Tempe Health and Human Services Department Reports and Increase in Alcoholism Among Seniors

By: John Skelton & Tempe Fire Data

Millions of people consume alcohol, but each person has their own unique relationship with this substance. While many are able to drink in moderation without it negatively impacting their health, relationships and careers, alcohol use can become problematic for some individuals. Alcohol has a particularly strong impact on older adults, even when consumed infrequently.

Age-related changes in the body, chronic health conditions, prescription medications and other factors can magnify the effects of alcohol consumption and jeopardize a senior’s health. This can cause an older adult’s relationship with alcohol to change even though they may not have altered their drinking habits. Unhealthy drinking patterns like binge drinking and heavy alcohol use are associated with serious health risks, especially for the elderly.

Alcoholism in seniors is commonly overlooked or misdiagnosed by health care providers. Therefore, it is crucial for family caregivers to be aware of the signs of alcohol abuse in older adults. While dealing with an elderly alcoholic parent can be extremely challenging, it is important to understand that treatment programs can be successful.

My Experience Caring for an Elderly Alcoholic

My neighbor Joe was rarely without a hip flask during Prohibition. While this accessory eventually went out of vogue, he didn’t change his drinking habits as he aged. Joe was a functioning alcoholic; he and everyone who knew him were well aware of that fact. But Joe was also a brilliant, inventive and funny man. By the time I had started caring for him, he was 87 years old and had no desire to quit drinking. His wife had died a few years before, and his only son lived half-way across the country. I was all he had.

I purchased and set up a medical alert system for Joe, and I was beyond grateful for that device. He would fall often due to his deafness, balance issues, and, of course, his alcohol consumption. When he fell, he’d activate his personal alarm, which would notify a dispatch center, who would then call me to check on him. I’d run next door to his house, and, with the help of a chair and some tugging, peel him up off the floor.

One evening, my phone rang as I was fixing supper. The dispatcher told me Joe had set off his wrist alarm, which was nothing new, but somehow this time felt different. As I walked through Joe’s kitchen door, I saw him lying in pain on the floor with his leg at an unnatural angle. I immediately called 911 and it was just what I’d suspected: a broken hip. The paramedics took Joe to the hospital, where he had surgery to repair his hip and then spent a horrible week there recovering. But, instead of healing and regaining his strength, he spent those miserable days hallucinating and shaking from alcohol withdrawal in addition to the pain of his broken hip.

I visited every day and never once saw any of the doctors or nurses do anything to help Joe through his withdrawal symptoms. I tried talking to them about his drinking habits but was largely ignored. At the end of that week, Joe was ready to be discharged from the hospital but had declined so significantly that he couldn’t return to his home. He moved to a nearby nursing home, where I continued visiting him. I never saw Joe smile again; he died about six weeks later.

While I can’t be certain what it was that killed him, I am certain that alcohol played a significant role in Joe’s demise. Drinking affected his already poor balance and coordination and contributed to his frequent falls. Going cold turkey after drinking regularly for decades caused debilitating withdrawal symptoms on top of an already considerable health setback.

Sadly, Joe’s story isn’t uncommon. Alcoholism affects many older individuals, whether it has been a lifelong problem or has become a relatively new dependence. Seniors are notoriously stubborn and most are capable of making their own decisions, so family members and friends are either largely unaware of any substance use issues or they avoid discussing the topic altogether.

Alcohol Abuse Among the Elderly

The fact is that families, friends and health care professionals often overlook their concerns about older people’s drinking. Sometimes the consequences of seniors’ drinking habits are mistaken for other age-related health conditions, such as dementia or depression, but increasing alcohol use deserves special attention. This is particularly important as the number of older Americans is growing rapidly and alcohol use among seniors continues to increase. According to the 2018 National Survey on Drug Use and Health, more than one in 10 seniors report binge drinking (consuming four to five drinks in about 2 hours) during the past month. Furthermore, 1.6 percent of seniors have been diagnosed with an alcohol abuse disorder, although alcoholism is admittedly underreported and untreated in this age group.

There are two main patterns of alcohol dependence: early onset alcoholism (beginning before age 25) and late onset alcoholism (beginning after age 45). Some people—like my neighbor Joe—have been heavy drinkers for many years, while others may develop a drinking problem later in life. Sometimes this is due to major life changes like shifts in employment, new or worsening health issues, or the death of loved ones. Often these events can bring on feelings of intense loneliness, boredom, anxiety and depression.

In fact, depression in older adults often goes hand in hand with alcohol use. One study conducted by researchers at the University of Georgia found that seniors with multiple chronic health conditions (MCCs) and depression were nearly five times as likely to experience problem drinking as older adults with MCCs and no depression. At first, a drink seems to bring relief from stressful situations, but adopting this unhealthy coping mechanism comes with its own serious health risks while hindering the ability to effectively deal with difficult emotions and any underlying mental health issues.

Determining if a Senior Has a Drinking Problem

It’s important to point out that not everyone who drinks regularly is an alcoholic, and not all problem drinkers consume alcohol every day. To complicate matters further, advancing age also affects how the body processes substances like alcohol and medications. This means that the same amount of alcohol can have greater intoxicating effects on a senior compared to a younger individual. Over time, someone whose drinking habits have stayed the same or increased may find that their alcohol tolerance has decreased.

If you notice any of the following behaviors or incidents in an elderly loved one, it may indicate alcohol abuse.

Common Signs of Elderly Alcohol Abuse

Drinking to calm their nerves, forget their worries or manage their depression
Quickly gulping down drinks
Frequently having more than one drink each day (Per the Dietary Guidelines for Americans 2020-2025, moderate drinking is defined as up to one drink per day for women and up to two drinks per day for men. A standard drink consists of 12 ounces of regular beer, five ounces of wine or 1.5 ounces of 80-proof distilled spirits.)
Lying about or trying to hide their drinking habits
Instances of hurting themselves or someone else while drinking
A high tolerance and need for more alcohol to “feel” its effects (Alcohol tolerance typically increases over time but declines later in life.)
Being irritable, resentful or unreasonable when sober
Having medical, social, legal or financial worries caused by drinking
Isolating themselves and avoiding activities that do not involve alcohol
Showing signs of drunkenness (slurred speech, loss of coordination, smelling of alcohol, etc.)
Cognitive decline or unusual changes in memory
A decline in self-care, care of their household and/or care of others in their charge (grandchildren, pets, care recipients, etc.)