alcohol older people feb 2013 pdf.pdf
TRANSCRIPT
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1 Age UK County Durham Older people and alcohol February 2013
Theres more to life than a drink:
Older peoples ideas about how to
reduce the harm of alcohol in
County Durham
A report to Durham County CouncilFebruary 2013
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2 Age UK County Durham Older people and alcohol February 2013
This word cloud shows the key triggers that cause older people to drink alcohol
identified by the participants in this study. Words are larger where they were
mentioned more often.
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3 Age UK County Durham Older people and alcohol February 2013
Contents Page
Page
1. Executive Summary 4
2. Introduction .. 6
2.1 Background 6
2.2 Methodology 7
2.3 Representation 8
3. Why do older people drink alcohol? 10
3.1 Summary 10
3.2 Triggers 11
3.3 Perceptions 12
3.4 Culture 14
4. Who or What can influence older people about alcohol .. 16
4.1 Summary 16
4.2 Who can influence older people about alcohol consumption? 16
4.3 What can influence older people about alcohol consumption? 19
5. How to reduce alcohol consumption among older people 20
5.1 Summary 20
5.2 How to reduce alcohol consumption among older people 20
5.3 Social interaction 21
5.4 Alcohol awareness 22
5.5 Counselling and support 26
6. Minimum price campaign for alcohol 26
7. Conclusions and recommendations . 27
7.1 Conclusions 27
7.2 Recommendations 28
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4 Age UK County Durham Older people and alcohol February 2013
1. Executive summary
Alcohol misuse among older people is associated with an increased risk of falls, poor
nutrition, hypothermia, anxiety and depression. Factors that can trigger heavydrinking in later life include loss, bereavement, loneliness, isolation and coping with
pain or ill health. Alcohol can also have an interaction with prescribed medications.
Alcohol misuse is thought for the most part to be unreported, undiagnosed, or
ignored. There is concern that in County Durham over the past 9 years there has
been a 290.2% increase in over 65+ alcohol related hospital admissions.
This report presents the results of a countywide consultation commissioned by
Durham County Council and carried out by Age UK County Durham to understand
why older people drink alcohol and identify actions which might reduce the harm
caused by alcohol consumption.
This report draws together the results of consultation with 140 people aged 50+
through 10 focus groups, 3 one to one interviews and a questionnaire returned by 80
people. The information collected will be used to inform the Alcohol Harm Reduction
Strategy for County Durham.
The consultation identified that the main triggers that caused older people to drink
alcohol are loneliness, boredom, depression, bereavement and pain or illness.
Socialising and celebration were seen as much lower. Alcohol was seen as an aid to
sleeplessness, a pain killer to numb pain and as a stress reliever.
The main influencer in relation to alcohol consumption is the GP and other healthcare
professionals and many older people admitted they have concealed their alcohol
consumption from their GP as they were worried they would not receive medical
treatment if the GP knew they drank. Family are also important influencers and their
support can make a big difference.
When asked how to reduce alcohol consumption among older people there was a
consensus of opinion;
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5 Age UK County Durham Older people and alcohol February 2013
Opportunities for social interaction in non-alcohol based activities;
Awareness raising about the impact of alcohol consumption;
Support through counselling or Listening Ear services.
The report makes 5 recommendations which are given in section 7 of this report.
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6 Age UK County Durham Older people and alcohol February 2013
2. Introduction
This report presents the results of a countywide consultation commissioned by
Durham County Council and carried out by Age UK County Durham to understandwhy older people drink alcohol and identify actions which might reduce the harm
caused by alcohol consumption.
This report draws together the results of consultation with older people through focus
groups, interviews and a questionnaire. The information collected will be used to
inform the Alcohol Harm Reduction Strategy for County Durham.
