The baby boomer generation is the fastest growing cohort in the United States. Baby boomers are now starting to experience the natural effects of aging. However, many people in this generation had experiences, uniquely different from other generations, that may affect their health today.
When this cohort hit puberty, it was the age of the free spirit. Society was going through huge social change: Hippies, sex, drugs, and rock and roll were becoming the new craze. Teens and young adults were experimenting more and more with drugs and alcohol.
Research and social support for parents and teens regarding substance abuse, health risks, and social ramifications were largely unavailable at this time, according to the Center for Substance Abuse Treatment, and as a result, symptoms were often overlooked or misdiagnosed.
Complications
Some baby boomers continue to have longstanding issues with abuse and addiction, wrote Celia Vimont for Partnership for Drug-Free Kids in 2013. Others stopped ingesting drugs and alcohol; however, the negative effects on their bodies can still be an issue for them, their families, and health care providers.
Furthermore, when people age, their sensitivity to drugs and alcohol increases while their tolerance decreases, according to the Hazelden Betty Ford Foundation.
Hazards such as DWIs, falls, breaking bones, starting fires, and becoming argumentative with friends and family are some behavioral issues that crop up in people who have substance addictions, according to a report on alcohol and injury in emergency departments by the World Health Organization. Aging medical diagnoses already may include high blood pressure, mental health issues, high cholesterol, and diabetes. Elderly people who experience untreated substance abuse will be more susceptible to these accidents and medical conditions than their peers, says Stephen Ross, MD, in “Alcohol Use Disorders in the Elderly,” in a 2005 issue of Psychiatry Weekly.
A medical professional’s goal is to keep patients healthy. The patient’s goal is to remain independent as long as possible. Patients who have a history of substance abuse are more at risk of becoming dependent, says Paul Beck in “Clinical Methods: The History, Physical, and Laboratory Examinations.” Prolonged substance use will eventually impact the entire body and cause serious health issues. Medical costs for these individuals may skyrocket, and in some cases Medicare may not pay for treatment, medical procedures, or medication.
What To Look For
Research shows that there are many reasons that people turn to drugs and alcohol. For instance, substance use may take away years of emotional and physical pain. Health care providers must be aware of “closet users” and patients in the pre-contemplation stage of change (not even realizing they have a problem).
Symptoms may be mistaken for other health concerns, such as dementia, mental diagnoses, or other ailments. As people age, they may face some kind of health or emotional difficulty. Relying on substances for relief will only result in exacerbation of health problems for the patient in the long run.
Identifying patients at risk is crucial. To start, providers should obtain a thorough list of medications, including over-the-counter drugs that the patient is taking, and complete a detailed medical and social history, including patient losses such as the death of parents, siblings, spouses, children, and/or friends. Be aware that patients may not divulge or may minimize their substance use. Patients may also be misusing their prescription medication.
Building rapport with the patient is an important first step. Be sensitive to the fact that patients may be losing their independence by not being able to drive or do the things they used to enjoy such as sports or hiking. They may have haunting military experiences or feel guilty about who they hurt as a youngster, causing them sadness and possible depression.
Treating the patient with dignity, using manners, and being respectful of their age is important. Visual and hearing loss will often be a factor, so be mindful of the setting—a quiet and private space works best. Allowing additional time and treating the patient as an individual will support a closer relationship.
Signs, Screens, And Service
In assessing new patients, providers should look for memory and coordination loss; trouble with concentration, sleeping, or eating; and lack of interest in what they used to enjoy. Patients may feel more secure being alone, and their hygiene may suffer. They may experience mental health issues—depression, anxiety, and possible thoughts or attempts of suicide—and close themselves off from family and friends.
Fortunately, education and substance addiction services are available. Building a social network for this generation is important. Providers can involve patients in social networks, adult day care, local church groups, military groups, or volunteering at a local shelter, according to “Planning for Eldercare” (
see References). Using substance addiction services can also help build resources for patients.
While patients may not be willing to face the fact that they have a problem, giving them resources may encourage them to educate themselves and finally admit they have a problem. According to New York State Office of Alcoholism and Substance Abuse Services (OASAS), completing a simple screening test such as the AUDIT-C, CAGE, and/or the Short Michigan Alcoholism Screening Test—Geriatric Version (S-MAST-G) can be helpful.
OASAS also suggests keeping family members included in the patient’s daily life and getting them involved in senior or social groups to build the patient’s self-esteem. Clinical treatment, Twelve-Step, self-help, and support group participation are other good options. The following websites can help guide practitioners in treatment solutions:
Gail M. Warchol, MS, LNHA, is coordinator of health care careers in the Center for Corporate and Community Education at Mohawk Valley Community College, Utica, N.Y. She can be reached at gwarchol@mvcc.edu or (315) 792-5305.