As Norway enters what many refer to as its traditional stille uke (quiet week) tied to the Easter holidays, the week can be dangerously quiet for the country’s elderly. Efforts to contain nursing home expenses mean many now live alone at home well into their 80s, with limited assistance, and loneliness is a growing problem that’s leading many to drink more alcohol than ever before.
New studies are setting off alarms at the national institute of public health (Folkehelseinstitutt, FHI), which is registering major changes in consumption of alcoholic beverages among the elderly. “Surveys show that there’s been an increase in drinking alcohol, and an increase in how often they drink,” Ingeborg Rossow, senior researcher at FHI, told newspaper Dagsavisen.
The survey showed the biggest changes in drinking patterns since the mid-1990s. Rossow is especially concerned, she said, because the elderly don’t tolerate alcohol as well as younger people: “Body fluids per kilo are lower and liver function is often worse.” Many elderly also suffer already from balance problems, slower reaction levels, confusion, reduced eyesight and hearing. Alcohol consumption can make all that worse, and dangerous if patients fall or behave irrationally.
Norwegian health care workers who provide medical assistance to the increasing numbers of elderly still living at home also report visible signs of more alcohol consumption and the problems that can cause. Dagsavisen reported that a survey of 859 home health care workers, conducted for the alcohol abuse prevention organization Actis, logged how they experience alcohol abuse among their elderly patients.
Fully 72 percent reported that they have patients with alcohol problems. In some cases, that also causes problems for the health care workers themselves, who have encountered elderly unable to care for themselves, living in unusually untidy homes, suffering from poor hygiene and exhibiting aggressive, inappropriate and even violent behaviour on their home visits.
Loneliness, which can increase during holiday periods, was cited as the major reason for their drinking. Nearly 40 percent of the health care workers questioned in the survey pointed sorrow following the death of a spouse as the reason their patients were drinking, while around 35 percent of their patients admitted they’re bored and feel they have little purpose left in life. Another 30 percent were said to use alcohol to relieve various aches and pains.
“These are people who are in a phase of life where they are experiencing many losses, both socially, physically and mentally,” Ruth Løken of the civic Nero Project in Oslo’s Østensjø district told Dagsavisen. Nero is charged with developing the public health service’s ability to deal with abuse of medications and alcohol, and improve both health and quality of life for the elderly.
“When you get older, you also can develop a lot more pain,” noted Aino Lundberg, leader of another program to battle drug and alcohol abuse for the charitable organization Kirkens Bymisjon. “Alcohol functions like a pain-killer, and the increase in drinking among the elderly can be connected to their attempts at medicating themselves.”
Were accustomed to drinking wine
Elderly women represented the biggest increase in drinking, although more men still drink than women. Rossow of the public health institute noted that the new generation of seniors and the elderly have also generally enjoyed more affluent lifestyles than their predecessors, that both men and women have had careers and they have “more continental habits” because they’ve traveled much more than earlier generations of elderly. “They’re accustomed to drinking wine and have been part of wine clubs,” Rossow noted. “That can be fine, but their bodies start changing and they don’t tackle alcohol as well as they might have when they were younger.”
Eli Gunhild By, leader of the Norwegian Nurses Organisation (Norsk Sykepleierforbund), stressed that it’s important that elderly patients with a drinking problem not be stygmatized but instead be met with respect and understanding. “We must not care for them with prejudice, but with competence,” she said.
Løken of the Nero Project suggests the most important “treatment” can simply be what she called “a good conversation.” That can help relieve their loneliness, help them unload and also help them see how mixing alcohol with various medications makes for dangerous cocktails.
Isolation and loneliness likely to increase
Since most Norwegian municipalities charged with carrying out elder care are doing all they can to keep the elderly in their own homes, because of a nursing home shortage and efforts to cut nursing home costs, the problems of isolation and loneliness are likely to increase, along with the ranks of the elderly themselves.
“They become isolated, can lose contact with friends and family, don’t eat properly and seldom go out,” noted Silje Eide Bentzen, a nurse working for the City of Oslo’s home health care service. “They can also lose pride in their own appearance, can even smell bad, and that compounds their isolation. There’s a lot of loneliness around their alcohol use.”
Mina Gerhardsen, leader of Actis, stressed how important it is for home health workers and others working close with the elderly to have the competence and confidence they need to recognize alcohol abuse and offer help. “They need to know what to look for, how to follow it up, how to speak with their patients,” Gerhardsen told Dagsavisen. She was distressed to hear about how some health care workers have been abused by drunk elderly patients, “but this is also about the elderly’s right to a good and dignified life. We have to take this seriously.”