Screening for Alcohol Issues in Older People

Screening for Alcohol Issues in Older People
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It is important to ask about alcohol use. Remember, alcohol is a drug! As we age there are inevitably changes particularly in older women in the ability to metabolize substances, even when used in moderation. We need to ask about the quality and type of substance in addition to quantity and frequency (including substances not intended to be imbibed.) We need to inquire about concurrent physical health (such as diabetes) and mental health conditions (such as depression) as well as other substances, prescribed and non-prescribed including over the counter, herbal, and shared medications. Increasingly, it is important to ask about recreational drugs as well.

To be useful, questions need to be appropriate for the individual’s life stage. It’s not just about asking the questions regarding alcohol and substance use but the context and sequence of the questions. A confident, simple and direct approach is important in clarifying information relevant to the client in their immediate situation. (We recognize that there may be limitations associated with language and cultural concerns.)

And the risks are greater. Be aware that the life threatening consequences of alcohol similar to benzodiazepine withdrawal (National Initiative for the Care of the Elderly,

2012) are more frequent in later life and require careful monitoring with concern for other medical conditions and consequences. In particular watch for tremulousness, palpitations, shaking, seizures; nausea, vomiting, diarrhea, sweating, agitation, anxiety, hallucinations; disorientation, and alteration of consciousness (Sullivan et al, 1989).

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National Initiative for the Care of the Elderly (NICE)
246 Bloor Street West, Room 234
Toronto, Ontario M5S 1V4, Canada