Alcohol and ageing well in a time of lockdown

Before the COVID-19 pandemic began, higher risk alcohol use in England was declining in all age groups except those aged 55 and over, with those aged 65-74 most likely to have drunk most days in the previous week. However, the past year has seen an increase in concerning habits. The Centre for Ageing Better found that around three in ten (32%) adults aged 50-70 have been drinking more during lockdown, citing anxiety, loss of structure and normal routines as causes. This reflects Drink Wise, Age Well's findings that loss of purpose and retirement are key factors for increased alcohol use in the over 50s, alongside bereavement and financial worries, all of which may be exacerbated by the pandemic. 

Many older adults face individual, societal and system barriers when trying to seek help – 80% of increasing and higher risk drinkers have never been asked about their drinking by health professionals, families or friends. Some of this is down to ageist beliefs such as ‘having a drink is their only pleasure’ or that alcohol problems primarily affect younger people, however there can also be more direct age discrimination. Research found that 75% of alcohol rehabs on Public Health England's directory had an upper age limit, which is in breach of the Equality Act. 

Health professionals may not recognise the signs of problematic use, putting these down to ageing which can lead to older adults being referred to care homes rather than for alcohol treatment. There may be practical or accessibility barriers around attending appointments or anxiety about attending an alcohol treatment service for the first time. Although the numbers of over 65s accessing alcohol treatment increased four-fold between 2005 and 2017, Drink Wise, Age Well has estimated that only 16% of those aged 65 and over with an alcohol dependency are in treatment.  

Our survey also found that one in four older adults with an alcohol problem would not know where to get help, along with there being a level of stigma and shame. It is important that alcohol awareness information is made available in community settings and all barriers to seeking help are removed. Promotional materials should be age-inclusive and referring agencies should be made aware that older adults are as likely to benefit from treatment as any other age group

• Services should offer home visits or appointments in community settings to increase engagement  
• Initial contact should focus on relationship building using a conversational approach  
• Assessments should focus on areas relevant to ageing including medication risks, sleep and energy, home safety, memory, isolation and loneliness, driving, hobbies and interests, and maintaining independence  
• Support should be non-judgemental and focus on individual strengths   
• Provide age-specific peer support and mutual aid groups  
• Focus on resilience building and social connections  

It is important to ensure there are robust care pathways and information sharing across teams supporting older adults so that their needs are more holistically met. Providing an inpatient alcohol detox to an individual who is then returning to a home where they are experiencing problems with isolation, their finances or self-care is futile. Increasing resilience, wellbeing and self-worth is so important in a recovery journey and alcohol services must recognise this when supporting older adults.

It is vital in the current context of lockdown to consider the needs of older adults who need help with their alcohol use. Voluntary sector and alcohol treatment services have responded quickly and creatively to ensure people can continue to get support. However, much of this support is currently online which will exclude those who lack equipment, connectivity and digital skills so Drink Wise, Age Well launched a telephone helpline.

Note: The free, confidential alcohol helpline provides advice, information and support to people aged over 50 who are worried about their drinking. Open 7 days a week; 12pm to 8pm Monday to Fridays and 12pm-4pm at weekends and the number is 0808 801 0750