1. Alcohol and Older people A Gloucestershire perspective Michele Le Mero Public Health Manager NHS Glos

2. Demographics Increasing older population Significant growth in 75+ and 85+ age groups Largely rural county 18.5% population 65 + By 2030 expected to rise to 26% 3% population 85+ By 2030 expected to rise to 5%

3. Population Projections Source:JSNA

4. SW ‘Calling Time’ results Older People: Drink less alcohol on any one occasion Drink more frequently 26% men + 14% women 65+ drank on 5 or more days in previous week Rates of drinking highest in middle aged men & women High rates of admission for mental & behavioural disorders due to alcohol consumption in 65+

5. Contributing Factors Social isolation – urban & rural Large numbers of people living alone Drinkers with multiple problems (e.g. limiting long term illness, mental health, learning disabilities Isolated areas – lack of local facilities and access to services Large numbers of older informal carers Carers in poor health

6. Alcohol Strategy 2006-2009 – refreshed Jan 2010 Strategic objectives have been mapped to the following LAA indicators: LI 18 - The number of people aged 75 or over admitted to hospital with fractured femur NI 39 – Rate of hospital admissions per 100,000 for alcohol-related harm

7. LI 18 - The number of people aged 75 or over admitted to hospital with fractured femur

8. Admissions in 75+ as a result of fall

9. Reasons & Consequences Social isolation Bereavement Illness Financial stress Retirement Loss of independence Divorce Insomnia Impaired brain function Dementia Falls Osteoporosis Medication interaction Malnourishment

10. So far… Education & Intervention Falls prevention banners & leaflets Healthy Ageing banners & leaflets Healthy Ageing coordinator - December 2009 Access to specialist services is available for older people Consistent messages and access to specialist support available at any interface with older people

11. Anna Gibbins Healthy Ageing Coordinator Public Health NHS Gloucestershire

12. What’s my role? Lead on range of health improvement areas in relation to older people across the county. Contribute/facilitate the development and implementation of local health improvement programmes and public engagement. Facilitate multi agency public health group work and community based needs assessments

13. How is this being done? Utilising my years of experience as a district nurse in rural, urban, town and inner city areas. First hand insight into the impact on alcohol dependency and the effects of this on individuals and their families health and wellbeing. Drawing on new experiences within the field of Public Health and working with a range of experts in the diverse needs of older people.

14. Work in Progress……. Library Clubs Music /Drama/ Folk Lore Dignity in Care Promotion of seated exercise via book/DVD Sustain and diversify Patient Ambassador role

15. Transferable approaches …..? Potential opportunities for foundation work in range of settings Using diverse mediums to get message across to individuals and communities Work with specialist personnel and communities to influence/inform key messages Enlist patients/ service users/public to participate in joint initiatives for alcohol behaviour change

16. Thank You Michele.lemero@glos.nhs.uk Anna.gibbins@glos.nhs.uk