BREAKING THE SILENCE ABOUT ALCOHOL ABUSE AMONG THE ELDERLY

Drinking eases their pains, but can have devastating effects

Alcoholism among the elderly is a widespread but seldom discussed problem
that's often carefully hidden by the drinker and explained away by their
embarrassed family members, SouthCoast elderly advocates say.

Tragically, many who have developed a drinking problem late in life are
offered help only when their dependence on alcohol lands them in a
courtroom or a hospital bed.

And, unfortunately, once their problem is discovered, there are few
programs designed specifically to help those who, late in life, have turned
to drinking to dull their sense of loss -- loss of their spouse, their
friends, their health and their youth.

Some here in the SouthCoast say that it's imperative that programs be
established to address the problems unique to senior alcoholics. They say
it's crucial that such initiatives, which would be based on a foundation of
peer counseling and support, be launched now so they can meet the needs of
the growing elderly population in the years to come.

"It's a problem and it's been known to be a problem for a long time, but
it's one of those we don't talk about," said Ora DeJesus, director of UMass
Dartmouth's Gerontology Center. "We have to let people know you're not a
bad person. You ache, you're lonely, you're depressed. We understand that
and you need to know that your drinking is not a flaw in your character,
but it may be killing you."

"If we don't address this now, it will get worse," said Cora Peirce, who is
studying gerontology and substance abuse among the elderly. She is the
legal advocacy program coordinator for the women's center at Stanley Street
Treatment & Resources in Fall River.

Just how widespread is alcoholism among the elderly here in the SouthCoast?
It's hard to pinpoint the exact numbers of those who might be affected, but
research conducted for Southcoast Health System -- the parent of St. Luke's
Hospital in New Bedford, Tobey Hospital in Wareham and Charlton Memorial
Hospital in Fall River -- sheds some light on the problem.

The survey shows that 5.5 percent of those who responded to that
questionnaire described themselves as chronic drinkers, compared to 4.5
percent of residents statewide. Chronic drinkers are defined as those who
have had at least 60 drinks of alcoholic beverages during the last month.

Of those 65 and older who responded to the Southcoast Health System Survey,
6.4 percent described themselves as chronic drinkers, compared with 5.1
percent of those between ages 18 to 39 and 5.7 percent of those aged 40 to 64.

Those figures were gathered as part of the 1997 Community Health
Assessments, studies conducted by the Nebraska-based Professional Research
Consultants Inc. Those studies will be used to help the New Bedford, Fall
River and Wareham Community Health Networks identify and prioritize health
problems and develop a plan to address them.

Mrs. DeJesus and Ms. Peirce say alcoholism among the elderly is one such
problem, and one that will grow more prevalent as the baby boomers grow older.

According to the state's office of Elder Affairs, there were 819,284 people
age 65 and over in Massachusetts as of the 1990 census. It is estimated
that by the year 2000, there will be 855,000 people age 65 and over in the
state -- 14 percent of Massachusetts' population.

And as people age, some who never drank or considered themselves just
social drinkers may develop a problem.

According to the National Institute on Aging and the National Institute on
Alcohol Abuse and Alcoholism, there are two types of problem drinkers --
chronic and situational. Chronic abusers have been heavy drinkers for many
years and although many chronic abusers die by middle age, some live well
into old age. Most older problem drinkers are in that group.

Other people may develop a drinking problem late in the life, often because
of "situational" factors such as retirement, lowered income, failing
health, loneliness or the death of friends or loved ones. At first, having
a drink brings relief, but later it can turn into a problem.

It's that latter group that Mrs. DeJesus and Ms. Peirce are working so hard
to educate.

According to Mrs. DeJesus, she's seen a host of different reasons why
elders turn to alcohol. They include: Self-medication: "They drink for
sedation," Mrs. DeJesus said. "Sometimes life isn't too pleasant and the
losses are tremendous. A lot of people think 'If I take a drink, it's a
little fuzzy and I can forget about it.' "

Pain relief: As their physical condition deteriorates, senior citizens may
turn to alcohol in an effort to dull their aches and pains. Isolation:
"They're watching television all day and they find that even the worst T.V.
looks pretty good after a few drinks," Mrs. DeJesus said.

As their problems escalate, elders may become more adept at hiding their
drinking and shun offers of assistance.

"It's very difficult for them not to feel they're being judged," said Ms.
Peirce, who will graduate from UMass Dartmouth with a bachelor's degree in
criminology and sociology and a minor in gerontology this spring.

"They grew up in a time when an alcoholic was a drunk on the street and if
you needed counseling, you were crazy."

Elders may be aided in their efforts to hide their addiction by family
members who are embarrassed or ashamed to admit their loved one has a problem.

"I've been places where the mother is obviously inebriated and the family
members say 'Oh no, it's her medication,' " Mrs. DeJesus said.

But it's imperative that senior citizens and those who love them address
the issue because alcohol abuse has potentially devastating, even deadly
implications for senior citizens.

Physiological changes that are a part of aging make the body metabolize
alcohol slower and less effectively, Mrs. DeJesus said.

"If you're older, you've had all these losses in your organisms and alcohol
is going to affect you differently. You have to know that," Mrs. DeJesus said.

Additionally, mixing alcohol and prescription or over-the-counter drugs has
its own set of potentially dire implications.

Mrs. DeJesus and Ms. Peirce suggest the best people to warn of those
dangers and offer assistance are the seniors' peers.

Such a system of peer counseling has been working successfully on Cape Cod
for years.

The Cape Cod Council on Alcoholism and Drug Dependence has been in
operation for 36 years and for the past 25 years, it has sponsored programs
geared specifically toward the elderly alcoholics -- programs which rely
heavily on peer counselors.

"There's less shame when you're talking to someone in your own age group in
your own home," said Patsy LaBelle, the Council's executive director. "It's
a much softer-sell approach to recovery."

The council operates three drop-in centers, in Hyannis, Falmouth and
Orleans, where people can come for assistance.

Additionally, the Council sponsors so-called Pause-A-While's -- group
meetings geared toward senior citizens where they can receive support,
encouragement and information.

"The (peer counselors) have experienced what these people are gong
through," Ms. LaBelle said. "A younger person might see a problem and want
to fix it, where a peer counselor can see a problem, talk about their own
experiences and help guide someone through a transition."

It's not easy -- the Council operates on a shoestring budget. Aside from
some assistance received from the towns on the Cape and the United Way, the
Council relies heavily on its own fund raising.

"We've stayed poor but effective," Ms. LaBelle said.

That type of effective initiative is what's needed here, Ms. Peirce and Ms.
DeJesus believe.

"The mentality many have about treatment is one-size-fits-all ... (but) the
approaches to treating alcoholism (in the elderly) have to be as different
as the people you're treating," Mrs. DeJesus said. "Who are you? What is
the problem? Why are you imbibing alcohol?"

In the meantime, she said, people must reach out to those who may be in
trouble.

"Neighbors need to be neighborly and reach out in friendship and they need
to be a little thick-skinned," Mrs. DeJesus said.

Failing to make that effort could be disastrous, Ms. Peirce said.

"They're alone. They're left to deal with their losses in a silent home and
that silence echoes," Ms. Peirce said.

Checked-by: Mike Gogulski