Book contents
- Frontmatter
- Contents
- Editorial Advisory Committee
- Contributors
- Acknowledgments
- 1 Essential Principles in the Care of the Elderly
- 2 Assessment of the Older Patient
- 3 Prevention for Older Adults
- 4 Common Complaints in the Elderly
- 5 Appropriate Use of Medications in the Elderly
- 6 Nutrition and Aging
- 7 Using Exercise as Medicine for Older Adults
- 8 Diabetes Mellitus in the Older Adult
- 9 Lipid Management in Older Patients
- 10 Hypertension
- 11 Diagnosis and Management of Heart Disease in the Elderly
- 12 Peripheral Arterial Disease in the Elderly
- 13 Stroke in the Older Adult
- 14 Neurological Problems in the Elderly
- 15 Recognition and Management of Delirium
- 16 Evaluation and Management of Dementia
- 17 Clinical Geropsychiatry
- 18 Alcohol and Other Drug Abuse in Older Patients
- 19 Aging in Adults with Developmental Disabilities
- 20 Pulmonary Issues in the Elderly
- 21 Gastroenterological Disease in the Older Adult
- 22 Serious Infections in the Elderly
- 23 Human Immunodeficiency Virus in the Elderly
- 24 Principles of Fluid and Electrolyte Balance and Renal Disorders in the Older Patient
- 25 Urological Issues in Older Adults
- 26 Urinary Incontinence
- 27 Geriatric Gynecology
- 28 Disorders of the Endocrine Glands
- 29 Osteoporosis and Other Metabolic Disorders of the Skeleton in Aging
- 30 Common Rheumatic Diseases in the Elderly
- 31 Musculoskeletal Injuries in the Elderly
- 32 Foot Health for the Elderly: Podogeriatric Overview
- 33 Geriatric Dermatology
- 34 Pressure Ulcers: Practical Considerations in Prevention and Treatment
- 35 Anemia and Other Hematological Problems of the Elderly
- 36 Cancer in the Elderly
- 37 Eye Problems of the Aged
- 38 Geriatric Ear, Nose, and Throat Problems
- 39 Geriatric Dentistry
- 40 Surgical Principles in the Aged
- 41 Rehabilitation in Older Adults
- 42 Community-Based Long-Term Care
- 43 Institutional Long-Term Care
- 44 Care for the Elderly Patient at the End of Life
- 45 Assessment of Decision-Making Capacity
- 46 Injuries in Older Adults
- 47 The Mistreatment of Older Adults
- 48 Driving and the Older Adult
- 49 Integrative Medicine in the Care of the Elderly
- 50 Successful Aging: Optimizing Strategies for Primary Care Geriatrics
- 51 Cell Biology and Physiology of Aging
- 52 Implications of an Aging Society
- 53 Ethnogeriatrics
- 54 Retirement
- 55 Geriatric Sexuality
- 56 The Elderly, Their Families, and Their Caregivers
- 57 Systematic Approaches to Preventing Errors in the Care of the Elderly
- 58 Health Care Organization and Financing
- 59 Advance Care Planning: Values and Families in End-of-Life Care
- 60 Ethical Decision Making in Geriatric Medicine
- Index
- Plate section
18 - Alcohol and Other Drug Abuse in Older Patients
Published online by Cambridge University Press: 19 May 2010
- Frontmatter
- Contents
- Editorial Advisory Committee
- Contributors
- Acknowledgments
- 1 Essential Principles in the Care of the Elderly
- 2 Assessment of the Older Patient
- 3 Prevention for Older Adults
- 4 Common Complaints in the Elderly
- 5 Appropriate Use of Medications in the Elderly
- 6 Nutrition and Aging
- 7 Using Exercise as Medicine for Older Adults
- 8 Diabetes Mellitus in the Older Adult
- 9 Lipid Management in Older Patients
- 10 Hypertension
- 11 Diagnosis and Management of Heart Disease in the Elderly
- 12 Peripheral Arterial Disease in the Elderly
- 13 Stroke in the Older Adult
- 14 Neurological Problems in the Elderly
- 15 Recognition and Management of Delirium
- 16 Evaluation and Management of Dementia
- 17 Clinical Geropsychiatry
- 18 Alcohol and Other Drug Abuse in Older Patients
- 19 Aging in Adults with Developmental Disabilities
