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

1. WELCOME
To The
Magic Kingdom

4. Dedicated To
Dorothy Louise Schwartz
Widow x 2
Early Childhood Trauma
Family History MH. Suicide
Heavy Drinking Throughout
Life
Parkinsons

5. The Silver Tsunami
Louise A. Stanger Ed.D, LCSW, CDWF, CIP

6. Substance Abuse- Mental Health-
Process Disorders and Medical
Maladies

7. 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

8. 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

9. 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

10. Welcome
To Aging !
How Old Is Old ?

11. How Old Do You Feel?

15. George Burns
“You Can’t Help
Getting Older ……
But you do not Have
to Get OLD!”

21. 1 in 5 U.S.
Residents
will be 65 or
older

22. 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

23. Geriatric Care Services 916.31 Billion in 2017 &
by 2023 1,390.63 Billion
Zion Market Research 2018

25. 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”

26. 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

28. Substance Use Facts
Older AdultsNumber 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
Total number of ER Visits was
105,982 that involved illicit drug
use

29. Prescription Drugs
Folks age 65 represent
about 13 % of the population
and 30% of all medications
prescribed in the US

30. 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

31. 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

32. Cocaine Use

33. Why the Increase?
Loneliness- Isolation
Children Grow Up Leave
Home
Retirement
Death of Partner and Friends
Physical Health Fails
Financial Changes

34. 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

35. 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

36. Senior Health Concerns
Arthritis
Heart Disease
Cancer
Respiratory Distress
Alzheimers
Osteoporosis
Chronic Pain
Medication Management
STD’s

37. Safe Sex Baby
STDS Never GET OLD https://www.youtube.com/watch?v

38. 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)

40. 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

44. More Health Concerns
Diabetes
Influenza & Pneumonia
Falls
Substance Abuse
Obesity
Oral Health
Poverty
Shingles

45. 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

46. Depression in and of Itself is Not A Fact of Life for
Folks Over 65 CDC Behavioral Risk Questionnaire

47. Frequent Mental
Distress
Social & Emotional Support
Life Satisfaction
Ability To Maintain Household
Physical Exercise
Lifetime Diagnosis of
Depression or Anxiety
Physical Health

49. 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

51. Gambling Addiction &
SeniorsGaming 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

53. 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

54. 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

56. Meet Sally

57. 2 year old Falls Out of
Grandmother’s Golf Cart

58. 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.

59. Meet Helen - 62 y.o
FemaleHip replacement
Knee replacement’
Shoulder
Constant pain-anxiety
Cancer survivor
Tried to commit suicide
Angry Husband & Family
Addicted

60. 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

61. I Have Lost
Relationships
Money
Self Esteem
Ability to Walk
Smile

62. Strategies
15 day detox- Pain still 20% due to
Hyperalgesia
Education
Cognitive Behavioral Therapy
Mindfulness
Mediation
Yoga etc - Canoeing- walking
Peer Support

63. Meet Dr. R

64. The Sweetheart Scam
Lonely
Divorced
Recently Retired
Gambled
Checked out Dating Site
Possible Early Onset
Dementia
Had Money

65. Meet Joel & Norman
Alcohol- PTSD- Trauma

66. The Grandparent Scam
Humiliation-Shame-Embarrassment

67. Who would of ever thought
Canoeing

69. 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 !

70. Successful Aging
Accomplishments
Enjoyment of Diet
Financial Security
Neighborhood
Physical Appearance
Productivity

71. Successful Aging
Sense of Humor
Sense of Purpose
Spirituality or
Being Consistent With Your
Values

72. Theoretical Definitions of
Aging
Life Expectancy
Life satisfaction and
wellbeing
Happiness & Contentment
Personal Growth Learning
New Things
Physical Health and
Functioning-Independent
Functioning

73. 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

74. Making LifeSpan Equal
HeathSpan- Ken Dychtwald
PHDLongevity-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

76. 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://agewave.com
Lidz, T. (1968) The Person. Basic
https://www.amazon.com/Person-Development-
throughout-Cycle-1968/dp/B009QL6544

77. 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
More Older Women are Drinking Hard.
https://www.cbsnews.com/news/more-older-women-
baby-boomers-binge-drinking/ March 29, 2017

78. Resources
The State of Mental Health and Aging in
americahttps://www.cdc.gov/aging/pdf/mental_health.pdf
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
https://datausa.io/profile/cip/3011/#institutions
Few Doctors Are Training To Care For US Elderly, July 3.2016.
NPR All Things Considered.

79. Resources
10 Facts About Mental Health and Aging
http://www.lifeseniorservices.org/seniorline/10_Facts_
About_Mental_Health_and_Aging.asp
15 Most Common Health Concerns For Seniors .
Everyday Health
Suicide Prevention Resource Center
https://www.sprc.org/populations/older-adults

80. Resources
Substance Use and SUD in LGBT
https://www.drugabuse.gov/related-topics/substance-
use-suds-in-lgbt-populations
STD’s Hit All Time High Says CDC.Oct, 3, 2017
STDS Never GET OLD
https://www.youtube.com/watch?v=wMFRM1bkEDg

81. 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

83. DegreesIn Gerontology
TOTAL DEGREES
AWARDED IN 2016
1,449
GROWING 10.4%
MEDIAN IN-STATE
PUBLIC TUITION
$7,248
GROWING 2.66%
MEDIAN OUT-OF-STATE
PRIVATE TUITION
$29,705
GROWING 0.78%
AVERAGE WAGE
$64,216
GROWING 7.29%
PEOPLE IN WORKFORCE
373,871
GROWING 8.19%
AVERAGE EMPLOYEE AGE
39.3
GROWING 0.72%