I drink because I'm lonely and I am lonely becuase I drink

Yesterday, as I facilitated the seventh meeting of my support group which is the midpoint of this pilot project, it struck me that that there is a commonality between the reasons many of the women in our group have turned to these addictions. I have heard many stories these seven weeks from six women who struggle with some type of addiction such as gambling, drugs or medication use, and alcohol. I have noted that the women in our group tend to drink or misuse drugs to forget about their unhappiness and the loss of control they are experiencing as they get older.

For example, an 80 year-old member commented about the rich and varied life she enjoyed and major accomplishments she achieved in her life, and I cannot help but notice her sadness as she mentions how she now has to depend on someone to give her a ride whenever she wants to leave the house. Interestingly, I think that one of the reasons she drinks is actually to prove the point that she can do as she likes when it comes to drinking. I find that this bears some similarity to teenage "acting out" despite occurring 60 years since she was a teen. This seems like a very sad irony, especially because whereas the young person will eventually come to learn to express herself in more productive ways as she becomes empowered with age, this lady will only lose more and more of her independence as time goes on - more so if she begins to experience increasing health and/or financial problems. Unfortunately, women with addictions are at higher risks of presenting one or the other if not both.

The question arises for me; what is the appropriate way to treat this behaviour. The depth of loss that an elderly person suffers watching every aspect of their self-sufficiency fade away defies the imagination of a younger person. What we hope and what I learned from other age-specific groups in different provinces of Canada is that by helping seniors socialize and create or form new networks, they will be able to start seeing themselves as being vital and active individuals again at some level and to feel less as is the world has passed them by.

Another lady, an active gambler, has joined us and shared what she gets out of this addictive activity. She gambles to forget the problems she has in her family (specifically with her children) and the frustrations she has with her worsening health. None of the men in the group have commented about such frustrations with their family, which I think has an interesting tie-in to theory. We always hear that women tend to be more defined by their family and relationships than are men. Therefore, if a senior experiences any type of a relationship breakdown, for any reason, a female senior is more likely to be affected at a higher degree compared to a male senior. This has been an ongoing struggle within the program, which as mentioned is based largely on re-socialization. In many cases, we are finding that the distance that has developed between our members and their families is so huge that bridging it seems all but impossible. Even becoming motivated to try to reconnect seems to be beyond the willpower of many.

With many of the seniors on our program, we have found that a significant reason they turn to alcohol is loneliness and isolation. The data supports a similar conclusion; Fredriksen (1992) found that the majority of women admitted to their treatment program were lived in isolation from their friends and family. Also, Pettigrew and Roberts (2008) note that excessive alcohol consumption tends to be positively correlated with isolation in seniors. From my own experience, this seems to be a common theme in the narrative from members of both genders, however, I suspect that women are probably more affected by this problem. From a statistical point of view, it is well known that because women tend to live somewhat longer than men, there is a higher chance that the female spouse will outlive the male. As a result, the woman is more likely to experience living in isolation due to the death of her spouse. As with other cohorts, elderly women also tend to start drinking because of increasing isolation, as noted above. This is something I have definitely noticed in our group. In general, more of the women are alone than the men, since men will tend to end their lives with their spouse still alive, whereas women are more likely to end it alone. Helping our members break free from their isolation, as mentioned previously, is turning out to be more difficult than I would have previously imagined.

The support group was designed to help counteract drinking due to loneliness, however, again and again we are finding that it is not simply a matter of finding or creating opportunities for socialization; the challenge is convincing a group of people who have essentially lost all interest in social interaction that it is worth their time and effort to do so again. This is most dramatically demonstrated for us in the drastically reduced number of seniors who attend any of the group lunches or activities as compared to the number in the program. A major ethical question for us is what level of persuasion is appropriate in our position and at what point we need to respect the wishes of our clients despite how convinced we are that their wishes are working against their best interests.

Finally, a unique issue when it comes to women and alcohol is the increased level of social stigma for women who drink (Fredriksen, 1992). A certain portion amount of this stigma may come from practical grounds, based on the fact that women have the unique ability to give birth to children and are in much greater danger of harming unborn children by drinking. Another part of this stigma, however, may be based only on old stereotypes that in general women are considered to be responsible for the care of others, and that they fail in this regard when they abuse alcohol or drugs. Women are supposed to be giving and sacrificing and therefore drinking is something that we see as being more unacceptably selfish for us than for men. From a practical standpoint, besides continuing to advocate against double-standards, there is much less that we actively do for our clients in this respect.

The lessons for practice that I take away from this discussion are similar to those mentioned above; that in order to treat a person suffering from an addiction, it is necessary to first understand what factors drive them towards the addictive behaviour. In the case of many elderly women, loneliness and isolation are two such factors, and by helping reduce these factors through socialization, we may be able to help dis-incentivize seniors to continue drinking, using drugs, etc.

References

Fedriksen, K.I. (1992). North of market: Older women's alcohol outreach program. The Gerontologist, 32(2), 270-272.

Pettigrew, S., & Roberts, M. (2008). Addressing loneliness in later life. Aging & Mental Health, 12(3), 302-309