alcoholuse.PDBoQfp29-fA[1].jpg0#RCH1DTGP@z` @z`J@z`&@z`&@z`; @z`@z` >%@z` >g@z` A@z` DMz`DQz`DUz`DY@z`Gz`Jz`Jz`K z`alcoholusePDB0PDA0o905alcoholuseXUiXUi   V{@II  Try This Dementia Series Volume 1, Number 7, Fall 2004 Series Editor: Marie Boltz, APRN, MSN, GNP Communication Difficulties: Assessment and Interventions By: Della Frazier-Rios, RN, MS and Cora Zembrzuski, APRN, MSN, CS, PhD (cand.) WHY: .+9O,: J 8OZ A ssessment"#2##3"$1##7&5)*3 ( ;VSheila Molony, MS, RN, C ;VD;VV;Vh9:z;;  TU4VVAlcohol Use Screening and Assessmentz6 Madeline A. Naegle, APRN-BC, PhD, FAAN&"&4&F Xn~  w  JJ KK  : *P: P ` pLMWMW r7 *9K9K r((:** +13 ,=A <YY LZ\Z *r r r /0:00 115OX :( 8H\ p   { r- *   7MORE ON THE TOPIC: Blow, F.C., Brower, K.J., Schulenberg, J.E., Demo-Dananberg, L.M. Young, T.P., & Beresford, J.P. (1992). The Michigan Alcoholism Screening Test Geriatric Version (MAST-G): A new elderly-specific screening instrument. Alcoholism: Clinical and Experimental Research, 16, 372. Blow, F. (1998). The spectrum of alcohol interventions for older adults. In Gomberg, E.S.L., Hegedus. A.M., Zucker, R.A., (Eds.) Alcohol problems and aging. Washington,D.C.: NIAAA, 373-396. Fleming, M.F., Barry, K.L.   Manwell, L.B., Johnson, K., London, R. (1997). Brief physician advice for problem drinkers: A randomized controlled trial in community-based primary care practices. JAMA, 277(13), 1039-1045. Graham, K., Schmidt, G., S. (1999). Alcohol use and psychosocial well-being among older adults. Journal of Studies on Alcohol, 60(3), 345-351. Tomson,Y., Romelsjo, A., Aberg, H.(1998). Excessive drinking: Brief intervention by a primary health care nurse-a randomized controlled trial. Scandinavian Journal of Primary H (* ealth Care,16 (3),188-192. 8  7 b&  7 tF  74   m%  .     1 6 . When talking with others, do you ever  6 F2 underestimate how much you drink? V ^ 2. After a few drinks, have you sometimes not eaten or been able to skip a few 4 % (meal because you didn't feel hungry?  J J *T K K3. Does having a few drinks help decrease your shakiness or tremors? : f 4. Does alcohol sometimes make it hard for you to remember parts of the day or night?  L 5. Do you usually take a drink to relax or calm your nerves?  % % `D & &6. Do you drink to take your mind off your problems? p [ [ ` \ \7. Have you ever increased your drinking after experiencing a loss in your life?  $f 8. Has a doctor or nurse ever said they were worried or concerned about your drinking? 4   D  9. Have you ever made riles to manage your drinking?  ; ; @ < <10.When you feel loney, does having a drink help? >  YES (1) NO (0)N Z Z n  [ [YES (1) NO (0) ~ [ [ [ [ [ [ k l   YES (1) NO (0)   $ 6 H   YES (1) NO (0) V  v      i iYES (1) NO (0)  i i i i i i  YES (1) NO (0)  " 4 F   YES (1) NO (0) X  x      | |YES (1) NO (0)  | | | | | |  YES (1) NO (0)  $ 6 H  YES (1) NO (0) Zz  !! !!S""coring(!(  ((: **20<++ OR MORE "YES" RESPONSES INDICATIVE OF ACOHOL@(*X  |SSLYY PROBKEM^_Laa.*d*d49 !) r*b ,U> rN b t  C Z Permission is hereby granted to reproduce this material for not-for-profit educational purposes only, provided The Hartford Institute for Geriatric Nursing, Division of Nursing, New York University is cited as the source. Available on the internet at www.hartfordign.org. E-mail notification of usage to: hartford.ign@nyu.edu. J$ppi6IT @ j  ? r A D A      $   6 D V f |             "   0   @  P ^ _f ^ ^ t r u q r p q p p  q q  q q     & 4 D T  j  ? x ( + ' ( & ' & &  ' '  ' ' & ' & &  ' ' Y Z$ Y Y 2 m pD l mT k lb k k p l l  l l         ! "( ! ! 6 5 8H 4 5X 3 4f 3 3 t 4 4  4 4 f g f f  z } y z x y x x  y y  y y , :  J l` p   T* OTAL S-MAST-G-SCORE (0-10)(      , < R ` p      78  PERMISSION is hereby granted to reproduce, post, download, and/or distribute this material for not-for-profit educational purposes only, provided The Hartford Institute for Geriatric Nursing, Division of Nursing, New York University is cited as the source. This material may be downloaded and/or distributed in electronic format, including PDA format. Available on the internet at www.hartfordign.org. E-mail notification of usage to: hartford.ign@nyu.edu.  &7 * !W5"  ! !( Try This Dementia Series is developed by the John A. Hartford Foundation Institute for Geriatric Nursing and the Alzheimer's Association. !8!'&!