Women and Alcohol

Background

Sixty-two per cent (62%) of women aged 65 and older in Canada are current drinkers. It is estimated that 6 -10% of older women have significant alcohol problems (10-17% of current drinkers).

That represents between 122,500 and 204,200 older women across Canada. Each year, less than 5% of older women experiencing problems with alcohol or other substance abuse problems receive any help for it.

Why Do Some Older Women Turn To Alcohol

as a Way of Coping?

For some women, it has been the way they have dealt with stresses throughout their lives. For others,  it is a response to situations that feel beyond their control.

Some are struggling with deteriorating health, particularly chronic pain and loss of eyesight.  Others are feeling  socially isolated.

For some, it is a response to the emotional pain of abuse- as child, as spouse, or as senior ("elder abuse") that has never been addressed, or in many cases, even previously disclosed.  For others, it may be in response to situational stressors. These can include:

• giving care (often long term care) to an ill spouse;

• loss of community;

• financial upheaval at retirement or at widowhood.

Special Obstacles that Older Women Face

to Receiving Help

· Gender Bias: Social and professional attitudes and assumptions about who typically has an alcohol problem and what constitutes an alcohol problem, results in under-recognition of the problem in older women

· Social Stigma: Alcohol abuse is supposed to be a "male problem", or a problem of people who are poor.

· Poor Health: Older women who have alcohol problems often have much poorer health than other seniors or compared or older men in a similar position. Women trend to develop health problems at a lower consumption levels than men.

· Mobility: A high percentage of older women with alcohol problems have mobility impairments, which adversely affects their ability to access services or activities that could reduce their social isolation.

· Isolation: Unattached older women often have fewer social resources on which they can rely. They are more likely to have a spouse who has died, children who do not live near, or peers who are as incapacitated as they are.

· Treatment and Support Services: On the whole, treatment services are designed with younger adults' needs in mind.

· Systemic Barriers: Seemingly neutral criteria for admission or discharge can have a disproportionately negative effect on older women.

· Finances: Older women, on the whole, are less well off financially than older men, and are disproportionately affected by any alcohol treatment service where the client bears the cost. For example 45% of older widows in Canada live below the poverty line.

Older Women, Alcohol, and Canadian History
 

Older women's situation and experience with life, drinking, and alcohol problems is different than that of younger people, or even older men. Here are some factors to consider:

Most older women today were raised during a time when alcohol consumption was heavily regulated and socially controlled.  When today's older women were young adults, legal alcohol consumption occurred only in private clubs or in people's homes. In many communities, women did not drink very much.  Some women drank alone and their alcohol problems developed in secret.

Alcohol consumption, particularly consumption by women, was socially and politically censured from the 1930s to the 1960s.  Younger people may not know that until the late 1960s, bars were segregated, with separate entrances for "Men" and "Ladies and Escorts".

At the same time, alcohol was prescribed by doctors for women during this period for a variety of conditions, including anaemia, nursing problems, and sleeping difficulties.

Alcohol treatment for women was late in development. The earliest treatment facilities were in mental institutions, where a woman went for a "nervous breakdown", not her alcohol problem. In seeking treatment in the 1950s to 1970s, a woman risked everything, including losing her children, as she was often deemed "an unfit mother" if "found out".

At the same  time, as  Canadians began to have more disposable income, having alcohol became more socially acceptable, indeed  often socially expected.

There has always been a double standard.  Women are expected to drink in moderation. Heavy drinking and being drunk is more tolerated of men than of women.

Older Women, Alcohol and Health

Alcohol consumption in quantities that cause little or no damage for younger adults or for older men, can be problematic for older women.

In 1997, we conducted a study  on Alcohol and Health, looking at the health of seniors who had been referred to an alcohol and drug outreach program for seniors. As part of the study, we reviewed the case files of 177 older women. One half of the women were aged 65-74; one third were aged 75-84. 

The results are quite striking:  Seniors being referred to program were experiencing many more health problems than other seniors their age, and even in comparison to older seniors (those aged 75+). In many cases, the older women being  referred were worse off health-wise, than the older men.

