Minutes for September 11, 2012
held at Malta Community Center, Malta, NY
Present: Cindy Harrington (Shelters of Saratoga), Joseph Yishar (Physician), Carole Kyer (DOH), Jeff Murratti (Merrill Lynch), Noreen Jones (O’Neil Apartments, Troy, NY), Maria Geizer (Home Instead Senior Care), Holly Pajak (Redesign in Mind), Reed Lehan (Saratoga County DSS), JoAnn Zales (National Grid), Kim Swire & Amanda Goodfellow (CHOICES at St. Peter’s), Jennifer Baldwin (Saratoga Hospital), Rebecca Zohn (Concepts of Independent Choices), Cathy Tucker (Ameriprise Financial), Jess Froehlich (Eddy DayBreak), Dawn Lincoln & Denis Livsey (SAIL), Jane Hurst (RSVP Volunteer), Mary Rickard & Ben Nichols (Saratoga County Office for the Aging), Nichole MacFarland ( Senior Hope Counseling, Inc.)
Introductions and Announcements
Cindy announced that the next meeting will be held on October 9th, 2:00 – 3:30 pm at Saratoga United Methodist Church, 175 5th Avenue, Saratoga Springs. Debbie Verni, Esq. of Herzog law Firm will be presenting on Advanced Directives. November’s meeting topic will be a presentation on Support Groups.
Senior Services of Albany and CDPHP Medicare Choice will present the 21st Annual Capital Region Senior Expo on Thursday, October 11th at Clifton Park Center Mall in Clifton Park. This day-long exposition is the largest and most widely recognized trade show of its kind in the Capital Region providing everything older adults need to know about housing, health insurance, transportation, home health services, home repair and modification, city and governmental services, trips and recreation, finances, volunteerism and much more.
Participants introduced themselves.
Presentation
Nicole MacFarland, LCSW-R, CASAC, is the Executive Director of Senior Hope Counseling. She spoke on “Late-Life Addictions: An Overview of An Age-Specific Clinic for Seniors”.
Senior Hope Counseling, Inc. is a nonprofit clinic that exclusively caters to the 50+ population struggling with alcohol and /or other drug addictions. It was founded ten years ago by Dr. Bill Rockwood and his wife, Adrienne. The agency’s mission is to provide high quality, science based, compassionate and comprehensive alcoholism and chemical dependency treatment. Their goal is to promote the highest quality recovery lifestyle possible for the clients and their families. It is overseen by a Board of Directors. Nichole has been with the agency since 2004. The Agency assisted 100 clients in the past year. Senior Hope Counseling is located at 301 South Avenue, Albany, near St. Peter’s Hospital. It is funded by the NYS Office of Alcohol and Substance Abuse, SUNY and through their client’s health insurance and private contributions.
There has been an increased concern of substance abuse for the “baby boomer” generation born between 1946 – 1964. The Office of Applied Studies Data Review (2009) rate for Substance use disorder for persons age 50 – 59 is projected to reach 5.7 million by 2020. The population for persons over 50 years of age in New York State was 6.3 million in 2009.
Alcohol drinking limits for older Adults: No more than 1 standard drink per day, no more than 2 drinks on any drinking day. The size of the drink matters. Limits for Older women should be somewhat less than an older man. Older adults should limit their alcohol usage due to a greater use of contraindicated medications, less efficient liver metabolism, increased alcohol sensitivity with age and less body mass/fat which increases circulating levels.
Persons who have had substance abuse problems during the earlier years of their life tend to have more physical and mental problems. Early onset patients comprise of about two-thirds of the clients that they see. Persons who started abusing substances after age 40 tend to have fewer medical problems.
Older Adults who abuse alcohol have an increased risk of stroke, impaired motor skills, are prone to injury, encounter sleep disorders, risk suicide, and may have an interaction with dementia symptoms. They also risk having impairments from higher blood alcohol concentration. Alcohol may also have an effect on their medications causing potential interactions and increased side effects.
