In one of the first studies conducted under this program of research, 120 service providers were asked about some of the existing barriers facing seniors.

Attitudes came across as one of the most important barriers. Professional attitudes affected whether the problem was identified, and whether help was offered. It also affected policies and practices.Professional attitudes can be crucial in whether a senior gets effective help for an alcohol problem.

In the "Physician Study", we asked almost 100 physicians from across BC about their experiences with seniors who have alcohol problems. We also asked for their views on a number of treatment issues. Here's what we found. After each statement, we've noted the reality or the barrier potentially created by the attitude.

It is important to point out that not only physicians express these attitudes. Similar comments and feelings have been expressed in most of the helping professions. ⁸

Why do some professionals feel this way?

There are many reasons:

�	A personal lack of knowledge about alcohol issues for seniors, and the problems that come with it.

�	Previous unpleasant experiences with seniors who have alcohol problems.

�	Anger directed at seniors unwilling or unable to alter their drinking behaviour.

�	Diagnosing the problems based on one's own drinking behaviour.

�	Previous unpleasant experiences with people in their own families who have alcohol problems.

A Vancouver study in the early 1990's indicated that 1 in 3 health care staff at a local hospital had a family member with an alcohol problem.

66% of the physicians felt that "Most older adults with alcohol problems have long histories of drinking problems"

�	In reality, one third of seniors have alcohol problems which developed in the last few years. By looking for that "long history", professionals may inadvertently ignore the late onset drinker.

�	Physicians tended to describe the "typical problem drinker" as "a person who is down and out, someone who ignores responsibilities to family; or someone who doesn't want to work"

�	Using these criteria, it is easy for seniors who have alcohol problems to get overlooked.

68% of physicians believed that "Nothing can be done for the person, unless he or she takes respnosibility for change."

�	This attitude is very hard on seniors with alcohol problems. Many seniors don't recognize there is a problem. Others cannot recognize it because of cognitive impairment caused by alcohol use.

�	Such an attitude also ignores the extremely strong stigma among seniors around acknowledging a drinking problem.

57% of the physicians felt that "if a person drops out of an alcohol program, it is probably due to a lack of motivation."

�	The reality is more complex than that. Many programs are currently not designed with seniors' needs in mind, and may not meet their needs.

�	In effect, we may be setting seniors up for failure. We give programs all the credit for when seniors succeed, and place all the blame on seniors if they don't.

52% of the physicians believe that "A patient must come to terms with the fact that he or she has an alcohol problem (in other words, admit it) before anything can help."

�	Once again, people who work with seniors emphasize that this may be an urealistic expectation. Those who work in alcohol programs geared specifically to seniors note that, in some of the best "successes", the senior never expressly acknowledged the alcohol problem.

42% of the physicians agreed that "Drinking is often one of a person's few remaining pleasures in later life."

�	What a sad statement about people's view of aging. The reality is that, for many seniors, drinking is not a pleasurable experience. Instead, it is a way of dealing with loneliness, grief, losses or boredom.

�	Most physicians (92%) believe that abstinence is the most appropriate goal for seniors with alcohol problems.

�	This creates a special challenge for agencies where the measure of "success" is much more flexible. Professionals can end up working at odds with each other, because they have very different expectations.