- 20 Pulmonary Issues in the Elderly
- 21 Gastroenterological Disease in the Older Adult
- 22 Serious Infections in the Elderly
- 23 Human Immunodeficiency Virus in the Elderly
- 24 Principles of Fluid and Electrolyte Balance and Renal Disorders in the Older Patient
- 25 Urological Issues in Older Adults
- 26 Urinary Incontinence
- 27 Geriatric Gynecology
- 28 Disorders of the Endocrine Glands
- 29 Osteoporosis and Other Metabolic Disorders of the Skeleton in Aging
- 30 Common Rheumatic Diseases in the Elderly
- 31 Musculoskeletal Injuries in the Elderly
- 32 Foot Health for the Elderly: Podogeriatric Overview
- 33 Geriatric Dermatology
- 34 Pressure Ulcers: Practical Considerations in Prevention and Treatment
- 35 Anemia and Other Hematological Problems of the Elderly
- 36 Cancer in the Elderly
- 37 Eye Problems of the Aged
- 38 Geriatric Ear, Nose, and Throat Problems
- 39 Geriatric Dentistry
- 40 Surgical Principles in the Aged
- 41 Rehabilitation in Older Adults
- 42 Community-Based Long-Term Care
- 43 Institutional Long-Term Care
- 44 Care for the Elderly Patient at the End of Life
- 45 Assessment of Decision-Making Capacity
- 46 Injuries in Older Adults
- 47 The Mistreatment of Older Adults
- 48 Driving and the Older Adult
- 49 Integrative Medicine in the Care of the Elderly
- 50 Successful Aging: Optimizing Strategies for Primary Care Geriatrics
- 51 Cell Biology and Physiology of Aging
- 52 Implications of an Aging Society
- 53 Ethnogeriatrics
- 54 Retirement
- 55 Geriatric Sexuality
- 56 The Elderly, Their Families, and Their Caregivers
- 57 Systematic Approaches to Preventing Errors in the Care of the Elderly
- 58 Health Care Organization and Financing
- 59 Advance Care Planning: Values and Families in End-of-Life Care
- 60 Ethical Decision Making in Geriatric Medicine
- Index
- Plate section
Summary
Acknowledgments: This work was supported, in part, by grant K23-AA015616 from the National Institute on Alcohol Abuse and Alcoholism (RDB and LMF).
INTRODUCTION
Alcohol and drug use disorders are significant problems among older patients. These problems may be underappreciated by health care professionals because of limited clinical evidence and research data to form practice guidelines, insufficient training, and rushed office visits that tend to focus on acute and chronic physical problems, which can easily consume all the clinician's attention leaving little time to screen, diagnose, and perform an intervention for a substance use disorder.
Diagnosis of a substance use disorder can be difficult in the older patient. Embarrassment, shame, and fear of disapproval by family members may lead older individuals to conceal their drinking or drug use. Family members, who would be unlikely to ignore alcohol or drug abuse in a young person, may tolerate alcohol or drug abuse in an older person because they may think that after a long life the person “deserves it,” or that “it makes no difference anyway.” Family members may also believe that an oversedated elderly patient is “more manageable.” Furthermore, the signs and symptoms of substance abuse often mimic the clinical presentation of other common medical or psychiatric disorders and health care providers may perceive their diagnostic role as being directed mainly toward the chief complaint.
Definitions
There is a confusing array of terms used to describe individuals who use and misuse alcohol and other drugs: “alcohol abuse,” “alcoholism,” “chemical dependency,” “drug addiction,” and “substance abuse.”
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- Chapter
- Information
- Reichel's Care of the ElderlyClinical Aspects of Aging, pp. 199 - 209Publisher: Cambridge University PressPrint publication year: 2009