Senior News May, 2003 Vol. 22. No.  5

 

Published by the Humboldt Senior Resource Center in Eureka, California. HSRC is a non-profit community-based organization offering services for senior citizens, multi-generational families and caregivers.

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Natoinal Council on Aging and American Society on Aging meet to enhance growing older

MSSP turns 20 Vital service has to be cut back by 13 people per month

Serving older Americans

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What is Olmstead and why should you care?

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Serving older Americans
by Barbara Clark

    Four local organizations joined forces in April to present an
in-depth look at mental health and aging. Three hundred local
professionals attended the day-long conference at the Eureka Inn,
including the entire staff of the Humboldt Senior Resource Center
(HSRC) which used the opportunity as its annual staff training.
    The conference - Of One Mind, Mental Illness and Dementia in
the Elderly - covered a variety of pertinent topics including the
personal side of serving older adults, substance abuse and the
elderly, communicating with people with dementia, recognizing and
responding to depression and suicide, and the risky business of
medications and the elderly. Collaborating to present the conference
were the Area Agency on Aging, Humboldt County Mental Health Older
Adult Program, HSRC's Alzheimer's Day Care and Resource Center, and
the Northcoast Association of Residential Care Administrators.
     Keynote presenter Wendy Lustbader, MSW from Seattle's Pike
Market Medical Clinic, kept the entire group of 300 interested in the
personal side of caregiving. "It's caring about people that heals
them," she said. Grief is healed when it is shared with someone who
cares, she added. She warned against "the rush to comfort" when
someone's grief begins to pour out. As caregivers, people are often
tempted to touch and comfort, when perhaps the person needs more just
to weep. She included advice on how to prevent burnout, how to keep
strong boundaries and the importance of thanking everyone in a
caregiving role.
    Lustabader also demonstrated a cross-discipline approach to
serving elders by presenting real cases and asking audience members
and the three other professional presenters how they would handle the
situations. The other disciplines were represented by Brad Strong,
MD, psychiatrist at the Eureka Veterans Clinic and former staff
psychiatrist for the Humboldt County Older Adults Mental Health
Program; Patrick Arbore, EdD, founder and director of the Center for
Elderly Suicide Prevention and Grief Related Services in San
Francisco; and Dianne Tobias, Pharm.D, who is a Certified Geriatric
Pharmacologist. It was clear from the exercise that cross-discipline
attention about each case would help the elder by raising and dealing
with different aspects of a problem.

Afternoon workshops:
    The four key speakers went deeper into their specialties
during the afternoon workshops-substance abuse, speaking about
feelings, depression and suicide and the risks of numerous
medications. I chose to attend the workshop on substance abuse and
focus on it here to the exclusion of the others. The other topics
were also interesting and deserve follow up in the future.
    Patrick Arbore of San Francisco raised awareness about the
hidden challenge of alcoholism, especially among women. "Alcoholism
among women older than 60 is not even on the radar screen when it
comes to assessment," he said. "Physicians will assess for depression
and give the women a prescription which could cause other problems
and interactions." He said that fewer than one percent receive
treatment for substance abuse.
    Alcohol, along with caffeine and nicotine, being a legal
substance, often isn't targeted as a problem, he added, because the
doctor can have a personal problem with alcohol and not see it as a
problem.
    He invited the attendees to talk with one another about the
role alcohol played in their childhoods and how it impacts them now.
The discussion revealed that many people in the room had experienced
problems with alcohol representing the spectrum of abuse, and that we
had learned to compensate for it, to enable the behavior or to escape
it. "If we learn codependent communication, it can be hard for us to
talk about the elephant in the room," he said.
Arbore advised care professionals to ask about drinking
habits of their clients, including what size of glass clients use for
their wine or how many drinks. Alcohol abuse might be a symptom of
something else, like drinking to cover depression or grief.
    A startling statistic of 20-30 percent of nursing home
residents have alcohol related problems and are still drinking,
getting family members and other caregivers to provide it
clandestinely or even a doctor to prescribe it. "Older men often
don't have the vocabulary to express their feelings, so they drink to
numb the feelings," Arbore said. "If a person enters a nursing home
and quits drinking, you may have a problem that never gets
addressed," he added.

Local help in Area Code 707:
    There's really not a number for older adults to call for help
if they are concerned about alcohol or drug abuse in themselves or a
loved one, according to Laura Holmes of the county mental health
program. Alcoholics Anonymous, 442-0711, or Al-Anon, 443-1419, might
be a good place to start.
    The phone number for the Mental Health Alcohol and Other Drug
Program is 476-4054. The program is for anyone dealing with these
issues, but it tends to serve a younger group.
    If people age 60 and older are dealing with a mental health
issue such as depression along with alcohol or substance abuse,
please call Laura at the Older Adults Mental Health Program,
476-2118, to make an appointment.
The Health Department senior clinics (listed on page 13) are
places where people can talk to the nurse about suspected alcohol or
prescription problems and get referrals for help.
Barbara Clark is editor of Senior News.

Editor's personal note:
The conference was geared to professionals who work with
older people as caregivers, doctors, social workers and mental health
workers, few of whom were in their 60s or 70s. As editor of Senior
News and soon to turn 60, my connection is with active elders. I took
this story to my writers group in mid-April, where the members of my
group, all of them older than 70, asked how many of the conference
participants or presenters were elders themselves. (Not many.) How
many of the people who study "elders" are elders themselves, they
wondered. My guess was that few who study elders are themselves older
than 60.