2.1 Background
Durham County Council have identified that the percentage of people who drink
above recommended units decreases from the age of 45 years onwards. However
the chronic health damage from prolonged alcohol misuse is more likely to manifest
itself as we get older. In County Durham over the last nine years there has been a
290.2% increase in over 65+ alcohol related hospital admissions. The rate increase
for 65+ males has been slightly higher at 301.2% whilst being slightly lower for 65+
females at 273.5%. The crude rate of 65+ admissions as of 2010/11 was 3.8% lower
than the North East average but 20.1% higher than the national average1.
Alcohol misuse among older people is associated with an increased risk of falls, poor
nutrition, hypothermia, anxiety and depression. Factors that can trigger heavy
drinking in later life include loss, bereavement, loneliness, isolation and coping with
pain or ill health. Alcohol can also have an interaction with prescribed medications.Alcohol misuse is thought for the most part to be unreported, undiagnosed, or
ignored.
In 2011 the Chief Medical Officer suggests that 20% of men and 10% of women aged
65 and over exceed recommended drinking guidelines and 3% of men and 0.6% of
women aged 65-74 are alcohol dependent. Nearly 20% of the population in County
Durham is of pensionable age (60 or over for women, 65 or over for men). People of1Draft Alcohol Harm Reduction Strategy for County Durham, Durham County Council, 2012
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pensionable age make up a larger proportion of the population in County Durham
(19.8%) than in England (18.5%). By 2029 it is projected that 28.9% of the population
in County Durham will be over the (current) pensionable age.2
The social marketing group involved in the alcohol harm reduction strategy agreed to
progress work with older people in line with the Joint Commissioning Strategy for
Older People Action Plan 2012/13. The aim was to establish level and type of need
of older people with alcohol dependency problems and older carers of relatives with
drug/alcohol dependency problems. The group asked Age UK County Durham to
undertake some research about alcohol with older people to identify their knowledge
of alcohol units, the reasons behind alcohol use by older people, sources and types
of alcohol, the impact of stigma and alcohol, and to contribute suggestions for actions
to support the alcohol harm reduction strategy.
2.2 Methodology
In total this consultation has involved 140 older people across County Durham. We
encouraged older people to participate in this consultation using a number of
approaches:
Consultation with focus groups of older people
One to one interviews with older people
Questionnaire distributed to EngAge Older Peoples Network
Articles in the Northern Echo inviting older people to participate
There were 10 focus groups, 3 interviews and 80 people participated by
questionnaire. The consultation breakdown is as follows:
1 x group of carers
4 x Older Peoples Network groups
3 x focus groups of EngAge members
1 x 50+ LGBT group
Members of a Confident Consumer Group
3 x one to one interviews
80 questionnaire respondents
2Draft Alcohol Harm Reduction Strategy for County Durham, Durham County Council, 2012
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8 Age UK County Durham Older people and alcohol February 2013
Each focus group was designed to take 1 hours and followed a plan agreed with
the Alcohol Harm Reduction Coordinator. All participants received a complimentary
Unit Measuring Glass, a self-screening toolkit and a colourful information pack of
leaflets to take away. Each group were introduced to the subject and then asked to
share their views on a range of questions including:
Awareness of alcohol units
What triggers may encourage people to drink
What would support an older person in reducing their alcoholic intake
Who or what would an older person take notice of when asked to cut down
their alcohol consumption?
How could we reduce alcohol consumption amongst older people in County
Durham?
What does the group think about the Governments idea of a minimum price
for alcohol?
2.3 Representation
Effort was taken to ensure coverage from across County Durham and to involve older
people of all ages, those with disabilities and carers.
Participants included older people from across the county (please see Table 1).
Table 1: Breakdown of participation across County Durham
Geographical area Number of people
Dales 20
Derwentside 32
Durham & Chester-Le-Street 44
East Durham 24
South Durham 15
Not given 5
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We involved 140 older people aged 50+ . The table below gives a breakdown of the
ages (please see table 2).
AgeFocus groups
& interviewsQuestionnaire Total
Total as
%
50-64 9 17 26 18
65-74 26 41 67 48
75-84 20 19 39 28
85+ 5 3 8 6
Total 60 80 140 100
Table 2: Breakdown of participation by age.
