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

5. Inventory of Specialized Programs

The objective of the inventory is to describe programs and specialized services presently available to seniors with substance use problems. There are approximately 180 mainstream programs in Canada that offer services to the general adult population, including seniors. These are listed in a database of treatment services, searchable through the Canadian Centre on Substance Abuse (CCSA) website (www.ccsa.ca).

The programs outlined in this document focus on programs solely for seniors with substance use problems. The names of senior specific programs were obtained through 1) the review of literature 2) the ADTR Working Group 3) the key experts and 4) the CCSA website.

Key personnel in each program were contacted and asked to provide a profile by completing a survey questionnaire that focussed on:

• organization coordinates;
• treatment orientation;
• geographic area served;
• referral sources;
• criteria for service (inclusion and exclusion);
• profile of clients served;
• treatment interventions;
• associated program supports;
• staff membership;
• staff training;
• key resources;
• other services referred to;
• key partnerships;
• cost to run program (approximate);
• ongoing monitoring or evaluation activities; and
• reports or evaluation.

The organizations approved their completed profile for publication in this document. This inventory of programs, listed by province from west to east, includes:

British Columbia:

• Elderly Services Program
• Seniors Liaison Program
• Seniors' Substance Awareness Program
• Seniors Well Aware Program (SWAP)
• Victoria Innovative Seniors' Treatment and Assessment Program (VISTA)

Alberta:

• Substance Abuse in Later Life (SAILL)

Manitoba:

• Substance Use Management, Intervention and Treatment (SUMIT)

Ontario:

• Community Outreach Program in Addictions - (COPA)
• Lifestyle Enrichment for Senior Adults (LESA)
• Older Persons Unique Solutions (OPUS-55)
• St Joseph's Care Group

Quebec

• Groupe Harmonie

Program Name: Elderly Services Program

Address:
Mental Health Centre
1444 Edmonton Street
Prince George, Bristish Columbia V2M 6W5

Phone:
(250) 565-7408

Fax:
(250) 565-7416

Contact Person:
Louise Holland

Organization:
Government

Treatment Orientation:
Outreach, holistic, client-centred, harm reduction approach that does not
focus on demanding abstinence.

Geographic Area Served:
Clinical services to Prince George, consultation and education to greater
regions.

Referral Sources:
General practitioners, continuing care, detoxification facility.

Inclusion Criteria for Service:
Age 55 and over with a substance use problem.

Exclusion Criteria for Service:
Age 54 and under, or someone with severe dementia.

Profile of Clients Served:
Average age: in their 70's
Predominant substance(s): alcohol, prescription drugs.
Gender ratio: M/F 80/20

Treatment Interventions:
Case management
Multidisciplinary case conferencing
Assessment (In facility and via outreach)
Individual therapy (Via outreach)
Education (In facility and via outreach)
Aftercare/maintenance: contact client at intervals

Associated Program Supports:

Supportive housing
Medical care
Residential care
Other: As part of supportive housing, clients are provided with financial management, transportation for grocery shopping, medication prompting, medical care, a meal program, and recreation. Supportive housing has a program fee that covers rent, food and miscellaneous costs.

Number of Full Time Equivalent Staff: 0.5

Social worker/outreach worker: 0.5

Background or Experience of Specialist for Seniors with Substance Use Problems:

The worker has trained with Victoria Innovative Seniors' Treatment and Assessment Program and has experience in gerontology.

Training Opportunities for Staff:

Peer education
Informal or on-the-job training

Consultation with outside experts
Specific training areas: e.g., adult guardianship law
Other: Supportive housing staff are trained in areas of gerontology, alcohol use, how aging affects metabolism, harm reduction approach, and working without labels.

Key Resources:

"Alternatives: Prevention and Intervention for Alcohol and Drug Problems in Seniors" developed by Community Outreach Program in Addictions and Lifestyle Enrichment for Senior Adults - A handbook called "Choosing to Change".

Other Services Referred to:

Long-term care services, seniors housing, public trustee, emergency shelter, Ministry of Human Resources (Income Assistance).

Key Partnerships:

Older Persons and Alcohol List (OPAAL) network, Elderly Services Program, mental health, physicians, long term care facilities.

Approximate Cost to Run Program:

Not specified

Ongoing Monitoring or Evaluation Activities:

Not specified

Reports or Evaluations:

Not specified

Program Name: Seniors Liaison Program

Address:

Abbotsford Community Services
2420 Montrose Avenue

Abbotsford, British Columbia V2S 3S9

Phone:

(604) 870-3762

Fax:

(604) 859-6334

Contact Person:

Sharon Elliott

Organization:

Non-profit

Web Site: www.abbotsfordcommunityservices.com

Treatment Orientation:

To provide services in the community to seniors who have problems arising from alcohol or drugs, (especially prescription drugs) and the combination of the two.

