Transcript Substance Abuse Among Older Adults

A PREVENTION PROGRAM ADDRESSING
MEDICATION ABUSE AND MISUSE IN OLDER
ADULTS: A GRANT PROPOSAL
By
Arwen Cho
California State University at Long Beach
May 2012
Introduction
 The use of prescription medications and over-the-counter
drugs by older adults can increase their risk for adverse health
effects and potentially even death.
 There are two main areas of risk for older adults regarding the
use of prescription medications; accidental misuse of
prescription medications and over-the-counter drugs (Rolita &
Freedman, 2008) and the abuse of psychoactive substances
originally prescribed to manage pain or other mental health
conditions (Simoni-Wastila & Yang, 2006).
 Given the prevalence of use and potential for abuse, the
purpose of this project was to prepare a grant proposal to seek
funding for an educational outreach program within the city of
Whittier, California for the prevention of prescription
medication misuse and abuse among older adults.
Social Work Relevance
 The risk for older adults to accidentally misuse prescription
medications and over-the-counter drugs and the potential for the
abuse of psychoactive substances originally prescribed to manage
pain or other mental health conditions is clear (Rolita & Freedman,
2008; Simoni-Wastila & Yang, 2006).
 Older adults have been marginalized from receiving the attention
they require to age successfully and (Blow, 1998).
 There exists a need for social workers and healthcare providers to be
culturally competent in addressing the geriatric and ethnic needs of
this population to develop best practices that support optimum
access of the resources that are available to them in order to adhere
to the ethics set forth by the field of social work.
Cross-cultural Relevance
 According to the Administration on Aging (2005), the older adult
Latino population will grow 254% from the year 2004 to 2030.
 Studies focused on the impact of ethnicity on issues of polypharmacy and psychoactive drug abuse show that the Latino
population follows the national trends of non-Hispanic Whites
(Espino et al., 2006; Loya, González-Stuart & Rivera, 2009; Ojeda
& McGuire, 2006).
 However, Latino populations have been found to access healthcare
and mental health related services for problems including polypharmacy and substance abuse at lower rates; Latinos access mental
healthcare resources at one third the rate of their non-Hispanic
White counterparts (Sorkin, Pham, & Quyen, 2009).
Methods
 Target Population: 19,000 adults over the age of 55 living in the city of
Whittier, which account for approximately 22% of the total population.
The program will also be open to individuals from the surrounding
communities of Pico Rivera, Santa Fe Springs, Downey, Norwalk,
Hacienda Heights, Rowland Heights, and La Mirada.
 Strategies Used to Identify Funding Source: The process of identifying
funding support for the proposed program included a comprehensive search
utilizing national, state and local resources. The resource librarian was
consulted at California State University, Long Beach and the services of the
library at the Long Beach Nonprofit Partnership were also utilized. The
World Wide Web was accessed using the search engines Google and Yahoo
to search websites that act as clearinghouses for public and private funding
sources.
Methods (continued)
 Projected Budget Range: The estimated budget and amount of
funding requested for the proposed program and subsequent
evaluation is $64,814.00. The funding will include salaries, direct
and in-direct program costs and will support facilitation,
administration and evaluation of both components of the SafeMeds
program.
 Funding Source: The California Wellness Foundation was chosen
due to its specific call for grant applications to promote healthy
aging in the capacity of preventive services that include in-home
services and specifically state that they are focused on providing
funds to be used for core operating support which align well with
the proposed program design and needs of this grant proposal.
Grant Proposal
 Program Summary and Description: The primary focus of this project is
to educate and empower older adult members living within and in the
surrounding communities of the city of Whittier to safely manage their use
of prescription and over-the-counter medications. The SafeMeds program
will (1) provide an interactive educational experience to increase awareness
and practice of medication safety, and (2) will provide in-home assessment
and follow-up care for members of the community at higher risk for
complications with medication use and abuse.
