Deck 14: Alcohol and Drug Misuse and Abuse in Late Life

Question 1

What specialized screening tools are available to assess elderly clients? Which would you use, and why? Summarize some best practices for treating older alcohol abusers.

Answer 1

Not Answer

Question 2

Early-onset AUD is also known as AUD.

A) Type I
B) Type II
C) Type III
D) ICD-10

Answer 2

Type I

Question 3

You need to perform an assessment on an elderly client. You want to use a tool that provides the greatest sensitivity. What would you use?

A) MAST
B) MAST-G
C) SMAST-G
D) Cyr-Wartman

Answer 3

MAST

Question 4

A 74-year older woman fell and was taken to the emergency room. You need to assess her for an alcohol use disorder. You find out her husband of 40 years died two months ago, and she started drinking. She is up to three or four drinks per day. She is also taking pain medication for arthritis. What do you recommend?

A) She clearly has a Type II AUD and needs treatment.
B) She has a Type I AUD and needs to enter treatment.
C) She is at risk for a Type I AUD and for adverse side effects from her medication; she needs education on AUDs and alcohol-drug interactions.
D) She is at high risk for a Type II AUD, probably due to depression; she needs education on AUDs and alcohol-drug interactions.

Question 5

One problem with using traditional screening tools for elderly clients is that .

A) older clients are typically more forthcoming than younger patients about their substance use, so the tools are not as necessary
B) memory loss in some older patients may skew self-reporting responses
C) they were designed for patients of all ages, but they are not as accurate in older populations
D) they do not apply to clients using prescription drugs, and elderly clients use these drugs more often than younger clients and exactly as prescribed

Question 6

You are a health care professional examining an elderly patient. He is currently taking medication for hypertension, arthritis, and hypercholesterolemia. The man is in the same physical condition as last time and seems to just need refills for his prescriptions; however, you smell alcohol on his breath. What do you do?

A) Refer him to a chemical dependency professional for an assessment.
B) Write the prescriptions for the refills and see your next patient.
C) Ask him about any changes in his use of alcohol since his last visit.
D) Give him a breath analyzer test.

Question 7

What are the American Geriatric Society's AGS) clinical guidelines for AUD in older adults? What cautions does the AGS recommend regarding drinking and regarding diagnosis using DSM-IV criteria?

Question 8

What are the five overlapping items that Graham indicated should be included in screening for alcohol abuse in elders? What neuropsychological tests should be administered as part of a screening?

Question 9

You are assessing a 60-year-old man who has been a habitual marijuana smoker since he was a teenager. He indicates during an assessment that for several years, he has been drinking alcohol about once a month, usually more than seven drinks. How would you best describe his substance use?

A) He uses marijuana and abuses alcohol.
B) He abuses marijuana and misuses alcohol.
C) Due to his age and marijuana abuse, he could be incorrect in self reporting, but he probably has an AUD.
D) Due to his age and marijuana use, he could be incorrect in self reporting. He might be at a higher risk for a Type II AUD than is obvious.

Question 10

An elderly man who lives with his adult son was diagnosed a year ago with early-stage Alzheimer's disease. The physician never discussed alcohol. The man gets angry when the son discusses his condition, and he drinks. The father drank all his life, but neither man considered it a problem. What does this information suggest?

A) The man has a co-occurrence of Alzheimer's disease and alcoholism.
B) The man very likely has an AUD and alcohol-related dementia.
C) The man is at risk for an AUD but probably does not have one.
D) The son is in denial about his father's alcoholism.

Question 11

A nursing home facility hosts a weekly cocktail hour. You are a social worker on staff. At the last few parties, you notice a 69 year old woman who appears to be inebriated but has only one or two drinks. In a short discussion with her, she says she enjoys parties and social drinking among friends. What does the situation suggest?

A) She must be drinking before the cocktail hour starts.
B) She probably has been prescribed new or different medication that interacts with the alcohol.
C) She is probably depressed, drinking more on her own time, and building a tolerance to alcohol.
D) You need to perform a detailed assessment to determine the cause of the inebriation.

Question 12

You are in charge of an outreach program for health care professionals on AUDs in the elderly. What is the most important issue to cover?

A) Statistics on AUDs in the elderly
B) Strategies for helping to detect an AUD in elderly patients
C) Strategies for discouraging alcohol use in elderly patients
D) How to lead discussions with elderly patients about depression and suicide

Question 13

The American Geriatric Society suggests AUD exists in elderly clients who .

A) binge drink once per year
B) drink more than one drink per day
C) drink more than two drinks per day
D) drink more than three drinks per day

Question 14

Which statement does not reflect a diagnosis of alcohol dependence?

A) A strong desire or compulsion to drink
B) Persistence of use despite clear evidence of harmful consequences
C) Evidence of alcohol intolerance due to the effects of aging
D) Evidence of alcohol tolerance

Question 15

What are Type I and Type II AUDs? Describe trends in alcohol consumption as people age. Consider gender.

Question 16

You are in charge of an outreach program for health care professionals on prescription drug misuse in the elderly. What is the most important issue to cover?

A) The difference between misuse and abuse
B) How physician-initiated misuse can be avoided
C) How and what drugs to prescribe considering the physiological and psychosocial aspects of aging
D) How and what drugs to prescribe considering alcohol-drug interactions

Question 17

What are the six diagnostic criteria of alcohol dependence as described by Wetterling et al? How many must be met for a positive diagnosis? Explain how these criteria might be affected by the type of AUD.

Question 18

You are assessing a 63 year old man who has smoked marijuana almost daily for 40 years. Throughout his life, he has been drinking alcohol once or twice a month, usually more than five drinks. He says he uses alcohol and marijuana but does not have a substance use problem. What might you recommend?

A) A physical health examination
B) AUD awareness education
C) A physical health examination and awareness education on alcohol and marijuana
D) A physical health examination, awareness education on alcohol and marijuana, and discussions about treatment for his substance use disorders

Question 19

An 80 year old woman has been drinking one alcoholic beverage every day for the last thirty years. She ensures she never drinks more, but she always has one. Why?

A) She has alcoholism, because she drinks every day.
B) She has a Type I AUD and needs help abstaining.
C) She is trying to lower her risk for ischemic stroke, cardiovascular disease, and heart failure.
D) She is trying to receive the benefits of research showing that one drink per day for women is beneficial for cognitive performance.