I could begin by quoting a statistic about the number of seniors affected by alcohol and prescription drug abuse, but that information is meaningless when you are struggling to care for a parent in this situation. I could then make you skim this article, searching for the paragraph that mentions whether an assisted living community can provide the supportive care your parent requires if you decide that allowing her to live alone is no longer an option. Instead, I’m going to say it upfront: it is possible to find an assisted living community that will take your parent—and you don’t need to hide or be embarrassed by your parent’s situation.
The truth of the matter is this—the substance abuse will likely be discovered during the assessment process and medical history review, according to Silva K. M. Gerety, a member of the Assisted Living Federation Association’s (ALFA) Quality Team and Corporate Director of Health & Wellness for Brightview Senior Living. In the case of alcoholism, a diagnosis of depression, past alcohol abuse, tremors, poor hygiene or an odor of alcohol can all serve as clues whether the potential resident has this form of substance abuse. “If information is withheld, it may lead to an inappropriate move in and subsequent move out,” Gerety shared via email—which can be very stressful for both you and your family.
The Importance of Full DisclosureDuring the admissions process, a good clinician will note if your parent self-medicates, says Sandi Flores, also a member of the ALFA Quality Team. In her years as a clinical supervisor, she has overseen thousands of resident admissions into assisted living communities and she says that having parents with substance abuse issues is common, especially as “alcohol is a socially acceptable effective coping mechanism” She adds that adult children shouldn't be ashamed of their parent’s behavior.
While you may be disclosing a family secret that you may have been or are still feeling ashamed of, it is important that you know the admissions clinician can be trusted with this family history, as most facilities are bound by the Health Insurance Portability and Accountability Act (HIPPA) to safeguard the privacy of residents. If you don’t feel comfortable disclosing your parent’s substance abuse issue with the staff at the community, then search elsewhere. And if your parent’s substance abuse doesn't come up during the admissions process, do not count this as fortunate but rather as a red flag to search for another community.
“Frankly, we’re not here to judge,” Flores says, adding that it’s important that the clinician develop a sense of trust with the family. After having seen many families go through the process of disclosing a closely guarded family secret to a stranger she says that “for the first time, they don’t have to worry” and there is a “phenomenal sense of relief.”
What Happens Next?Once the issue is disclosed, the clinician needs to know about the history and pattern of substance abuse. This information allows caregivers to determine whether your parent can live safely at the community—which is the priority, Flores says. Unfortunately, disclosing this information doesn't guarantee the community will accept your parent, not because of the substance abuse, but because his safety cannot be guaranteed. Our priority is to keep our residents safe, Flores says, “some alcoholics are darn safe [such as remaining in their room while drinking]” while others are at risk for frequent falls. Gerety also stresses that it’s important for the individual to live in a setting where the proper care is available.
What both Gerety and Flores want you to know is that assisted living communities are not detox or rehabilitation centers; staff will strive to keep the substance abuse habits manageable, but they will not infringe upon your parent’s independence. Flores also constantly educates and coaches her nurses on how to care for residents with substance abuse issues, stressing that the priority is to keep them safe, not to change their lifestyle.
The next question on your mind is likely, “Are there additional costs caring for someone with substance abuse issues?” Flores says that there may be, and those costs will be determined by how much care the resident needs. Disclosing the full details of your parent’s situation can prevent unanticipated spikes in cost associated with care needs that were not initially assessed.
Community ResourcesShould your parent not be accepted into an assisted living community due to safety concerns or refuses to cooperate, you still have options. First, don’t try to handle it all on your own. There are county-level Area Agencies on Aging in every state that are staffed with specialists who are experienced with situations like yours. Like the clinicians at the assisted living community, these specialists do not judge and are required to maintain confidentiality. They can match you with community resources that fit your needs, whether that is an in-home care service or organizations that specialize in treating seniors with substance abuse.
Doing an online search with phrases such as “geriatric consultation services” or “geriatric assessments” and your locale will yield organizations that provide such services. Examples of these organizations include EvergreenHealth, located in Kirkland, Washington, which has a Geriatric Regional Assessment Team, or Ohio’s Southwest General which also offers geriatric consultation services. Even though substance abuse may not be called out as an issue that they address, don’t be afraid to ask. You are not the only family struggling with a parent with substance abuse and you would be surprised at the people willing to help lessen the weight of the secret you have been carrying.
Andrea Watts is a Seattle-based freelance writer who covers sustainable forestry and agriculture issues. Her writings have appeared in publications that include TimberWest, The Forestry Source and Acres U.S.A.