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Caregiving

Addressing Drug or Alcohol Abuse as a Live-In Caregiver

by Kimberly Johnson
written by Kimberly Johnson

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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When Roles Reverse: Talking to Parents About Alcohol
Healthy Living

When Roles Reverse: Talking to Parents About Alcohol

by Guest Blogger
written by Guest Blogger

In every parent-child relationship, there eventually comes a time when roles reverse. It’s a natural and inevitable extension of the aging process. The mom or dad who once changed your diapers, drove you to soccer practice, and applied Band-aids to skinned knees will gradually lose their mobility and independence, requiring greater help and supervision with their own health and safety needs. For the child who in turn is tasked with caring for an aging parent, navigating this new juncture can be difficult because it means taking a more directive role in relation to a grown-up who, in addition to having parented you, is used to having their own independence and making their own lifestyle decisions. When Roles Reverse: Talking to Parents About Alcohol
Take, for example, the issue of alcohol consumption in old age. It’s a biological fact that alcohol tolerance decreases as you age, so that moderate drinking that caused no health problems earlier in life may pose serious dangers later in life, purely because of the aging process. Consequently, maintaining a healthy lifestyle in the golden years often requires scaling back one’s drinking habits-to a weekly intake of seven drinks or less, according to recommendations from the National Institute on Alcoholism and Alcohol Abuse.

But tell that to an aging parent who is accustomed to several glasses of wine every night, and chances are that you’ll draw some ire. While some of this touchiness may be unavoidable, the following tips and guidelines can ease a conversation about drinking-related concerns with an aging parent:

Pick the right time to talk. As a good rule of thumb, “the right time” for a conversation about your parent’s alcohol use will not be when they are drinking. If their habit is to polish off a bottle of wine in the evening, choose an earlier time in the day to broach the subject. If you’re noticing signs of alcohol abuse-a morning hangover, for example-the best time to talk with your parent may be when they’re experiencing the negative side effects of their drinking. In that state, they may be more open to seeing how their drinking is adversely impacting their health.

Arm yourself with the facts. Because of aging-related differences in how the body metabolizes alcohol, just two or three beers at age 70 have about the same impact as four or five beers at the age of 50, according to Dr. David Oslin, M.D., in a 2010 article in the New York Times. “The effect almost doubles,” Dr. Oslin said, with the result that a seemingly moderate intake of alcohol can lead to insomnia, depression, exacerbated arthritis pain and heart damage, among other serious conditions. These dangers are compounded by the fact that many doctors do not sufficiently screen older patients for alcohol and other drug use-so it is safe to assume that your parent may not be aware that a long-held drinking habit may pose new health risks in their golden years. They also may not realize that alcohol may interfere with one or more of the medications they take and that in some cases the combination may be toxic. Sometimes, simply laying out these facts for an older parent will be enough to motivate them to rein in their alcohol consumption.

Open the conversation with a question. This way you convey your concern honestly and directly, but in a gentle, non-confrontational style that invites (and shows that you value) your parent’s feedback. A good lead-in question might be, for example, “Have you talked with your doctor about the medications you’re taking and their interactions with alcohol?”

Avoid labeling or diagnosing the problem. Even if it is an accurate description of your parent’s drinking habits, addiction terminology like “alcoholism” or “alcoholic” is not helpful because of the heavy stigma it carries. Using these labels can amplify your parent’s sense of shame or embarrassment about their drinking. (After all, if their alcohol consumption is causing negative consequences, they will have at least some awareness of the problem-even if they can’t admit it to you.)

Be specific about your observations and concerns. The caution to avoid labeling or diagnosing your parent’s problem should not require that you be silent about your observations and concerns. Just because your mom or dad is elderly does not mean they need to be coddled or protected from the truth. On the contrary, it is perfectly appropriate to say, “I am concerned about your drinking, because of x, y, z.” You can convey your concerns in a gentle and respectful tone.

