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:
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A
personal lack of knowledge about alcohol issues for seniors,
and the problems that come with it.
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Previous
unpleasant experiences with seniors who have alcohol problems.
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Anger
directed at seniors unwilling or unable to alter their drinking
behaviour.
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Diagnosing
the problems based on one's own drinking behaviour.
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Previous
unpleasant experiences with people in their own families who
have alcohol problems.
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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.
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66% of the physicians
felt that "Most older adults with alcohol problems have long histories
of drinking problems"
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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.
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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"
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Using
these criteria, it is easy for seniors who have alcohol problems
to get overlooked.
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68% of physicians
believed that "Nothing can be done for the person, unless he or she
takes respnosibility for change."
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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.
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Such
an attitude also ignores the extremely strong stigma among seniors
around acknowledging a drinking problem.
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57% of the physicians
felt that "if a person drops out of an alcohol program, it is probably
due to a lack of motivation."
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The
reality is more complex than that. Many programs are currently
not designed with seniors' needs in mind, and may not meet their
needs.
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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.
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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."
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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.
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42% of the physicians
agreed that "Drinking is often one of a person's few remaining pleasures
in later life."
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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.
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Most
physicians (92%) believe that abstinence is the most appropriate
goal for seniors with alcohol problems.
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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.
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33% of the physicians
believed that "The treatment prognosis for older adults is not very
good."
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There
is a sense of discouragement among many professionals even before
the senior starts out.
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The
reality is that in programs designed with seniors' needs in
mind, seniors do as well, if not better than younger adults.
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