Aging is a part of life for all of us, and learning how to make your home a safe place for seniors is important not only for ourselves, but also for our senior family members and friends. So how do you go about making your home suitable for aging in place? Read more
The elderly may be the last population you’d imagine would have issues with drugs and alcohol. Think again. New data shows the number of seniors with drug problems are on the rise. But the causes are complex and the solutions aren’t easy. Get educated about the scale and nature of senior drug abuse and misuse, signs of dependence and addiction in older loved ones, and how to get help for an older loved one with a drug problem.
The Increasing Prevalence of Drug Problems among Seniors
The precise rate of seniors and elderly people with drug problems is difficult to assess. One reason is that “many of the signs and symptoms of misuse and abuse mirror common signs of aging in general” as Belinda Basca notes in an article for the periodical Prevention Tactics. Recently released statistics present clear hints at a growing epidemic of drug abuse.
According to the Prevention Tactics report, “prescription drug abuse is present in 12 to 15% of elderly individuals who seek medical attention. What’s more, a document from the Johns Hopkins Medical School notes that the number of Americans over age 50 abusing prescription drugs is projected to rise to 2.7 million in 2020 — a 190% increase from the 2001 figure of 910,000.
Drinking Problems and Seniors
Alcohol abuse and alcoholism are other major issues among seniors. A study published in the Journal of General Internal Medicine found that “more than a third of drinkers 60 years old and older consume amounts of alcohol that are excessive or that are potentially harmful in combination with certain disease they have or medications they are taking.” Alcohol abuse and addiction can be just as dangerous and destructive as drug addiction, so don’t turn a blind eye to an older loved one’s alcohol problem.
Misuse vs. Abuse
It’s worth making a distinction between drug misuse, which is common among seniors, and drug abuse which is less prevalent among the older population.
The majority of seniors who become dependent on prescription drugs are being treated for legitimate medical issues such as pain, anxiety, depression or insomnia. They may increase their dose against medical advice in order to seek greater relief from their condition. This is drug misuse.
Drug abuse is less common among seniors, but is a big issue none-the-less. As one article puts it, abuse involves the “repetitive and willful habit of taking drugs for the purpose of pleasure, ecstasy and euphoria but does not include the repeated use of drugs for therapeutic purposes.”
This distinction is important. Seniors who are misusing medications for therapeutic purposes may be doing so because their current treatment plan simply isn’t effective in addressing their symptoms. Misuse or overuse can be controlled if physicians reevaluate treatment options so that patients don’t rely on more medication than prescribed in order to get full relief.
Drug abuse on the other hand can be more difficult to get under control, and may require drug treatment.
Dependence vs. Addiction
Just as there is a distinction between misuse and abuse, there is a distinction between dependence and addiction. Many medications are physically addictive, such as opioid painkillers like Vicodin or Percocet. Sedative, anti-anxiety, and insomnia drugs like Xanax and Valium can also cause physical dependence when taken daily, even at prescribed doses. Even without any misuse or abuse, a patient who is physically dependent will experience uncomfortable drug withdrawal symptoms if they abruptly stop taking the medication. If a patient stops medication that they are dependent on, their doctor will often prescribe gradually decreasing doses (a “taper”) to reduce discomfort.
Addiction is more often the result of drug abuse. Addicts, seniors and otherwise, are usually not only physically dependent on the drug or drugs they are taking, but also take them clearly compulsive and harmful way. As the National Institute on Drug Abuse “compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; and failure to meet work, social, or family obligations.”
Drugs of Misuse Among Seniors
Prescription drug and misuse and abuse and alcoholism are much more of an issue for seniors than abuse of hard street drugs like heroin or cocaine. Being aware of the primary classes of medicines that lead to dependence or addiction can be helpful:
Opioids: Opioids are used to treat pain. Common opioids include oxycodone (the active ingredient in Percocet and Oxycontin), hydrocodone (the active ingredient in Vicodin and Norco) and numerous other related medicines such as morphine, codeine, hydromorphone and fentanyl. Opioids are a vital tool for pain management, but carry clear risks of dependence and addiction. The number of fatal opioid over doses has risen dramatically over the last decade.