Focus on the present, by identifying positive incentives for adopting a healthier alcohol intake. Even at an advanced age, the promise of better health and quality of life-and making the most of the time that is left-can be compelling motivation to modify one’s drinking habits. Try to emphasize the things that you know give your parent joy in the present, and that will give them even more joy when alcohol is less of a crutch. Whether it’s spending time with grandchildren, pursuing a romantic flame, or learning a new hobby in retirement, something else is worth more to Mom or Dad than their drinking ritual. By bringing that “something else” to their attention and encouraging them to pursue it, you’ll be sending the message that you love your parent and want them to be happy and healthy. It is hard to think of anything more persuasive than that.

Anna Ciulla is the Vice President of Clinical and Medical Services at Beach House Center for Recovery where she is responsible for designing, implementing and supervising the delivery of the latest evidence-based therapies for treating substance use disorders. Anna has a passion for helping clients with substance use and co-occurring disorders achieve successful long-term recovery.

When Roles Reverse: Talking to Parents About Alcohol

When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol When Roles Reverse: Talking to Parents About Alcohol

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Caregiving

Privacy Issues: Personal Boundaries Between Caregivers and Families

by Kimberly Johnson
written by Kimberly Johnson

In their role of caring for the elderly, caregivers must strike a tricky balance. On the one hand, they often enjoy unparalleled access to a client’s private information. On the other, if they are to be effective (not to mention ethical) in the job of caring for their client’s therapeutic needs, they must maintain clear professional boundaries with the client and family members. Privacy Issues: Personal Boundaries Between Caregivers and Families
Needless to say, it’s not always immediately obvious what constitutes crossing the line in a professional helping relationship with a client and their family. Here are some questions caregivers can ask themselves in order to delineate appropriate personal boundaries in these more ambiguous situations:
Am I over-helping or under-helping in this situation? An example of “over-helping” would be taking on a role or duties that ordinarily would be reserved for a partner or family member, such as helping a client balance their checkbook, giving or receiving special gifts, or (maybe most blatantly) getting romantically involved.
Signs that you may be over-helping—what we in the addiction treatment world often refer to as “codependency”—include: visiting the client when you are off-duty, spending inordinate amounts of time with the client, using family nicknames with the client, a growing self-perception that you are the only person who can help the client, and confusing the needs and feelings of the client with your own. (The latter can happen if you begin to project your emotional needs onto the client, assuming that what you are feeling may be what they also need, or become so invested in their welfare that your own health suffers.)
“Under-helping” manifests itself as neglect of the client’s therapeutic needs. One example might be keeping a personal secret with the client that compromises their health and welfare.
Am I serving the client’s therapeutic needs and interests, or are my actions more about taking care of my own personal needs? Your No. 1 professional obligation as a caregiver is to ensure the client’s therapeutic needs are being met. One good litmus test for any situation is therefore to ask yourself whether you are in fact prioritizing this job duty—or, whether your own need to receive love or care for your emotional needs is actually motivating your actions.
Am I soliciting extraneous private information from a client and their family, or am I sharing extraneous private information about myself with a client and their family? What you choose to talk about can also border on inappropriate boundary-crossing. Invasive questions about a client’s private life, answers to which have nothing to do with the client’s medical care, are inappropriate—but “TMI” (Too Much Information) is a two-way street, meaning that what you share with a client and their family can also fall into this category of extraneous private information.
If, based on your answers to these questions, you believe that you may have crossed a boundary (or may be at risk of doing so), talking to your supervisor or a trusted colleague about the issue may be a wise precaution. They may also help advise you about whether reassignment to another client is necessary. In some cases, it may be appropriate to discuss your concerns with the client and/or family members, so that they can be made aware of the importance of personal boundaries.
By Anna Ciulla
Anna Ciulla is the Vice President of Clinical and Medical Services at Beach House Center for Recovery where she is responsible for designing, implementing and supervising the delivery of the latest evidence-based therapies for treating substance use disorders. Anna has a passion for helping clients with substance use and co-occurring disorders achieve successful long-term recovery.
Link Between Immobility and Substance Abuse

Privacy Issues: Personal Boundaries Between Caregivers and Families

Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families Privacy Issues: Personal Boundaries Between Caregivers and Families

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