slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Reaching out to older drinkers: - a new practice model Greg Scott 9 March 2010 PowerPoint Presentation
Download Presentation
Reaching out to older drinkers: - a new practice model Greg Scott 9 March 2010

Loading in 2 Seconds...

play fullscreen
1 / 27

Reaching out to older drinkers: - a new practice model Greg Scott 9 March 2010 - PowerPoint PPT Presentation


  • 376 Views
  • Uploaded on

Reaching out to older drinkers: - a new practice model Greg Scott 9 March 2010. An alcoholic is someone you don't like who drinks as much as you do. Dylan Thomas. Every man desires to live long, but no man wishes to be old. Jonathan Swift. Some basic background UK.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Reaching out to older drinkers: - a new practice model Greg Scott 9 March 2010' - albert


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Reaching out to older drinkers:

- a new practice model

Greg Scott

9 March 2010

slide3
An alcoholic is someone you don't like who

drinks as much as you do.

Dylan Thomas

slide4
Every man desires to live long,

but no man wishes to be old.

Jonathan Swift

slide5

Some basic background UK

  • Alcohol consumption rose by 60%: (1970 – 2006)
  • Affordability of alcohol doubled (1970 – 2001)
  • Most popular drinking venue is the home
  • ANARP (2004) excluded the over 65s
  • Models of Care for Alcohol Misusers
  • Review of Effectiveness: 1 reference for older people
slide6

Focus on Older People (65+)

  • Little published research or data
  • Demographic changes
  • Levels of alcohol related harm
  • Vulnerability to alcohol related harm
slide7

Alcohol & older people

  • “Wet Generation” born after World War II
  • Older men drink nearly as often as all adults
  • 84% increase in cost of treating alcohol related harm
  • Currently > 50% total NHS spend on alcohol related harm
  • 75% increase alcohol related hospital admissions
changing patterns of alcohol consumption
Changing patterns of alcohol consumption

Past experience indicates that alcohol consumption decreases with age, but recent patterns of behaviour may change due to ageing of the ‘baby boomers’ generation who have traditionally had more permissive attitudes towards alcohol and high level of consumption than earlier generations.

slide9

Changes in alcohol related admissions for 65+

Source: NHS Information Centre for Health & Social Care

unique vulnerabilities
Unique vulnerabilities

Metabolism slows down with age

Lower body mass

Lower proportion of water in a body

Decreased hepatic blood flow- liver will receive more damage

Interaction with other medical conditions and interaction of alcohol with medication taken as a treatment of those conditions

Inefficiency of liver enzymes- alcohol broken down inefficiently

vulnerability to alcohol related harm
Vulnerability to alcohol related harm
  • Psycho- social challenges of ageing and impact of alcohol (isolation, depression, memory deterioration, change of role, food preparation skills, opportunities, nutritional needs)
  • Shrinkage of cerebellum - posture and falls
  • Bones becoming more brittle – higher fracture risk- poorer nutrition- less chance of recovery
  • Mistaken for common physical or psychiatric conditions
  • Alcohol – medication interactions
  • Inadequate screening & reporting
  • Age group less likely to disclose
  • Risk of abuse and neglect
early onset
Early onset:

Describes those who have a lifelong pattern of drinking, have probably been alcoholic all their life, and are now elderly.

More likely to have chronic alcohol-related medical problems such as cirrhosis, organic brain syndrome, and co-morbid psychiatric disorders.

late onset
Late onset:
  • Describes those who have become alcoholic in their drinking pattern for the first time late in life.
  • Often triggered by a stressful life event.
  • Generally represented by milder cases with fewer accompanying medical problems.
  • More amenable to treatment, more likely to have spontaneous recovery
wiser drinking
“Wiser Drinking”
  • Kensington & Chelsea pilot 2008/9
  • Aims:
    • Assess need for treatment services
    • Increase screening capacity in older persons services
    • Reduce alcohol related hospital admissions
    • Identify potential need for specialist alcohol service
  • Provision for treatment capacity
  • Service re-commissioned 2009/10
older people s service
Older People’s Service
  • Specialist Service embedded in Tier 2 Alcohol Service
  • Providing training for other services
  • Outreach and site based
the pilot
The Pilot..
  • Working with local services to build capacity
    • Raise awareness of alcohol and ageing
    • Training in use of screening tool
  • Individual case work
    • Harm reduction advice and support
    • Pathways between geriatric & specialist alcohol services
    • Referral to treatment
    • Support accessing health & care services
    • Liaison with carers
referrals
Referrals
  • 70% women
  • Oldest: 87 years
  • All had their alcohol delivered to home
  • Half drinking 70+ units pw
  • 40% drinking over 50 units
  • 80% admitted to hospital in previous 6 months
  • 80% treated by GP for depression
  • Previous contact with alcohol services: 3
screening
Screening

Identifying the problem is the first step towards resolving it

Older people are at higher risk of harm and are better respondents to treatment, but failure to screen may lead to less frequent access to it.

Low threshold interventions delivered early alongside general health promotion and in conjunction with other medical treatments are likely to be effective.

assessment
Assessment

Substance abuse screening instruments

Special assessments

Functional abilities

Co-morbid disorders

Physical co morbidities

Psychiatric co-morbidities

Cognitive impairments (dementia, delirium and other)

Affective disorders

Sleep disorders

assessment1
Assessment

Substance abuse screening instruments

Special assessments

Functional abilities

Co-morbid disorders

Physical co morbidities

Psychiatric co-morbidities

Cognitive impairments (dementia, delirium and other)

Affective disorders

Sleep disorders

co morbidity
Co-morbidity

Hip fractures

Blood pressure

Gastric problems

Constipation

Malnutrition

Stroke

Depression

Isolation and poor social functioning

Reduced/ impaired mobility

Driving

reasons for alcohol use
Reasons for alcohol use
  • Unresolved emotional difficulties from past (53%)
  • Loneliness & isolation (23%)
  • Bereavement (10%)
  • Loss of status in the community (9%)
  • Ill prepared for retirement (9%)
findings
Findings
  • Older people receptive to interventions
  • Enthusiastically received by fellow professionals, the drinkers (and the media)
  • Need for health specialists in alcohol & ageing
  • Evidence of unmet demand for alcohol interventions
implications
Implications
  • Evidence of significant unmet need for services
  • Demographic projections suggest rising need for alcohol interventions with 65+ age group
  • Need to develop data and experience
  • Older people appear to welcome appropriate help
  • Alcohol related harms are often reversible
next steps
Next steps
  • More of the same
  • More similar
  • Partnership with a University & another charity
  • Replicate the pilot to see if findings confirmed
  • Development of evidence base
slide26

How should we address alcohol use amongst older people?

  • More research & better data
  • Guidance on development of local treatment pathways
  • Cross-authority co-operation to develop services
  • Greater awareness amongst health & social care staff
  • Greater attention to drinking habits
  • Some increase in treatment capacity
slide27
www.foundation66.org.uk

info@foundation66.org.uk

Foundation66

7 Holyrood St

London SE1 2EL

020 7234 9940