ABSTRACT

Older adults with mental health issues often have complex and ongoing physical problems which are further exacerbated by problematic substance use. In care for older adults experiencing mental health–substance use problems, which also experience age-related illness and infirmity, there may be multiple caregivers involved. Comorbidities are more common in older adults, and caregivers must be cognisant of drug-drug interactions and further potential adverse effects. As many older adults face the serious illnesses, as well as various social and economic difficulties, health and social care professionals may mistakenly conclude that depression is a normal consequence of these problems, an attitude often shared by the person. An older adult experiencing mental health–substance use problems can remain in the community while their substance use and mental health problems are active. Mental health–substance use problems are not a sufficient diagnosis to warrant admission to long-term care. The chapter examines sensitivity to screening for mental health–substance use in the older adult population.