Some authorities believe that at least half of hospital admissions among
the elderly are related to drug intoxication. Many of these problems stem
from misuse of medications; in addition 10 to 15 percent of seniors are
troubled by alcohol abuse, frequently leading to serious medical problems.
The good news is that alcoholics over 60 are particularly responsive to
treatment ... provided the problem is discovered early enough. Other cases
of drug misuse are more than likely mishaps with prescription and over-the-counter
medications that could be avoided with more observant monitoring.
Charlie: A Problem Escalates
Everyone knew that Charlie was an enthusiastic drinker. Even after retirement
he still went to the bar every afternoon to have a few drinks with his friends.
The drinking was always structured and limited by the implicit disapproval
of his wife if he overindulged.
When his wife died, the structure suddenly disappeared. He went to the bar
more frequently and stayed longer. He even went there on weekends, when
most of his friends were occupied, to watch football. Because he was living
alone, he often skipped meals or snacked at the bar.
Charlie's friends knew he was having trouble with grief and loneliness.
When he drank a little too much, they were glad to see him having a good
time. His two sons were preoccupied with their own lives and families. They
didn't know that with age even an experienced drinker like Charlie feels
the effects much sooner. His problems were compounded by medications he
was taking. Only after an automobile accident, and a stern warning issued
by the investigating police officer, did Charlie get the treatment he needed.
Grace: A Crate of Oranges
Unlike Charlie, Grace drank very little until after the death of her husband.
Lonely and grieving, she started taking just a small amount of gin to help
her sleep at night.
Even though she may have fallen asleep easier, she got less rest and eventually
needed more alcohol just to put herself to sleep. As for her grief, the
alcohol, a central nervous system depressant, ultimately made her feel increasingly
despondent, and her grief deteriorated to a feeling of hopelessness.
Like Charlie, Grace lived on her own and had no one to notice or monitor
her drinking. The problem was detected by a neighbor who was asked to help
her carry in a "crate of oranges". Hearing the tinkling of glass
from a box labeled Gilbey's Gin, the neighbor talked to one of Grace's adult
children who investigated. Following a few weeks of treatment and provision
of much-needed home health care services, Grace improved immensely.
Bill: A Pocketful of Pills
Bill's problem was not alcohol but drugs -- the legal kind.
For different medical conditions, Bill was seeing three physicians, and
each was prescribing on-going medications. No one had checked to see if
any of these had adverse interactions or duplicated effects. He was also
taking over-the-counter pain relievers and cold remedies.
Bill wasn't aware that age could affect his reaction to the drugs he had
taken safely for years. Changes in body com-position affect the length of
time a fat-soluble drug stays in the body and how much is absorbed. Because
his liver and kidneys were less efficient than before, Bill was less able
to metabolize his medications and remove them from his bloodstream.
When his memory started to fail, his family blamed it on age rather than
his daily regimen of medications. Only when his new heart specialist took
it upon herself to review all of his medications, did Bill finally escape
the many side effects.
Since Bill didn't drink, he escaped another potential hazard. Alcohol can
exag-gerate the effects of a medication or have an adverse interaction.
The Food and Drug Administration reported that more than half of the 100
most commonly prescribed drugs "contain at least one substance that
reacts badly with alcohol."
These cases highlight the need for close monitoring of drugs--not just
by the patient but by family, friends and doctors. Anyone over 50 taking
several medications should ask a doctor to review them and their possible
side effects and interactions. Or the doctor should initiate the review.
A family doctor should also inquire about a patient's drinking and give
advice about how much is safe to consume when taking medications.
Family and friends of the elderly person should notice changes in behavior
and personality. It's too easy to attribute deteriorating memory, thinking
ability, coordination or motor skills to aging when in fact they may be
caused by drugs or drug interactions.
Any expression of hopelessness should be taken seriously; many prescription
drugs cause symptoms of depression and so does chronic alcohol abuse. About
50% of suicide attempts are made when the victim is under the influence
of alcohol or drugs.
Chronic drug use can cause malnutrition. And when elderly persons skip
meals, as they often do when living alone, the effects of medications and/or
alcohol are exag-gerated. Eventually misuse of alcohol and prescription
medications can bring on or complicate medical problems such as high blood
pressure, heart disease, ulcers and gastritis.
When used properly, prescription drugs and even alcohol have a vast potential
to improve quality of life. It's up to seniors and those around them to
ensure that they are used properly.