 Population Served: The SafeMeds program will be administrated by the
Whittier Senior Center which is an arm of the Community Services branch
of the City of Whittier. The target population for this funding request is
adults over the age of 55 living within and in the surrounding communities
of the city of Whittier, California.
Grant Proposal (continued)
 Program Goals: The SafeMeds program will (1) provide an interactive
educational experience to increase awareness and practice of medication
safety, and (2) will provide in-home assessment and follow-up care for
members of the community at higher risk for complications with
medication use and abuse.
 Program Evaluation: Evaluation of the SafeMeds program will include
evaluation of attendance records of interactive educational experiences,
records of referrals and completed assessments for the In-Home Medication
Safety Assessment component will be maintained, Surveys of each
participants’ (Interactive Educational Presentations and/or In-Home
Medication Safety Assessment) experience of Adverse Drug Effects
(ADEs) will be tracked from their initial response to the survey with a
follow up survey 3 months later to determine the rate of post-intervention
ADE occurrence.
Implications for Social Work
 In the field of social work and especially in an economic downturn, it becomes apparent
that the already competitive field of grant writing will become even more so. When cuts
are made, a vital asset to an agency is a professional who can ferret out resources,
including grants. Social workers appear to be ideal candidates for the task in that the
training of accredited schools requires a broad knowledge base and cultural competency
and this aligns with what most foundations state that they are looking for in programs.
 A social worker who can assess what would benefit the community through a
comprehensive needs assessment, who can complete an exhaustive and thorough
literature review and then design a program to meet those needs will not only be in
demand for their skills but will be able to impact their community, upholding the ethics
and professionalism of the field of social work.
 Traditional public service announcements or informational seminars do not have the
depth or reach necessary to impact this often isolated population. Innovative techniques
must be used to engage, educate and motivate an older adult to receive the help they may
need in the environment they are most comfortable (Benza et al., 2010). The SafeMeds
program has the potential to effectively impact older adults in the community of Whittier
and potentially any community it is implemented. The academic and professional
standards of the social work profession as applied to the grant writing process will ensure
its’ success.
References
Administration on Aging. (2005). A profile of older Americans: 2005. Department of Health and Human Services.
Washington, DC: U.S. Government Printing Office.
Benza, A., Calvert, S., & McQuown, C. (2010). Prevention BINGO: Reducing medication and alcohol use risks for older
adults. Aging & Mental Health, 14(8), 1008-1014.
Blow, F. (1998). Substance Abuse Among Older Adults (Treatment Improvement Protocol (TIP) Series, No. 26 ed.).
Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Substance Abuse and
Mental Health Services Administration, Center for Substance Abuse Treatment.
Espino, D. V., Bazaldua, O. V., Palmer, R. F., Mouton, C. P., Parchman, M. L., Miles, T. P., & Markides, K. (2006).
Suboptimal medication use and mortality in an older adult community-based cohort: Results from the hispanic
EPESE study. Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 61A(2), 170-175.
Loya, A. M., González-Stuart, A., & Rivera, J. O. (2009). Prevalence of polypharmacy, polyherbacy, nutritional
supplement use and potential product interactions among older adults living on the United States-Mexico border: A
descriptive, questionnaire-based study. Drugs & Aging, 26(5), 423-436.
Ojeda, V. D., & McGuire, T. G. (2006). Gender and racial/ethnic differences in use of outpatient mental health and
substance use services by depressed adults. Psychiatric Quarterly, 77(3), 211-222.
Rolita, L., & Freedman, M. (2008). Over-the-counter medication use in older adults. Journal of Gerontological Nursing,
34(4), 8-17.
Simoni-Wastila, L., & Yang, H. (2006). Psychoactive drug abuse in older adults. American Journal of Geriatric
Pharmacotherapy (AJGP), 4(4), 380-394.
Sorkin, D. H., Pham, E., & Quyen, N. (2009). Racial and ethnic differences in the mental health needs and access to care
of older adults in California. Journal of the American Geriatrics Society, 57(12), 2311-2317.