Benzodiazepines: Benzodiazepines are a class of medicines primarily used to treat anxiety, panic disorders, insomnia — and can also be used to treat bipolar disorder and even epilepsy. Common benzodiazepines include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan) and clonazepam (Klonopin). This class of medications can be highly habit forming, dangerous when mixed with other sedatives, and abrupt withdrawal can lead to seizures and other major medical issues.
Alcohol: Alcohol is undoubtedly a drug, but because it’s considered socially acceptable, seniors with alcohol problems can fly under the radar. Alcohol abuse can lead to dementia, liver failure, and other serious and potentially lethal health problems and should not be ignored. What’s more, alcohol affects seniors more strongly than younger people, so seniors should be particularly prudent with alcohol.
Stimulants: Stimulant such as Ritalin or Adderall are often prescribed to younger people for attention deficit hyperactivity disorder (ADHD), and sometimes prescribed to older adults for disorders such as narcolepsy and obesity. Stimulants can be habit forming and stimulant abuse can be highly injurious to health, particularly among seniors.
Signs of Drug Problems
Here are some signs that can indicate that your older loved one may have a substance abuse problem:
- Appearing over sedated, disoriented or impaired
- Poor balance or unsteady gait
- Requesting early refills
- Reporting that their medications have been lost or stolen (particularly if this occurs more than once)
- Poor hygiene or disheveled appearance
- Appetite changes
- Mood swings or major personality changes
- Increased isolation
- Demanding narcotic drugs at visit to the doctor
- Apparent doctor shopping
It’s important to note that any of these signs and symptoms could be due to reasons besides drug problems, but they are definitely cause to investigate further.
Help for an Older Loved One with a Drug Problem
If you believe an elderly loved one may have a drug problem you should intervene. One option is alerting your loved one’s physician about your concerns. The right type of treatment will vary as well as the individual and the circumstances. A hopeful trend is the emergence of drug treatment programs especially for seniors, which was born out of the recognition that there are differences in the drug treatment strategies that are effective for seniors as compared to younger people.
There are all kinds of benefits to downsizing in your golden years — lower energy bills, a smaller space to clean and maintain, and the potential of moving closer to loved ones are just a few. It’s a wonderful way to open the door to the next stage of your life. Even so, downsizing can be a difficult and sometimes painful experience for seniors. Saying goodbye to the home they’ve raised a family in doesn’t come easily, even if it’s the right choice from a logical standpoint.
This guide is designed to make the downsizing process as simple as possible for seniors and their loved ones. It will help prepare both house and senior for the transition, as well as offer advice to loved ones on the duties they can help perform. Keep the lines of communication open, take it one step at a time, and don’t rush into anything before you’re ready.
Step One: Determine Where the Senior is Going
It’s important to establish exactly where the senior is headed. Not only will it affect just how much they should (or must) downsize, it adds an exciting element to the process: instead of focusing on leaving their old home behind, a downsizing senior can look forward to their new home.
Of course, where the senior goes will depend on any number of factors. Mobility and ability restrictions, care-giving needs, location of loved ones, and budget will all play a role. The senior’s preferences are also crucial to the equation, and should be taken into consideration at each step. There will likely need to be compromises, especially if budget concerns are an issue, so be prepared to have multiple conversations to work out all the details. Keep in mind that the arrangements can look just about any way you want them to — many retirement communities and assisted living facilities offer personalized options to meet any need or comfort — so it’s important to make sure everyone feels comfortable with them.
There are five main options for downsizing seniors:
- Buying a smaller house or condo
- Renting a smaller home
- Moving in with a loved one (adult child, sibling, etc.)
- Moving into a retirement community
- Entering assisted living
The sooner you discuss what downsizing will actually look like, the more time everyone will have to evaluate all of the options. Don’t force the conversation if the senior seems resistant to the idea; unless your loved one has had a recent medical or care-giving issue that could hinder their quality of life, there’s no need to rush into talking about it. Bring the topic up again at a later date, potentially with additional support from family or friends. It shouldn’t feel like an intervention or anyone trying to make decisions for the senior, but a group of loved ones who genuinely want to help figure out a positive solution to their living situation.
