Who is the Client?

Choosing to Change: A Client-Centred Approach to Alcohol and Medication Use by Older Adults

Section 2: The Client - Identifying the Problem

Pete, 75, sits alone in his apartment, drinking a beer and waiting for his home-care worker to arrive. He is happy that she is coming, because he'd like to talk to someone. He’s having problems again with his landlord. And his hip is worse — he can barely walk. Then, he remembers that his home-care worker might ask about his medication. He can't remember if he took his pill today or not. He goes to the cupboard and takes two pills just to be sure. One green. One red. Pete finishes his beer and carefully puts the bottle away. No need for her to know that it’s his fourth drink of the day.

Grace, 67, was never interested in drinking. She was always too busy raising three children and running a busy household. There was the odd weekend binge, but nothing serious. Then, two years ago, her husband died. All their plans for retirement died with him. Their lives were so intertwined. Last year, her sister died after a long, painful time with cancer. At first, Grace just took a drink or two at night to help her sleep. The sleeping problems worsened. Now, she is drinking every night and sometimes earlier in the day. Once immaculately groomed, Grace isn't taking care of herself anymore. Old friends are avoiding her. Her grandchildren suspect that she’s getting senile, but they have their own lives. Besides, she’s not hurting anyone, they conclude.

Who Is the Client?

Counsellors who work with older adults probably meet people like Pete and Grace many times in the course of their work. Sometimes, as is the case with Grace, problems with alcohol are recent and linked to specific life events. Sometimes, as in Pete’s case, the history of problems with substance use is long or hidden, and the person is dealing with a range of health problems, including problems related to both alcohol and psychoactive medication use.

Who is the client? Clearly, older adults are a heterogeneous group. Those who enjoy stable health, adequate finances and good relationships are worlds apart from those struggling with major illness, poverty or grieving recent losses. Heredity, lifestyle, diet, attitudes, spiritual beliefs and life experiences influence the way people age and the way they look at life and at themselves.

Nevertheless, there are similarities in the patterns of alcohol and medication use among older adults — patterns that are distinct from those of younger age groups.

Choosing to Change - Section 2: The Client - Identifying the Problem

• Who Is the Client?
• Older Adults' Use of Alcohol and Medication
• When Does Substance Use Become a Problem
• Low-Risk Drinking Guidelines
• Distinguishing Problems with Alcohol and Medication from Symptoms Associated with Age-related Illness
• Reasons for Alcohol and/or Medication Use
• Life Patterns of Substance Use
• Summary

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