Down and in? – reducing social isolation in older people with alcohol misuse Dr Tony Rao South London & Maudsley NHS Foundation Trust

Older people drinking above UK ‘sensible limits’ % of men % of men % of women % of women (Office of National Statistics) (Office of National Statistics)

20035% Patients on caseload drinking > 14/21 units per week %

Homelessness (Crane 1996) Recent bereavement (Byrne et al 1999) Depression (Copeland et al 1999) Social isolation (Hanson et al 1994) HIGH RISK GROUPS Past harmful/hazardous drinking (Welte & Mirand 1992) Retirement (Carstenson et al 1985) Immobility (Fink et al 1996)

Older people with alcohol misuse: ‘..not the sort of people that are causing problems in the middle of the night or beating people up but are quietly vegetating and [their] problems are not being addressed’ ‘Community initiatives to reduce isolation in older people and develop social networks should be prioritised..a cross-cutting theme is the importance of social support ’ ‘...the most complex, vulnerable, resource poor and high risk long term service users’ in society today’

Older Adults Support in Southwark (OASIS) - a specialist home care service

Costs Hospital bed = £2,660 per week Hospital bed = £2,660 per week Long term care bed = £ per week Long term care bed = £ per week OASIS average cost per week = £260 OASIS average cost per week = £260 The OASIS Partnership

OASIS Philosophy The OASIS Service takes a person-centred care approach, working with people, not doing for them. The OASIS Service takes a person-centred care approach, working with people, not doing for them. It focuses on intensive community intervention, usually of up to 6 weeks but sometimes longer It focuses on intensive community intervention, usually of up to 6 weeks but sometimes longer Enabling service based on a recovery model Enabling service based on a recovery model The OASIS Partnership