By Mary Bart
As the Jimmy Buffett song goes, it’s always five o’clock somewhere. But when it comes to some seniors and their caregivers, it might be more than a casual drink that ends the day.
The facts are somewhat sobering. Canadians drink 3.6 more litres of pure alcohol per capita than the worldwide average. Drinking has a direct economic impact of $13.5 billion per year: A combination of $7.1 billion from lost productivity caused by premature death and illness, a whopping $3.3 billion related to healthcare costs and another $3.1 billion attributed to the cost of enforcement. Apparently, drug- and alcohol-related issues are responsible for 14 per cent of hospital admissions among older adults and 20 per cent of admissions to psychiatric hospitals.
Is there a risk?
To some, alcohol may seem like a friend. But, in reality, as we age, alcohol is more of an enemy. The social aspects of dinner parties with friends and the rituals of “happy hour,” whether in condo party rooms, retirement homes, long-term care homes or among snowbirds on vacation, are often part of daily life. Some drink to relax or justify a glass by saying “I’m retired, I can do what I what.” Others drink to help them cope with the difficulties that have come with age, such as loneliness, boredom, financial worries, personal health issues, loss of independence or family challenges.
When older adults drink, it can affect their health and well-being. After the age of sixty, our bodies have much less tolerance for alcohol and we feel the effects of it faster. Older bodies have more fat and less muscle to absorb alcohol, which means there’s more alcohol flowing through the bloodstream for a longer period of time. Hence, there is a greater risk of falls and fractures because of poor balance, as well as the possibility of gout and exacerbating pre-existing medical conditions. Combine the natural decrease in water in older bodies with alcohol and it can be a recipe for dehydration. And all of this is not to mention the potential risks associated with drinking and driving if mom or dad is still behind the wheel.
Many Canadian seniors take prescriptions daily and also use alcohol. A publication from Alberta Health Services called “Alcohol and Seniors” notes that: “Serious physical and psychological problems can occur when alcohol is combined with medication for rheumatism, arthritis, pain, infections and depression.”
In addition, relationships with friends and families can be strained, or even destroyed, by excessive drinking. There are greater risks of domestic violence, trouble in care facilities and abuse when alcohol is part of the picture.
Caregivers who drink
Looking after a parent, spouse or friend can be both rewarding and stressful. It can be especially difficult when care is given extensively over a long period and where there is no hope of recovery or a happy ending. Research shows that there are five areas of caregiving that impact the amount and frequency of alcohol consumption as a coping strategy.
• Physical: Caregiving can be physically very hard work, especially if it involves lifting a person to and from a car, wheelchair or bed. This physical work is very tiring and can cause caregivers injury or illness.
• Financial: Family caregivers are rarely paid for their services or reimbursed for out-of-pocket expenses such as parking or purchasing food and drug-store items. They might also have to quit work or reduce their hours, which can impact their daily living standards, opportunities for promotion and retirement savings.
• Time: The amount of time (hours, days, weeks and years) spent on caring for a loved one impacts caregivers’ lives. The more time spent caregiving, the more this burden becomes an issue. For example, it is not uncommon to hear a caregiver say: “I never get time for myself; my husband always needs me.”
• Emotional: Feelings of resentment, guilt, anger and frustration are just a few of the common negative feelings that caregivers experience.
• Personal growth: “Me time” can be limited or greatly decreased because of caregiving responsibilities. Caregivers often notice that their non-caregiving friends and peers have much more personal time and, in general, seem to have better a quality of life. As one caregiver says: “I wish I could take a local art class, but I just can’t be away from Dad for that long.”
On the Job
Caregivers rarely deal with just one of these things at a time, and the weight of their responsibilities can be overwhelming. Turning to alcohol as a temporarily escape from reality can numb their pain.
Obviously, carers who are drinking on the job or hungover put themselves and their care recipients in danger. Risks include accidentally mixing up or forgetting medication schedules; neglecting to prepare and serve healthy meals; ignoring the care of the recipient’s daily personal hygiene; and driving while impaired. Substance abuse can also cause missed work days, increased money worries as more funds are being allocated to buying alcohol, missed or ignored health changes in both themselves and their care recipients, loss of perspective, and poorer judgment and common sense.
The potential for elder abuse is significantly increased when a caregiver in a position of trust is inebriated or hungover. With their inhibitions and patience dulled, and their anger and frustrations flaring, caregivers may be more likely to subject the care recipient to abuse. The abuse can be physical, verbal, psychological or financial, or take the form of neglect—and can appear as a single incident or a repeated pattern of behaviour over time.
Caregiving is very complicated. Adding alcohol to the mix clearly makes life even more complex and unhealthier.
There is nothing equal about the sexes when it comes to how alcohol affects the body. The Canadian Institute for Health Information has noted that alcohol-related hospitalizations among women are increasing rapidly (25,000 women hospitalized last year alone), as is the death rate. The rates for men have increased, too, but by a much smaller number. And although women still drink less than men, the effects on women are said to be greater.
Women’s bodies are generally smaller and have more fat than men’s bodies, which means that women do not process alcohol as quickly and can have a higher blood alcohol concentration from the same amount of drink. Other factors that can negatively influence the liver’s ability to metabolize alcohol include estrogen-containing medications, the monthly menstrual cycle and menopause. The double-whammy is that many women are also caregivers.
Making positive changes
There are a wide variety of programs and services across Canada that can help with problem drinking. Many of the services include self-regulating strategies, therapy sessions, online chat forums and in-person support groups. See the “Need help?” sidebar for more.
To make any of these programs and services of value, however, people have to first come to the realization that they need help and that they need and want change. After all, drinking is a personal choice—as is asking for help.
Mary Bart is the chair of Caregiving Matters, an Internet-based charity that offers education and support to family caregivers.
There are a wide variety of services and supports available. Here are just a few:
• Drug Rehab Services: drugrehab.ca
• Alcoholics Anonymous: aa.org
• SMART Recovery: smartrecovery.org
• Bounce Back: online.bouncebackonline.ca