ELDERLY AMERICANS BATTLE ALCOHOL

Senior Drinking Too Often Ignored

Hildegard Leonard, 73, used to wake to drink, and take her waking slow. A
shot of scotch kept her numb and buzzing throughout the day, which she'd
spend, usually in her pajamas, watching TV, dozing and waking only to drink
more.

Sober for eight years now, she was once one of America's darkest secrets:
one of an estimated 3 million older alcoholics. As many as 20 percent of
those over 65 have some problem with alcohol, several studies show. But
since most of them spend dull, oppressive days alone and isolated, few
people think there's a problem.

But there is.

More older people are hospitalized for alcohol than for heart problems.
Nearly onefourth of all those hospitalized over age 60 are diagnosed with
alcoholism, with treatment costs as high as $60 billion.

One quarter of financially strapped Medicare's costs go to pay for
substance abuse among the elderly. And alcohol is the drug of choice.

With the much larger and much heavierdrinking baby boom generation 15
years from old age, the hidden problem will only get worse.

``By the year 2030, fully onethird of our population is going to be older
adults,'' said Carol Egan, director of Older Adult Services at
HanleyHazelden, a drug and alcohol treatment center in West Palm Beach,
Fla., and herself a recovering alcoholic. ``If we don't start addressing
older adult issues like alcoholism now, they'll be plunked right in our lap.''

Doctors often misdiagnose the shaking hands, confusion and memory loss of
elderly alcoholics as old age. Many ask the wrong questions: ``How much do
you drink?'' rather than, ``How does drink affect you?'' As the body ages,
alcohol is not processed as quickly. One drink can do the harm in an older
person that a sixpack used to.

About 25 percent of patients diagnosed with dementia, many of whom are
mistaken as Alzheimer's sufferers, are actually impaired by alcohol.

Many In Denial

Raised in the era of Prohibition, where drinkers were moral failures and
alcoholics were bums in the gutter, most older alcoholics fiercely deny
they have a problem. And many live reclusive lives, calling the liquor
store for the next delivery, and are nearly impossible to reach.

Spokane, Wash., is one of the few communities to try to bring older
alcoholics into treatment. Under what is called the ``gatekeeper'' program,
counselors train postal workers, meter readers and others who come in
contact with the elderly to recognize problems with alcohol. Gatekeepers
now find four out of every 10 admissions to local substance abuse programs.

Families, many of whom live miles away, are often silent. Raised to respect
their elders, they either leave them to their ``hobby,'' ignore the
problem, don't want to air embarrassing dirty family laundry, or are unable
to confront it.

Those who do confront it find, usually after a lengthy search, that only a
handful of treatment centers care for the elderly, that treatment costs can
run into the tens of thousands of dollars and that Medicare has cut the
inpatient treatment it covers from 28 days to five.

The federal government, too, ignores the problem, focusing instead on
youths. Research on the elderly gets 2 percent of the addictions budget;
only one of the 14 federally funded addiction research centers is dedicated
to studying the elderly.

``I feel I should have been ahead of this curve,'' said David Mactas,
director of the federal Center for Substance Abuse and Treatment, who has
set a March deadline for a report on how to better treat elderly
alcoholics. ``It's not too late. But we've got to catch up.''

Older alcoholics have traditionally been divided into two groups: those
who've had a problem all their lives, and those who begin to drink to
excess only after retirement or the death of a spouse or out of depression.

Larry Schonfeld, who works with older alcoholics at the Florida Mental
Health Institute, said that because of the boredom and loneliness of old
age, finding activities and social networks are keys to recovery. ``It's
important to look for different ways to break the cycle of drinking in
front of the TV and getting snockered,'' he said.

Unlike many colleagues, Schonfeld does not believe alcoholism is a disease
although many studies show it dramatically alters brain chemistry.
Instead, he treats it as a problem that can be overcome. If people drink
because they're angry, he tries to help them find a way to cope with anger.

Few Seniors Treated

But few people ever get into treatment. Researchers estimate only 10
percent of those with alcohol problems ever make it through a center's
front door many coming in when families reach the breaking point during
the heavy drinking and the emotional upheaval of the Christmas and New
Year's holidays.

Because alcohol is a chronic addictive problem, fully 80 percent of those
who do get treatment will relapse, either once, or for good, within one year.

In the face of such odds, Leonard's story and those of others like her
offer hope. She was on the verge of joining the 30,000 older Americans who
die every year from abusing drugs and alcohol. Instead, she changed her life.

Leonard, who lives in Ann Arbor, Mich., had always been a social drinker,
indulging at parties or sharing a drink with her husband at the end of the
day. In 1975, when her mother suffered a stroke and had to be put in a
nursing home, Leonard started reaching for a slug of scotch to brace
herself before visiting. Then she found a swig once she got home gave her
relief.

Her husband's death in 1987 sent her into a twoyear alcoholic haze.

She'd call her daughter, Suzanne Vanderburg, crying that no one cared about
her or demanding that she come fix her a sandwich. Or she'd call her son,
Richard, asking why she hadn't seen him in a few days. She lied about
drinking. Constantly.

``I never hated her badly enough to disown her,'' her son said. ``But I
came close.''

In And Out Of Programs

Drinking a fifth of alcohol a day, Leonard dropped nearly 30 pounds. She
was in and out of detox programs.

Finally, Richard found the Older Adult Recovery Center at Chelsea Community
Hospital, one of the handful of treatment centers aimed at the elderly. She
went through the sixweek program once, then relapsed at her favorite
restaurant, Sneaky Pete's. That did it for Richard.

``I just lost it. I said, `We've had enough.' She didn't care about
anything, she was so selfish. I didn't want to talk to her anymore. I told
her not to call anymore, and I hung up on her,'' Richard said. ``After
that, she never drank again.''