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Statistics show that "10 to 15% of the population over 65 suffer from alcoholism," according to Zimberg (1996, p. 45). However, in reviewing available research, it appears that most practitioners have overlooked alcohol prevention, treatment, and maintenance geared specifically for the elderly. Many researchers support the idea of special treatment approaches for the elderly, feel the numbers are under-reported, and expect the numbers to increase. Therefore, I have developed a special alcohol treatment program, "My Life Matters" (MLM), which targets the elderly.
Prior to offering this program numerous fundamental issues need to be addressed. Most critically, depending on the severity of the dependency, detoxification may need to take place. An individual could not grasp intellectually the foundation of the MLM treatment while still under the influence or suffering through withdrawal. Also, clinical depression, if present, would have a negative influence on ones ability to change, so medication (not benzodiazepines) may need to be prescribed.
MLM is holistic in approach addressing spiritual, nutritional, physical, emotional, psychosocial, and psychological aspects of the aging individual. The program would be presented in a group educational/experiential environment. Group approach is essential due to the many issues facing the elderly such as, isolation, loss of loved ones, and missing support systems. This format would fill some of that void and should be an enticement for the individual to return and continue the program. A perfect location would be Senior Centers, particularly the ones where people come together for meals. While they would be there enjoying a nutritious meal, they could receive the attention they crave through interactive, educational seminars designed to help them understand the dynamics of alcoholism, the stresses of aging, how these issues are affecting them, and developing new strategies for overcoming them.
Older adults often experience fear associated with the stresses of aging, i.e., isolation, loss of loved ones, depression, health challenges, death, etc. As President Roosevelt said in his inaugural speech, "the only thing we have to fear is fear itself." And without coping skills and strategies to resiliently overcome these hurdles, many seniors turn to alcohol's numbing effect and become late-onset alcoholics. Once the destructive alcoholic thinking takes over, it becomes a Catch-22 situation because alcohol exacerbates, perpetuates, and escalates fear. Consequently, the individual can become frozen in fear. If MLM strategies can dissipate that intrapersonal fear the possibility exists that the alcohol abuse could simply melt away. "When life becomes worth living again, the alcohol problem frequently disappears." (Zimberg, 1996, p. 48).
Current research claims that 50% of individuals suffering from depression are either drug or alcohol dependent. Since the elderly find themselves in high risk situations for depression, their susceptibility for dependence on alcohol is greatly increased. Determining which one is the causal factor is open to debate in many lives. Regardless of age, quality of life is the issue faced daily by all people. Often family members enable their elders because of not wanting to curtail the one remaining pleasure, but in reality, permitting the problem to pose as the solution. If we can convince these elders to eliminate their alcohol abuse, they have an excellent chance to reclaim their lives and resume having a quality existence.
The My Life Matters program is structured around "The 4 Cornerstones." 1st Cornerstone: Attendance at AAA (Aging Alcoholic Anonymous) Meetings. This group will be able to accommodate the elderly by going at a slower pace, speaking more slowly, explaining things more clearly. We will request of AA that a group of elderly "old-timers" come together to carry on Twelfth Step work in order to form this new group. The old-timers will chair the meetings and present modeling examples on how meetings operate, how people share, what is expected of the new members, how to work the steps, etc. Once the members of AAA begin sharing their own stories, they will begin to heal themselves in the process. Although AA is not a religious program, the introduction of a "higher power," or "God as we understood him" would introduce a spiritual element which is part of the 4th Cornerstone of MLM.
2nd Cornerstone: Educational/Interactive Seminars delivered in two phases. The first phase teaches how to build resilience by mastering the seven skills presented in The Resilience Factor (Reivich and Shatté, 2003). They posit that the "principal obstacle to tapping into our inner strength lies with our cognitive ... thinking style" (p. 11). This phase would begin with each participant taking the 56 item RQ test, a self-assessment measuring the seven abilities of resilience: emotional regulation, impulse control, optimism, causal analysis, empathy, self-efficacy, and reaching out (pp.34-36). Once the results are known, each participant knows what abilities need work and the interactive instruction commences through discussion, role-playing, and exercises created to develop the seven skills.
