Baby Boomers, the generation that is 77 million strong, born between 1946 and 1964, have always assumed that they would live longer and healthier than their parents’ generation. The promise of ongoing youth, health and vitality was the accepted belief. However, there are some rocky obstacles on this road to healthy aging that have roots in lifestyle, genetics, and the inevitable aging process itself.
In 1992 the National Institute on Aging (NIA) sponsored a Health and Retirement Survey of 20,000 Americans age 50+. Results show that chronic pain plagues many in their early to mid-50’s. Respondents reported poorer health, more pain, and more difficulty doing routine physical tasks than their older peers had reported at the same age. The youngest group in the NIA survey (now ages 54-59) reported having more pain, chronic health problems, drinking, and psychiatric problems than those surveyed earlier. Diabetes and other chronic conditions are on the rise among those 50+.
Is 50 years of age really the new 35? It depends. After our mid-50’s, seventy percent of all aging is controlled by lifestyle: active or inactive, smoke or drink to excess, sleep patterns, interaction with friends and family, and degree of engagement in work, community, and life.
This age wave brings a corresponding trend of illicit drug use to older adults. A national survey by the Substance Abuse and Mental Health Administration (SAMHSA) showed that between 2002 and 2005, the use of illegal drugs increased by 63 percent among those in their 50’s. This means that over 3 million adults aged 50+ have used hashish, marijuana, cocaine, crack, heroin, hallucinogens, or inhalants. As a whole, boomers account for one out of two drug fatalities.
a 2007 Scripps Howard News Service survey analyzed death records of more than 304,000 boomers who died in 2003. This survey indicates that the impact of early and enduring drug use, a long history of depression, and a stubborn tendency not to “act their age” results in premature death. Because drug deaths typically go unreported, the problem of risky substance use among Young Older Adults is probably larger than statistics show, and certainly its consequences will grow.
Addressing Life Stages
Boomers comprise two distinct groups within a large age span: Leading and Trailing Edge Boomers. Individual life stages vary from demanding careers with kids at home to empty nesters. Leading Edge Boomers were influenced in their youth by the Vietnam War and civil rights era, and the assassination of President John F. Kennedy. The Trailing Edge Boomers were born a year after President John F. Kennedy’s assassination, a year after three civil rights workers were killed in Mississippi and never experienced a draft.
Boomers have been an unprecedented force in American society and will continue to be as they age. Many do not plan on retiring any time soon. We know that finding purpose and meaning in life is vital to Boomers. Learning not only healthy coping skills in middle life but also tools to explore purpose may be lifesaving. The pursuit of vitality for example, can be channeled into a second career, adult education, travel, and volunteerism. But when “youth,” optimal health careers and idealism fade, and financial and family pressures rise, old lifestyle habits can resurface.
For those who have slipped into dangerous drinking, prescription and/or illicit drug abuse or are now suffering the devastating consequences of a lifetime of addiction, simply living day to day is a challenge. A 50+ year old body can not process alcohol in the same way it’s processed in a younger body, and alcohol is often taken in combination with another substance. Those in their 50’s are, on average, taking more than one prescribed medicine. This profile creates a poly pharmacy that is one of many factors to address in a whole new realm of older adult addiction.
In treatment, we’ve learned that rather than engage Boomers only by age, we need to address life stages. Where are they in the spectrum of transitions such as career, empty nest, and perhaps divorce, caring for elderly parents and/or kids at home?
Physical and mental factors in aging, and whether or not a person thinks “young,” are tangible in life and in treatment. There are some new challenges in treating an older adult including the high incidence of dual diagnosis, such as depression and anxiety.
The Young Older Adult is now presenting to treatment with alcohol use coupled with prescription drugs and/or illicit drugs. For those who mix illicit drugs, or drugs with alcohol, a medically supervised treatment program is absolutely necessary. Detox is a slow process and medical stabilization may take longer. It has been found that a personalized 90 day residential treatment course is more successful than shorter primary residential treatment. A continuing care plan, along with regular support group participation, is relevant for virtually every older boomer patient, whether in an intensive outpatient or in a transitional housing setting.
Boomers have long subscribed to the notion that every problem has a relatively quick fix. Boomers like to make decisions based on personal research, which is often found on the Internet. They are not impressed with authority. All these factors help in the recovery process, as long as engaging in treatment doesn’t mean the patient directs the care, or engages in compulsive behavior such as an extreme exercise regimen. Treatment is a step-by-step process, especially when dual diagnosis, medical complications, and the use of several substances have created a complex health profile, or when they have a long history of substance abuse. A holistic care plan that treats the whole person, mind, body and spirit, is ideal.
Interactive therapies within a holistic care plan have been effective, such as motivational interviewing, which helps a person move through his ambiguities about recovery and engage in his own recovery. Dialectical Behavior Therapy allows a person to learn to stabilize mood and address life with mindfulness and acceptance. The patient needs to understand the basic bio-neuro biological nature of the disease of addiction, and the effects of substances on the brain, particularly because poly pharmacy and dual diagnosis are prevalent.
Specialized group therapies that address specific life stages are especially relevant. We’ve found that wellness therapies such as therapeutic massage are also well received especially in a serene and non-medicinal setting. Wellness activities such as Tai Chi, gentle yoga, aquatics, and expressive therapies offer appropriate choices.
The exploration of spirituality, including connectedness to self, others and a deeper meaning to life can lead to an unexpected “a-ha” moment for many, and this becomes the catalyst for their own change.
Alcohol and substance abuse in the Boomer age wave will significantly impact our institutions from health care to housing and the workplace to family. Addiction is an insidious thief that, left untreated, will rob the individual of health, relationships, and a life with meaning. With the possibility of decades of healthier life, and renewed connection to loved ones and community, aging Boomers who suffer from debilitating addictions deserve the chance to explore the possibilities.
Carol Colleran, a pioneer in the treatment of older adults, is Executive Vice President of Public Policy and National Affairs at Hanley Center in West Palm Beach, FL. She is co-author of “Aging and Addiction: Helping Older Adults Overcome Alcohol or Other Medication Dependence.“
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