Abstract
BackgroundWhilst alcohol misuse is decreasing amongst younger adults in many countries, it is increasing in older adults. Residential rehabilitation (rehab) is a vital component of the alcohol treatment system, particularly for those with relatively complex needs and entrenched alcohol problems. In this study, we sought to find out to what extent rehabs in England have upper age limits that exclude older adults, whether rehabs are responsive to older adults’ age-related needs and how older adults experience these services.MethodThis is a mixed method study. A search was carried out of Public Health England’s online directory of rehabs to identify upper age thresholds. Semi-structured qualitative interviews were carried out with 16 individuals who had attended one of five residential rehabs in England and Wales since their 50th birthday. A researcher with experience of a later life alcohol problem conducted the interviews.ResultsOf the 118 services listed on Public Health England’s online directory of rehabs, 75% stated that they had an upper age limit that would exclude older adults. Perceived differences in values, attitudes and behaviour between younger and older residents had an impact on older residents’ experience of rehab. Activities organised by the rehabs were often based on physical activity that some older adults found it difficult to take part in and this could create a sense of isolation. Some older adults felt unsafe in rehab and were bullied, intimidated and subjected to ageist language and attitudes.ConclusionThis study identified direct and indirect age discrimination in rehabs contrary to the law. Further research is required to find out if age discrimination exists in rehabs in other countries. Rehabs should remove arbitrary age limits and ensure that they are responsive to the needs of older adults.
Highlights
Whilst alcohol misuse is decreasing amongst younger adults in many countries, it is increasing in older adults
Of the 118 services listed on Public Health England’s online directory of rehabs, 75% stated that they had an upper age limit that would exclude older adults
Upper age thresholds in residential rehabs and disabled access Of the 118 services listed on the Public Health England database for alcohol rehabs, excluding those for young people, three quarters (75%) stated that they had an upper age limit of anywhere between 50 and 90 years
Summary
Whilst alcohol misuse is decreasing amongst younger adults in many countries, it is increasing in older adults. In England, those aged 65–74 are the only age group where daily alcohol consumption is increasing [1, 2]. In Scotland, harmful, hazardous and binge drinking is increasing amongst those aged 65–74 but decreasing in other age groups [3]. In Wales, those aged 65 and over are the only age group where drinking above the daily guidelines is increasing [4]. For the first time in recent history, drinkers aged 55–64 in England and Scotland drink more and are more likely to exceed the recommended weekly guidelines than any other age group [1, 3]. Alcohol consumption is increasing in older adults in the United States [6] and other European countries [7]. The World Health Organisation has identified alcohol-related harm among older adults as an increasing concern [8]
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