NICHE steering committee members and volunteers include, from left, Carnette Smith, RN; Enid Topchik, volunteer; Bonita OConnor, education department secretary; Pat Mansfield, RN, clinical educator; JoAnn Valent, RN, wound care specialist; Constance Sullivan, RN, lead qualty coordinator, quality management; Tisha McTigue, RN; and Joan Beloff, community outreach director and interim director of the Chilton Hospital Foundation.
Chilton Hospital in Pompton Plains, N.J., hosted the eighth annual Nurses Improving Care for Healthsystem Elders conference in October at Cedar Crest Senior Living. In addition to discussions on palliative care and hospice, the importance of turning and polypharmacy, this years program included segments on how to recognize and care for the growing number of older patients who misuse alcohol and drugs.
According to NICHE steering committee members Tisha McTigue, RNC-OB, MS, APN, manager, education; and Constance Sullivan, RN, BA, lead coordinator, quality assessment, alcohol and substance abuse was a topic suggested on an attendees evaluation from last years conference.
“We often refer to the previous years evaluations for topics,” Sullivan said, noting this particular problem can easily go undetected, so it was a good choice for the conference.
“The elderly metabolize differently, so they may not even realize theres a problem,” McTigue said.
Seventeen percent of the 35 million people in the U.S. age 65 and older are affected by alcohol and substance abuse, said Elizabeth Micich-Otero, RN-BC, MSN, clinical educator, mental health and long-term division, clinical education department at Christian Health Care Center in Wyckoff, N.J., a presenter at the conference.
“Alcohol and substance abuse are among the fastest-growing problems among the elderly,” she said. “Its not really talked about because of the stigma associated with it.”
Because these patients are elderly, their symptoms often are mistaken for psychiatric or anxiety disorders, Micich-Otero said. Family members also may be unaware of the abuse, especially if a loved one already is receiving mental health services. Family members also may excuse the behavior because they dont want to deal with the consequences of interfering.
“Family members arent always able to identify the signs and symptoms of alcohol and substance abuse, or they may not want to confront the person for fear of rocking the boat,” she said.
The elderly are the largest consumers of prescription drugs in the country, said Micich-Otero, and nonmedical use of these drugs by those ages 50 and older is expected to increase by 2.7 million people by 2020.
“We see a lot of patients who present with anxiety and comorbidities of substance abuse, especially opioid abuse,” she said.
Illegal drug use also is being recognized in this population, as measures are put in play to prevent polypharmacy.
“Its not a huge problem yet, but its out there,” Micich-Otero said. “Its just not as well-documented as substance and alcohol abuse.”
Chilton recognizes the importance of their nurses being well-versed in elder care and has been a NICHE hospital since 2005, said Vice President and CNO Joanne Reich, RN, MA, NE-A, BC. The steering committee already is busy planning next years conference, which will include topics on evidence-based care.
“The value in evidence-based practice is sharing it with not only our colleagues at Chilton, but also those in home care, at Cedar Crest, etc.” Reich said. •
@Bio end:Tracey Boyd is a regional reporter.Photo by Tracey Boyd
From left, Passaic County Technical Institute students Lisbette Saladin, Ghia Jackson, Jennifer Capo and Ilsa Alamo were among the 27 students who attended the NICHE conference.