuse. As such, this paper has the assumption that adding the concept of religious spirituality to alcohol abuse treatment programs can help to decrease the amount of relapses by elderly patients.
Conclusion
Overall, when taking everything that has been stated into consideration, it can be seen that addressing the issue of alcohol abuse among the elderly needs to go through several steps. The first is identifying why the consumption is occurring (i.e. is it due to dependence, a coping mechanism or simply a long term habit) and afterwards choosing the appropriate means of addressing the identified cause. So far, these aspects have been detailed in this paper, however, they are in no way the only means by which alcohol abuse can be identified and prevented. Instead, what has been presented is a general overview regarding the process and what can be expected should it be used in a professional setting.
This study believes that “emotional numbing” which is symptom that manifests itself as a distinct detachment from people, social situations and activities that were previously thought of to be enjoyable, comes about through depression over some aspect of an elderly person’s life (usually the death of their spouse or the idea of their impending death) that causes them to turn towards the use of alcohol as a coping method. It also happens to manifest itself a form of detachment or state of withdrawal where these individual are apparently unresponsive to external stimuli. It is from this perspective that this paper recommends that in order to truly determine appropriate methods of treating alcohol abuse among the elderly, it would first be necessary to determine why they drink excessively in the first place. If they utilise alcohol as a means of covering up some form of emotional heartache or trauma, it would be necessary to address that issue first prior to getting them to stop drinking. Otherwise, it is unlikely that they would stop since the only thing that is being addressed is the external issue rather than the internal psychological issue that is at the heart of the problem.
Recommendation
When going over all the information that has been presented so far in this paper regarding alcohol abuse among the elderly, the one topic that was not focused on was strategies delving into early onset alcohol abuse detection. Ranging from observing a patient’s behaviour to blood testing, early onset detection helps doctors and family members determine whether an elderly individual in their care has been imbinb alcohol to such an extent that it may cause considerable health problems down the line. It should be noted that early onset detection is far better way of addressing the issue of alcohol abuse since it enables intervention at an early stage before the patient in question begins to manifest a psychological dependency on alcohol which would make withdrawal that much worse. However, while there are methods that have been developed to detect high levels of alcohol consumption in the body, there have yet to be strategies that have been devised to actually convince the children of elderly parents or retirements homes to submit the elderly people that they are caring for to undergo mandatory alcohol testing. Simply stating: “we are doing this in order to prevent alcohol abuse” would result in an onslaught of possible recriminatory accusations from the centres and from the children of the patients.
As such, new strategies need to be developed so as to convince people that elderly alcohol abuse is actually a prevalent issue and that it should identified and addressed immediately to prevent the problem from worsening. Aside from this, strategies also need to be developed to prevent identified individuals from consuming more alcohol than they should. While this paper has delved into various possible strategies, it cannot be stated that these are “absolutes” since there is always the potential that alternatives exist to what has been presented so far. Another issue that should be focused on to a greater extent is the potential for information campaigns to change the way in which people view the act of drinking. It is assumed that the more people associate drinking as something that causes more harm than good; the more likely they are of not participating into such an activity in the first place. However, this is merely an assumption and few studies have actually delved into the long term effectiveness of information campaigns on the drinking habits of people starting from a young age (i.e. the legal drinking age) all the way until they reach retirement.
While it is assumed that exposure to information campaigns would help to lessen the psychological dependence to drink when confronted with the possible health issues that a person would develop due to excessive alcohol consumption. It is with this in mind that this study recommends that future researchers attempt to determine the overall effectiveness of information campaigns in preventing early onset alcohol abuse. This particular approach in examining such an issue can apply either to younger demographics or the elderly. The main purpose of the study would be to determine if information campaigns would be effective and, if so, what method would be the most appropriate depending on the age group that is being targeted. It is expected that such a study would go a long way towards contributing towards present day literature on the issue of alcohol abuse and should result in the development of new strategies that should reduce the number of people that turn towards alcohol consumption as a form of psychological support.
Personal Experience: Lessons Learned
It is interesting to note that aside from affecting a person on a psychological level alcoholism also affects them on a biological level as well. This often comes in the form of lack of REM sleep, increased feelings of anxiety which lead to high blood pressure, an overall feeling of exhaustion despite not enduring any form of strenuous physical activity, a distinct lack of desire to eat and in the case of certain women fluctuating period rates. It must be noted though while personal factors are the prevailing main cause of triggering alcoholism among the elderly (ex: dependence due to the death of a spouse), however, not all elderly individuals are affected similarly and, as such, the biological symptoms of alcoholism vary from person to person. It is based on this that my research into this topic has taught me that there is no such thing as a one size fits all strategy when it comes to addressing the issue of alcohol abuse among the elderly. Simply implementing a “recommended” strategy is insufficient to actually address the issue, at times it is necessary to determine if the current strategy would be ill suited to the person being approached, whether alternatives would be necessary and what the process of implementation would be in this case. I have come to the conclusion that without a sufficient understanding of current methods, their weaknesses and the presence of potential alternatives, healthcare workers could potentially fall into “traps of complacency” wherein they focus on standardised methods of dealing with patients instead of tailoring processes to better suit the type of patients that they are dealing with.
