The document discusses the need for specialized alcohol and drug treatment services for older adults, as they often face unique challenges such as increased risks from alcohol use disorders, social isolation, and complex medical needs. It emphasizes the importance of developing age-appropriate, flexible, and holistic treatment approaches that account for the psychological and social factors affecting older individuals. The proposal includes outreach and targeted services to better address the specific needs of this demographic, particularly considering the aging population and shifting health service demands.

1. Building an Older Adult Treatment Service Simon Ruth – Director, Complex Service Peninsula Health

2. Background Victorian Travelling Fellowship 13 Older Adult services visited Older Wiser Lifestyles Program Treatment Prevention

3. Why? Alcohol use disorders in the elderly are common Alcohol problems in the elderly are insufficiently treated Physiological changes and increased isolation put older people at increased risk of developing AOD issues Use of drugs in combination with alcohol increases risk for older people Just maintaining life long drinking patterns is likely to put older adults at risk Older adults are poorly educated about AOD issues and are not targeted by public campaigns. We have an ageing community 2003/04-2007/08 Over 65s = 0.8% of AOD treatment episodes

4. Questions. How can services engage older persons in alcohol and drug treatment? What constitutes age appropriate and effective alcohol and drug treatment for older persons? What factors assist older persons to change their drug using behaviours? What skills and knowledge do treatment staff require?

5. Access Acknowledge Issue Develop Relevant Services Raise Awareness Be Useful and Convenient CALD Aware Be Accessible Legislation

6. Treatment Treatment requires longer episodes of care and needs to be slower, gentler, holistic and more flexible Treatment is medically more complex Loss, hopelessness and social isolation are more prevalent amongst older adults Treatment is more likely to involve significant others Treatment agencies are more likely to inadvertently create barriers to treatment Non-medicated withdrawal is inappropriate Collaborative

7. Early Onset or Late Onset Early Onset alcoholism : A long history of chronic alcoholism Early drinking age between 14-20 years. High tolerance to alcohol that has increased over time Multiple attempts to quit, treatments and withdrawal experiences. Family History more prevalent Cognitive loss more severe, less reversible Late onset alcoholism : Drinking problems began post 50 years of age. Significant Transitions or loss late in life Increased toxic effects related to lower tolerance and mixture of medications Shame and grief. Family History less prevalent Cognitive loss less severe, more reversible

8. Transitions & Spirituality Older adults face loss of employment, loss of mobility, loss of health, loss of peers, loss of partner, loss of hope and loss of identity. Older adults feel unneeded and useless “ Spirituality is about learning to be comfortable with who you are rather than what you do”

9. Contributing Factors Health - Physical & Mental Poverty Shame Social isolation Abuse CALD

10. Workforce Knowledge of, or background in, gerontology particularly in relation to medications used by older adults Respect for older adults and their place in the community Patience and perseverance Strong boundaries. Resilience Qualifications in AOD treatment Partnerships

11. Prevention – Reducing Risky Drinking VAAP funded Prevent late onset issues Educate about alcohol, medications and standard drinks Alcohol Related Problems Scale (ARPS) www.wisedrinking.org

12. Future Getting older Baby boomers are more demanding of health services Likely broader range of drugs Likely more health issues associated with ageing and chronic disease

13. Victorian Alcohol and Drug Association - VAADA Easier entry and targeted AOD services for older adults A pilot drug treatment project to address the gap in AOD services for older adults. The project should include outreach, project coordination, medical support coupled with funding for research and evaluation. This should then translate into broader program and service delivery

14. Thanks St John of God Healthcare Victorian Government Australian Drug Foundation The OWL team Simon Ruth [email_address]