Alcohol Problems

Responding to Older Adults with Substance Use, Mental Health and Gambling Challenges

On this page:

Effects of alcohol on older adults
What can you do?
How common are alcohol problems in older adults?
Signs of alcohol problems
How to talk with an older adult who has an alcohol problem
When to get help

Many adults drink alcohol without problems. When problems do develop, they may begin at a young age or later in life, such as when a person has difficulty coping with retirement or the death of a loved one. Older people can become isolated as they try to hide their drinking from others, or as family and friends choose to stay away from them.

Effects of alcohol on older adults

As people age, they become more sensitive to the effects of alcohol, and their bodies process alcohol more slowly. This means that older adults are more vulnerable to the negative effects of alcohol. For example:

Alcohol reduces muscle control, increasing the risk of injuries due to falls.
Alcohol can make some health issues worse, such as confusion and memory loss, liver damage, diabetes, heart or blood pressure problems and stomach problems.

Some older adults may be alcohol dependent (also called addicted). They may feel they cannot stop drinking, even when alcohol causes problems with their health, finances, housing and social or family life. If people who are alcohol dependent suddenly stop drinking, they may experience withdrawal. Withdrawal can make them seriously ill, and can be life-threatening in some cases.

What can you do?

While you may not be able to help a person reduce or stop drinking, you can help to reduce the harm caused by drinking. You can also help the older person become better prepared to reduce or stop drinking.

One way to help is to work with your supervisor to develop a care plan. This plan makes sure the person has food to eat and the rent paid before money is spent at the liquor store. This will help to stabilize older adults with alcohol problems. It will also help them form a connection with you.

If an older adult asks you to buy alcohol and bring it to him or her, check with your supervisor to see if this is permitted. Your supervisor may feel it is safer to supply alcohol than for the older adult to go out or get help from someone who may take advantage of him or her.

How common are alcohol problems in older adults?

Six to 10 per cent of older adults have alcohol problems, which is the same rate as other adult groups (Seeking Solutions, 2004).

Signs of alcohol problems

Warning signs of problems include:

loss of co-ordination, falls
slurred speech
problems sleeping
poor personal care, such as not bathing, not eating (or not eating well) or not taking care of health problems
empty bottles or cans in the garbage
irritability, depression or confusion
making excuses or making up stories to cover up the truth about their drinking
memory trouble after having a drink
losing touch with friends or family.

How to talk with an older adult who has an alcohol problem

People with alcohol problems often have a low opinion of themselves. They may feel they cannot give up drinking, or that no one cares about them.

You can’t stop people from drinking, but you can help them to feel better about themselves. By treating them with respect, you can help them to find the self-respect and strength they need to deal with their alcohol problems.

If you confront the person about his or her problem alcohol use (e.g., “You’ve got a problem” or “You should stop drinking”) the person will likely deny having a problem, and will refuse to talk about it. When talking with older people with alcohol problems, put “the person” before “the problem.” Try the following approach:

Don’t use terms like “alcoholic” or “addict.”
Encourage the person to talk about his or her drinking when the person is sober (e.g., “What did you do last night?” “How are you feeling this morning?”).
Describe what you see (e.g., “I’ve noticed you’ve been having difficulty walking.” “As far as I can tell, you’ve eaten only butter tarts this week. Is there a problem with your meals?”).
Avoid saying that the person’s problems will go away if he or she stops drinking. Instead, try saying, “You don’t seem to be your old self these days; you haven’t been going out as much, and you don’t eat as much either. How are you feeling? Would you be interested in having someone to talk to about it?”
Encourage the person to attend activities that he or she enjoys that do not involve drinking.

When to get help

It’s hard to know what you can or should do to help older adults who have drinking problems. One thing you can do is let your supervisor know the signs that tell you the person’s drinking is causing problems. Your supervisor can then try to connect the older adult with an alcohol-treatment professional.

Older people who get professional help for their drinking problems are often able to cut down or quit drinking, and stick to these changes, even better than younger adults. However, some older adults may not be willing to accept treatment. In addition, sometimes treatment geared to older adults may not be available in your community.

If an older adult (or anyone else in the older adult’s home) is drinking or intoxicated when you visit, your agency may require that you leave and contact your supervisor. If this is your agency’s policy, let the older adult know this is why you cannot provide care at this time.

Even when it seems there is little hope of improvement in an older adult’s drinking problem, you can help—with the same level of care, patience and support you give to other older adults in your work.

In Responding to Older Adults :

1 The Nature of Aging

2 Substance Use, Mental Health and Gambling Challenges in Older Adults

3 Communication Tools and Techniques

Extra resources

Alcohol Problems

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