Of the participants:
32% are male, 68% are female
18% are older carers
4% are housebound
54% consider themselves to have a disability with 39% having physical disability,
29% have hearing loss, 14% have visual impairment and 6% have a mental
health problem.
88% are heterosexual, 4% are gay men and 2% are lesbian / gay women, 6% did
not state.
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3. Why do older people drink alcohol?
3.1 Summary
There are many reasons why older people have an alcoholic drink. We askedparticipants in this consultation to tell us about their own drinking habits and what
factors led them to drink alcohol. Many also talked about the impact of alcohol on
friends or members of their family. Across the county and through interviews, focus
groups and questionnaires, many identified the same triggers that led older people to
drink alcohol. These triggers include loneliness, boredom, bereavement, depression
and habit. Other factors are linked to perceptions (a tot of whisky is medicinal, a
glass of red wine is good for you, only alcoholics have a problem) and also a culture
of drinking after hard physical work in heavy industry which then continues into
retirement.
3.2 Triggers
Among the 80 questionnaire respondents, the most commonly identified reason for
drinking alcohol was loneliness. In this study, 76% of questionnaire respondents said
this was a main trigger for themselves or those they know. Boredom and depression
were the next most common triggers with 31%, followed by bereavement with 25%
and pain or illness identified by 24% of respondents. Socialising (11%) and
celebration (10%) are less common triggers than low mood and isolation (please see
Figure 1 overleaf).
Comments from questionnaire respondents included some strongly worded
statements; alcohol consumption among older people is a topic that people feel
strongly about.
We are bored and lonely, theres nowhere to go, nothing to do, transport facilities
are very weak; we suffer from constant government pressure and we worry about
our lack of income / managing to pay bills etc. Drink might be seen as a tool to
help someone relax or sleep when faced with the empty bleak existence like ours.
What else can a person do to escape the horror of life?
Questionnaire respondent
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0
10
20
30
40
50
60
70
80
%o
frespondents
Triggers for older people to drink
alcohol
Figure 1: Triggers that cause older people to drink alcohol identified by
questionnaire respondents
Participants in the focus groups discussed their own triggers. These included:
Boredom;
Pain relief;
Depression;
Relationship problems;
Stress relief If you have had a hard day it is easy to come in and pour a glass
of wine. Its a reward after a busy day. (Focus group participant)
Having it in the house. If you know its there, you want it(Focus group
participant)
Socialising with people who are drinking;
Keeping up with others drinking in rounds;
Availability of affordable alcoholThe supermarkets almostthrowalcohol at
you!(Focus group participant);
Drink does sneak up on you it becomes a habit and can become
alcoholism (Focus group participant);
In Scotland the alcohol measures are bigger than in England (Focus group
participant);
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To unwind at the end of the day Warm and comfy at home, we enjoy a drink
when relaxing (Focus group participant);
I like a whisky but it would be after I have walked the dog. I like it with a drop
of green ginger and hot water to combat the cold. (Focus group participant)
It is a comfort thing, it warms me up. (Focus group participant)
I know friends who share a bottle of wine with dinner every night. (Focus
group participant)
I dont drink but I would take it for a heavy cold to help me breathe. (Focus
group participant)
Whisky, sugar and hot water, no lemon, it works for me as medicinal. (Focus
group participant)
I have a cupboard full - I bring it back from holidays. (Focus group
participant)
At a funeral the drinks get passed around;
There is nothing secret about my drinking habits. I like a wine and a whisky.
(Focus group participant)
Im not an alcoholic. I drink every day. I dontthink it is doing me any harm.
(Focus group participant)
I have brandy in the house it heats you up and stimulates you. When I am
very low and poorly I take two teaspoons in milk, its like a tonic. I doubt poorly
people will over drink. The brandy goes right to the spot of the discomfort.
