Aging & Disability; Considerations for AODA Counseling

By Mike Micoliczyk

LP#5

Age is more than a definition or measurement of time in chronological years. More accurately, age is a collection of life experiences. Many biases, misguided assumptions or stereotyping takes aging out of its proper context and places a devaluation on our understanding of its true context. I’ve certainly been affected by societal impressions which have had an influence on my interpretation and understanding. I, being a husband of 23 years now, navigating through the empty nest years with regressing physical capabilities and function that were once taken for granted as a young man. My attitudes and perceptions have unintentionally been altered from a limiting view to a greater understanding. Similarly, to aging, persons with disabilities have a common devaluation by society. Whether that disability is physical, psychiatric or intellectual, it is often hard to put an absolute clearly defined construct on a person with disability limitations. The Americans with Disabilities Act (ADA) encompasses many conditions with disability. By their definition ‘impairments can be temporary or permanent, reversible or irreversible, progressive or regressive, or serious or minor (Bickenbach, 1993). For example, even sustaining a broken leg or limiting sprain can amount to a temporary experience of disability. I’m going to explore some of the considerations that need to be taken into contemplation when addressing Aging or Disability related to Substance Abuse Treatment.

With relation to Aging, Ageism can refer to negative perceptions or behaviors towards an individual based on their age, which sometimes is unintentional and operates at an unconscious level. Compared to sexism or racism, ageism has received very limited verifiable observation in psychology or theoretical literature. Ageist attitudes, beliefs and behaviors are incredibly ingrained in our society which poses a problem to bring heightened awareness to breaking down barriers that are rather difficult. For example, many perceptions exist about the elderly being intellectually deficient, physically unsuitable for work, resist change, poor performers at work and waiting for retirement. These perceptions in general are inaccurate and unchallenged beliefs held by many in the mainstream. Additionally, contemporary U.S. society is focused heavily on maintaining youthful appearance. Women specifically are in conflict with their aging bodies. Media propagates such marketing angles to “dye hair”, “age defying lotions” “look younger creams” or “wrinkle removing” products. Whereas men are not as entwined in physical appearance but more focused on physical strength or athletic ability.

Most importantly ‘regarding counseling there are similar, yet different, life stages that can be kept in mind when counseling people of different ages. They are not rigid stages but are flexible guidelines for counseling people at different places along their life paths’ (Choudhuri, Santiago-Rivera, & Garrett, 2012). Aging lowers the body’s tolerance for alcohol. Alcohol can be a problem for older adults especially if they are taking medications with alcohol. Maybe grandma is drinking each night to help her get to sleep after grandpa has passed. Often times conditions related to drinking or substance abuse are mistaken for other conditions in the elderly. Like lack of balance. Or possibly that more pain medication is being taken to address pain management but now there is a dependency by grandpa to take greater amounts or more frequent dosages. Increased falling or fractures; Alcohol is a factor in 60 percent of falls (National Institute on Aging, 2017) Greater memory loss heightened by alcohol or drug use. More forgetfulness or confusion mistaken for Alzheimer’s. Additionally, some medical problems make it hard for doctors to treat or find because alcohol can cause changes in the heart and blood vessels. Also, alcohol may dull pain that could be a warning sign of a heart attack.

Deeply rooted beliefs about health, attractiveness, productivity, competence, and the value of human life create an environment where those with physical, mental, cognitive, or sensory disabilities are treated with discrimination (Choudhuri, Santiago-Rivera, & Garrett, 2012). Within culture today people with disabilities are perceived as damaged and have been historically marginalized or segregated from mainstream society. A great illustration given in our text which demonstrates an identity barrier that say a person in a wheel chair encounters; while they may not be expected to climb a flight of stairs, they then are also assumed to not be able to do anything else either. This lends itself smoothly into the definition of Ableism. Which is the ‘manifestation of oppression against individuals with physical, mental, or developmental disabilities that is characterized by the belief that these individuals need to be repaired or cannot serve as full members of society (Choudhuri, Santiago-Rivera, & Garrett, 2012). There were nearly 40 million Americans with a disability in 2015, representing 12.6% of the civilian non-institutionalized population (Bialik, 2017).

Some people with physical or cognitive disabilities may begin misusing substances to cope with chronic pain, social isolation, stigma related to their disabilities, or physical or sexual abuse or other trauma (SAMHSA, 2019). Often physical or cognitive disabilities are not always obvious. Statistically it has been proven that persons with limiting disabilities have a higher prevalence of Serious Mental Illness (SMI) as well as lower treatment rates compared to people without the same disabilities. Treatment for the disabled also has limiting instances that make treatment more difficult. For example, lack of materials for the blind, or larger print materials for the visually impaired. In addition, there may be lack of trained staff or technologies for communicating with people who are deaf. Another barrier noted is the overestimation of some centers that are unaware of the wide range of disabilities that exist and the means to accommodate them. ADA.gov is the sure source for information and materials on ADA accessibility requirements. Determining intellectual disability isn’t always detectable or easy to recognize. Often the clients won’t always know or say if they have cognitive problems. So, providing simplified handouts and forms is very assistive. Reminders of appointments or activity in the form of alarms, apps or tasks set up on smartphones is great use of the technology out there that can be incorporated. Creating a treatment environment that is welcoming and understanding of people with disabilities is one of the most important accessibility measures you can take.

References

Bialik, K. (Ed.). (2017, July 27). Pew Research Center. Retrieved from https://www.pewresearch.org/fact-tank/2017/07/27/7-facts-about-americans-with-disabilities/

Bickenbach, J. E. (1993). Physical disability and social policy. Toronto: University of Toronto Press.

Choudhuri, D. D., Santiago-Rivera, A., & Garrett, M. T. (2012). Counseling & Diversity. Brooks/Cole, Cengage Learning.

National Institute on Aging. (2017, May 16). Retrieved from https://www.nia.nih.gov/health/facts-about-aging-and-alcohol