Map your steps - AOD and older people
Activity may include some or all steps below, depending on the capacity of the LDAT and partner community organisations.
The key steps involved in delivering ’Alcohol, Other Drugs and Older People’ activities are provided below as a useful starting point for developing your activity and informing your approach.
These steps provide an indicative guide; it is important to tailor your approach to your local community.
LDATs may be responsible for delivering activities if they have the appropriate expertise. Alternatively, they can work with their partners and communities to support the delivery of these activities. This might include:
- Engaging with community organisations to raise awareness about alcohol and other drug-related risks for older people and to motivate them to take action
- Providing evidence and data on alcohol and other drug-related harms for older people
- Linking with community organisations to quality programs and services
- Promoting collaboration between community organisations.
Engaging the community
Engage the community to get alcohol, other drugs and older people on the agenda by:
- Identifying relevant community organisation who have access to older people in your community
- Establish key contacts/gatekeepers within those organisations to champion the issue within the organisation
- Provide your community organisations with information about the evidence on alcohol, other drugs and older people
- Establish ‘what’s in it’ for the community organisation
- Ensure consistency of information being provided by community organisations on alcohol, other drugs and older people by addressing any sensitivities or misinformation that exists within the organisation.
A critical role for LDATs is to engage with their community to put alcohol and other drug-related issues on the public agenda and to motivate them to take action.
Tips for engaging the community:
- Identify community organisations that you may partner with. See Planning: Working with community partners.
- Identify key contacts and/or gatekeepers. Find someone in the organisation you’re targeting who can act as a champion and invest time into this activity. A champion may be in leadership role, have an influential personality or be a proactive person who is passionate about preventing alcohol and other drug-related harms. For example, key contacts may include local doctors or council staff. Meet face-to-face if you can, rather than just sending out information via email.
- When discussing alcohol and other drug use in older people, provide evidence on why older people are at risk from alcohol and other drug-related harms. Outline how supporting older people to prevent alcohol and other drug-related harms can help them live longer and healthier lives – and how this is beneficial not just for older people, but for the wider community, and how it aligns with the core business and values of the community organisations that you’re speaking to.
- Answer the question: ‘What’s in it for me?’. Finding the hook for people will lift their engagement and boost the sustainability of your LDAT’s activity. Understand the motivations of those you’re speaking to. For example, are they motivated to deliver alcohol and other drug-related activities due to existing problems, and what are these (e.g. high risk of mediation interactions, high levels of mental health issues in this age demographic)?
- Be aware of the sensitive nature and complexity of the topic. The task of reducing alcohol use can be challenging in a community where alcohol and socialising go hand-in-hand and varied ‘expert’ and anecdotal information can place pressure on older people. Refer to Planning: select an evidence-based activity.
Providing evidence on alcohol and other drug-related harms for older people
Providing older people in your community with quality information and resources on alcohol and other drugs by:
- Establishing reputable sources of evidence and data on the impacts and effects of alcohol and other drugs on the ageing body
- Working with your established community organisations to determine courses of action to raise awareness of the impacts and effects of alcohol and other drugs on the ageing body e.g. at community events, via local media, and existing networks.
LDATs can help to combat the mixed messages people may hear in the media and in social circles; this can help counter misinformation.
There is a lack of readily available information for older people about the impact and effects of alcohol and other drugs on the ageing body, and existing information can be conflicting or misinformed. Some research indicates that drinking small amounts daily or regularly improves heart health in middle-aged and older people, but that conclusion is challenged by public health oriented researchers who believe that research is flawed. Nevertheless, this has created a ‘health benefits of alcohol’ bias that is prominent in this age group. Hence, older people have limited knowledge and can be sceptical about the harms of alcohol.
Confusion about healthy drinking guidelines is common. LDATs can counter this through the provision of resources to community organisations. This includes providing evidence and data on the risks that older people face when they consume alcohol and other drugs.
Providing clear, evidence-informed facts on the impact and effects of alcohol and other drug use for older people is important. Table 1 provides an overview of the evidence including the key issues and facts. Links to more detailed information is provided throughout.