(Focus group participant)
3.3 Perceptions
During the discussions in the focus group a number of perceptions were identified
including:
That some people with a higher tolerance level can drink safely;
That you can line your stomach and drink more;
What you can drink SAFELY depends on what you are used to;
A glass of red wine is good for us;
A hot toddy sounds more medicinal. Many people perceive that a drop of
spirit is medicinal;
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13 Age UK County Durham Older people and alcohol February 2013
It is only alcoholics who have the problem. These are seen as persistent
drinkers, abusive, drunk, violent, causing trouble. It took a while for one group
to acknowledge that an alcoholic could also be a secret drinker, a social
drinker or someone they know.
There was a perception that spirits are better for you as they are more natural
and less processed.
There is a difference between what you drink. Whisky is better than lager.
You cant drink as much spirits as you can lager. Spirits are not as bad on the
body. Spirits can take 12 years to make, whilst lager is 3 weeks.
Focus group participant
General comments around older people and alcohol consumption
There was a great deal of discussion about alcohol in the focus groups, its effects on
themselves and people around them. There is concern that older people could
become more vulnerable when drinking, for example open the door to strangers.
Participants often agreed that there is a great deal of self denial around alcohol
consumption.
People dont admit things; they might have a fall but do not blame this on their
drinking. Focus Group participant
People drink in secret due to a perception of what older people should be
doing. There is a stigma. Older people who have a drink dont admit it. Society
is a lot toblame. It places restrictions on older people. Older people dont have
sex either. My family would be fine with me getting a fella at 74, others
wouldnt. Drink is viewed in a similar way older people shouldnt do it.
Focus Group participant
Doctorsdont know that people drink or how much they drink. People lie.
Focus Group participant
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A number of focus Group participants and questionnaire respondents defended their
right to have a drink. Similar comments to the following were made in focus groups
and by questionnaire respondents.
How much time have I got left what harm will it do now?(Focus group
participant)
TV every time you watch TV they are pouring wine. You see it all the time
could make you want a drink.(Focus group participant)
I have a glass of wine with my meal at night on my own. I have white wine. I
always have it in the house and never have more than one glass. I enjoy it. I
mentioned it to my GP and he said Why not? it wont do you any harm
(Focus group participant);
Some participants have experience of alcohol dependency and told us their stories.
Ive no alcohol in the house now I gave it all away. It was starting to get to
me. I fell down the front steps at home I was trying to fly! The white rum was
on offer at the club and it was cheap, the house special. I was drinking trebles
and at home. I was lucky I hurt my back. When I went to the doctors the next
day I didnt tell him I had been drinking and he didnt ask. I thought if I told him
he wouldnt send me for the X-ray. My friend told me it was time to pack it in
and keep off the shorts. I used to have a bottle and think nowt about it.
One to one interview
3.4 Culture
Focus group participants often identified that the North East has a reputation and
history of hard drinkingbecause of culture in heavy industry, mining, ship building,
and steel industry.
People worked hard under difficult circumstances and sweat had to be
replaced. Alcohol was considered to work better than water. The last of that
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generation are probably the older ones now so there will be a generation
change. Focus group participant
Some members agreed that by necessity, doing a certain type of work gave you
dust, and you had to lay the dustwith a pint in a little group at the pub. That
culture of work place was relevant even when someone didnt work anymore. A habit
formed after a lifetime of work. Many older men told us that they will go to the
Working Mens Club or their local pub to have company and some social interaction
to relieve loneliness, isolation or the stress of caring. They will watch the sport on the
TV, chat to others and have a drink.
Men who used to go on the drink in the evening, now go on an afternoon and
go to bed early. There is risk of trouble in the evening and men dont like to
leave their wife at home alone. Men go to the Working Mens Club. People go
for the conversation and company. They put a bet on; have a pie and a drink.
Focus group participant
I know a fella who used to have 5- 6 pints in his 40s but can now only
manage 2 3 pints. He is 76 years old and goes out on an evening. He goes
out 5 nights a week and Sunday morning. He has vertigo now so he has cut
down on his drinking. Focus group participant
We have made alcohol a part of our lives now. Focus group participant
I have bar lunches at the pub, I have a drink with mine because I enjoy it. It
helps me unwind. I have a very stressful life caring for my wife. I live in an
area that I dont know, with no friends, and my wife doesnt know what day of
the week it is. The pub is a good place to talk to people and socialise. A pint
does me far more good than a glass of orange. I never look at the price. I
usually drink at home. I have a pint with every bar meal. I wouldnt think that it
is doing me harm although I could do with losing a couple of stone.
