Alcohol and old lace
Gerald W. Deas M.D., MPH | 1/16/2014, 5:08 p.m.
Many renowned persons have made comments regarding alcoholism. One of those is John W. Gardner, an American educator who stated, “No other national health problem has been so seriously neglected as alcoholism. Many doctors decline to accept alcoholics as patients. Most hospitals refuse to admit alcoholics. Available methods of treatment have not been widely applied. Research on alcoholism and excessive drinking has received virtually no significant support.”
In all media, tasty alcoholic drinks are advertised mostly to young audiences who really have no idea of the bottomless alcoholic “hole.” It is not hard to visualize in the media, which depicts young folks “drinking it up,” not realizing the consequences of its effects. As a result, many young people have died behind the wheel. It has recently been shown that some elderly people also become closet alcoholics.
Not too many moons ago, I was called to make a house visit to a 72-year-old widow who lived in a senior housing complex. When I entered her bedroom, she was lying facedown in vomit while breathing heavily. It was obvious that she needed hospitalization. While waiting for the ambulance, I observed on her nightstand several types of medications that included blood pressure pills, diabetic medications and sleep capsules. There was also an open half-pint bottle of vodka and a quart of warm orange juice. This grand old lady was not known to be an alcoholic to her friends or family. The hospitalization resulted in her rehab and recovery.
Alcoholism among the elderly is a growing but little discussed social and medical problem. It has been reported in medical literature that 10-15 percent of people over the age of 65 have a drinking problem. Many of them began drinking during their senior years due to depression resulting from loneliness after living a long and productive life. Friends and family are no longer around to monitor them and provide support. Their only comfort is to sit and sip an alcoholic beverage supplied by the local liquor store while watching television.
Most senior citizens have medical conditions that require medications that do not mix well with alcohol. Often, when these patients are admitted to a hospital, it is not obvious that they may be alcoholics, and they begin to show withdrawal symptoms, which can complicate their treatment. Even a simple case of pneumonia will not do well with the best of care, because the alcohol depresses the immune system, which protects the body from invading organisms. In fact, alcoholism also causes vitamin and mineral deficiencies, which can lead to neurological deficits and chronic brain syndromes. It is therefore necessary to treat a patient with alcohol-related problems with vitamins and mineral supplements such as B1 (thiamine) and magnesium, along with other micronutrients.
The adverse social conditions that lead to alcoholism must be addressed by social service agencies such as Alcoholics Anonymous (AA), religious groups and concerned relatives. The afflicted senior citizen must be encouraged to go to recreational centers for interaction with others in their peer group. If they cannot reach the center for want of transportation, retired neighbors or church members may be able to form voluntary transit services.
With adequate medical care and alcohol detoxification, the above patient responded well. The Department of Social Services arranged for her to attend AA meetings in her senior housing development. She was also encouraged to give a key to her apartment to her neighbor, who could periodically check on her. She is doing well.