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Addicted Seniors

From the 2005 Spring TCA NEWS: TCs Respond to Needs of Addicted Seniors

As the elderly population grows and baby boomers move into their senior years, the number of older adults who abuse drugs and alcohol will increase.

Although a number of older adults are in need of drug treatment, few programs are designed specifically for seniors. Odyssey House Inc. (NY) created the ElderCare Residential Program in 1997 to accommodate the special needs of older adults.

The program is designed for chemically dependent men and women 55 and older. Participants are encouraged to share life experiences with peers who can empathize. Respect for the mature life experiences and strengths of older adults and sensitivity to their cultural and gender differences are hallmarks of the program. Older adults with prior treatment experience often admit to leaving programs prematurely because they could not identify with younger peers. The ElderCare Program achieved a 50 percent completion rate since its inception, higher than the field’s adult norm. As described by the Substance Abuse and Mental Health Services Administration (SAMHSA), drug and alcohol abuse by older adults is an “invisible epidemic,” and historically, older addicts have been overlooked and underserved. According to the federal agency, the number of older adults currently in treatment is small - only 3 percent of the more than 1.5 million substance abuse clients in the nation.

But the treatment needs of this population are set to rapidly increase as demand for services rises along with an increased number of older drug abusers. Recent SAMHSA data found that about 1.25 million people age 55 and older used illegal drugs sometime during 2003, a 12 percent increase from 2000 [ii].

Drug and alcohol abuse by seniors is under-reported, under-diagnosed, and often untreated. Seniors are more likely to hide their substance abuse and less likely to seek professional help. At the same time, family and friends are frequently in denial about an older person’s usage, associating it with dementia, depression, or simply a slip up. While some of the clients in treatment in the ElderCare Program seek help on their own or are referred by a family member, hospital, or detox program, 63 percent of program participants are referred from the criminal justice system.

The ElderCare Program features holistic treatment that impacts all major spheres of life. The program offers a treatment continuum that begins with assessment, evaluation, and levels of core treatment including: residential, outpatient services, and supportive independent housing. ElderCare clients participate in group and individual counseling, while rooming with other mature peers. They also have access to a 24-hour on-site medical clinic, age appropriate cultural and recreational activities, vocational/educational services, and mature staff with experience in geriatric care.

All individuals in treatment at this program, including seniors, follow a basic routine that includes job functions, caseload groups, encounter groups, seminars, and individual counseling. All clients complete anger management and relapse prevention workshops and are screened for mental health needs. A key focus of the ElderCare Program is health and wellness issues. The majority of ElderCare clients require medical attention for chronic, but manageable conditions such as diabetes, HIV, and hypertension. For many seniors, treatment offers rare access to consistent medical care.

The therapeutic community model encourages ElderCare clients to act as mentors/role models and share their life experiences with younger residents of the broader treatment community. This includes participation in the Odyssey House Library and Literacy initiative, where older residents read to the preschoolers of parents in treatment in the Family Center Program.

Because of demand, this program opened an outpatient clinic for older addicts needing a longer transition back to society. The outpatient program offers services geared towards the needs of older adults who live in the community and require rehabilitation or assistance in maintaining a sustained sobriety.

Through an internal research project, this program has identified two sub-groups of older addicts based on onset of abuse. Serious problems start later in life (mean age of 45) for about one-third of older addicts, who typically abused drugs and alcohol following a traumatic event. Late-in-life users within the program participate in trauma/bereavement counseling groups.

Life-long users (started using drugs at a mean age of 14) often abuse many different drugs and require a greater emphasis on relapse prevention groups. At this program, life-long user group therapy places individuals with similar life experiences together, where causes of addiction and patterns of relapse can be openly discussed.

As the nation’s population ages, and the unmet needs of drug-addicted and isolated seniors continues to grow, specialized services should be embraced as essential components of effective substance abuse treatment.