Focus group participant
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Participants often agreed that older people dont go out at night as much as they did
when they were younger, especially in the winter. Also drinking in pubs can be
expensive. This leads to them having a drink in the home and many told us that they
live alone and will drink on their own.
Older women in my church are in their 70s and have a hot toddy every night.
They dont see it as a problem at all. Its not secret.Focus group participant
My friend took a bottle of whisky to bed. He is over 70 years of age and drinks
on a regular basis. He says he needs a small amount to help him get to sleep,
but he is drinking a lot more than he used to.
Focus group participant
4. Who or what can influence older people about alcohol?
4.1 Summary
We asked participants in the focus groups and our questionnaire respondents to tell
us who or what could have enough influence on an older person to get them to take
serious notice of their alcohol consumption. Where should a message be placed and
where do older people access help? The majority of questionnaire respondents
(58%) told us that a GP or other healthcare professional would have the most
influence on an older person who was drinking too much. This was followed by family
(35%) and friends (15%). When asked what might get the attention of an older
person, 5% said becoming ill or having an accident as a result of alcohol
consumption. However, 10% of people said there was no-one or nothing that would
influence them.
4.2 Who can influence older people about alcohol consumption?
We asked people who they thought could have enough influence over them or other
older people they know to get individuals to take notice of their alcohol consumption.
One focus group participant told a story of her friend who she goes on holiday with.
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I take my friend on holiday twice a year. On holiday she drinks to excess. I
think she thinks she has to get her moneys worth as it is all inclusive. She has
a brandy in her coffee at 10am; I have to escort her to lunch as she has drunk
too much. She has a sleep on the afternoon and then starts drinking again at
4pm. She drinks a lot at home too; it just gets worse on holiday.
She always has a whisky in her coffee when she visits me. She is not bothered
by her drinking at all. She is 85 years old. She is so embarrassing. If I say
anything to her she tells me I am nagging, a spoil sport, she doesnt care. I have
given up preventing the alcohol now; I now prevent any accidents occurring
because of it.
Focus group participant
It is interesting to note that whilst the other participants were listening to the story, the
facilitator noted that everyone laughed when the ladys age was mentioned. They all
thought it was too late to do anything about it.
Many participants told us that spending time with young members of the family,
especially grandchildren influence them greatly as they would not want to drink
alcohol in front of them or appear intoxicated. Participants identified that family
members can both be a trigger for drinking alcohol (family arguments, domestic
abuse) and also the source of great support.
It is lonely being on your own. I was a carer for 20 years so I could have
easily turned to drink, but I didnt. I have family support. This is the biggest
thing you can have. Focus group participant
If close family are made aware of the damage to health caused by over
indulgence of alcohol they would be a powerful influence on the older person.
The peer group similarly although they may be part of the problem rather
than the solution. Questionnaire respondent
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0
10
20
30
40
50
60
70
GP / Health
professional
Friend Family
member
Becoming ill Nothing
%o
frespondents
Influences
Who or what would influence an
older person's attitude to alcohol?
Questionnaire respondents identified that healthcare professionals (GP, nurses,
Consultant, Care Team or other medical staff) are key influencers when it comes to
alcohol consumption (58%). Many people said members of their family could
influence them (35%) and 15% of respondents told us that friends would influence
them. The chart below shows the key influencers of opinion (please see figure 2).
Figure 2: Health professionals were identified as the most likely to
influence an older persons attitude to alcohol(questionnaire respondents)
Focus group participants recounted stories of medical tests or check ups which had
influenced them enough to make them change their lifestyle. They told us their GP
would be taken more seriously than a friend trying to influence them (sometimes
friends can be part of the problem). A number of participants told us that they had
told their GP how much they drank and that they had been reassured that it was
acceptable. Others told us that it was a stern instruction from their GP that shocked
them into reducing or stopping their alcohol intake.
