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The Silver Tsunami


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Aging & addiction

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The Silver Tsunami

  1. 1. Seniors Welcome toVirginia - 2019-Stanger
  2. 2. How did you arrive ?
  3. 3. Dedicated To Dorothy Louise Schwartz Widow x 2 Early Childhood Trauma Family History MH. Suicide Heavy Drinking Throughout Life Parkinsons
  4. 4. The Silver Tsunami Louise A. Stanger Ed.D, LCSW, CDWF, CIP
  5. 5. Substance Abuse- Mental Health- Process Disorders and Medical Maladies
  6. 6. Objectives Demonstrate, Recognize, Define & Identify what we mean by “AGING” Identify special considerations for this population including : Substance Abuse (Alcohol & Opioids) Mental Health (Depression & Anxiety), Grief and Loss,( loss of a loved one or function) , Suicide Other Physical Maladies -Chronic Pain-Knees, Hips, Shoulders , (Heart Diabetes, Hypertension, Cataracts, Glaucoma , Dementia, Alzheimers Problematic Gambling, Financial Issues
  7. 7. Objectives Differentiate Specific Needs of An Aging Population and Behavioral Health Care Needs Identify & Describe Collaboration of Services necessary for Effective physical, mental health,& substance abuse treatment Charge the Professional to Innovate and Create New Service Delivery Systems
  8. 8. Meet Dr. Louise Stanger Clinician-Educator-Blogger - Thrive Global, Huffington, Addiction Blog, Counselor Magazine, The Sober World etc Interventionist Author-Falling Up A Memoir of Renewal -Amazon The Definitive Guide to Addiction Interventions-CIS (in press Rutledge) Senior, Baby Boomer, Widow, Wife, Mother. Grandmother, Soul Cycler, Adventurer
  9. 9. Welcome To Aging ! How Old Is Old ?
  10. 10. How Old Do You Feel?
  11. 11. George Burns “You Can’t Help Getting Older …… But you do not Have to Get OLD!”
  12. 12. 1 in 5 U.S. Residents will be 65 or older
  13. 13. Ken Dychtwald PHD -CEO The Age Wave- Quest for longevity is not a new idea-Think Ponce DeLeon Fountain of Youth Throughout 99% pf history growing old did not occur-people died young. People living past 65 is still a novelty Old is the new Young 65 was designated as old in 1880 by Otto von Bismarck where average life expectancy was 45 Today at 77 John Glenn went back in space. Its Time To Retire Retirement Fellow of World Economic Forum American Society on Aging Award American Demographics honored him as the single most influential marketer to baby boomers
  14. 14. Geriatric Care Services 916.31 Billion in 2017 & by 2023 1,390.63 Billion Zion Market Research 2018
  15. 15. Theodore Lidz -The Person “Aging Is the Process of Growing Old. You are no longer that well oiled machine rather you creak and groan a bit”
  16. 16. Gerontology Senescence- Biological aging Psychology- What does it mean to get old?Generatively- Basic Trust Sociological - Networks to Engage with Spiritually or Consistent With Ones Values
  17. 17. Substance Use Facts Older Adults Number of Older Americans with SUD expected to go from 2.8 million in 2006 to 5.7 million 14,230 admissions age 65 or older to SA Programs 9 29 admissions per day for alcohol , 6 admissions for heroin and other opiates Drug Warning Network on an average day 2011 2,056 drug related ER visits of those 290 were for illegal drug use, nonmedical use of pharmaceuticals or alcohol combined with other drugs
  18. 18. Prescription Drugs Folks age 65 represent about 13 % of the population and 30% of all medications prescribed in the US
  19. 19. Dramatic Statistics 2.5 million older adults experience AOD problem 6-11% of hospital admissions result of AOD, 14% of ER admissions and 205 of psychiatric admits WIDOWERS-over 75 -highest rate of alcoholism in US Nearly 50% of nursing home residents have alcohol related problems
  20. 20. Dramatic Statistics Binge drinking among older women increasing faster then in men Older adults are hospitalized as often for alcohol related problems as for heart attacks 17 million prescriptions for tranquilizers are prescribed for older adults Benzodiazepines most commonly misuse and abused prescription drug
  21. 21. Cocaine Use
