When people talk about an older adult who abuses or misuses alcohol or other drugs, we're likely to hear comments such as these:

This woman lost her husband and her house and now she's headed to a home for older people. She's lonely, and drinking is the one joy she has in life. Why take it away from her?

Dad is too old. Sure, he drinks too much; he always has. He'll never change.

Such attitudes from family members or loved ones pose stiff barriers to getting help for this population. The adult son who thinks drinking is his mother's one and only joy is fooling himself. Chances are the drinking doesn't make his mom happy at all. Instead, it's probably causing her misery, depression and shame and robbing her of the good health she could enjoy for many years to come.

Getting older adults the addiction treatment they need and deserve means overcoming myths about older people.

"Drinking in an alcoholic way is not a joy if you're falling in the bathroom and hitting your head on the sink," said Carol Colleran, addiction professional. "And it's not a joy if you're passing out in front of the television set at four o'clock in the afternoon on a routine basis."

Getting older adults the help they need means changing attitudes of the older person, who may view alcohol dependence as a moral weakness rather than a treatable disease. It also means understanding how they are at risk for addiction.

Loss plays a major part in this risk. Losses can multiply quickly for older people: the death of a spouse or close friends, the loss of a job because of retirement, loss of a home, loss of self-worth, or the loss of siblings who move out of state.

"The problem isn't just the loss of a spouse or another person," said Egan. "It's also the other losses. For example, older adults who've been active all their lives may look forward to retiring but then find that it is not very fulfilling. Suddenly they don't feel they have a sense of purpose. They feel that they're not needed."

The physical effects of aging also make older adults more susceptible to addiction. One example is the change in body mass and lowered efficiency in processing alcohol or prescription drugs. The result: Older adults may drink or use other drugs less and feel a greater effect. Drugs can build to a toxic level more easily in bodies that function more slowly.

Loved ones can take several actions to turn these situations around. Begin by watching for signs of addiction in older adults. Take note, for example, when the person drinks in spite of warning labels on prescription drugs, undergoes a personality change after drinking, is frequently intoxicated, drinks alone, loses interest in hobbies and activities, and neglects personal appearance.

If you are concerned about such signs, consider talking to an addiction counselor, psychologist, physician or minister about what you've seen. Working together, you can decide whether further action is necessary. If it is, then you need to express your concern to the older adult. Be gentle and caring, but at the same time be direct. Do not appear condescending, and avoid judgmental labels such as "alcoholic" or "addict."

You might simply state that you are concerned about the effects that alcohol may have on the person's welfare: "I'm concerned about your health and would like you to be assessed and evaluated by a professional."

When approached in this way, many older adults may admit a need for help. But even if the person reacts negatively, don't give up. You've planted a seed of recovery that can still grow.

Older adults can succeed in recovery. Edith Gomberg, professor of psychology at the University of Michigan Alcohol Research Center in Ann Arbor, Mich., notes that detoxification among older adults must be carefully managed. But she adds, "Where problem drinking is recognized and treated, prognosis is often good."

Egan agrees, stating that older adults in general have higher abstinence rates after treatment than their younger peers. Despite the myths, older adults show that they can change and enjoy the benefits of sobriety.

For tips on speaking to an older adult, read "How to Talk to an Older Person Who Has a Problem With Alcohol or Medications."

--Published June 22, 1998