When we think of the Golden Years, we don’t usually like to think of them as tarnished. Yet, addictions—substance abuse, alcohol, gambling, and compulsive shopping—are problems that challenge our assumptions about senior citizens while also surprising us with the senior’s capacity to change.
Because we’ve grown up with the perception that Grandpa and Grandma are like the Waltons, fountains of wisdom and knowledge, it’s difficult to view senior citizens as those struggling with addictions. Prevention programs reinforce this because most of them are directed at people in their teens and twenties, and most treatment is aimed at people under 50. Many people struggling with addictions, in reality, are over 50.
University of Iowa Psychiatry Professor Stephen Arndt said, “We’re at the leading edge of a wave.” The federal government’s latest drug use survey estimates 1.25 million people 55 and older used illegal drugs sometime during 2003. By 2020, 4.4 million Americans age 50 and older will have drug and alcohol problems, according to the U.S. Substance Abuse and Mental Health Services Administration. With older people, the tendency is to look at them and say, “She’s such a nice old lady; she couldn’t be an alcoholic or drug addict.”
Drug and alcohol abuse is no respecter of social class, economic line, or age. Older addicts don’t necessarily start abusing when they’re young. Some become addicted very late in life. Some, for instance, are successful in business and in relationships but begin to drink or use to fill up solitary hours due to retirement or loss of relationships.
Another addiction that’s attractive to seniors is gambling. Organized bus trips to gambling casinos provide a diversion—a day trip outside the house, the opportunity for fortune, and a “reasonably priced lunch.” The Massachusetts Council of Compulsive Gambling says seniors represent the fastest-growing population of gamblers and are one of the high-risk groups that are gambling’s biggest losers.
Unfortunately, a huge disservice is done by researchers who suggest a little gambling is good for the older adult. The faulty reasoning is that gambling provides a diversion and can be controlled. In contrast, one study published in the American Journal of Geriatric Psychiatry reported older adults with a gambling disorder experienced increased severity of health and psychosocial problems compared to older adults without a gambling disorder. Symptoms of senior problem gambling include:
• Changes in normal communication with others.
• Frequent, unexplained absences.
• Repeatedly borrowing money when this hasn’t been a past behavior.
• Paying bills late when this hasn’t been a past pattern.
• Frequent illness due to failure to buy needed medication.
• Personality changes.
• Neglecting finances and health.
• Avoidance of talking about or denial of gambling.
Compulsive shopping and spending, whether in person or online, also can tarnish an older adult’s “golden years.” Compulsive shopping can occur when a person feels depressed, lonely, or angry—and some older adults experience these feelings daily. They feel out of the mainstream of life, and they seek to feel better by spending money. In addition, when they shop online, they have no need to leave their homes and, therefore, think the addiction can be hidden from family members.
Compulsive shopping is defined as a pattern of chronic, repetitive purchasing that becomes difficult to stop and ultimately results in harmful consequences. It’s an impulse control disorder. The following are behaviors typical of compulsive shopping:
• Shopping or spending money as a result of feeling disappointed, angry, or scared.
• Shopping or spending habits causing emotional distress in one’s life.
• Having arguments with others about one’s shopping or spending habits.
• Feeling lost without credit cards.
• Buying items on credit that wouldn’t be bought with cash.
• Feeling a rush of euphoria and anxiety when spending money.
• Feeling guilty, ashamed, embarrassed, or confused after spending money.
• Lying to others about purchases made or how much money was spent.
• Thinking excessively about money.
• Spending a lot of time juggling accounts or bills to accommodate spending.
As family or friends of older adults, be aware of the above behaviors. These behaviors are symptoms of a life out of control. Obviously, they also may be indications of other problems such as dementia, but we have to be careful not to jump to that conclusion without accurate diagnosis.
Health care professionals need to make sure they recognize and acknowledge an older adult’s ability to change. Working with the elderly can be very rewarding. We need to focus as much on seniors when it comes to addiction diagnosis and treatment as we do on younger people. As the first wave of baby boomers approaches retirement age, the proportion of people over 65 is going to increase greatly.
Programs need to be designed with the following in mind: seniors don’t like to admit they have a problem, the language used and the approach taken is critically important, and collecting data on this population is difficult. One of the most effective forms of treatment seems to be in the area of attending not just to the addiction itself, but to other conditions that may have propelled the older adult to cope in an unhealthy way. Licensed clinical social workers or licensed clinical psychologists, as well as psychiatrists, are reimbursable through Medicare. TPW