  22. 22. Why the Increase? Loneliness- Isolation Children Grow Up Leave Home Retirement Death of Partner and Friends Physical Health Fails Financial Changes
  23. 23. Signs of Alcohol Abuse Solitary or Secretive Drinking Ritual of Drinking before, with , after dinner Loss of interest in hobbies Immediate & Frequent use of Tranquilizers Slurred Speech, empty liquor bottles, smell of alcohol on breath Chronic unsupported health complaints Memory loss , Confusion Hostility or Depression
  24. 24. Barriers to Addressing Substance Abuse in Older Adults Drinking is the only thing that makes Dad happy Mom is old, what difference will it make She/He will never change Treatment Wont Work Grandpa has nothing better to do, so what if he enjoys a few drinks Only young People Experience Addiction Shame & Stigma Misdiagnosis
  25. 25. Marijuna and Boomers A Mixed Bag
  26. 26. Senior Health Concerns Arthritis Heart Disease Cancer Respiratory Distress Alzheimers Osteoporosis Chronic Pain Medication Management STD’s
  27. 27. Safe Sex Baby STDS Never GET OLD v=wMFRM1bkEDg
  28. 28. Chronic Pain There are 133 million people in the US with Chronic Pain That is 1 in 5 adults globally Physical pain increases when there is an emotional factor -Anger-Anxiety-Depression 65% of all Americans see care for persistent pain at some point in their lives Opioids are frequently prescribed and over prescribed 75% of all Heroin Users Started With Prescriptions Drugs (JAMA Psychiatry 2014 Theodore Cicero University of Washington)
  29. 29. Chronic Pain Lasts for several weeks, months and years and can cause its own disease Pain signals are sent to the brain once the pain stops brain signals with acute pain stop With Chronic pain brain signals are sent to the brain and the signals do not stop
  30. 30. With a 10 day supply of opioids 1 in 5 become users With a 6 day supply there's a 12% chance of becoming a user With a 10 day supply the odds on being on opioids a year later hits 20 percent 91 people die daily from opioid overdose University ofArkansas 2016
  31. 31. More Health Concerns Diabetes Influenza & Pneumonia Falls Substance Abuse Obesity Oral Health Poverty Shingles
  32. 32. Mental Health and Aging 20% of all people age 55 or older experience some type of mental health Anxiety Cognitive Impairment Mood Disorders -Depression - Bipolar
  33. 33. Depression in and of Itself is Not A Fact of Life for Folks Over 65 CDC Behavioral Risk Questionnaire
  34. 34. Frequent Mental Distress Social & Emotional Support Life Satisfaction Ability To Maintain Household Physical Exercise Lifetime Diagnosis of Depression or Anxiety Physical Health
  35. 35. Suicide and Aging Older adults have highest suicide rate in Country. Plan more carefully and use more deadly methods Those over 85 highest attempt-75-84 second highest Those who have just been released from nursing homes 1 Suicide for every 4 attempts compared to 1 Suicide for every 20 attempts other age groups Depressed Mood, Health problems, Isolation
  36. 36. Gambling Addiction & Seniors Gaming Centers as the new Senior Center Casinos supply scooters, wheelchairs oxygen and wheel chairs. Bathrooms have boxes to throw away diabetic needles Remember Birthdays- Celebrate the Senior Provide Entertainment, Connection and Food Distraction from what ails one Allows for Excitement and a sense of belonging
  37. 37. Risks & Signs Seniors have money to spend and some burn through savings Seniors cannot make up losses Impaired cognition may make poor decisions and reduced aversion to risk Medications dopamine antagonist s for Parkinson or other movement disorders may put one at higher risk Early signs of Dementia or Alzheimers Depression- Shame _ Anxiety
  38. 38. Are Loved ones asking for loans Are there more Dr. Visits or ER Visits Hobbies or other recreational hobbies Change in Hygiene Less Food in their refrigerator Past due Utilities Poor Decision Making Skills
  39. 39. Meet Sally
  40. 40. 2 year old Falls Out of Grandmother’s Golf Cart
  41. 41. Meet Nick 72 Years old High Powered Executive Car accident-Hurt Neck Popping Pills Speech Slurred , Memory Poor Stopped taking Grandchildren out Stayed in bed -Grumpy.