Step Two: Declutter
It’s amazing the number of things you can acquire over the course of a lifetime. From an endless array of dishes to closets full of linens to the many mementos and knickknacks of a life well-lived, addressing these items quickly feels overwhelming for seniors and their loved ones. It’s also an incredibly emotional process for the senior involved. These aren’t just objects, they’re memories; they’re what’s made the house a home for all these years. Whether it’s you or a loved one downsizing, it’s important to acknowledge and respect this loss. Go into the process prepared to part with plenty, but giving yourself room to keep the items that mean most.
The most straightforward way to sort through items is to ask yourself four questions about the item:
- Do I need it or want it?
- Does it have sentimental value?
- Do I use it often?
- Do I have another item that performs the same function?
Do I need it or want it?
You don’t have to throw out everything you can literally live without, but you should be pretty strict about your definition of need. If you have a bread maker that’s been sitting in the cabinet untouched for years, don’t feel like you “should” keep it just because it was a Hanukkah gift. Think realistically about the years ahead: will you use it more than a few times? Are you genuinely excited for the few times you’ll use it? Will it make an important difference in your life to hold onto the item? It’s OK to say yes, but skip the guilt if the answer is no. Downsizing is about simplifying, so make a decision and feel confident in sticking to it.
Answering whether or not you want something is complicated — it’s hard to say you don’t want something you’ve had for decades, no matter what it is. Start by making a list of your absolute must-haves, the things you absolutely refuse to leave behind. It might include items like:
- Your engagement ring or wedding band
- Pocket watch
- Photo albums
- Sobriety chips
- Military badges, garments, etc.
Sit down and create a list with absolutely everything that comes to mind. Be realistic — maybe you’ll keep only a few of your favorite porcelain frogs rather than the entire 43-piece collection — but don’t worry if it seems long. Over time, reflect on each item. You don’t have to sit and agonize, just ponder the list while you’re doing the dishes, going for a walk, or running errands. Are there any items that, in retrospect, you’re ready to part with? Is there anything you’d like to give to a loved one instead? Do you know anyone who could get more use or value out of an object? Keep in mind that even if you plan to leave someone an item in the future, it can be a beautiful gift to actually watch them appreciate it in the present.
Does it have sentimental value?
The hardest items to part with will be the ones directly tied to beloved memories with your family and friends. Still, if you kept absolutely everything of sentimental value, downsizing would be impossible. Use the packing and sorting process as a way to reflect and let go. As you and a loved one go through your things, talk about them and the memories they conjure up. If you’re working solo, it can still be therapeutic to say these thoughts out loud — you can even tell your dog about the items. Just letting yourself really look back and appreciate the good times can sometimes be enough to help you let go of the mementos.
Do I use this item often?
There are going to be some items you’re simply used to having around, but ultimately don’t use very much. Think about your day-to-day routine: which items do you use the most? When you look around your house, which objects have been merely functional décor? Additionally, consider whether where you’re going will have a valuable replacement — just because you’ve always used a traditional toaster doesn’t mean you can’t adapt to your daughter’s toaster oven, for instance. Continue to be realistic about the future, keeping in mind that there might be someone else who would get much more use out of the item.
Do I have another item that performs the same function?
Whether it’s two blenders or a dozen winter coats, duplicate items are the easiest way to downsize. Choose the newest or best-functioning electronic (don’t forget to test them out to ensure everything’s in good working order), and a reasonable amount of more practical items like towels, blankets, outerwear, and other clothing. Use the opportunity to clean out your closet. Embrace the opportunity to minimize: if you really only ever wear the same three cardigans, keep those and donate the rest. Make sure you’ll have everything you’ll need, but be willing to see a smaller wardrobe. Remember: it means less laundry!
Step 3: Find new homes for the items you aren’t keeping
Moving expenses can get to be pretty pricey, especially if you hire a professional moving company or consult with a senior move manager. Yard sales are a great way to make some extra money to help fund the move, and a great way to find new homes for your things quickly.
