Reprinted from "Stigma & Discrimination" issue of Visions Journal, 2005, 2 (6), p. 14-15
Seeking Solutions: Canadian Community Action on Seniors and Alcohol Issues, a national project funded by Health Canada (20002003), examined promising practices emerging in prevention and treatment. As part of this project, seniors and service providers from across Canada shared their personal experiences of stigmatization associated with drinking problems. Here are a few excerpts from the report
Imagine a place where you were unable to let anyone know about the personal struggles and fears you faced in daily life. Imagine taking the risk of being shunned by your few remaining friends if you dare to let them know about your condition.
Consider the frustration of being told that you aren’t allowed to receive help in your apartment from special community services so that you could handle your condition better, and yet being told if things don’t change, you will have to move.
Imagine being reluctant to talk openly with your doctor about your condition, and your doctor being afraid to ask you. Or imagine knowing if that you did disclose, that you would be given a label that coloured the way people saw you and everything you did. If you ended up in hospital, you might be arbitrarily denied access to emergency care, treated as a ‘bed blocker.’ The pain you experienced from a broken arm might not be treated. Ageism and stigmatization can be a fatal combination.
These are a few of the real effects of misconceptions, stereotypes and stigmatization for an estimated 21,900 older seniors in British Columbia—and more than a quarter million seniors in Canada—who experience alcohol use or prescription drug problems. Alcohol use problems affect between 6% and 10% of seniors who drink, a rate on par with other age groups. However, the issue often remains hidden until a health care, housing or service delivery crisis develops. And, because substance abuse is largely invisible, the appropriate community resources to help are often lacking.
Stigma and its effects
Ancient Greeks used the word stigma to refer to body marks that identiﬁed people others should avoid. Academics describe stigma as having ‘master status,’ meaning it eclipses all other aspects of the person, including their strengths, talents and abilities.
Seniors point out that stigmatization makes it unsafe for them to acknowledge personal alcohol or prescription drug abuse concerns. They are fearful of being judged by others, particularly by their peers. While having an alcohol or prescription drug problem is painful and isolating, stigma reinforces that pain and isolation many times over.
Even language com- monly used by the public and service providers (like alcoholic or addict) is often highly stigmatizing. It often conjures up images of those who are ‘down-andout,’ or who lie, manipulate and fail to live up to their responsibilities.
Stereotyping overlooks the diverse circumstances in which alcohol and drug use problems may develop. Older women may feel more social pressure and stigmatization than older men do. It’s somewhat acceptable for men to drink to excess, but not for women, and certainly not older women. “You are supposed to be little ladies, prim and proper,” shared one study participant. Another said, “I remember my father saying to his ﬁve daughters, ‘I don’t care how much you drink, just don’t show it.’"
Hope for the future
Seniors point out that during the past 40 years many social and health issues that used to be highly stigmatized have lost their shaming effect. One example was cancer: “In earlier generations, people did not mention the ‘C’ word.” Another participant shared: “Family matters such as divorce or out-of-wedlock pregnancy were once considered shocking.” And children with developmental disabilities used to be hidden or institutionalized, “but that changed a lot with the Kennedy’s daughter [Rosemary] in the 1960s.” Seniors note that attitudes and beliefs have improved signiﬁcantly through public education and awareness. Active efforts to normalize these issues, as well as changes in legal systems and social structures along with positive role models, have helped to open up discussion and break down stereotypes. Older adults ask you to imagine a similar positive future for people experiencing alcohol use problems—and to help make it happen.
About the Author
Charmaine has worked at the Gerontology Research Centre at Simon Fraser University since 1991. Working closely with community agencies that serve seniors, she focuses on mental health, substance use and aging issues. Charmaine was Project Coordinator for the national Seeking Solutions: Canadian Community Action on Seniors and Alcohol Issues project