Each week a new skill would be thoroughly explained, discussed and practiced. Homework would be assigned and outcomes would be discussed in the weekly group sessions. According to their research, resilience assists in overcoming the obstacles of childhood, steering through everyday adversities, bouncing back from monumental life crises, and reaching out to achieve all that is possible. By developing the skills needed to build these resiliency abilities, the "Stinkin' Thinkin'" as AA calls it or the typical addictive thinking evolving out of immaturity, ego-mania, low frustration tolerance, and the necessity for constant immediate satisfaction, could be eliminated and replaced with resilient thinking. Productive, intelligent, successful living could begin again.
Phase two would be teaching Seligman's (2002) Authentic Happiness program. "New research into happiness demonstrates that it can be lastingly increased." (p. xii). The Three Paths to Happiness would be explained. Self-assessments would be completed to determine depression and optimism levels, followed by the Values In Action (VIA) Signature Strengths inventory. Seniors would learn their top five Signature Strengths and simply knowing that has been shown to increase self-worth. Seniors would perform unique exercises developed to broaden and build those strengths, providing the beginnings of a "life worth living."
As with the resilience training, new exercises would be explained each week, homework assigned, and outcomes discussed in the group. Using these tools would provide the participants the opportunity to mature in coping skills, realize personal success, and feel empowered with personal strengths.
3rd Cornerstone: Interactive group discussion revolving around alcohol abuse and aging issues would be facilitated by a Coach specializing in group process and alcohol addiction. Since alcoholism is categorized as a chronic condition according to the AMA, it would seem imperative to have continuous treatment available. And yet, according to O'Brien and McClellan (1996) most people including physicians approach it as an acute condition like a broken leg when in reality "addictive disorders should be considered in the category with other disorders that require long-term or life-long treatment" (p. 239). The MLM program provides this recommended ongoing treatment in the group format. This delivery method provides to the participants many of the therapeutic factors that Yalom (2005) enumerates: installation of hope, universality, imparting information, altruism, development of socializing techniques, group cohesiveness, imitative behavior, interpersonal learning, catharsis and existential factors (pp. 1-2). These factors are beneficial because the participants are alcoholic and because these factors profoundly support the participants through the challenges of abstinence and aging. The nature of "group" removes isolation, permits connection, and fosters the development of a new social network, all critical to good mental health for the elderly. In addition to the discussion of homework, the group is open for discussion of alcohol and aging issues and concerns.
4th Cornerstone: Physical/Spiritual Connection will be introduced through aerobic and anaerobic exercise, yoga, Tai Chi, Qi-gong, meditation, and prayer groups. According to Read and Brown (2003) there is overwhelming evidence to support the benefits of exercise on physical and psychological well-being particularly in the areas of anxiety, depression, and self-concept, which are of particular concern when considering risk-factors for the elderly. And although "a small body of research has examined physical exercise interventions as applied to addictive behaviors and has suggested promise for such interventions, to date ... exercise based interventions have rarely been applied to this population" (p. 49). The MLM program will utilize this excellent strategy for physical and mental health and psychological well-being. Also, research has found that spiritual attention and concern is the first layer of defense against addictive thinking and relapse. This program will shore up against "The Beast" as described in Rational Recovery through attention to that "still small voice within."
A pilot program for the My Life Matters program will be delivered once funding and sponsorship has been acquired. It could be delivered through senior centers as part of a grant for low-income seniors or through the Department of Elder Affairs. It could also be delivered in upscale venues for self-pay clients.
Cher Tanner is known as The GPS to Happiness. She is a published writer, presenter, actor, & Authentic Happiness Coach. With a Summa Cum Laude degree in Psychology & graduate work in Counseling, she was a natural to join the dynamic field of Personal Life Coaching. Because of her creative insights and exceptional talents for presentation, people respond positively by engaging in ongoing, mutually beneficial relationships with her.
Fast Track Happiness Coaching offers individual & group coaching with an emphasis on bursting forward. Try the "Six Week Fast Track to Happiness" program to quickly find your Paths to Happiness or the "Single, Over 50, but Not Over Love!" program assisting later-in-life singles develop successful relationship strategies to find their true mates. You or someone you know may need the new program "TKO Alcohol Today" defeating alcohol NOW to get their life back.
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