According to “Inebriated Elders,” a just-published article in the University of Illinois Elder Law Journal, as many as one in six Americans 60 and older are overdependent on alcohol. Twenty percent of the elderly who are admitted to psychiatric wards show symptoms of alcoholism or substance abuse. By some estimates, alcoholism today rivals heart attacks as a killer of senior citizens.
A growing type of abuser is the “late-onset alcoholic,” according to author Susan Abrams, a UI law graduate who is the clerk for U.S. District Judge Harld A. Baker in Central Illinois. Such a person shows no sign of alcoholism until major physical or lifestyle changes, such as health problems, death of a spouse, financial worries, depression or sleeplessness, trigger overdrinking after age 50.
Women are more prone than men to late-onset alcoholism, Abrams reported, and women also develop alcohol-related health problems more quickly. Equally serious is the problem of elderly women who “often suffer from shame and embarrassment, and their families often fail to help because of denial or desperation.” Moving an alcoholic to a retirement community may actually increase the problem because the social activities provide more opportunities to drink.
Prescription and over-the-counter drug abuse also increase with advancing age. While some seniors turn to alcohol, others turn to antidepressant medications. Fifty percent of all sedatives are used by people over the age of 59. One out of six Medicare recipients is prescribed medication inappropriately, according to a survey of elderly women.
One of the most serious aspects of the “invisible epidemic,” wrote Abrams, is the inability (or unwillingness) of doctors and hospitals to diagnose the problem. The Federal Substance Abuse and Mental Health Services Administration has characterized substance abuse as “under-estimated, under-identified, under-diagnosed and under-treated” among the elderly.
Only a tiny percentage of primary care physicians consider alcohol abuse when a patient shows symptoms typically associated with the problems, a 1998 study found.
Even when properly diagnosed, the standard methods of treatment of substance abuse may be ineffective for elderly sufferers. Effective withdrawal from alcohol or drug dependence is a psychological as well as physical process, greatly enhanced by a spouse and other family members helping the abuser. But the elderly often do not have a support system within reach after their children move elsewhere and longtime friends leave the neighborhood.
Turning to the government for help is not a viable alternative. Medicare will cover the cost of alcohol detoxification, but will not cover a hospital stay for rehabilitation if a less expensive setting is available. Government-reimbursed alcohol treatment rarely lasts more than two weeks, Abrams reported.