Are older adults getting the alcohol support they need during COVID-19?

Remote support has helped older adults with drinking issues during the pandemic but face to face is still key

By Dr Paulina Trevena, Researcher, Glasgow Caledonian University

After the death of his wife and an early retirement, 60-year-old John began to drink more than usual. Two years later he noticed that he couldn’t get out of bed without having a drink. After going through a specialist detox program John now feels in a very good place in his recovery. But at the beginning of the COVID-19 outbreak he thought “this could be the biggest test yet that I’ve faced” and decided to pour all of the alcohol he kept for guests down the sink. Despite not having had a drink in eight years, he said “I was confident I wouldn’t be tempted but I didn’t know how I would pan out in a pandemic.”

John’s wariness around alcohol during the pandemic reflects a lived reality for many over 50s in the UK. A recent We Are With You opinion poll showed 51% of over 50s are drinking above healthy limits during lockdown. Nearly one in four could be classed as high risk or possibly dependent based on their drinking patterns.

This is alarming. The impact of alcohol on health becomes more serious as people age. Older people who drink at harmful levels are more likely to develop alcohol-related conditions, such as coronary heart disease, strokes, liver problems or certain types of cancer. They also tend to suffer more alcohol-related falls and accidents. They take more medication and mixing it with alcohol increases the risk of detrimental side-effects.

Older people are also more vulnerable to the wider effects of the pandemic. They tend to be more isolated and sometimes fall through the support net. For instance, some older people were too frightened to do their own shopping at the onset of lockdown. In extreme cases this resulted in malnutrition. Older adults also have more underlying health conditions and are at increased risk of harm from COVID-19 as compared to other age groups.

Our new qualitative study, which we conducted in partnership with the University of Bedfordshire, adds to the wider picture that has emerged around the impact of the pandemic. It explores how older adults with alcohol problems are coping with the pandemic and how they feel they’re supported under COVID-19.

We found alcohol support services across the UK, like most other health services, had to adapt quickly to the pandemic. Remote service provision, over the phone and online, became the norm. Unexpected benefits to remote support emerged but our report also highlighted the continued importance of face to face services for this age group.

Do older people use online support?

Following the announcement of a national lockdown in March, alcohol services moved their usual face-to-face support to phone or online support including one-to-one appointments and peer support meetings. Some services also offered online activities such as yoga, mindfulness, dance, or arts and crafts workshops.

However, despite the variety of support available online, we found this wasn’t commonly used by older people. Many were receiving support over the phone only and missed out on accessing peer support groups and other activities online. Older people often face various barriers to accessing online support. Many don’t have modern technology, don’t know how to use it, or don’t have internet access. For instance, one of the research participants used a 26-year-old mobile phone for communication. Another only had limited internet access via his phone.

For some older people, accessing support online was also difficult due to confidentiality concerns. One man who had become homeless during the pandemic was staying in a shelter, where he had no privacy.

Does phone support work for older people?

Older people generally appreciated receiving phone support during the pandemic, especially those who were striving to maintain abstinence or lower levels of drinking. Recipients felt their alcohol workers were highly approachable and “always there,” at the other end of the phone, when they needed them. They believed they might have relapsed otherwise.

However, support over the phone doesn’t work for everyone. Some older people who have memory, speech or hearing impediments, or serious mental health issues can’t communicate over the phone. For example, Alistair, an older man who had a severe speech impairment following a stroke, found communicating over the phone very difficult and using online support impossible. For people like Alistair, face-to-face support is irreplaceable.

Recovery workers also saw support over the phone as insufficient for people who drink heavily. They maintained an in-person intervention was essential in such cases.

Face-to-face contact for older people is key

Face-to-face contact is particularly important for older people for a number of reasons. It helps alleviate loneliness which is a frequent reason behind drinking in older age. It helps older people better understand alcohol interventions. It is absolutely crucial for those with memory, speech or hearing impairments, serious mental health issues, or drinking heavily.

At the end of the day, most of the people who participated in our research expressed a clear preference and need for face-to-face contact.

For the last 9 months the pandemic has affected almost every aspect of our lives and will continue to have big impacts on our lives for the foreseeable future.

There are benefits to remote support and telehealth, such as more flexible provision and increased capacity. However, our research clearly shows that these cannot substitute face-to-face support in the case of older adults. When considering future models for service provision, this is a crucial point to bear in mind.

Many older adults are struggling with loneliness and isolation under Covid-19. This is an especially difficult time for people in recovery from alcohol. To support older adults struggling with alcohol issues at this difficult time, We Are With You have launched a helpline for over 50s who are worried about their drinking as well as their friends and family. Call 0808 8010750 or visit the With You website for more information.