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Addressing Drug or Alcohol Abuse as a Live-In Caregiver

by Kimberly Johnson
The Greatest Fears in Grief

How to Talk About Drug or Alcohol Abuse as a Live-in Caregiver and What to Look Out For

When you’re a live-in caregiver, your No. 1 priority should be the health, safety and well-being of the person you’re caring for. Given the rising tide of prescription drug and alcohol abuse among today’s seniors, that entails knowing the signs of drug and alcohol abuse—and being able to talk about a potential problem with drugs or alcohol when you have suspicions. Addressing Drug or Alcohol Abuse as a Live-In Caregiver

Substance Abuse and the Elderly

Substance abuse by elderly Americans—particularly of alcohol and prescription drugs—is “an invisible epidemic,” a report by the Substance Abuse and Mental Health Services Administration warned in 1998.
By a recent estimate, more than half of older adults (ages 65 and older) drink alcohol, and of these seniors, roughly one in five drinks to excess at unsafe levels, according to a CBS News report in 2015.

Prescription drug abuse, too, is cause for concern, as evidenced by the fact that a vast majority (87 percent) of older Americans take at least one prescription drug on a regular basis, according to a 2005 report by the American Association of Retired Persons (AARP). Among elderly people who seek medical attention, the rate of prescription drug abuse is reportedly between 13 and 15 percent. (The actual rate of drug abuse is likely much higher, given that many instances of abuse go unreported.)

Signs of Alcoholism and Drug Abuse – What to Look for

The signs of alcoholism and/or drug abuse in older Americans can be harder to miss—hence the term “invisible epidemic.” For example, a reliable sign of a substance use disorder (SUD) is having problems at work, but many older Americans are retired and no longer working. They may therefore not manifest this more obvious warning sign of a drug or alcohol problem. Sometimes, too, the symptoms of a SUD can masquerade as merely the natural symptoms of aging.

Live-in caregivers, by virtue of dwelling in close proximity to their elderly clients, are uniquely positioned to catch the signs of a potential SUD, however. In this sense, they are first responders on the frontlines of catching a substance abuse problem before it’s too late. Below are signs to look for if drugs or alcohol may be a source of concern: Addressing Drug or Alcohol Abuse as a Live-In Caregiver

  • Drinking alone and often
  • Ritualized drinking (for example, needing a drink at a certain hour of the day and becoming frustrated, irritable or belligerent when that’s not possible)
  • Drinking in spite of label warnings on prescription drugs or the misuse of prescription drugs
  • Slurred speech, the smell of liquor on one’s breath and/or signs of intoxication
  • Changes in mood (seeming down, anxious or depressed or more prone to sudden outbursts)
  • Memory problems
  • Unexplained burns, bruises, falls or other injuries
  • Other worsening health problems—or, chronic health complaints that seem to have no physical cause
  • A loss of interest in hobbies that once brought pleasure
  • A history of alcohol abuse or a recent life-changing event such as the loss of a spouse or retirement (coupled with one or more of the above signs)

Tips for Talking About Drug or Alcohol Abuse

If you suspect drug or alcohol abuse is at play based on the above signs, talking about your concerns may be the next step (depending on the circumstances). When you broach your concerns regarding drug or alcohol abuse, the following guidelines may help:

  • Talk with the person when they are not drinking or under the influence. If the person is intoxicated or under the influence of alcohol or another drug, he or she will be less likely to hear you or more prone to defensiveness.
  • Emphasize your love and concern. Someone with an addiction problem is more likely to listen to your concerns when on the receiving end of a loving attempt to connect. This is not the time for barking orders or flushing pills or liquor down the toilet or sink dispenser. Instead, stay positive, by noting the qualities you admire in the person, the memories you’re grateful for, and the positive core values he or she has modeled for you (such as the love of family or the importance of faith). These core values can also be a way to reinforce the positive motivation(s) someone with a potential SUD might have for getting treatment. For example, if you know family is important to him or her, spending quality time with grandchildren may be a good incentive to enter drug or alcohol treatment.
  • Be gentle but direct about your concerns. In a great number of instances, just because a client is elderly does not mean he or she is not able to understand you, or needs to be babied or sheltered from the truth. Matter-of-factly and as non-judgmentally and non-confrontationally as possible, mention the behaviors you’re noticing that are causing you concern and why.
  • Avoid the terms “drug addict” and “alcoholic.” Because these terms can be stigmatizing, they can perpetuate people’s sense of shame and/or denial, thereby pushing them further away from receiving help. Addressing Drug or Alcohol Abuse as a Live-In Caregiver


By Linda Williams
Linda Williams is the Executive Director of Beach House Center for Recovery. She is also a seasoned clinician with specialization in addiction and trauma.
For additional information please visit The National Council on Seniors Drug & Alcohol Rehab: https://rehabnet.com/

Addressing Drug or Alcohol Abuse as a Live-In Caregiver

Addressing Drug or Alcohol Abuse as a Live-In Caregiver Addressing Drug or Alcohol Abuse as a Live-In Caregiver Addressing Drug or Alcohol Abuse as a Live-In Caregiver Addressing Drug or Alcohol Abuse as a Live-In Caregiver

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