Once a little-noticed problem, substance abuse among the elderly has become an issue for seniors and the providers that offer them caregiving services.
Substance abuse among seniors is an almost invisible problem. They can be found living alone or with their families, in independent living apartments or in any type of senior care facility.
The senior care sector needs to do a better job of identifying and treating those at risk, as well as managing the costs. The risks are plenty: To start, senior care facility operators who do not address substance abuse can face consequences for neglecting to meet federal standard-of-care requirements, not to mention the threat of litigation.
Senior substance abuse has increased
Medicare-funded senior living facilities are required to perform assessments and must demonstrate compliance to the Centers for Medicare and Medicaid Services (CMS). Those not funded by Medicare don’t have the same legal requirements but have a responsibility to monitor potential liabilities.
The issue has become particularly acute over the last 10 years. By 2020,167,200 people 55 or over were admitted to addiction treatment, a 53% increase from a decade earlier.1 One estimate puts the prevalence of substance abuse by those over 65 at 4% of the population.2
Alcohol is the most abused substance among the aging, but pharmaceutical abuse is also common. Healthcare providers often prescribe opioids with a high potential for addiction to elderly adults for pain management.
Today’s seniors are as likely as earlier generations to self-medicate given the stress of changes late in life, including health issues, isolation and loss of independence.
The keys to recognize and manage substance abuse for senior care providers
Liability and related insurance can only serve as backstop to the risk of senior substance abuse, and coverage does little in the way of preventing the problem in the first place.
There are several keys to reducing the risk of substance abuse in senior care facilities and communities, but perhaps the most important is intake and screening. Providers need to assess potential residents to detect behaviors that could signal developing mental health issues or substance abuse. And these assessments must be ongoing.
However, assessment and follow up for substance abuse can be suboptimal, often stemming from a lack of skills and knowledge to identify potential problems. In addition, providers need to create documented policies and procedures to detect and monitor such behaviors and signs they are worsening.
Numerous resources are available to advance caregivers’ understanding of and capabilities in screening, monitoring and treating residents with addiction issues, such as the SAMSHA Resource Center, the Center of Excellence for Behavioral Health in Nursing Facilities and the Alliance for Aging Research.
HUB International’s healthcare experts are ready to help your organization respond to the opportunities and risks in a constantly changing healthcare environment.
1 SeniorLiving.org, “Guide to Substance Abuse in Older Adults: Risks, Warning Signs, and Treatments,” April 12, 2024.
2 National Library of Medicine, “Substance Use Disorder in Older Adults: Mini Review,” accessed May 31, 2024.
