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Caring for Caregivers: The Problem of Substance Abuse

You do it all, day after day, and night after night. You keep track of her medications, and make sure that she’s eating properly. You take her to and from every doctor’s visit, and answer his questions thoroughly and carefully. You clean up the inevitable accidents and change her clothes. “It’s OK, Mom, I’ll take care of this.” But while you’re taking care of her, who is taking care of you?

A Silent Struggle

Caregivers are likely to neglect their own health care concerns. They’re more likely to miss preventative care appointments with their physicians and to report that their exercise and nutritional routines have fallen by the wayside since they began caregiving. They’re more likely to smoke and to use drugs or alcohol to cope with the chronic stress associated with caring for a sick or aging parent or loved one. Substance abuse among older people is understudied and underdiagnosed, but it has been a growing concern for decades. Its symptoms are often overlooked among the myriad maladies of aging.

Doctors are often hesitant to bring up the subject with their patients. Generational attitudes toward mental health and depression may mean that sufferers are ashamed to discuss their issues, or that family members are embarrassed to confront them about concerns. But the statistics on substance abuse in the aging population are sobering. The elderly are three times more likely to use medications than the general population. There is a strong correlation between age-related infirmity and medication abuse.

Patients with chronic pain, such as arthritis, are likely to become dependent on prescription pain relievers, and doctors are more likely to over-prescribe to their age cohort. Baby boomers, in particular, have higher rate of substance abuse than any previous generation.

Signs of a Problem

The American Psychological Association identifies women and older people in caregiving roles as being more at risk for becoming highly strained and experiencing negative health effects. Women in general take on more of the tasks of caring for relatives, and older people are more likely to suffer compromised immune systems and physical injuries from caregiving. Older caregivers also use more medications and are more at risk of slipping over into misuse and abuse of them.

The National Council on Alcoholism and Drug Dependence warns that drug and alcohol abuse is particularly dangerous for the elderly.  Its impact is more deleterious long-term because of the potential for harmful medication interactions. Its effects are more debilitating than on younger, healthier people.  Indicators of a drug or alcohol problem include:

  • Solitary or secretive drinking.
  • A ritual of drinking before, with, or after dinner.
  • A loss of interest in hobbies or pleasurable activities.
  • Drinking in spite of warning labels on prescription drugs.
  • Immediate and frequent use of tranquilizers.
  • Slurred speech, empty liquor and beer bottles, smell of alcohol on breath, change in personal appearance.
  • Chronic and unsupported health complaints.
  • Hostility or depression.
  • Memory loss and confusion.

Neglect and Abuse

When a caregiver is struggling with addiction, they are less able to provide the care their loved one needs. Substance abuse is one of the leading risk factors for elder abuse in all its ugly forms: financial, physical and emotional. The most vulnerable patients are the extremely aged and those suffering from dementia, but statistics are hard to find on just how widespread the problem actually is. Only 1 in 14 allegations of elder abuse are brought to the attention of the authorities, but the National Council on Aging estimates as many as 5 million seniors are abused each year, and usually by a relative.

The elderly comprise 14 percent of the American population, and that percentage will continue to rise as the baby boomers move into their final years. This demographic shift from the young to the aged will have ramifications across our entire society. As more of our population becomes aged, their problems will belong to all of us. We must all learn to recognize when a family is in crisis, and to implement strategies to deal with the challenges of caring for our nation’s senior citizens.