Family andfriends had spoken to me about my drinking but this did not have
an impact. There is a lot of denial in drinking. I used to drink 3 litres of White
Lightening and 2 bottles of Jack Daniels a day, plus go to the pub for a fewpints. It was a shock from the GP that made me give up alcohol. I went to see
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the GP for pain in my shoulder after a fall. The GP sat me down and said if I
didnt stop drinking I had only 3 months left to live. This was what made me
take notice. I had to stop drinking completely rather than just cut down. I had a
seizure after Istopped drinking which was a very scary experience for me.
Focus group participant
4.3 What could influence older people to reduce their consumption
Questionnaire respondents and focus group participants had similar suggestions
about what would make older people take notice of the need to reduce their intake.
These are:
A health scare;
A fall caused by intoxication;
A reaction to medication mixed with alcohol;
Friend or family member being very ill or dying as a result of alcohol;
Being presented with information about the harm that can be caused by
alcohol consumption (including the gory details);
Increased price of alcohol;
Support from family members and spending time with grandchildren.
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5. How to reduce alcohol consumption among older people
5.1 Summary
We asked older people to suggest ideas to reduce alcohol consumption amongstolder people in County Durham. There was a great deal of consensus among
participants about how to achieve this. Participants said they would like to see:
Opportunities for social interaction that provided an enjoyable distraction from
alcohol. Suggestions included arts and crafts, physical activity and exercise,
learning IT, friendship groups and lunch clubs, developing hobbies and
interests that could occupy people during otherwise lonely evenings.
A strong awareness raising campaign that would not be patronising but would
get the message across that older people process alcohol differently as they
may have a different diet, often weigh less and often take regular medication
that may react to alcohol. The campaign should make older people aware of
alternatives to alcohol and provide opportunity or encourage them to try
different drinks. There was agreement that the GP should be involved but an
awareness of how busy they are. Older people would listen to informed
strangers and they would like to hear from people who have overcome alcohol
problems.
Counselling and support should be available to older people. Some people
asked for a Listening Ear service that could be local, others saw a need for
more specialist counselling.
5.2 How to reduce alcohol consumption among older people
The questionnaire respondents were very clear about how to help older people drink
less alcohol (Please see Figure 3 overleaf).
Opportunities for social interaction to reduce loneliness and isolation (76%),
Raising awareness about the dangers of alcohol consumption (19%) and
Access to counselling, support and listening ear services (19%).
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0
10
20
30
40
50
60
70
80
Social interaction Alcohol awareness Counselling & support
%o
frespondents
Suggestions
Suggestions to reduce alcohol
consumption among older people
Figure 3: Questionnaire respondents identified that opportunities for social
interaction are needed to help older people reduce their alcohol intake.
Participants in the focus groups also presented the same solutions to reducing
alcohol consumption by older people. We were able to explore some of these in more
detail within the groups.
5.3 Social interaction
We saw from the questionnaire that 76% of respondents told us that older people
turn to alcohol because they are lonely and isolated. Both questionnaire respondents
and focus group participants told us that the solution is to provide opportunities for
different types of activity to promote social interaction and stop older people turning
to alcohol.
Although it can be difficult to make new friends in later life, participants told us that
this can be greatly helped by community based activities where older people can
meet others who have lost long term friendships and enjoy companionship, contact
with others and something to look forward to. Many people said that evenings were
lonely for them and a trigger for having an alcoholic drink. Those who did have a
hobby or interest to keep them occupied in the evening told us that helped them to bebusy and prevented loneliness.