Choose a day that’s likely to be nice, even if it’s somewhat far in the future. It might feel frustrating to wait a few months until fall, but having a yard sale in the dead of summer can be miserable in hotter regions. Plus, shoppers will be eager to get out of the sun and probably won’t have much patience. You may need to check with your neighborhood association or city zoning about having a yard sale, so find out what’s required in your area ahead of time.
Don’t underestimate the power of signage and advertisement for your yard sale — place them throughout the neighborhood, even several streets over. You never know who might be looking for bargains! Price items low and be prepared for people to negotiate. It’s more important to clear your yard of as many items as possible than to get a couple more dollars, so use your best judgment when it comes to bartering. And don’t forget to put your most valuable items in clear view so people can see all that your yard sale has to offer!
Donate any remaining items. Many charities and organizations can even pick up boxes directly from your home. It can feel impersonal and somewhat distressing sometimes — even with a yard sale, your items tend to go to neighbors you’re familiar with — but it’s important to focus on the end result. Someone in need will truly benefit from your donation and appreciate it each and every day.
Step 4: Say goodbye
Just as the senior had to say goodbye to their possessions, the time will come to say goodbye to the house, as well. It will be a difficult process, one with plenty of love and support from family and friends.
The truth is, there’s not necessarily a right or wrong way to say goodbye to the family home. It can start even before items have been packed away, as the senior walks through each room and reflects on the many memories created there. Some seniors might appreciate taking photos of all of the rooms that they can look back on while the new home feels foreign. Others may prefer to move out early instead of seeing their beloved home taken apart. Discuss what will work best for your family in an open and honest setting; don’t feel ashamed if you’re having trouble. It’s vital that the entire family supports one another throughout the downsizing process, so don’t be afraid to ask for or offer help.
However the goodbyes are said, make it a point to bid farewell. You’re closing a major, important chapter of your life. It’s OK to feel sad, even as if you’ve suffered a loss, but don’t lose sight of the exciting next step that lies ahead.
Step 5: Make the transition
No matter where the senior is headed, the new home won’t feel like home right away. Do what you can to bring in the most important items first, those that will make the senior feel especially comforted. Move-in day should be a family affair, even if you hire movers. Any member who is able to should stop by to help out, bring food and refreshments, troubleshoot issues, and simply make the occasion a happy one. Keep the mood as light and exciting as possible: focus on the fact that it’s a new beginning rather than an end.
Seniors and their loved ones should check in regularly to discuss how things are going. You don’t have to stop by every day, but a nightly call for the first week or two can certainly make a displaced senior feel less lonely. It’s especially important if they’ve just moved to an assisted living facility or nursing home, but shouldn’t be overlooked if they’ve moved in with a loved one. Just because they are with family doesn’t mean it’s been a seamless process, and there could still be underlying emotional trauma from the move itself. Find the balance between hovering and checking-in, even rotating responsibility among family members.
Give everyone time to adjust, including your spouse and children if the senior has come to live with you. It’s going to be a process for everyone to get used to the new routine, and you can’t rush the adjustment. The most important thing is to keep communication open and address issues right away. Don’t let things fall into an unhealthy or unhappy pattern; even if it’s an uncomfortable conversation initially, solving the problem is always better than turning a blind eye and hoping for the best. Remember, it’s a difficult time for all, so support is imperative.
Downsizing is often one of the best choices a senior can make, but it’s their decision in the end. Ease into the idea and keep the conversation ongoing. It will be painful, but the inevitable sting of leaving the family home should never stop a senior from simplified, happier living.
Note: All images and content in this guide are free to be published on third party websites. If doing so, please include a citation to the original article from Redfin.com
Karpoff Affiliates is proud to be a sponsor for this 2 hour “Grief Work and Coping with Loss” workshop on October 12th at Brookdale Battery Park.
Come listen to Marilyn give advice and tips on how to organize not only your home but also your life when preparing to downsize, declutter, move, or sell your home.
We are proud to support the “Older Adults Art Exhibit” as part of Older Americans Month, on view May 17th thru June 15th @ the Manny Cantor Center. Come by and see some great art!
Have a happy and healthy Passover!