Down and in? – reducing social isolation in older people with alcohol misuse

Dr Tony RaoSouth London & Maudsley NHS Foundation Trust

Older people drinking above UK Older people drinking above UK ‘sensible limits’‘sensible limits’

19901990 1998 1998 20062006

% of men 14 16% of men 14 16 22 22

% of women 5 7 11% of women 5 7 11

((Office of National Statistics)Office of National Statistics)

20032003 5%5%

Patients on caseload drinking > 14/21 units per Patients on caseload drinking > 14/21 units per weekweek

20082008 10%10%

• Homelessness (Crane 1996)

• Recent bereavement (Byrne et al 1999)

• Depression (Copeland et al 1999)

• Social isolation (Hanson et al 1994)

HIGH RISK GROUPS

• Past harmful/hazardous drinking (Welte & Mirand 1992)

• Retirement (Carstenson et al 1985)

• Immobility (Fink et al 1996)

Older people with alcohol misuse:Older people with alcohol misuse:

‘..not the sort of people that are causing problems in the middle of the night or beating people up but are quietly vegetating and [their] problems are not being addressed’

‘Community initiatives to reduce isolation in older people and develop social networks should be prioritised..a cross-cutting theme is the importance of social support’

‘...the most complex, vulnerable, resource poor and high risk long term service users’ in society today’

Older Adults Support in Southwark (OASIS)- a specialist home care service

CostsCosts

Hospital bed = £2,660 per weekHospital bed = £2,660 per week Long term care bed = £380-500 Long term care bed = £380-500

per weekper week OASIS average cost per week = OASIS average cost per week =

£260£260

The OASIS Partnership

OASIS PhilosophyOASIS Philosophy

The OASIS Service takes a person-The OASIS Service takes a person-centred care approach, working centred care approach, working withwith people, not doing people, not doing for for them.them.

It focuses on intensive community It focuses on intensive community intervention, usually of up to 6 intervention, usually of up to 6 weeks but sometimes longerweeks but sometimes longer

Enabling service based on a Enabling service based on a recovery modelrecovery model

The OASIS Partnership