#q$!!QQ" PQ"* RS"8P"FQR"X"hEE "xFF "one (")" *"U_"AS"""#   G# H#, H#B #X #b #rYc #Try This Assessment Series Volume 17, 2003 Series Editor: Sheila Molony, MS, RN, C Alcohol Use Screening and Assessment By: Madeline A. Naegle, APRN-BC, PhD, FAAN WHY: While as many of 60% of older persons abstain from alcohol use, drinking problems are the largest category of substance abuse problems in older adults. Alcohol consumption is associated with high morbidity and mortality in middle age adults and the vulnerability of older adults to the effects of alcohol, alone and in combination with multiple co-morbidities, increase the risk for immediate and long-term harm. The National Institute of Alcohol Abuse and Alcoholism recommends that alcohol consumption for adults 65 and older be limited to one (1) standard drink: 12 oz. beer 4-5 ounces of wine 1 ounces of distilled spirits per day or seven standard drinks per week. BEST TOOL: The Short Michigan Alcoholism Screening Instrument Geriatric Version was developed as the first short-form alcoholism screening instrument for the elderly. A score of 2 or more yes responses indicates an alcohol problem. TARGET POPULATION: Older adults who are regular users of alcohol in any amount. The goal of screening is to identify an at risk population of persons drinking at levels linked with negative outcomes for physical and mental health such as: stroke depression gastrointestinal problems. Older persons taking prescription medications are at greater risk. VALIDITY/RELIABILITY: The MAST-G, the original instrument from which this measure was derived, has a sensitivity of 93.9%, specificity of 78.1%, a positive predictive value of 87.2% and a negative predictive value of 88.9%. STRENGTHS AND LIMITATIONS: The instrument serves as a screening tool only. A more comprehensive assessment for alcohol/drug dependence requires the clinician to inquire about: quantity and frequency of use, negative social and health consequences of each drug used, including: nicotine prescription over- the- counter recreational drugs alcohol. FOLLOW-UP: Brief interventions by health care providers with older adults who are drinking at higher levels have been shown to be useful in reducing alcohol consumption by older adults. Nurses in all health care settings serving adults over 60 should screen for excess alcohol use. Short Michigan Alcoholism Screening Test - Geriatric Version (S-MAST-G) When talking with others, do you ever underestimate how much you drink? YES (1) NO (0) After a few drinks, have you sometimes not eaten or been able to skip a meal because you didn't feel hungry? YES (1) NO (0) Does having a few drinks help decrease your shakiness or tremors? YES (1) NO (0) Does alcohol sometimes make it hard for you to remember parts of the day or night? YES (1) NO (0) Do you usually take a drink to relax or calm your nerves? YES (1) NO (0) Do you drink to take your mind off your problems? YES (1) NO (0) Have you ever increased your drinking after experiencing a loss in your life? YES (1) NO (0) Has a doctor or nurse ever said they were worried or concerned about your drinking? YES (1) NO (0) Have you ever made riles to manage your drinking? YES (1) NO (0) When you feel lonely, does having a drink help? YES (1) NO (0) TOTAL S-MAST-G-SCORE (0-10) Scoring: 2 OR MORE "YES" RESPONSES INDICATIVE OF ALCOHOL PROBLEM. The Regents of the University of Michigan, 1991. Source: University of Michigan Alcohol Research Center. Reprinted with permission. MORE ON THE TOPIC: Blow, F.C., Brower, K.J., Schulenberg, J.E., Demo-Dananberg, L.M. Young, T.P., & Beresford, J.P. (1992). The Michigan Alcoholism Screening Test Geriatric Version (MAST-G): A new elderly-specific screening instrument. Alcoholism: Clinical and Experimental Research, 16, 372. Blow, F. (1998). The spectrum of alcohol interventions for older adults. In Gomberg, E.S.L., Hegedus. A.M., Zucker, R.A., (Eds.) Alcohol problems and aging. Washington,D.C.: NIAAA, 373-396. Fleming, M.F., Barry, K.L. Manwell, L.B., Johnson, K., London, R. (1997). Brief physician advice for problem drinkers: A randomized controlled trial in community-based primary care practices. JAMA, 277(13), 1039-1045. Graham, K., Schmidt, G., S. (1999). Alcohol use and psychosocial well-being among older adults. Journal of Studies on Alcohol, 60(3), 345-351. Tomson,Y., Romelsjo, A., Aberg, H.(1998). Excessive drinking: Brief intervention by a primary health care nurse-a randomized controlled trial. Scandinavian Journal of Primary Health Care,16 (3),188-192. Try This Dementia Series is developed by the John A. Hartford Foundation Institute for Geriatric Nursing and the Alzheimer's Association. PERMISSION is hereby granted to reproduce, post, download, and/or distribute this material for not-for-profit educational purposes only, provided The Hartford Institute for Geriatric Nursing, Division of Nursing, New York University is cited as the source. This material may be downloaded and/or distributed in electronic format, including PDA format. Available on the internet at www.hartfordign.org. E-mail notification of usage to: hartford.ign@nyu.edu. #%+  -  C F   H)[ $%$T%$e%$O%$D%$`%$f%$D%$G$$B&7# ! $+Po BCS `G & \ );K4 m% .#q$ !W5"###e\  ##. @ @ ``   ` }   r3