Addiction in old age

When a person is young, excessive consumption of alcohol isn't necessarily less harmful - although it is more accepted. Anna-Lisa is 76 and speaks of blame and shame when talking about the alcohol and pills that give her a rush. The diminutive woman has been receiving therapy for the past several months at a recovery clinic in Essen, in western Germany.

"Older people experience a greater sense of shame because drinking is connected to blame, with failure," she said.

Living longer - drinking longer

The German population is getting ever older - in 20 years, 30 percent of the population is expected to be over 80 years old. Alcohol consumption, as well as alcohol addiction, are generally less common in older age groups than in younger ones. This was one finding of a German government report, which also noted that an aging population will lead to higher numbers of older alcoholics.

Even today, one-third of alcoholic elderly are addicts that just got older. There are also those who were previously alcoholic, were able to kick the habit, then picked it up again when they got older. Anna-Lisa is among them. After a series of tough breaks, she began drinking again at 70.

"I knew that the first glass meant a backslide, but I thought, I can now afford to live like other people. So I drank. It was so wonderful, liberating, cathartic," she said. But she quickly lost control over her drinking, combining alcohol with sleeping pills. She ended up in an emergency room.

Pills and alcohol

There are also those who became addicts after losing friends or partners as they got older, after becoming isolated, or after suffering from depression or anxiety because they feel less valued by society.

Most seniors with addictions take up pills and alcohol, the government study reports. Although it doesn't provide exact numbers, it estimates that on average, 7 percent of Germans under in-patient treatment are addicted to medication, while 8 percent are alcoholic. It's apparently more of an issue with in-patient treatment than in assisted living facilities or private households.

Alcohol addiction is taboo in the 80-plus generation, said Hedi Blonzen, head of an old-age home in Essen. It's not considered an illness by those affected; rather, it's seen as shameful behavior. However, in this generation, some high-alcohol products are still considered healthy.

Seeing the signs

Blonzen estimates that about 10 percent of people in her facility are hooked on alcohol, sleeping pills or sedatives, she said. The signs of addiction include withdrawal from social interaction, she said, or "when they won't allow us to access their closets, that they're especially keen on events with alcohol available, that they simply act very inhibited otherwise."

She added that addressing alcoholism must be done gingerly so as to prevent sufferers from withdrawing in shame. Those who drink too much often do so out of loneliness, Blonzen said.

Intervening is important, though, because otherwise such residents are a danger not only to themselves, but also to others. Older bodies don't process alcohol as well as younger bodies, due to slower metabolism and less water content to dissolve alcohol. Older drunks are more aggressive, more forgetful, their gait is much less steady, and their risk of falling increases. Alcohol kills brain cells and can even lead to alcohol dementia, also known as Korsakoff's syndrome, Blonzen said.

Projects combining support for both old age and addiction aim to address the problem of substance abuse among the elderly. One such project receiving government support, in Essen, seeks to regularly rotate workers between old-age and addiction support centers, as well as discussing cases and improving training for nursing personnel.

Active rather than sedated

Psychologist Arnhulf Vosshagen often hears that it's not worth treating older addicts. People ask: Why should society help them when they're already at the end of their lives? In fact, only those who want help receive it, Vosshagen said. Such therapy prolongs life, as well, even there's no apparent "monetary gain," since elderly addicts no longer participate in the job market.

"But there's a societal gain in drawing out the potential of such people. To have active rather than sedated or drunken seniors out and about," Vosshagen said.

His patient, Anna-Lisa, sees this the same way. "It's clear that this is a deadly sickness in old age. Death in installments, one says, which in old age is truly palpable, and only avoidable when one receives competent help," she said.

"To be clean and clear one last time in old age, that's what I would really wish from my heart," she said.