Alcohol abuse by older family members: A family systems analysis of assessment and intervention

The Substance Abuse and Mental Health Services Administration (SAMHSA) describes alcohol related problems with older adults as "underestimated, underidentified, underdiagnosed, and undertreated" (SAMHSA, 2004, p. 1) and describes the phenomenon as an "invisible epidemic" (SAMHSA, 2004, p. 1). The purpose of this review is to address the prevalence and consequences of alcohol abuse in the older adult population by emphasizing the heterogeneity of factors contributing to, and providing a context for, the understanding of alcohol abuse in aging families. Issues surrounding the sensitivity and specificity of assessment of older adult alcohol abusers are covered. Strategies for intervention at both an individual and family level are also included. Although much of the literature available on older adult alcohol use and misuse addresses the consequences, assessment, and intervention from an individualized perspective, this review concludes that a family-oriented approach to intervention may best serve the needs of older alcohol abusers and their support network of family and friends.