To be actively involved in the development and delivery of alcohol and drug education and early intervention.

Geographic Area Served:

City of Abbotsford and outlying regions

Referral Sources: Continuing care, mental health, hospital acute care, psychiatric wards, home support, family, friends, and relatives.

Inclusion Criteria for Service: Age 55 and over with substance use problems, or co-dependence of someone with substance use problems or family concerned about a parent with substance use problems.

Exclusion Criteria for Service: Age 54 and under

Profile of Clients Served:

Average age: in their 70's

Predominant substance(s): primarily alcohol, also prescription drugs

Gender ratio: M/F 60/40

Treatment Interventions:
Case management
Multidisciplinary case conferencing
Assessment (In facility and via outreach)
Individual therapy (In facility and via outreach)
Family therapy (In facility)
Education (Via outreach)
Aftercare/maintenance: contact client at intervals
Consultation with physician about prescriptions for client.

Associated Program Supports:
The following are accessible: Meals on Wheels, caregiver support
program, peer counselling, dining program.

Number of Full Time Equivalent Staff: 0.7
Management: 0.1
Clinician/therapist: 0.6

Background or Experience of Specialist for Seniors with Substance Use Problems:

Substance use counselling certificate (one-year program).

Training Opportunities for Staff:

Consultation with outside experts

Key Resources:

None specified

Other Services Referred to:

Continuing care, mental health, hospital acute care, psychiatric wards, home support, family, friends, and relatives.

Key Partnerships:

Sponsors: Ministry of Health Services, Fraser Health Authority.

Community partners: continuing care, case managers, mental health, acute care (Enhanced Care Team), Meals on Wheels, "Lunch with the Bunch" dining program, Abbotsford Peer Counselling and Friendly Visitor Program.

Approximate Cost to Run Program:
$48 000

Ongoing Monitoring or Evaluation Activities:

Statistical information and a statement of activities.

Reports or Evaluations:

None available

Program Name: Seniors' Substance Awareness Program

Address:

104 - 1790 152^nd Street
Surrey, British Columbia V4A 4N3

Phone:

(604) 535-4526

Fax:

(604) 535-4545

Contact Person:

Marj Nelson

Organisation:

Non-profit

Treatment Orientation:

To achieve a healthier society by reducing the misuse of alcohol/drugs and the effects of addictions. This includes playing a role in primary, secondary and tertiary prevention and, where appropriate, this also includes harm reduction.

Geographic Area Served:

South Fraser Health Region

Referral Sources:

Hospitals, physicians (indirectly), families, social workers, mental health, self-referrals, other alcohol and drug treatment programs, detox, nursing homes, friends.

Inclusion Criteria for Service:

Age 55 and over with a substance use problem, and/or family members, friends, and/or individuals, regardless of age, who are concerned about a senior who may have an alcohol/drug problem. The program will accept clients below age 55, depending on their circumstances.

Exclusion Criteria for Service:
No criteria

Profile of Clients Served:
Average age: age 55-65
Predominant substance(s): alcohol, and infrequently, prescription
drugs
Gender ratio: M/F 40/60 (currently, this does change)

Treatment Interventions:
Case management
Multidisciplinary case conferencing
Assessment (In facility and via outreach)
Individual therapy (In facility and via outreach)
Family therapy (In facility and via outreach)
Education (In facility and via outreach)
Support groups - clinician facilitated
Aftercare/maintenance: contact client at intervals.

Associated Program Supports:

The system of care is linked to Alcohol and Drug Services B.C., which includes out-patient and outreach, treatment facilities, and supportive recovery.

Number of Full Time Equivalent Staff: 0.6
Management: 0.1
Clinician/therapist: 0.5

Background or Experience of Specialist for Seniors with Substance Use Problems:

RN, Masters (Psychology); Alcohol and Drug Services Clinical Practice; Addiction Counselling Training.

Training Opportunities for Staff:

Seminars/video conference
Informal or on-the-job training
Specific training areas: examples: alcohol and the family, seniors and the law.

Key Resources:

Provincial Alcohol and Drug Services: Standards and Policy Manual.

Other Services Referred to:

Detoxification, other alcohol and drug treatment programs, Alcoholics Anonymous, Al-Anon, mental health.

Key Partnerships:

Hospitals, Surrey Mental Health, Langley Family Services, Maple Cottage Detox, Alcohol and Drug Services B.C., Peace Arch Community Services - Addiction Services.

Approximate Cost to Run Program:
$45 000

Ongoing Monitoring or Evaluation Activities:

Follow-up by phone or by a personal meeting

Reports or Evaluations:

None available