Some signs of potential alcohol problems include: anxiety, depression, blackouts, dizziness, seizures, disorientation, falls, bruises, burns, headaches, incontinence, memory loss, unusual response to mediations, and difficulties in making decisions, poor hygiene and nutrition, sleeping problems, family problems, financial problems, legal difficulties, social isolation and increase alcohol tolerance.
The traditional perspective is that aging adults are increasing unproductive. However, older adults have a natural role to contribute to society such as volunteering.
When a client first arrives at the office they do not feel very good about themselves, but once they have gone through an analysis, they become aware of some of their great life experiences they have encountered. Natural aging, Alzheimers and substance abuse have similar symptoms. During analysis, addiction problems can be diagnosed after being hidden for years.
When interviewing a client, one needs to address the client’s needs from his or her perspective according to the client’s readiness for change.
Senior Hope Counseling has an ACE Informed Outpatient Clinic. They examine Adverse Childhood Experiences. They look for adverse childhood experiences that could affect a client’s current mental, physical and addiction problems. They try to help the client distance themselves from the past so they can find freedom from pain and suffering.
Persons with co-occurring disorders suffer from a mental illness along with substance abuse. The most prevalent mental health problems are depression and anxiety. Depression and alcohol abuse are the most common concerns among the elderly suffering from dual disorders. Older persons require a different approach to their care from adolescents with similar diagnoses.
Some treatment approaches include: individual counseling, age-based group counseling, medical/psychiatric approaches, cognitive/behavioral therapy, harm reduction, marital and family involvement, family therapy, case management/community-linked services and outreach and formalized substance abuse treatment.
The Harm Reduction Technique is unlike traditional approaches. It does not require an individual to stop using, but instead works on the goal of abstinence, recognizing that not everyone is able to abstain from substance use during the early stages of treatment.
CAGE screening tool can be used casually in conversation to determine if a client has a substance abuse problem.
C – Have you ever felt you should cut down on your drinking?
A – Have people annoyed you by criticizing your drinking?
G – Have you ever felt bad or guilty about your drinking?
E – Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
A positive answer of two or more indicates a high likelihood of a substance abuse problem. An answer of “Yes” to one question indicates the need for a referral for a full evaluation.
When planning treatment, it is critical to integrate services. The client with co-occuring issues needs a combined effort of mental health and addictions services. If the agency cannot provide both, it is important to coordinate care for the service that is not available. Case management is an integral part of servicing the older patient.
Senior Hope Counseling provides services to individuals, groups and families. They provide nursing assessments and assist with family interventions. Non-Intensive levels of outpatient services are provided, along with day and evening treatment programming. Included in their services are: assessments, treatment planning, linkage, referrals and discharge planning.
Senior Hope Counseling has 15 age-specific groups offerings: 3 Psycho-Ed groups, a Trauma Survivors’ group, a Men’s group, a Women’s group, 2 Mental health and Recovery groups, an Anger Management group, 2 Life Transitions groups, Recovery topics, 2 Relapse Prevention groups and a group for Recovery in the Golden Years.
The agency has 15 staff members headed up their founder, Dr. Bill Rockwood and Nichole MacFarland, Executive Director. The staff includes: Director of Public Relations and Communications, a Medical Director, Nurses, Licensed Certified Case Workers, Student Interns, a volunteer, Business staff and a receptionist.
Senior Hope Counseling receives referrals from many community agencies, judicial courts, family and friends. They serve a diverse cliental. There has been a large growth in the units of services since their inception.
Senior Hope Counseling only provides services at their location in Albany. It was suggested that there is a need for satellite offices to reach a larger portion of the Capital District area.
Nichole MacFarland, LCSW-R, CASAC , Credits and contact information
Nicole teaches a continuing education course through NASW-NYS, entitled “Geriatric Addictions”. It is a CEU 2 credit course. Member cost is $20 and the non-members cost is $25.
The International Journal of Aging and Human Development published an article written by Nichole and H. Larkin entitled Restorative Integral Support (RIS) for Older Adults Experiencing Co-Occurring Disorders.
Nichole can be reached by phoning 489-7777 or by fax 489-7771. Her email address is N.MacFarland@Seniorhope.org. The agency’s website is seniorhope.org.
Respectively Submitted,
Jane Hurst
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