  42. 42. Meet Helen - 62 y.o Female Hip replacement Knee replacement’ Shoulder Constant pain-anxiety Cancer survivor Tried to commit suicide Angry Husband & Family Addicted
  43. 43. IN THE BEGINNING Not able to take breaths - use of Heart Math Self Esteem was missing Smile was gone Only memories of what once was
  44. 44. I Have Lost Relationships Money Self Esteem Ability to Walk Smile
  45. 45. Strategies 15 day detox- Pain still 20% due to Hyperalgesia Education Cognitive Behavioral Therapy Mindfulness Mediation Yoga etc - Canoeing- walking Peer Support
  46. 46. Meet Dr. R
  47. 47. The Sweetheart Scam Lonely Divorced Recently Retired Gambled Checked out Dating Site Possible Early Onset Dementia Had Money
  48. 48. Meet Joel & Norman Alcohol- PTSD- Trauma
  49. 49. The Grandparent Scam Humiliation-Shame-Embarrassment
  50. 50. Who would of ever thought 
  51. 51. There Is Time For There’s Time for Laughter Theres Time for Tears Theres Time for Joy For Creativity For Love For Forgiveness For Moving On For Starting Over For Making Amends For Coloring Outside The Lines For Making A Difference For Communicating With The Cosmos For Spirituality For Curiosity For Imagination For Bravery For Falling Up !
  52. 52. Successful Aging Accomplishments Enjoyment of Diet Financial Security Neighborhood Physical Appearance Productivity
  53. 53. Successful Aging Sense of Humor Sense of Purpose Spirituality or Being Consistent With Your Values
  54. 54. Theoretical Definitions of Aging Life Expectancy Life satisfaction and wellbeing Happiness & Contentment Personal Growth Learning New Things Physical Health and Functioning-Independent Functioning
  55. 55. Theoretical Definitions of Aging Psychological Characteristics and resources- Perceived Autonomy, Control, Independence, Adaptability, Self-Esteem, Positive Outlook, Goals, Sense of Self Social, Community, Leisure Activities, Integration & Participation Social Networks, Support, Participation, Activity
  56. 56. Making LifeSpan Equal HeathSpan- Ken Dychtwald PHD Longevity-Ready Health Professionals There are over 12o medical schools in US only 13 depts. of gerontology -(5% of all doctors will not of taken an elective in geriatric medicine Wellness Marketplace- People over 50 are 44% of adult population and account for 52% of personal care sales, 55% of all PT sessions and 63% of all Surguries “The Wellness marketplace needs to be re conceptualized to be inclusive and respectful to elders Crowdsource Solutions- Alzheimers X Prize
  57. 57. Resources Ramirez , V ., Nov.9, 2017 .The Age Wave is Transforming Longevity and It’s Just the beginning. Singularity Hub Age Wave From Baby Boom to Age Wave.https:// Lidz, T. (1968) The Person. Basic https:// Cycle-1968/dp/B009QL6544
  58. 58. Resources The CBHSQ Report :A Day in the Life Of Older Adults Substance Use Facts . SAMHSA (May 11,2017) Parker, P. (2009How Old Is Old Age. New York Times The CBHSQ Report :A Day in the Life Of Older Adults Substance Use Facts . SAMHSA (May 11,2017) Parker, P. (2009How Old Is Old Age. New York Times More Older Women are Drinking Hard. news/more-older-women-baby-boomers-binge-drinking/ March 29, 2017
  59. 59. Resources The State of Mental Health and Aging in americahttps:// Geriatric Care Services Market by Service Type (Home Care, Adult Day Care, & Institutional Care ) : Global Industry Perspective, Comprehensive, Analysis and Forecast 2017-2023. Zion Market Research. May, 2018. Gerontology Data by Degrees #institutions Few Doctors Are Training To Care For US Elderly, July 3.2016. NPR All Things Considered.
  60. 60. Resources 10 Facts About Mental Health and Aging http:// 10_Facts_About_Mental_Health_and_Aging.asp 15 Most Common Health Concerns For Seniors . Everyday Health Suicide Prevention Resource Center
  61. 61. Resources Substance Use and SUD in LGBT https:// in-lgbt-populations STD’s Hit All Time High Says CDC.Oct, 3, 2017 STDS Never GET OLD watch?v=wMFRM1bkEDg
  62. 62. Few Drs to Care for Elderely The US has 13o Geriatric Fellowships, with 368 positions . In 2016 only 192 were filled Average medical student graduates with $183,000 in debt West Virginia has the third largest aging community , right behind Maine and Florida