Based on what has been presented so far in this paper, it can be seen that there are 3 effective forms of treatment which are being utilised at the present when it comes to handling cases of alcohol abuse of the by the elderly, namely: patient education, pharmacotherapy and psychotherapy.
Pharmacotherapy
This method of treatment utilises the administration of drugs as a way of dealing with the symptoms and resulting adverse mental conditions that come about from alcoholism. What must be understood is that alcoholism can cause medical issues when it comes to the continued health of a patient’s liver due to the excess consumption of alcohol. This issue is further exacerbated by the age of particular individuals which contributes towards possible liver failure. It is often the case that various drugs are utilised in order to help stabilise the liver and ensure its continued health. However, the main issue with the use of such drugs is that they may interfere with the drugs already present in an elderly person’s system that would be there to deal with an assortment of other health issues brought about by their advanced age. As such, there is the very real possibility for liver toxicity to occur due to the presence of excessive amounts of foreign chemicals in the body.
It must be noted though that pharmacotherapy is often utilised as a method of last resort when it comes to dealing with alcoholism should treatment methods such as psychotherapy and patient education fail to produce relevant results. The problem with pharmacotherapy is that it merely addresses the symptoms of alcohol abuse and does not actually address the main issue behind the problem. While general physicians are normally aware that excessive alcohol consumption is the reason behind the need for extensive pharmacotherapy in some cases, this paper has shown that there is nothing doctors can actually do if a patient drinks alcohol outside of a hospital setting. It is with this in mind that when viewing pharmacotherapy as a means of addressing the problems related to alcoholism, it should be stated that it would be the same as putting a band-aid on top of a deep puncture wound. While on the surface it may appear to have resolved the problem, the fact remains that it is still far from actually resolving the issue. As such, other methods need to be implemented to either supplement or replace pharmacotherapy as a solution towards ensuring the health of the elderly when it comes to their alcohol abuse problems.
Psychotherapy
This particular form of treatment involves 1 on 1 (or at times group sessions) between the patient and a trained psychotherapist. These particular forms of treatment often involve an exploration of what triggers instances of re-experiencing and attempts to help resolve such issues through progressive methods of disassociation till the event no longer elicits the same amount of stress (i.e. the death of a loved one). This particular method of treatment also involves the implementation of a variety of coping mechanisms in order to lessen the degree of anxiety connected to the use of alcohol as a coping mechanism for the elderly when it comes to addressing their personal issues. Overall, I have determined that therapy sessions would definitely be one of the most advisable methods of handling the issue of alcohol abuse among the elderly. There are an assortment of strategies that could be implemented to help a person slowly rely less and less on alcohol as a psychological crutch. This can range from joining group therapy sessions such as those in alcoholics anonymous as well as having private sessions with a therapist. Whatever method would be most appropriate can be determined by the general practitioner that the patient goes to. It is my belief that this particular method holds the most “promise” so to speak when it comes to creating a long lasting means of ensuring an elderly individual does not abuse their consumption of alcohol.
Patient education
This particular aspect of the treatment procedure imparts relevant information to patients in order to help them better alter their behaviors and improve their overall mental health. This process often involves helping patients understand their current condition, how it is negatively affecting their mental and physical well-being and the various methods they can employ to get better. The inherent problem though with utilising patient education as a means of addressing alcohol dependency is that there is no guarantee that a person will actually go through with limiting their alcohol intake. Based on what I have learned thus far from the materials I have covered, patient education can only go so far in convincing a person that they need to stop drinking alcohol excessively. It is with this in mind that this paper cautions future strategies that focuses exclusively on patient education as the primary method of treatment for alcohol abuse among the elderly. The fact is that some form of reliability is needed and present day studies have yet to show sufficient reliability with an information oriented strategy that deals with alcohol abuse.
It must be noted though that it really is not an issue of which method produces the best treatment outcome since all of the methods of treatment have varying levels of results. Rather, it has been discovered by clinical psychologists that by implementing all therapies in conjunction with one another, this often creates a more effective outcome as compared to using the aforementioned treatment methods individually.
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