“A frightening normality”: this is the characteristic that unites the pathological consumption of alcohol and gambling in the elderly segment of the population. A hidden phenomenon, underestimated (the Istituto Superiore di Sanità estimates that 2,700,000 elderly people are at risk for alcohol-related diseases and problems, about one in five elderly; in 2019, gambling burned 111 billion, almost the same amount as healthcare spending ), which devours entire families and is particularly complex to manage for services.
A Cisf-Order of Social Workers Lombardy training seminar
It was discussed yesterday – September 20 – in Milan during the training seminar Elderly, gambling and alcohol: the possible role of home and proximity services and operatorsthe result of a collaboration between the CISF-International Center for Family Studies and the Order of Social Workers of Lombardy.
“Alcohol and gambling have in common a wide presence and diffusion in people’s daily lives, just think of the bars with machines, the Scratch-and-Win in tobacconists, or the over-consumed glasses to alleviate loneliness, boredom , emotional suffering, ”he explained Beatrice Longonispecialist social worker who illustrated a unique research, carried out between 2020 and 2021, which focused on the phenomenon through the responses of over 2 thousand Lombard social workers (Gambling and alcohol in old age: thoughts and experiences of Lombard social workers).
The social acceptance linked to drinking and gambling, together with the effort that goes into recognizing when excess begins, and the social shame of families in admitting that there is a problem, causes the phenomenon to explode when the problems (economic, health, family and social relations) have already made a scorched earth around.
Late addictions, matured in solitude
«Imagine an elderly person who has worked all his life and who, suddenly, as a retiree, finds himself having an empty day all day. He approaches those bars and tobacconists that have rooms for the machines, and he begins to spend his time there. Little by little, unsuspected people, who in their life had never even experienced “traditional” gambling, such as casinos or horse racing, find themselves consuming the entire liquidation, or their life savings between machines and Scratch-and-Win, ”he explained a delegate from Gamblers Anonymous, present at the seminar along with members of Alcoholics Anonymous and ACAT Clubs. “The component of shame and suffering, in these cases, is very high. In our groups we welcome elderly people destroyed by pain, aggravated by the awareness that they no longer have much time in their lives to remedy the harm done to their children and their families ».
“Late” gamblers and drinkers (who begin to have pathological behaviors after 65 years of age) are a phenomenon that social workers are familiar with: after an absolutely “regular” life, retirement, widowhood, distant children , make the elderly extremely vulnerable. “Loneliness is the highest risk factor for these problematic behaviors,” explained Beatrice Longoni. In the case of alcohol, for example, it is necessary to take into account that the tolerance threshold becomes more unstable with the passing of the years, and the “low risk” remains limited to the consumption of a glass of wine a day.
What are the warning signs
«Among the warning signs of a situation of alcohol abuse we note the progressive neglect in one’s person and in the home; the presence of bottles on the shelves; swollen abdomen; red hands; walking problems. And then, the request to buy alcohol in the monthly shopping, the retirement money that runs out quickly and is not enough to make it to the end of the month, the nervousness if not the aggression when trying to tackle the issue “, he explains. Sara Pizzetti, professional educator and coordinator of social caretakers in Milan.
«Alcohol addiction, like gambling addiction, starts long ago. There are emotional and relational difficulties that the elderly have been able to control throughout their active life and which then, in the most delicate phase of retirement, emerge in all their strength. In a society linked to performance and productivity like ours, there is the fear of ‘no longer serving anyone’: we listen to many elderly people who live this drama, and we try to help them by making them feel part of the group, involving them in participation which is part of the change, ”explained the delegate of Alcoholics Anonymous, a reality that in Italy celebrates 50 years of presence and aid activities.
What to do?
How to respond to the phenomenon and become the bearers of interventions including prevention? The complexity of the problem, the social workers admitted, does not allow for univocal answers. Certainly it is necessary to proceed by implementing the training and strengthening the alliances between various realities (services for the elderly, Sert, self-help groups, but also general practitioners and hospitals). Then it is necessary to contribute to changing the culture, raising awareness and informing, for example, about health risks and the harm related to the consumption of alcohol and gambling. In terms of interventions in the area, it is important to enhance all the moments of aggregation of the elderly and positive use of time, supporting all the “healthy” meeting places alternative to those at risk (eg aggregation centers for the elderly, dedicated association offices, University of the Third Age), to maintain high attention, at a community level, with respect to risk situations that can be intercepted early.
Three open challenges
“The theme we have addressed in this seminar is innovative and challenging, for three main reasons,” he explains Francesco Belletti, director of the Cisf. “The challenge of integration within the services and within the networks (elderly and addictions, services, care workers and family and neighborhood relationships), but also in all short, primary relationships, first of all family, then friends, neighborhood, etc., which they are (or can be, adequately stimulated). In particular, intergenerationality seems important to us, as a dimension in which it is necessary to think of the elderly condition as redefined within the intertwining between generations, not only within family networks, but also at the community level “.
Belletti then remembers the challenge of early taking charge and the challenge of promoting the subject“A challenge of extreme complexity, this, both for the family and for social services and more generally for the welfare of aid at the micro-social level, and which seems to me to also have ethical and deontological implications: the difficulty of adopting a process of promoting the autonomy and dignity of the subject and his freedom when the subject’s freedom seems to be the engine of his own dependence (we can speak of empowerment, promotion of people’s resilience, promotion of capabilities or residual skills) “.