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Specific social interaction activities suggested include:
Activities with people with no alcohol;
Art & Craft clubs such as music, writing, acting, painting, singing;
IT classes;
Trips out / travel clubs;
Exercise / get active activities;
Group activities, friendship clubs, dinner clubs, WI / Townswomens Guild /
University of the 3rd Age;
Getting involved in voluntary activity;A befriending service. Someone to keep in touch, share information and help
people take part in activities. It was suggested that this needs volunteers who
know whats on in the area;
A visiting service for the isolated and lonely. This would give people something
to look forward to;
Lunch clubs meet for lunch and then do more activities later;
Whilst discussing befriending in one focus group, a participant asked How many
people would be happy to befriend others? The people who need support would be
lonely, isolated. Lonely old people could be abusive. Who wants to do the job?A few
people then responded that they would like to do it.
5.4 Alcohol awareness
People need to understand the real downfalls of alcohol and the damage not
only to themselves but to whom and what gets in the way as the disease gets
further control and leads to severe addiction.
Focus group participant
Questionnaire respondents and focus group participants suggested that it is
important to raise awareness of the harm that alcohol can do (including even the gory
details). Many participants said they felt an intensive programme of publicity was
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probably needed, similar to the one for smoking awareness as people need to first
recognise they have a problem before they reduce their intake. They suggest that
you need to get the message out there that older people process alcohol differently.
They suggested a number of ways of doing this.
Getting the message across
Many participants were concerned that simply handing leaflets out will not work and
that older people will feel resentful if they feel they are being patronised. There were
suggestions that Carers who may buy the alcohol for the older person need to be
aware of the risks. They suggested having a pro-active approach that involves
sharing information amongst older people would work with efforts made to target
sheltered accommodation and bungalows. Participants felt that you have to
recognise that you have a problem but suggested that by increasing the awareness
of the problem it will eventually penetrate to those with a problem.
Participants told us to be careful how the message is communicated. People dont
easily take advice; they sayIm 70 years old and Im not going to change(Focus
group participant).
It needs to be advice rather than an order. Its my life so I will do what I want.
Focus group participant
People can feellike they are being preached to, that you arehaving a go at
themif you comment on their drink intake. My friend knows it is for his own
good but he does not want to hear it.
Focus group participant
Importance of using medical information
Given the influence of healthcare professionals on older peoples attitudes, it is not
surprising that many participants suggested that medical information should be used
to raise awareness of why older people should reduce their alcohol intake.
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Clarify the mixed messages from the media. Focus group participants told us
they are confused by the conflicting messages such as Red wine is good for
youor that there are safe levelsof alcohol consumption.
I feel it is medical informationwhich would be most useful in reducing
someones intake. Showing someone the damage that is being caused to their
body. Similar to the stop smoking campaigns and have a real push to raise
peoples awareness. I think pictures on bottles would be good. These should
show pictures of ill people not just a damaged organ. There is more impact
with a picture of a jaundiced person or someone with mouth cancer than just a
damaged liver. Focus group participant
Make people aware of the side effects of alcohol on medication. These
should be made clear to people and then they can make their own minds up.
The GP only reminds us sometimes, you should always check the
instructions. Focus group participant
Photos should be made available of the deterioration of human organs due to
excessive alcohol practices and the cost involved to treat patients who took
very little or no notice ofGPs warnings. Focus group participant
The role of GP and healthcare professionals
The family GP and healthcare professionals have already been identified as key
influencers and participants. Participants identified that they have a key role to play in
getting the message across and that older people who drink alcohol regularly need
guidance and advice from their GP. There were suggestions that hospitals should
inform GP that a patient was admitted to hospital and alcohol was a contributory
factor.
However, participants are aware that GPs are very busy and that whilst they are the
right place, they have no time or support to find out how much you are really drinking
and can probably do little more than give people a leaflet. It was suggested that
perhaps a nurse in the surgery or health centre could have this role? Some
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participants suggested the GP could have a pack to give to people to introduce them
to activities and alternatives to alcohol.
Hearing the message from strangers
Participants said they would listen to informed strangers and people who were
speaking from experience.
