A recent client of mine, Stacey, was ambivalent about seeking help for her mother, Catherine. She wasn’t sure how to approach the issue. Stacey, a busy mom herself with four kids, a husband and a side career didn’t have time to deal with what was developing with her mother. Catherine recently lost her husband not long after turning 75, but that didn’t slow her down.
“After dad died, she started planning all these parties and book clubs, vacations and events. I think it was her way of coping with her loss – she blocked it out,” Stacey told me during one of our initial talks. “But then the gambling started. One of her friends had a birthday at a casino and it was like a moth to the flame for my mom.”
“Were you worried about her?” I asked Stacey, half knowing the answer. “Not really,” she said with confidence. “It seemed like a necessary distraction, a hobby for her new version of life getting older without her husband by her side.” When Stacey mentioned her mother was getting older, I knew this was a positive entryway into discussing the finer points of aging and the impacts it’s having on families like Stacey’s.
In the coming decades, millions of Americans will reach senior citizen status. In fact, the baby boomer generation – 78 million strong – will be over the age of 65 by the middle of the century, reports the Census Bureau. This means that 1 in 5 Americans will be a senior citizen – the largest group of older citizens in American history. In addition to the United States, the world’s population of elderly folks will double – from roughly 500 million to nearly 1 billion adults over the age of 65 by 2030.
With the turn in demographics, a challenging question is posed for policymakers and health care professionals: how does our society prepare for and take care of an older population? More importantly, this population of Americans are experiencing upward trends in substance abuse, chronic pain, disease and other physical maladies, grief and loss, suicide, and process disorders such as gambling, financial issues, excessive shopping, disordered eating, etc.
These multiple forces – the greying of baby boomers and increase in addiction and physical and behavioral health issues amongst this group – are merging together and creating a cacophony of dilemmas in our country and abroad.
What factors are driving these struggles amongst aging adults? First and foremost, as we age one experiences physical changes in the body. Our bodies endure wear and tear, eyesight changes at least 4 times in a lifetime. We may require hip and knee replacements, surgeries, rehab and physical therapy. Other diseases that arise from physiological changes and aging include arthritis, heart disease, cancer, Alzheimer’s, osteoporosis, diabetes and obesity. In addition to the financial strain this may put on aging folks and their families, these maladies open the door to chronic pain and co-occurring issues.
“What do you mean by co-occurring issues?” Stacey asked. I explained to Stacey the example of chronic pain. When someone experiences chronic pain – pain lasting longer than 90 days, long after the initial wound has healed – they may develop an addiction to pain pills to cope. The person wasn’t addicted to pain pills before and was able to take them in a healthy manner up until the chronic pain opened the door to coping with addictive prescription painkillers.
“Maybe that explains her drinking.” Stacey went on to say that Catherine had never been much into drinking. It wasn’t until after the gambling started that she would drink three to four vodka sodas in a short period while at the slot machines. She said they went on a cruise together recently and when she couldn’t find her mom at the slot machines, she went back to the room hoping she’d be there. A few hours passed and she got worried. Stacey then alerted the staff and together they looked for her mom. They finally found Catherine asleep on a deck chair.
“When I talked to my mom about it after, she said she got lost and wandered until she was tired and decided to sit down,” Stacey said through tears. “I was so worried because my dad was no longer there to look after her. How was I going to keep an eye on her?”
I explained to Stacey that life transitions such as retirement, children growing up and moving away, grief related to loss of loved ones, and even depression, loneliness and isolation can trigger a substance abuse, mental health or process disorder like gambling. The gambling can then trigger a co-occurring issue like alcoholism.
According to SAMHSA, alcohol and drug abuse is one of the fastest growing healthcare problems for Americans 60 years and older. In fact, alcohol is the most widely abused substance for Americans over the age of 50, nearly 50% of nursing home residents have alcohol related issues, and widowers over 75 have the highest rate of alcoholism in the U.S.
Despite substance abuse issues being a major problem for aging adults, there are certain barriers to treatment this population may encounter. Some barriers include:
- Misdiagnosis – doctors and healthcare professionals may believe older Americans won’t have a cocaine or marijuana addiction (because it is assumed only younger people abuse these drugs) and will instead look to other symptoms.
- Shame & stigma – family and friends close to the individual don’t want to talk about real struggles. For instance, STD’s are a major health concern for this population, as dramatized in this humorous physician written & performed public health Youtube video, yet few will discuss sex because of shame and taboo surrounding the topic.
- Ageism – a belief that time and resources should not be spent on these individuals because they are too old or won’t be open to changing and improving behavior.
- Denial – family and friends may look the other way or explain it as “the only thing that makes grandpa or grandma happy.”
Once Stacey was able to talk through her fears related to her mom, she could see that real help was available for their family. I advised her mom begin to see a therapist to talk through her grief and channel it into productive ways of living. I also explained that because her mother was aging, changes to her mind and body and the ways she lived in the world would be common place. We also discussed ways the family as a whole could adjust to the changes to make their grandmother feel loved and supported.
“I’m glad I was able to talk to someone about this,” Stacey said after opening up about her fears. “My mom means so much to me and I want her to live a happy and healthy life just as she wants for me.”