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

Alcohol and prescription medications represent a special challenge for older people - one that is different from other age groups.  

Similarly, identifying substance misuse problems among older adults may be difficult, because the symptoms can sometimes resemble symptoms generally associated with aging.

Choosing to Change is a practical guidebook for professionals who come into contact with older adults who may be experiencing problems with their use of alcohol or medications. Using case studies the book offers tips, techniques and strategies that can be used to help identify  such problems and to successfully intervene with clients. This approach is appropriate even for clients who are not suited to or who are resistant to involvement with traditional substance abuse programs.

This handbook is for professional staff of health and social service agencies who, in their work with older adults, encounter people with problems associated with alcohol and psychoactive medications. People working in addiction treatment programs who are developing or expanding services for older adults may also find this handbook useful.

The approach taken in this handbook is holistic and client-centred, and it accepts that harm reduction, or reduced substance use (as compared with abstinence), may be an acceptable treatment goal. This approach to working with clients with substance use problems may differ from the approaches you have used in the past.

This handbook stresses that substance use problems are best addressed within the overall context of helping older adults to improve their general health and well-being. You can play an important role in helping older adults make lifestyle changes that will improve their overall health and reduce or eliminate problems with substance use.

As a professional caregiver, you have a unique advantage in assisting clients. You have many of the communication and support skills that are necessary in helping to reduce or alleviate problems with alcohol or psychoactive medications.

This handbook is designed to help you understand the dynamics around substance use and allow you to feel more comfortable when talking with clients about the issue.

Choosing to Change - Contents

Project team

Acknowledgments

Introduction

Glossary

Section 1: Background

• A Client-Centred Approach
• Why Different Treatment Options Are Needed
• Successful Counselling Relationships

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

Section 3: Things to Know about Alcohol and Medication Use

• Chronic Diseases and Alcohol
• Alcohol and Medication Interactions
• Dependence and Withdrawal
• Summary

Section 4: Assessment and Stages of Change

• Assessment
• Stages of Change Model
• Relapse

Section 5: How to Help

• Understanding Denial
• Enabling
• Individual Counselling and Support
• Group Support
• Recreational Support
• Suggestions for a Healthier Lifestyle
• Summary

Section 6: Common Questions

Section 7: Client Profiles

Appendices

Appendix A: Additional Information

Appendix B: Monitoring Form

References

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