Best Practices - Treatment and Rehabilitation for Seniors with Substance Use Problems

2002
ISBN: 0-662-33394-2
Cat. No.: H46-2/03-295E

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Table of Contents

• Executive Summary
• 1. Project Background and Description
  • 1.1 Introduction
  • 1.2 Project Goal
  • 1.3 Sources of Information
    • 1.3.1 Literature Review
    • 1.3.2 Key Expert Interview Methodology
    • 1.3.3 National Program Inventory
  • 1.4 Project Definitions: Treatment and Best Practice
    • 1.4.1 Definition of Treatment
    • 1.4.2 Definition of Best Practice
    • 1.5 Project Limitations
• 2. Review of the Literature
  • 2.1 Introduction
  • 2.1.1 Terminology
    • 2.1.2 Young-Old versus Old-Old
    • 2.1.3 Demographics on Aging
    • 2.1.4 Different Cohorts, Different Views
    • 2.1.5 Outline of Review
    • 2.2 The Aging Population
    • 2.2.1 The Aging Process
    • 2.2.2 Symptoms of Chronic Conditions or Substance Use Problems
    • 2.2.3 Age-related Changes and Substance Use
    • 2.2.4 Losses and New Roles
  • 2.3 Patterns of Substance Use Problems in Seniors
  • 2.3.1 Alcohol
    • 2.3.2 Prescription Drugs and Over-the-Counter Medication
    • 2.3.3 Illicit Drugs
  • 2.4 Gender Differences
  • 2.5 Physical and Mental Health Issues
    • 2.5.1 Health Problems Associated with Substance Use Problems
    • 2.5.2 Psychiatric Problems Associated with Substance Use Problems
  • 2.6 Risk Factors
    • 2.6.1 Practical Factors
    • 2.6.2 Biological Factors
    • 2.6.3 Psychosocial Factors
    • 2.6.4 Protective Factors
  • 2.7 Screening and Diagnosis<
    • 2.7.1 Screening
    • 2.7.2 Screening Tools
    • 2.7.3 Diagnostic Criteria
  • 2.8 Treatment Issues
    • 2.8.1 Education and Awareness
    • 2.8.2 Age-specific Interventions
    • 2.8.3 Tailoring Treatment
    • 2.8.4 Case Management
    • 2.8.5 Psychiatric Co-morbidity
  • 2.9 Treatment Approaches
    • 2.9.1 Peer-Led Self Help Groups
    • 2.9.2 Brief Interventions
    • 2.9.3 Cognitive-Behavioural Approaches
    • 2.9.4 Psychosocial Approaches
    • 2.9.5 Outreach Services
    • 2.9.6 Harm Reduction Approach
    • 2.9.7 Pharmacological Interventions
  • 2.10 Barriers to Treatment
    • 2.10.1 Practical Considerations
    • 2.10.2 Misdiagnosis
    • 2.10.3 Denial
    • 2.10.4 Social Stigma
    • 2.10.5 Fear of Failure
    • 2.10.6 Enabling Attitudes and Behaviours
    • 2.10.7 Attitudes of Health Professionals
  • 2.11 Specific Groups: Aboriginals
    • 2.11.1 Substance Use Problems
    • 2.11.2 Treatment
• 3. Interviews with Key Experts
  • 3.1. Selection of Key Experts
  • 3.2. Key Expert Interview Process
    • 3.2.1 Theoretical Orientation
    • 3.2.2 Risk Factors for Substance Use
    • 3.2.3 Areas to be Addressed in Treating Seniors with Substance Use Problems
    • 3.2.4 Outreach, Contact & Engagement
    • 3.2.5. Assessment Components
    • 3.2.6. Barriers to Participation in Treatment and Rehabilitation Programs
    • 3.2.7 Principles that Guide Treatment Processes
    • 3.2.8 Model Program Components
    • 3.2.9 Aftercare
    • 3.2.10 Measuring Effectiveness
• 4. Best Practices
  • Prescription and Over-the-counter Medications
  • Prescribing Practices
  • Medication Compliance
  • Illicit Drugs
  • Losses as Risk Factors
  • Screening and Diagnosis
  • Education and Training: Professionals
  • Education and Training: Public
  • Awareness of Services
  • Engagement
  • Assessment
  • Treatment Issues: Client-centred
  • Treatment Issues: Social Roles
  • Treatment Issues: Family and Peers
  • Treatment Issues: Daily Living
  • Treatment Issues: Socio-Cultural Differences
  • Treatment Issues: Collaboration and Communication
  • Treatment Approaches: Outreach
  • Treatment Approaches: Transportation
  • Treatment Approaches: Harm Reduction
  • Treatment Approaches: Age-specific Interventions
  • Treatment Approaches: Tailoring to Individual Needs
  • Measuring Effectiveness
• 5. Inventory of Specialized Programs
  • Elderly Services Program - British Columbia
  • Seniors Liaison Program - British Columbia
  • Seniors' Substance Awareness Program - British Columbia
  • Seniors Well Aware Program (SWAP) - British Columbia
  • Victoria Innovative Seniors' Treatment and Assessment Program (VISTA) - British Columbia
  • Substance Abuse in Later Life (SAILL) - Alberta
  • Substance Use Management, Intervention and Treatment (SUMIT) - Manitoba
  • Community Outreach Program in Addictions - (COPA) - Ontario
  • Lifestyle Enrichment for Senior Adults (LESA) - Ontario
  • Older Persons Unique Solutions (OPUS-55) - Ontario
  • St Joseph's Care Group - Ontario
  • Groupe Harmonie - Quebec
• 6. Key Considerations
  • 6.1 General Considerations
  • 6.2 Future Research Considerations
  • 6.3 Future Policy Considerations
• References