Chapter 6: Substance Misuse and Cognitive Impairment

This chapter outlines the ways in which substance misuse can affect (and be affected by) declines in thinking, including the occurrence of dementia.

In Chapter 6, you will learn about:

• Facts that show substance misuse can and does occur in older adults, particularly alcohol misuse.

• The latest research on the effects of substances and certain medications (e.g., benzodiazepines) on cognition and brain functioning in general.
• The link between substance misuse and the risk of developing cognitive disorders in the future, such as dementia and MCI.
• The many mental disorders/symptoms that co-occur with substance misuse and that negatively infuence thinking, such as depression and depressive symptoms, anxiety, and PTSD and trauma.
• Screening instruments developed for and tested in populations of older individuals are available. nubstance Use Disorder in Older Adults
• The numerous interventions for older clients with substance misuse and co-occurring behavioral health and cognitive disorders, including education, drug and alcohol counseling, brief counseling, referral to mutual-aid support programs and peer-recovery programs, and other interventions that do not involve pharmacotherapy.
• Why including caregivers is essential for successfully treating older adults with substance misuse and co-occurring dementia or MCI.

Chapter 7: Social Support and Other Wellness Strategies for Older Adults

This chapter outlines ways to help older clients with substance misuse leverage social supports and other wellness strategies to improve their chances of achieving and maintaining long-term recovery.

In Chapter 7, you will learn that:

• By helping older adults increase and enhance their social network and feelings of connectedness, you are at the same time also helping them improve their chances of overcoming substance misuse.
• Be sure to offer recovery-specifc social supports, like mutual-aid support programs and peer support programs, among your services and referral options.
• In addition to focusing on social functioning, help older clients with substance misuse establish all-around wellness by addressing multiple areas of functioning, like their physical health, spirituality, emotional health, fnances, work, and cognition.
• Brainstorm ideas together and link your clients to a wide range of wellness activities, like exercising, joining a spiritual or religious fellowship, creating a safe and welcoming living environment, enrolling in adult education or senior college courses, and volunteering.
• Older adults should learn self-management techniques to independently monitor and improve their health.

Chapter 8: Drinking as an Older Adult: What Do I Need To Know?

This chapter focuses on older adults’ alcohol consumption and key facts and information they (and family members/caregivers) should know about alcohol use and misuse.

In Chapter 8, you will learn about:

• Guidelines that defne “moderate” and “at-risk/high-risk” amounts of alcohol for adults, including what counts as one drink.
• The causes of older adults’ alcohol misuse, such as certain stressful major life events (e.g., forced retirement, death of a signifcant other), increased isolation, physical disability, and boredom/lack of meaningful activities or hobbies.
• The signs and symptoms of alcohol misuse in older adults, including cognitive, physical, emotional, social, and behavioral conditions.
• Tips and strategies for older adults who want to try to manage their alcohol misuse on their own and how to tell when it is time to seek help from a professional.
• The steps that occur when a person accesses professional treatment or services, such as screening, assessment, and follow-up visits.
• Vital information for family and caregivers, like warning signs of alcohol misuse, helping an older adult access professional care, and the importance of self-care.