The potential of substance use disorders in older adults is often overlooked in a general health assessment. Substance use disorders have a high comorbidity with other psychiatric disorders. Physiologic changes in older adults make them more susceptible to the negative effects of alcohol use. With the proper support and resources older adults with alcohol use disorder can live a healthier, happier life free from alcohol. Cannabis use is increasing in all age groups including older adults. Be aware that older adults may be using cannabis to self medicate psychiatric conditions such as anxiety and depression or to treat chronic pain despite limited evidence for long term improvement. Older adults may be at risk of opiate use disorder due to chronic pain issues, multiple medical comorbidities, and psychiatric comorbidities. Treatment options for opioid use disorder such as medications, outpatient treatment programs, and psychosocial supports are often as effective in older adults as in younger patients.

When age-related physical impairments affect a person’s performance of functional tasks, rehabilitation may restore function and improve an elder’s independence and participation in society. Included is a review of how to perform a functional assessment, a description of the members of a rehabilitation team, and an introduction to the various settings where an elder can receive rehabilitation. The chapter describes geriatric assistive devices that improve self-care and mobility and reviews specific rehabilitation interventions for common debilitating conditions such as stroke, Parkinson’s disease, hip fracture, and lower-extremity amputation.