Alcoholism in Retirement: Overlooked and Undertreated
Late-onset alcoholism is more common than you think. Here’s what you need to know about drinking after 60.
By Tammy Worth
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Clare Mannion used to follow the mantra that if one is good, then more must be better. And alcohol was no exception.
Around age 60, it caught up with her. Mannion was drinking larger quantities more frequently than when she was younger. As she got older, her occasional social drink turned into an isolated, lonely ritual. It wasn’t until she was pulled over while driving intoxicated that she reached out for help.
“I didn’t wake up one morning and say, ‘It would be a good idea to go into treatment today,’” she says. “I didn’t think there was anything wrong with what I was doing. You don’t often know there is a problem until you have some kind of consequence.”
Mannion isn’t alone. The 2013 National Survey on Drug Use and Health found that, among people age 60 to 64, 14.1 percent said they had taken part in binge drinking, and 4.7 percent said they drink heavily on a regular basis.
For most people, alcohol misuse starts young: They may begin drinking in college and struggle with it thereafter. But for a smaller number of people, problems with alcohol don’t start until later in life. This is considered late-onset alcoholism. And drinking at 65 looks very different than it does at 25.
What Triggers Late-Onset Alcoholism?
“Late-onset people are folks who never had a problem, and then all of a sudden something changes,” says Brenda Iliff, executive director of the Hazelden Betty Ford Foundation in Naples, Florida, where Mannion sought treatment. “We see a lot more women than men, and a lot of educated and affluent people in this group.”
The trigger, Iliff says, is typically a life change like retirement, kids leaving home, or new physical challenges.
RELATED: Alcoholism in Women: The Hidden Health Hazard
This was exactly the case for Mannion. In her late fifties, she moved to Florida for a job. Unlike most of her peers there, she enjoyed work and had no plans to retire any time soon. Gradually, she began to feel isolated and lonely.
“I was struggling with my own place in the world, and I didn’t want to feel those feelings,” she says. “What better way not to feel them than by using alcohol?”
Nicole MacFarland, PhD, executive director of Senior Hope Counseling in Albany, New York, says her clients often begin misusing alcohol because of a spousal death, divorce, movement to a fixed income, or inability to do normal physical tasks.
“It's very difficult for someone who is independent to begin to realize they have limitations, and sometimes the bottle becomes their best friend,” Dr. MacFarland says.
The Physical Effects of Alcohol
For people 65 and older, MacFarland recommends consuming no more than two drinks a day. The National Institute on Alcohol Abuse and Alcoholism is slightly more liberal, calling for no more than three drinks a day, or seven drinks per week for people older than 65.
“Ten years ago, I could have a certain number of drinks and be functional,” Mannion says. “But my body wasn’t processing it like before.” That’s because, as we age, the body’s ability to tolerate alcohol is reduced. According to Iliff, we have more fat and less water in our systems as we get older. Chemicals are better absorbed, but the kidneys and liver aren’t as efficient at detoxifying afterward.
RELATED: Alcoholism and Depression: Frenemies Forever
Because of these bodily changes, the signs of alcohol abuse in older people are unlike those of younger individuals. They can frequently mimic other medical conditions, like stroke, Parkinson’s disease, or diabetes, Iliff says.
Some of the “symptoms” of excessive drinking at an older age include: sleep problems, isolation, memory loss, incontinence, bruises from unexplained falls, and blacking out.
Is Your Drinking Habit Alcoholism?
Older individuals are often less likely than younger generations to self-identify as abusing substances.
“They are more likely to say they are getting depressed or are grieving, which can be natural,” Iliff says.
For Baby Boomers, alcohol was part of the culture, but alcoholism was not. Parents and peers drank, and cocktail hour was completely en vogue. When people had issues with drinking, they had a “problem,” Mannion says – the word alcoholic was taboo.
Determining who has a drinking problem, and who doesn’t, isn’t easy. Mannion describes a situation after she left treatment where she confided in a friend that she was an alcoholic, and remembers the woman saying she didn’t think Mannion was one. “My answer was, ‘I, Clare, am not able to drink safely,’” she says.
Spotting whether you or someone you love is wrestling with alcoholism isn’t always as clear as a confession. Resources to gauge if someone has an issue with alcohol are abundant. Iliff recommends the CAGE test:
- C– Have you tried to cut down orcontrolyour drinking?
- A– Are othersannoyedor angered by your drinking?
- G– Do you feelguiltyabout drinking, or about your behavior while drinking or what you might be missing because of drinking?
- E– Do you find yourself needing an “eye-opener” or drinking earlier than planned?
There are also websites that can help identify alcohol misuse. Screening tests and other information can be found online at the American Federation for Aging Research and the Hazelden Betty Ford Foundation.
For people concerned about friends or family who may be drinking too much, subtlety is best for handling the situation, Iliff says. It may go more smoothly if the issue is approached as a medical problem instead of alcoholism.
“If they can’t get their blood sugar under control, you may ask if they will go with you to talk with someone about what’s going on and whether or not alcohol may be impacting it,” she says. “Or, ‘I noticed you were staggering, and that isn’t like you. Can we go to the doctor to see if we can figure out what is wrong?’”
For Mannion, “The Mother Ship,” as she affectionately calls Hazelden, taught her how to sit, listen, and understand she had a problem. And she has found hope on the other side.
“Life can be better than anyone thought it could be at an age when we think it’s over — we have lived the best parts of it,” she said.
Video: 2016 National Recovery Month Press Conference
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