I would be more influenced by someone who is a drinker and medically
unwell speaking to me. It would need to be extreme to get people to take
notice. Focus group participant
Hearing of other peoples actual experiences could help. I was shocked to
find out that a person can drink enough alcohol to damage their liver without
ever being drunk. This is not the image presented by the media of physical
damage from alcohol. Focus group participant
The information needed
Participants told us that they liked the message that older people process alcohol
differently. They suggested the use of good slogans and repetition.
The information about units and safe drinkingis far too complicated. A
simpler way of getting the message across is needed just like the 5 a day
message What about two days a week to encourage abstinence on at least
two days of the week? Anyone can remember two alcohol free days a week.
How safe is 4 units a day when you are doing it every day? You need to break
the habit. You can start in easy stages and do just one day a week.
Focus group participant
Suggesting alternatives
Participants would like to get more ideas about alternatives to alcohol.
Raise awareness about non-alcoholic drinks with opportunity to taste the
products and also to be made more aware of how to have a healthier lifestyle.Focus group participant
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Encourage different ideas for rewarding selfFocus group participant
5.5 Counselling and support
As it was recognised that many older people drink alcohol because of depression,
habit and stress, many participants suggested different forms of individual support
could help people. These varied from a Listening Ear service (telephone helpline or
local drop in) to support groups and addiction support. The important factor was that
older people who drink alcohol need empathy from health care professionals.
6. Minimum price campaign for alcohol
There was lively discussion in the focus groups about the 50p per unit campaign.
Participants generally supported the campaign and felt that the minimum price of 50p
per unit would not affect them greatly as it would only be a few extra pounds.
However, there is concern that those who drink a lot of alcohol will continue to drink
but people would find the money from somewhere and sacrifice essentials such as
food and heating. There is also a fear that people may turn to a black market for
alcohol or to crime to find the extra money.
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7. Conclusions and recommendations
7.1 Conclusions
The majority of older people have heard the term units applied to alcohol and havesome level of awareness of how it equates to beer, wine or spirits. Very few people
measure their units if they drink at home, they would just pour out what they want.
There are a number of reasons why older people drink, these are linked to
Culturemen would gather together at the pub or club to lay the dust or
relax after working in the traditional heavy industries and this practice
continues into retirement.
People drink because they are lonely. This may be due to living alone,
bereavement, depression or boredom. With older age comes loss of friends
and physical or sensory impairments can impact on social interaction and
people find themselves at home and alone.
Lack of awareness. Many older people consider whisky or brandy to be
medicinal (as a result they hardly count as alcohol) and use it to combat colds.
There is an understanding that red wine is good for you.
The availability of alcohol sold cheaply in the supermarkets means that older
people can afford to have alcohol in the home and once in the home, they will
drink it.
There is a stigma surrounding drink and those who drink too much will often conceal
this from their GP as they worry that they will be refused treatment. However, the GP
and other healthcare professionals are considered the most influential people when
needing to advise an older person to reduce their alcohol consumption.
Actions to reduce alcohol consumption amongst older people fall into 3 main
categories:
Opportunities for social interaction in non alcohol based activities;
Awareness raising about the impact of alcohol consumption;
Support through counselling or Listening Ear services.
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Older people are generally supportive of the 50p per unit campaign and a minimum
price per unit for alcohol. They are concerned that some people with an alcohol
addiction problems will sacrifice other essentials such as food and heating to pay for
alcohol or that people may turn to the black market or crime to find the money.
7.2 Recommendations
1. Social marketing campaign with a simple and non-patronising message that can
be used by GPs, healthcare professionals and professional staff from other
agencies such as Age UK County Durham to get the message across.
2. To use the suggestions in this report to help develop the campaign, such as the
pro-active outreach approach, a simple message repeated and reinforced, and
images showing the impact of alcohol consumption.
3. Development of a colourful and informative pack that explains the facts to older
people which can be distributed through a range of agencies.
4. Promotion of existing opportunities for older people to access to relieve
loneliness, isolation and boredom.
5. Exploring the potential for funding to develop additional opportunities for social
interaction or services such as befriending or counselling where there are gaps in
existing provision.