Aging can increase vulnerability to problems

From Chapter 1: Introduction in Improving our Response to Older Adults with Substance Use, Mental Health and Gambling Problems: A Guide for Supervisors, Managers and Clinical Staff

Most people age well and are able to continue to apply or adapt the coping mechanisms they have developed over their lifetimes to deal with the stresses, losses and transitions often associated with aging. However, the challenges of the following age-related changes can increase some older adults’ vulnerability to problems with substance use, mental health and gambling. No one factor will necessarily cause a problem, but it may increase the risk, especially when combined with other factors.

Older adults’ vulnerability to problems may be increased by:

Physiological changes: As people age, changes in metabolism, body fat, body water and body size can cause alcohol and some medications to have an increased effect.

Changes in mental capacity: Cognitive impairment can increase stress and anxiety and affect judgment regarding substance use and gambling.

Losses in ability: The loss of physical abilities such as mobility, hearing or vision can reduce a person’s ability to engage in activities that once gave pleasure, enjoyment and independence and can also increase isolation.

Loss of social networks: Significant gaps in support may be created by the loss of social networks, for example, through retirement, relocation, reduced mobility, death, separation or divorce.

Other losses, changes and transitions: Older adults often experience many cumulative losses and changes; for example, leaving the family home, mourning the death of a spouse or friends and losing their independence. These losses, particularly if the person’s repertoire of coping strategies no longer works, may compound and increase his or her vulnerability to trauma, grief and despair.

Pain, insomnia and stress: Physical and emotional stress that is not adequately or appropriately addressed, or that worsens over time, can also affect someone’s ability to cope. Research has shown that older adults use both alcohol and medication to treat psychological symptoms (e.g., to relax, to promote sleep, to relieve tension or anxiety, to forget worries and to relieve pain). This behaviour places them at risk for substance misuse, abuse and dependence (Graham et al., 1996; Health Canada, 2002).

Other physical conditions: Heart disease, digestive problems, arthritis and other health conditions ranging from mild to severe can also challenge an older person’s ability to cope and increase his or her use of prescribed and over-the-counter medications.

A reduction in financial resources: Having less money can affect a person’s choice of or access to housing, food, clothing, transportation and health care.

A spiritual shift in values: As people age, the meaning they attach to material goods, social relationships, success and failure and life itself may change; life may seem meaningless.

• Print Bookmark