24 Mar Is Your Parent Depressed and Abusing Alcohol or Prescription Drugs? Here’s How to Help
Caring for elderly parents can be frustrating and confusing. But when your parent is living alone or with a spouse, is showing signs of depression and you suspect is also abusing alcohol or prescription drugs, it can be doubly confusing for you.
You may be afraid that any offer of help will be rejected since your parent wants you to believe – and makes frequent pronouncements – that everything is fine.
Adult children who witness signs that may indicate depression and substance abuse, alone or in combination, need help in determining if there is truly a problem worth investigating. What should you be on the lookout for, how many symptoms constitute a problem, and what can or should you do if you believe there is a problem?
Let’s first take a look at depression that may be present in an elderly parent.
According to the Mayo Clinic, depression is a medical illness that causes a persistent feeling of sadness and loss of interest in activities. Depression can also cause physical symptoms.
It has different names, including major depressive disorder, clinical depression, and major depression. It affects how individuals think, feel and behave. People who are depressed may have difficulty doing everyday things to the point that their quality of life suffers or they endanger themselves or others by their behavior.
Worst of all, depressed individuals may begin to feel that their lives are meaningless and no longer worth living. Such individuals may be at high risk of suicide.
Depression is not simply a case of the blues or a feeling of temporary sadness. Depression is a chronic illness that generally requires long-term treatment. People can and do get better with treatment, which typically involves a combination of medications, counseling and support groups.
The National Institute of Mental Health reports that the risk of depression in the elderly increases with the presence of other illnesses and when the ability to move about or function becomes limited. The institute estimates incidences of major depression among the elderly living in the community at less than 1 percent to 5 percent, but that figure rises to 13.5 percent in those requiring home healthcare and 11.5 percent in hospitalized patients.
How to Know if Your Parent Is Depressed
There are a number of symptoms that indicate depression in an elderly parent. Any one of them alone may not indicate a problem, but if several are present, there could be cause for concern.
People who are depressed may:
- Have feelings characterized as sadness or unhappiness
- Feel tired and exhausted most of the time
- Have a lack of energy, even for the simplest tasks
- Have a reduced sex drive
- Frequently become frustrated and irritated over seemingly small matters
- Be unable to sleep, or sleep too much
- Lose interest or pleasure in activities that used to be enjoyable
- Display angry outbursts or extreme irritability
- Undergo changes in eating habits – either loss of appetite and weight loss or cravings for food and weight gain
- Become restless and agitated, engaging in activity such as pacing, hand-wringing, being unable to sit still for very long
- Have problems with memory, concentration, focus, decision-making
- Be easily distracted, have a lack of concentration, be unable to make a decision
- Have feelings of worthlessness or guilt, blaming themselves for past failures and being fixated on the past
- Start to show signs of slowed speech, thinking, and movement
- Erupt in frequent crying spells for no apparent reason
- Suffer unexplained physical pain, such as back pain or headaches
- Have frequent thoughts about death, dying or suicide
It is important to note that depression is not a normal part of growing older. While people with depression can be successfully treated, the problem with many older adults is that some of the symptoms they exhibit may be mistaken as being caused by other illnesses. Thus, depression often goes undiagnosed.
Alcoholism and the Elderly
Just because your elderly parent may like to have a drink now and then does not mean that he or she is an alcoholic. But when medical conditions start to increase and your parent begins to lose functioning and freedom of mobility, self-medicating with alcohol may start to become apparent.
What should you look out for? According to the National Institute on Aging, U.S. Department of Health and Human Services, you may have cause for concern if you see the following signs in your parent:
- Drinking to quell depression, to calm nerves or forget troubles
- Drinking when alone and on a regular basis
- Gulping down drinks
- Loss of interest in food
- Lying about or trying to hide drinking habits
- Hurting self or others when drinking
- Were drunk more than three or four times in the last year
- Acting irritable, unreasonable or resentful when not drinking
- Requiring more alcohol to get “high”
- Incurring social, legal, medical or financial problems as a result of drinking
If any of these warning signs are present, it doesn’t automatically mean that your elderly parent is abusing alcohol. Some of them also accompany other health problems that adults confront as they age. Some behavior changes are the result of stress, which may have prompted a sudden increase in alcohol consumption as a means of coping.
In addition, retirement, if recent, the loss of a spouse or other loved one, loss of the family home, and being recently diagnosed with a disease can all trigger substance abuse, whether that substance is alcohol, drugs or both.
After careful analysis of the situation with your elderly parent, if you determine there is reason to be concerned about drug or alcohol abuse, the first thing to do is to talk with your parent about what you have observed.
An elderly parent may deny that a problem exists, promise to quit drinking and/or taking too many drugs, or ask you to mind your own business. You should not give up in the face of resistance, though, since the life of your loved one could depend on him or her getting professional help.
You may be able to convince your parent to see his or her doctor and allow you to go along for the visit. This isn’t always practical and parents may refuse to either go to the doctor or let you accompany them. It may be considered an invasion of privacy, a desire to remain independent, a denial of any problem, or all of these.
If your parent refuses to get help, consider an intervention by a professional. Do not consider doing one yourself. You’re not equipped to handle the emotional aspects of an intervention.
With a professional interventionist present, however, you can be assured that the meeting will take place according to evidence-based procedures. There will be a pre-meeting for family members and possibly close friends where everyone talks with the interventionist.
The sole purpose of the intervention is to get your elderly loved one to acknowledge that his or her abuse is a problem and to accept and be willing to go into treatment. During the meeting, family members and close friends read aloud statements that they have prepared, telling the loved one how his or her drug or alcohol abuse has impacted them, that they are at the intervention out of love and only want him or her to get treatment.
