Delivering

These steps provide an indicative guide; it is important to tailor your approach to your local community.

The key steps involved in delivering ’Alcohol, other drugs and older people’ projects are provided below as a useful starting point for developing your Community Action Plan and informing your approach.

LDATs may be responsible for delivering project activities if they have the appropriate expertise. Alternatively, they can work with their partners and communities to support the delivery of these project activities. This might include:

  • engaging with community organisations to raise awareness about AOD risks for older people and to motivate them to take action
  • providing evidence and data on AOD harms for older people
  • linking with community organisations to quality programs and services
  • promoting collaboration between community organisations.

A critical role for LDATs is to engage with their community to put AOD issues on the public agenda and to motivate them to take action.

Engaging the community

Tips for engaging the community:

  • Identify community organisations that you may partner with.
  • 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 project. 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 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 AOD harms. Outline how supporting older people to prevent AOD 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 project. Understand the motivations of those you’re speaking to. For example, are they motivated to deliver AOD programs 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 seemingly easy 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.
  • When discussing alcohol and other drug use in older people, provide evidence on why older people are at risk from AOD harms. Outline how supporting older people to prevent AOD 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 project. Understand the motivations of those you’re speaking to. For example, are they motivated to deliver AOD programs 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 seemingly easy 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 Section 2a: Information about Alcohol and Older People.
Older people

Providing evidence on AOD harms for older people

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.[1] 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.

LDATs can help to combat the mixed messages people may hear in the media and in social circles; this can help counter misinformation.

Providing clear, evidence-informed facts on the impact and effects of AOD 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

Key issues Evidence
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: http:// goo.gl/a1PzQ1

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.
AOD 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 AOD 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. [2]

Preventing and reducing alcohol- and other drug related harm among older people: A practical guide for health and welfare professionals.
http://goo.gl/rJ6dj2
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.[3] 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.[4]

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:

  • at community events (e.g. retirement village open day, community festival)
  • via local media (e.g. local paper, radio station)
  • or through new or existing partnerships and networks (e.g. inclusion in partner newsletters, speaker at RSL event).

LDATs might provide opportunities for participation and social connection directly, or working with partners to promote external opportunities.

Increase community participation and social connection

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

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 AOD risk in older age.

Promoting collaboration between community organisations

LDATs have a key role in facilitating productive partnerships in the community. Collaboration between community organisations may focus on:

  • delivering community-wide awareness raising campaigns and education programs
  • 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 AOD 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 AOD treatment).
Please get in touch to find out more about the program
Please get in touch to find out more about the program