Very few of the women were considered "healthy". Well over half of the women referred to the program had three or more significant health problems. One in six had seven or more health problems. 

In the study, 33% of the seniors had mobility impairments making it far harder for them to get around. Among older women, this rate soared to 59%. As well, 31% of older women were experiencing chronic pain, often from arthritis or osteoporosis; compared to 12% for the clients generally.

Older Women, Alcohol and Abuse

In the Health Study, 15% of the women clients had experienced (or were currently experiencing) some form of abuse. This took several different forms:

a) childhood abuse
b) earlier sexual abuse
c) current or previous spousal abuse
d) "mutual abuse", a poor term for when the woman is both the recipient of violence and person committing the violence,
e) elder abuse

In each of these instances, the older woman may be drinking in response to the emotional pain of abuse.

Alcohol and Depression

In the Health study, 24.8% of the older women with alcohol problems were also experiencing depression. The "reason" for the depression took many forms, including

• life stresses,
• deteriorating health of her self or her spouse,
• inability to give "proper care",
• chronic pain,
• loss of close relationships with offspring, or
• simply the fact that the woman was drinking more than she wanted, and felt unable to stop.
  
  

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Recommendations for Helping Older Women Better

 

In Prevention/ Education

• Understand older women's concerns. These include health, financial matters, current and  past abuse issues, family relationships, retirement, and much more.

• Help identify the health consequences of drinking for older women in  educational materials in an easy to understand non-stigmatizing way. Identify the way that alcohol can undermine older women's independence (because of falls, fractures), mobility, and memory. 

• Be very concrete in this information.  Generalizations and vague suggestions are not helpful.

• Recognize that not all older women are the same. Recognize the heterogeneity among older women, in terms of their life circumstances, and their alcohol consumption.

• Clearly identify gender differences in the health consequences (positive and negative) of drinking. 

• Aim educational materials about alcohol issues in later life towards higher risk populations of women that have heretofore been ignored, such as cancer support groups, caregiver organizations, Alzheimers' support groups.

• Aim education materials on alcohol issues in later life at service providers or families, and help them become better aware of the seriousness of "leaving it alone".
  

In Treatment

• Recognize how health problems can affect access to treatment. Address these barriers at a systems and policy level.

• At a policy and funding level, recognize and accommodate the fact that most older women are not financially equipped to pay for alcohol treatment services.

• Facilitate and encourage mental health and alcohol services to work together to help older women who are experiencing the dual issues of alcohol problems and depression.

• Help residential treatment and supportive recovery programs recognize that older women who have alcohol problems usually do not have the physical resources to make it through traditional programs successfully. To act otherwise, simply sets older women up for failure. To ignore older women's needs is unjust.

• Educate addiction treatment staff on aging issues, particularly aging issues as they relate to older women to increase sensitivity and awareness.

• Only use staff who have had gerontological training in counselling older women.

• Develop and expand outreach programs for older women with health/ alcohol programs.

• Facilitate multidisciplinary approaches to the collateral problems that older women are facing, e.g. integrate pain management strategies into alcohol programs for women; incorporate elder abuse strategies.

• Develop treatment options for older women that
  
  • Give support and nurturance
  • Are in a safe environment
  • Offer sharing about older women's issues
  • Have positive emphasis and focus on self esteem and self confidence
  • Recognize the health, financial, and social situations that many older women are facing
  • Build on older women's strength.

   

• Plan treatment in a way that gives older women opportunities to continue contributing to society.
  
   

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Suggested Resources

Women's Addiction Foundation.  Alcohol and Older Women. Short information sheet. www.womenfdn.org/Resources/info/pdfs/older%20women.pdf

Page last updated March 15, 2002.

© Charmaine Spencer, Gerontology Research Centre, Simon Fraser University, Vancouver, B.C. To put it simply, you are welcome to use this material as long as you cite the source and do not use it for commercial purposes.  Some of the clipart photos on this page are from Microsoft Office ©  Online.