It’s also critically important that your elderly parent realizes that there will be no more enabling of the drug or alcohol abuse by you or other family members. Excuses will no longer be tolerated and there will be no further support unless your parent accepts treatment.
Once your parent agrees to go into treatment, the intervention is over. Arrangements for admission to a drug or alcohol rehab facility should already have been made and the interventionist often accompanies the individual directly to the facility. There’s no downtime, no delay to give the individual an opportunity to back out.
When looking for a professional interventionist, search for one that is board registered and certified by the Assn. of Intervention Specialist Certification Board.
Prescription Drugs and the Elderly
An estimated 20 percent of adults aged 65 and older take painkillers several times a week. Of that number, about 18 percent become addicted to the prescription drugs and begin taking them for reasons other than prescribed. This includes taking more of the drug than the doctor prescribed, taking it more frequently, or taking someone else’s medication.
Prescription drug abuse of opioid painkillers is continuing to increase, with a resulting increase in opioid-related deaths. Oxycodone (OxyContin), hydrocodone and methadone are the most frequent cause of prescription drug abuse deaths.
Many of these prescription drugs, especially painkillers, are extremely addictive. The bodies of older people have a slower metabolism, making them more susceptible to becoming dependent on the drugs they’re taking.
Add in the fact that medicine cabinets across the nation are filled with outdated and unused prescriptions, confusion may set in when an elderly person is rummaging around, looking for something to ease the pain. Add in difficulty in reading labels and forgetting what and how much was already taken, and the risk for abuse and overdose magnifies.
As the adult child of an elderly parent who takes one or more prescription drugs, especially painkillers, seek help for your parent if you see:
- A decrease in activity and/or lack of participation in activities that once were enjoyed due to all the attention focused on drugs
- Decreased attention to hygiene, starting to appear unkempt and/or dirty
- Pleas for help to combat pain
- Demanding potent painkilling medication from the doctor on a first visit, or when it is seemingly unwarranted
- Seeming to be preoccupied or somewhere other than the present, as well as no longer being interested in family or other activities
- Increase in body odor
- Exhibiting signs of sickness when stopping their medications – these are symptoms of withdrawal: chills, fever, cough, runny nose, agitation, depression, nausea, vomiting and stomach pain
If you suspect your elderly parent is abusing prescription drugs, here are some things you can do.
First, take an inventory of all the medications your parent (or parents) takes. Write down the name of the medication, the manufacturer, strength, dosage and any contraindications mentioned on the container. Also write down the name and phone number of the prescribing doctor. If there are different pharmacies used, include that. Don’t forget to list all nonprescription over-the-counter drugs, along with vitamins and herbs. Many of these have contraindications when taken in combination with prescription drugs and/or alcohol.
Next, research the medications. Look for mentions of side effects, long-term consequences, potential for addiction, recalls or negative mentions. A good resource for this is the National Institute on Drug Abuse.
Prescription drug abuse among the elderly, the institute says, is a growing problem in America due to the fact that this population takes more medications than their younger counterparts. Physicians prescribe painkillers (opioids), central nervous system depressants and stimulants to a dizzying extent. All of these medications have the potential for dependence and addiction. Many medications are also available over the Internet, compounding the problem. Some Internet “pharmacies” will dispense these medications without a prescription.
Now comes the hard part: discussing what you’ve learned with your elderly parent. It is important that you speak in a calm and loving voice. Don’t threaten or chastise. Treat your parent with dignity and respect. What they may not realize, especially after taking prescribed medications and renewing them for years, is that they may not need them any longer, or that there are sound reasons why they shouldn’t take certain medications at the same time. End the discussion with an action plan. Tell your parent you want to make an appointment with their primary doctor, and you’ll go with them to the visit.
When you accompany your parent to the doctor, bring the list of medications. Ask if some of them could be eliminated. Remember that your parent may have been to several doctors over the years and the list of medications may not be known to any or all of them. The current doctor may need to consult with the original prescribing doctor in order to safely recommend discontinuing a medication.
If your parent is to be weaned off of a medication, monitor his or her progress, ensuring that your parent follows the doctor’s instructions. A pill organizer may make it easier, but you’ll have to be diligent about checking up on your parent’s consumption of prescribed medications.
Keep in mind that treatment for prescription drug abuse may ultimately be required, especially if there is also alcohol abuse or addiction and depression. This may involve a residential treatment program after detoxification from the prescription drugs and alcohol. Insurance generally covers a good portion of this, and assistance is available through federal and state agencies. Continuing therapy, counseling and group support meetings can provide lasting assistance to the elderly in recovery from prescription drug and alcohol abuse, and depression.
Hardest Part Is Admitting There’s a Problem
While it may sound like a daunting proposition, getting help for your elderly parent isn’t that difficult. Perhaps the hardest part is admitting there is a problem – both on your part and that of your elderly parent.
Acknowledgement of a problem and acceptance of help are the first steps toward healing. While your elderly loved one may have been quick to dismiss your concerns, once he or she enters treatment and commits to sobriety, a new sober lifestyle is often embraced with gusto.
However, one time in rehab for drug or alcohol abuse may not be sufficient to overcome chronic addiction. Your elderly loved one may relapse, requiring further counseling or treatment. This does not mean the first time in rehab was a failure, but rather that more time may be needed for your parent to understand the disease of addiction, learn more about how to recognize triggers, and learn and practice coping strategies for dealing with cravings and urges.
Participation in 12-step groups such as Alcoholics Anonymous, Narcotics Anonymous or other self-help groups is also strongly encouraged after completion of drug and alcohol rehab.
With continued support and encouragement from family and peer support groups, your elderly parent will have a much better chance of maintaining sobriety and living a more fulfilling life. Don’t shortchange your parents who may be in trouble with drugs and/or alcohol and are depressed. Resolve to get them the help they need so that their healing may begin.
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