title: Alcohol Use in an Older Adult Referred to a Consultation-Liaison Psychiatry Service: A Case Report.
abstract: Alcohol use disorder in older adults is associated with a number of substantial medical complications, including cognitive decline. Due to limited success and application of screening approaches in this cohort, older adults are more likely to present to general hospital settings with undiagnosed problematic alcohol use. Consultation-liaison psychiatry services operating in general hospital settings are likely to be referred older adults with alcohol use disorders for assessment and management. A 77-year-old female presented to a metropolitan hospital with symptoms including frequent falls, slurred speech, difficulty judging distance, hypersomnia, poor reasoning, and odd behaviours. She also presented with severe anxiety and bruxism. Several diagnostic tests were inconclusive, and a consultation-liaison psychiatry assessment revealed a prominent heavy drinking pattern and concurrent abuse of oxycodone and benzodiazepines. This report adds further support to the case for uniform screening of all older adults for alcohol and other drug (AOD) use. A number of weeks had passed before the patient's drinking pattern was established, with no withdrawal management in place. A multifaceted treatment approach, including antidepressant therapy, anticraving medication, benzodiazepine as well as opiate rationalisation, and AOD counselling support was commenced prior to discharge from the general hospital.
authors.affiliation: a Alfred Health, Prahran, Victoria, Australia/RMIT University School of Health and Biomedical Sciences (Nursing) , Bundoora , Victoria , Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: Searby
authors.affiliation: b Alfred Health , Prahran , Victoria , Australia.
authors.forename: Natalie
authors.initials: N
authors.lastname: van Swet
authors.affiliation: c Alfred Health, Prahran, Victoria, Australia/RMIT University School of Health and Biomedical Sciences (Nursing), Bundoora, Victoria, Australia; University of Tasmania, School of Health Sciences (Nursing) , Hobart , Tasmania , Australia.
authors.forename: Phil
authors.initials: P
authors.lastname: Maude
authors.affiliation: d RMIT University School of Health and Biomedical Sciences (Nursing) , Bundoora , Victoria , Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: McGrath
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D012017:Referral and Consultation; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy