A local woman is doing work on older adult substance use, addiction and mental health that may one day be used to set policy.
Marissa Stalman is president of the Ridge Meadows Hospice Society and also a second year master’s student at Simon Fraser University. She studies gerontology – the aging population – with a focus on end of life care for persons with dementia.
She also has an interest in older adult addiction.
Her research is showing that health care practitioners need to listen to older adults who use drugs, and hear their insights.
Harm reduction, rather than abstinence, could be best for them, she said.
Stalman was a care aide at 18, and became a registered nurse working in geriatrics. She has had an interest in homeless seniors, end of life care for seniors with dementia and other related issues. When she suffered server injuries in a car accident, she was left with chronic pain that cost her a nursing career, and with depression.
Part of her solution and rehabilitation has been to go back to school, and to volunteer with the hospice.
In April, two articles she co-authored were published in peer-reviewed research journals. Stalman was the first author on an article published in the International Journal of Mental Health Nursing, and co-author on a second article published in Aging and Mental Health. Both projects disseminate findings from a study about persons with bipolar disorder who regularly use substances, including alcohol, marijuana and others.
“Society knows that bipolar disorder, formerly known as manic depression, is an increasing health concern for older adults, and that these individuals are at higher risk of substance abuse. Increased mental health service needs and substantial use of health care resources are associated with this population,” she said.
“What our research adds to the current discourse is the importance of coming to understand the older adult with bipolar disorder and co-morbid substance use. Our participants shared personal theories and highlighted different aspects of control related to their bipolar disorder, medication adherence and substance use.”
Stalman said alcohol, marijuana and amphetamines were all used by the subjects interviewed for her research, and one person used crack cocaine.
They described their symptoms. A woman described her mania:
“Being manic is an itch, like a nasty, ouchie scratch on my head. Like if you’ve ever had poison ivy and you scratched it too hard and it hurt. It’s a sharp itchiness between me and the world, and I’m agitated, and I can’t calm down, and I’m like, ‘Go, go, go, go’ just to burn it off, and nothing will get rid of it …”
Another woman talked about not having control over substance abuse.
“Even though we’re trying to help ourselves soothe whatever is ailing us mentally, emotionally or psychologically, we’re hurting ourselves further, and we even know that, and yet we still do it.”
Stalman said the people interviewed are surprisingly open and insightful.
“They want to talk about what’s going on, and our papers give voice to those issues,” she said.
Mental illness, she added, can rob seniors of their sense of control, at a time in their lives when they may be already losing friends, and changing households.
“Their symptoms can leave them feeling totally out of control of their bodies and minds.”
One of her findings is that health care practitioners need to listen to seniors who are using substances.
“Although they may be old, and although they made be entrenched in their addiction, they have valuable insights into their health and their need.”
Stalman said more research is needed in traditional abstinence-based substance abuse models and their usefulness for people with bipolar disorder.
But in clinical practice, she said nurses need to openly discuss the use of alcohol and other drugs with patients of all ages.
Isolated seniors need to be more connected to their community, because loneliness can be a huge contributor to mental illness, she said.
It is important to give the elderly suffering bipolar disorder quality of life, because seniors can have long lives suffering with these issues.
“The population is living longer, so the 62-year-old who has uncontrolled mental health and substance abuse problems has the potential to live much longer than a couple of decades ago.”
