It s Time To Talk Again Substance Abuse Among Older Adults

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1 Objectives It s Time To Talk Again Substance Abuse Among Older Adults Julie Stevens, MPS, ACPS, CI 2015 Ohio Prevention & Early Intervention Conference June 30, )Understand the magnitude and consequences of abusing alcohol, prescription drugs, tobacco and other mood altering substances in older adults. 2)Understand the unique and important role of family members, friends, caregivers and service providers in influencing the use or non use of alcohol, prescription drugs, tobacco and other mood altering substances by older adults. 3)Help older adults enhance protective factors and minimize risk factors for substance abuse. 4)Develop personal guidelines for use or non use of these substances. 5)Effectively talk to someone whose use of alcohol, drug or tobacco is a concern to them. THE GAME F AGREE / DISAGREE DISCUSSION QUESTIONS SUBSTANCE ABUSE AMONG SENIORS THE BIG, SILENT PROBLEM WHAT DEFINES A SUBSTANCE ABUSE PROBLEM?? WHY ARE WE BLIND TO THE SILENT EPIDEMIC? 1

2 THE BABY BOOMER IMPACT 78.2 million boomers born between million used Marijuana in million used prescription drugs such as sedatives, tranquilizers or pain relievers in million used cocaine in 2005 Marijuana use among year olds more than tripled from 1.6 percent to 5.1 percent from 2002 to Office of National Drug Control Policy MOOD ALTERING DRUGS Drugs (substances) that act on the Central Nervous System and alter its normal everyday activity, causing changes in mood, awareness and/or behavior. Alcohol Prescription drugs Tobacco NIDA WHAT ARE THE SIGNS & SYMPTOMS OF POSSIBLE SUBSTANCE ABUSE? MENTAL HEALTH ISSUES EFFECT AGE-RELATED BEHAVIORS POSSIBLE ABUSE Almost 20% of people over 55 experience mental disorders that aren t a normal part of aging. In % of adults 50 and older reported current depression. CDC: Addressing Depression in Older Adults (2009) Men 85 and over have a suicide rate of 43 per 100,000 compared to 11 per 100,000 for all ages. CDC ( STRESS, ANXIETY AND INSOMNIA WHAT DO YOU THINK MAKES THE DIFFERENCE? Discussion Questions An increase in the usage of alcohol as well as Benzodiazepines in the elderly is a strong indicator of mental health issues such as stress, anxiety and depression leading to insomnia. 2

3 Risk and Protective Factors for Substance Abuse among Adults Genetic predisposition Why people use drugs The link to mental health Keys to Healthy Living Healthy family & social relationships Strong purpose for living Doing things to enhance physical, mental, emotional & spiritual health Fostering Healthy Relationships 1) Increased zest (vitality)- good relationships increase a person s energy vs. depression 2) Increased ability to take action (empowerment) vs. feeling powerless 3) Increased clarity (clearer picture of one s self, other relationships or a situation) vs. confusion 4) Increased self worth (positive feelings about one s self) vs. worthlessness 5) Desire for relationships beyond that particular relationship vs. isolation The Relational Cultural Theory- Jean Baker Miller (1976) A Sense of Harmony and Balance A Sense of Purpose We only become fully engaged when we care deeply and passionately for something that is bigger than ourselves. ENVIRON- MENTAL ENVIRONMENTAL EMOTIONAL EMOTIONAL FINANCIAL FINANCIAL We only become fully engaged when we feel that what we are doing really matters INTELLECTUAL INTELLECTUAL SOCIAL SOCIAL Purpose is what lights us up and feeds our souls and is the fuel needed to make tough changes in your life PHYSICAL PHYSICAL SPIRITUAL SPIRITUAL OCCUPATIONAL OCCUPATIONAL When is it Time to Talk Again? WHAT is your role? What do you say? What do you do? HOW do you say what needs to be said? How do you keep the relationship strong? WHY SHOULD YOU SAY ANYTHING AT ALL?? When we talk We need to be clear on where we stand on alcohol or other substance/drug use. We need to have the utmost concern for the relationship. We need to know what to say and how to say it. 3

4 THE 6-STEP PROCESS 1) I CARE 2) I SEE. 3) I FEEL.. 4) I M LISTENING. 5) I WANT.. 6) I WILL.. I CARE. Tell the person that you care about him/her. Establish a personal connection to reduce defensive feelings. I love and care about you very much. You ve been a super dad all of my life. I care about you and want you to be able to live life to the fullest as long as you can. I SEE. Tell the person exactly what he or she has done that concerns you. Present clear facts, not impressions based on what you have seen. I notice that you have only a six pack of beer in the refrigerator and no food. I see that you get very angry when I mention how many medications you are on. I found some illegal drug paraphernalia in the bathroom. NOTE: Making I see observations helps you if you are unsure if there is a problem. When you state what you see, you aren t making a judgment call, just stating the facts. I FEEL. Tell the person how you feel about the way you see him/her acting. Remove blame from the interaction. Simply state the facts of how you are feeling. I get really scared I get really angry.. I feel really sad I am worried. LISTEN. After you tell the person that you care, what you have seen and how you feel, it s important to be willing to listen to what he/she says. A variety of responses can be expected since they will probably be unprepared for this discussion. Some may thank you and will be ready to share the problem (and maybe even share a deeper problem). Some may get angry ( it s none of your business ). Many will be stone silent. I WANT. Tell the person what you would like them to do. I want you to call me when you are lonely rather than having a couple of drinks. I want you to make an appointment with your medical doctor to review all of your medications. I want you to call the tobacco hotline to and talk to a tobacco cessation counselor. 4

5 I WILL. Tell the person what you are willing and able to do to help. Our responses can range from simply being available to be a good listener to helping arrange a meeting with someone who can help. If the person chooses not to say anything, let him/her know that the door is open to discuss this at any time. SHARING CONCERNS Discussion Questions I will always be just a phone call away if you are lonely or feeling down. I will go with you anywhere to help sort out these problems. I will bring you to the senior community center twice a week so you can be with your friends. TIMING IS EVERYTHING THE BEST TIME TO TALK TO SOMEONE ABOUT AN IMPORTANT TOPIC IS. When you feel comfortable and private When you re not likely to be disturbed When you have time to talk things through When neither of you have been inappropriately drinking IMPORTANT THOUGHTS TO TAKE NOTE OF Always strive to make the relationship the priority. Remember, you are not in charge of the outcome, you are merely the messenger. You are not making a judgment. You are simply stating what you see and how you feel. No matter what the initial outcome of this discussion, keep the lines of communication open and caring. If struggling with initiating the discussion, contemplate the potential consequences of staying silent. Either you risk the relationship by having a discussion, or you say nothing when there may be a serious problem and risk serious consequences. Practice Scenarios Your Trainer Julie Stevens, MPS, ACPS, CI juliestevens@ou.edu