CAMH program offers older persons unique solutions: Breakthrough Spring 2004

At the Centre

At 86, Trudy is as spry and quick-witted as ever. A widow for the past 20 years, she takes a walk each day to the corner store to buy her cigarettes and spends the afternoon watching television, talking with her daughter on the phone, and baking bread and biscuits for her grandchildren.

While her smoking habit is compromising her health and she'd love to quit, Trudy is aware that she could be doing much worse. She has a friend who, recently widowed, drinks a bottle of sherry every afternoon 'for her nerves.' Trudy tells me she thinks her friend is 'drinking herself to death' and wants her to get help but doesn't know of any place that her friend could go to.

Responding to the needs of older adults who may be struggling with a substance use problem is exactly what CAMH's OPUS 55 (Older Persons' Unique Solutions) program is all about and the program would be a good place for Trudy's friend to get help.

A unique program launched in 1999, OPUS 55 provides services to adults, aged 55 and older, who live in the Greater Toronto Area and have problems related to substance use. The program provides a progressive, client-centred program responsive to the special needs of the older person and their families.

As our population ages, it is likely that these types of problems will become more prevalent. Indeed, Ontario's population is aging: in the 2001 Census, Statistics Canada reported seniors aged 65 and over made up 13 per cent of Ontario's population. There were notable increases in each age group above 70 and increases as large as 49 per cent are predicted in some age groups over the next ten years.

As adults move into this phase of their life, they may discover that with aging comes a whole new set of issues, such as social isolation, loss of partners, reduced income, decreased physical health, memory loss and loss of interest in activities. Although these changes may be age-related, they do not apply to all seniors.

Further, this period may be a new phase for friends and family members caring for an older adult. Frequently, those who care for older adults have concerns about the person they are a caregiver to - concerns often heightened after a health crisis - and they may want to know how to get help for their loved one.

By supporting the individual who misuses alcohol or drugs, family members can become a part of the solution. OPUS 55 offers consultation to family members, and ongoing counselling is available through CAMH's Family Services at (416) 535-8501 ext. 6765. Services provided by OPUS 55 respond to this growing need, and are completely confidential and free of charge. Client services include telephone or face-to-face counselling, case management, active treatment and continuing care groups, and family consultation. In addition to the client-centred services, there is also a community education and outreach component, as well as professional consultation and training for health care professionals who wish to address the growing priority of working with older adults experiencing substance misuse.

Margaret Flower, manager of OPUS 55 at CAMH along with MSW student Ellie Munn, explains that the OPUS 55 program takes an unconventional approach.

As Margaret describes, the treatment approach of OPUS 55 is based on a cognitive/behavioural model. Should the participant wish to be involved in Alcoholics Anonymous (AA), they are supported in this, but they would have to access AA outside the therapeutic treatment provided at CAMH. OPUS 55 provides an opportunity for clients to address issues unique to them, in a problem-solving format, based on their past experiences. This is done through one-hour sessions of one-on-one counseling an innovative approach in substance abuse counselling. The idea is to help the client identify what they see as the issue, and this is built up through a trust relationship. "There is no formalized group of 'sessions' to our services," says Margaret, "we work diligently with the clients to move forward from the problem, and to work in the 'here and now'."

Some methods used in counseling include problem solving, ways of motivating, and narrative therapy, where a client works through issues in conversations with the therapist and revisits the story of their lives, identifying strengths, successes and capability. "We look at the client's strengths, and help them to apply these in working against their substance use issue." Narrative therapy allows for an interaction that transcends different systems of values and beliefs.

The first step is to acknowledge the social environment that is true for the client. The goal is to have them recognize that their problem has roots outside of themselves. Bringing out the strengths, successes and abilities in the face of this problem creates a new, more workable reality and by making the problem separate from the client, the client is able to see that they are not the problem but rather the choices they are making are the problem.

It is a common understanding that as our population ages; many of us will take prescription medication as we age. Most of us take over-the-counter drugs, but along with medication (either prescribed or over-the-counter) come unforeseen problems. Activities such as drinking while taking medication (see below), deciding not to take medication, or taking others' medication are all common, and are examples of the concerns clients in OPUS 55 work through.

OPUS 55 also works closely with CAMH's Diversity Programs office, as there are a number of issues such as stigma and myths attached to aging. These issues are highlighted on a regular basis through the community education component of the program.

"As individuals we are unique. It is the life experiences, strengths, and problem solving skills that we possess as unique individuals, that can become the integral tools used to solve our problems." For instance, if Trudy wants to stop smoking, she probably has a lot of the strengths to help her achieve her goal; the OPUS program would help her tap into those strengths.

Clients and their families can learn more about OPUS 55 by calling (416) 595-6128. For more information on CAMH's Family Services please call (416) 535-8501 ext. 6765.

Becky McEwen is the Communications Assistant at CAMH.