Table 1: Evidence on alcohol and older people
|NHMRC guidelines||Information should be aligned with the National Health and Medical Research Council’s Australian Guidelines to Reduce Health Risks from Drinking Alcohol available at: nhmrc.gov.au/health-topics/alcohol-guidelines The current NHMRC Australian guidelines ‘to reduce health risks from drinking alcohol’ do not provide a limit on daily or weekly consumption of alcohol for older people. Instead, it advises older adults to consult their health practitioner to discuss the most appropriate level of alcohol consumption for them. It suggests they take account of the effect drinking has on certain health conditions and medications, as well as the possible harms associated with older people drinking.|
|Alcohol and other drug harms for older people||Older people are at an increased risk of: • higher intoxication at lower amounts of alcohol • all types of accidents, especially falls • motor vehicle accidents • suicide • impaired bone regeneration and regrowth after a fracture • alcohol dependency • unpleasant or dangerous side effects from interactions from medication • adverse impact on existing health conditions.|
|Alcohol use in older people||Older people are living longer, and often experience increased health conditions and increased use of over-the-counter (OTC) and prescription medication as they age. Older people are more likely to consume alcohol daily than younger people.|
|Factors that contribute to alcohol and other drug consumption among older people||Substantial work is required to improve our understanding of older people’s use of alcohol – including the role of cultural differences. For many older people, drinking is an important and enjoyable part of a social life. Other factors that contribute to AOD consumption at this age may include: • lack of knowledge about how the effects of alcohol can change with age • lack of understanding about the interaction between alcohol and other drugs and medication • high levels of mental health issues • social isolation and reduced social opportunities • having a partner or friend who drinks • living in a family or community tolerant of heavy drinking • financial stress • other stresses including loneliness which may result in self-medicating • alcohol and other drug dependency.  Preventing and reducing alcohol- and other drug related harm among older people: A practical guide for health and welfare professionals. nceta.flinders.edu.au/files/4614/4892/9660/EN605.pdf|
|Older people and alcohol: key issues||The ageing process and metabolic changes As people age, their metabolism slows and their tolerance of alcohol lessens. This can lead to alcohol having a more potent effect on an older person compared to a younger person who consumes the same amount of alcohol. When alcohol is absorbed, it is distributed throughout the body’s total water content. As the volume of total body water decreases with age, a given amount of alcohol produces a higher blood alcohol concentration (BAC) and intoxication at lower amounts of alcohol (possibly from just one or two standard drinks). This effect is relevant to people over about 70 years, although there is considerable variation from person to person. Medications Older people often take regular medication, which may interact with alcohol to cause unpleasant or dangerous side effects. The risk is considerably greater when a number of medications are involved. People may be unaware of the interactions between medication and alcohol. See the Australian Government’s Department of Health Quality Use of Medicines information http://goo.gl/czzoUz Preventing and reducing alcohol- and other drug related harm among older people: A practical guide for health and welfare professionals. http://goo.gl/Qkho8J Retirement Retirement can also be a time of increased financial vulnerability, decreased social activity and loneliness. People may respond by taking substances and may also begin to self-medicate at this time; especially if health issues are causing pain, discomfort or insomnia. Social connection Social isolation is a risk factor relating to the development of alcohol and other drug issues. Promoting social connections, including good relationships with others and a sense of belonging to the community can protect older people against AOD harms.|
LDATs can distribute information to older people and community partners in a number of ways. This could include:
- Community events (e.g. retirement village open day, community festival)
- Local media (e.g. local paper, radio station)
- Through new or existing partnerships and networks (e.g. inclusion in partner newsletters, speaker at RSL event).
Increase community participation and social connection
Increase community participation and social connection by:
- Working with your community organisation partners to plan a range of activities to increase participation and social connection
- Establish sources of quality information on the impacts and effects of alcohol and other drugs on the ageing body to promote at your activities
- Developing a series of promotional activities to raise awareness of impacts and effects of alcohol and other drugs on the ageing body
- Use local media to promote healthy activities and services for older people
- Connecting older people to counselling services and relevant helplines.
LDATs might provide opportunities for participation and social connection directly, or working with partners to promote external opportunities.
LDATs have a critical role in increasing participation and social connection for older people.
Consider action to increase social networks (e.g. run networking events, increase membership of local groups), build social connection through arts participation, promote civic engagement and volunteering, increase people’s sense of belonging, and promote a culture where people socially support one another to engage in low-risk drinking practices.
Examples of action that could increase community participation and social connection include:
- offering activities for older people that provide opportunities to meet and connect with peers
- assisting newcomers to a town or suburb so they feel part of the community
- providing information stalls in shopping centres to inform people of health problems and how they can take action to reduce risks to their health
- using local media to promote healthy activities and services, so they can benefit more people
- bringing counselling services to the local area or promoting telephone helplines.
Linking community organisations to quality programs and services
Link community organisations to quality programs and services by:
- Working with the community organisation to select an appropriate existing quality alcohol, other drugs and older people activities to deliver
- Engaging an expert guest speaker to assist with the delivery of an activity for older people
- Establishing accurate sources of information for older people to support your activity
- Working with the community organisation to plan upskilling, and social and networking opportunities for older people
- Working with the community organisation to promote relevant health care services, such as mental health services.
A key role of Local Drug Action Teams is to link communities to quality AOD programs. These may include:
- existing education programs
- expert guest speakers, sourced from local networks or peak bodies
- accurate information and materials, such as the NHMRC guidelines
- upskilling opportunities for older people
- social and networking opportunities for older people
- healthcare services, such as mental health services.
LDATs can also provide advice and support to help community organisations determine a course of action for delivering quality AOD programs, such as awareness raising campaigns about increased alcohol and other drug-related risk in older age.
Promoting collaboration between community organisations
Promote collaboration between community organisations to:
- Deliver community-wide awareness raising initiatives and education activities on alcohol,other drugs and older people
- Build supportive and inclusive healthcare services
- Create a supportive culture
- Create strong community referral networks.
LDATs have a key role in facilitating productive partnerships in the community. Collaboration between community organisations may focus on:
- delivering community-wide awareness raising initiatives and education activities
- building supportive and inclusive healthcare services to reduce stigma and increase health seeking behaviour (facilitating safe and supportive healthcare services is a key goal in making people feel comfortable and confident enough to seek treatment and support)
- helping to create a culture where the age-specific harm associated with alcohol and other drug-related consumption is recognised
- creating strong community referral networks (this might include working with healthcare service providers to facilitate referral pathways for people experiencing mental health issues, and those who need more specific alcohol and other drug-related treatment).
See Planning: working with community partners for further guidance on engaging with community partners.
Measuring success and reporting
Measure the success of your Alcohol, Other Drugs and Older People activity:
- Collect measures of success with the community organisations you are engaging with, as well as the older people you are have been reaching with your alcohol, other drugs and older people activity. Consider doing follow-up with both the community organisations you are engaging with as well as the older people you have been reaching to track their progress
- Report on your success, acquit your funds and consider other things you can do to support older people in your community.
- Kelly, S. et al., 2018. Alcohol and older people:A systematic Review of barrriers, facilitators and context of drinking in older people and implications for intervention design. PLoS One, 13(1).
- Institute of Alcohol Studies, 2017, ‘Older people’s drinking habits: Very little , Very Often’ Institute of Alcohol Studies, 2017.