[Identifying and treating alcohol use disorders in the elderly].

IDENTIFYING AND TREATING ALCOHOL USE DISORDERS IN THE ELDERLY Aging does not prevent the occurrence of alcohol use disorders, the frequency of which declines little with age. And advancing age increases the risks and effects of alcohol consumption (even seemingly modest) or the damages caused by alcohol use disorders. Polypathology, which is more frequent with age and a source of polymedication for the elderly, further increases the risks and damages incurred, as does the concomitant use of other psychoactive substances.

[Smoking prevalence among nursing students and nursing assistants in Mâcon: 2021 survey and evolution over 13 years].

Introduction: Smoking is a public health issue in France, especially among the young. Its specificities for caregivers and health students are part of a nationwide "Tobacco-free health place" strategy, underlining the importance of individual choices and the clinical roles of future health professionals.

Method: Prospective survey by online questionnaire, conducted in 2021 among 238 nursing students and nursing assistants in Mâcon, concerning their smoking habits, vaping and the impact of the Covid-19 health crisis, the objectives being to assess the prevalence of smoking in this population, and compare it to previous surveys and data from the literature.

Misuse of opioid analgesics in elderly patients: a review.

Opioid analgesic (OA) addiction occurs frequently among the elderly, and results in high morbidity and mortality due to geriatric pathologies associated with pharmacokinetic modifications. However, patients with this type of addiction are under-identified and specific screening tools should be more widely used to detect the risk factors for OA addiction. Before initiating an opioid prescription, exhaustive research into associated treatments (to track drug interaction) and opioid prescriptions by other clinicians (a phenomenon known as "doctor shopping") is required.

[Substance use disorders and addictions among carers].

Carers also use psychoactive substances and sometimes at work. The risks of use and especially the misuse of psychoactive substances at work take characteristics in health area. Often silent or concealed, substance use disorders of health professionals justify identifying, screening, care and prevention through comprehensive institutional programs involving supervision team.

[Analgesic opioids misuse in the elderly: A review].

Analgesic opioids addiction (AOA) is very frequent in the elderly, and results in a high morbi-mortality due to geriatric associated pathologies with pharmacokinetics modifications. However, it is poorly detected in these subjects and specific screening tools should be widely used to detect the risk factors for AOA prevention. Before initiating opioid prescription, exhaustive search of associated treatments (to track drug interaction) and of opioid prescription by other clinicians (doctor shopping) are requisite.

[Day hospitalisation in addictology].

The day hospital in addictology is a recent hospital service for patients with substance use disorders. It lies somewhere between an inpatient withdrawal unit and outpatient consultations. The day hospital service provides care ranging from withdrawal preparation, abstinence support, the reduction of risks or harm and long-term support for patients.

[Old age and smoking].

Elderly people today have seen a radical change in the image of smokers over the last half century. While once it was approved, it is now demonised. Although smoking declines with age, there are still many elderly smokers.

[Alcohol intoxication in old age].

Acute alcohol intoxication occurs in elderly subjects. Drunkenness appears in banal clinical forms in geriatrics: falls, dizziness or confusion. Elderly people are more vulnerable to alcohol and need less alcohol to become intoxicated.

[Medicines and elderly patients: abuse, dependency or attraction?].

Psychotropic medicines represent, after alcohol, the second class of substances most susceptible to abuse by elderly people. It can be particularly difficult for caregivers to understand such behaviour as these are prescription-only medicines. This misuse is partly a result of older people tending to trivialise and overrate pharmaceutical drugs, ignoring the potential of non-medicinal methods and psychotherapeutic treatments.

Caregivers' representations of elders who drink too much alcohol: crossroads between professional home caregivers and hospitals nurses.

Being old or having alcohol use disorders are two unfavorable conditions for receiving help or optimal care. When these two conditions are associated, professionals are even less attracted to work with old alcoholics. To address this issue, from the professionnals perspective, two studies based on research interviews were crossed, one was conducted with 17 professional home caregivers and the other with 29 hospital nurses.

Alcoholic abstinence in elderly subjects with misuse of alcohol.

Alcohol use disorder does not disappear with aging, neither the associated induced-suffering. While the prevalence of alcohol use disorder still remains around 10% in the subjects over 65 year old age, and daily encountered by hospital or nursing-home caregivers. Alcohol misuse is often overlooked in elderly people, which then obtain lesser care than younger adults although the care prognosis remains as good as or better than before the age of 65, alcoholic abstinence gets always a place among care offers to elders suffering of alcohol use disorders and dependence.

[Alcohol in care homes for the elderly].

The majority of those living in care homes for the elderly are very old, with multiple pathologies and taking multiple forms of medication. They are therefore more fragile and vulnerable in the face of alcohol, both with occasional consumption or with addictive behaviour. Far from anecdotal, these situations arise almost on a daily basis for the frontline caregivers.

[Aging and alcohol consumption].

The risks associated with the consumption of alcohol are higher in old age. These risks are somatic, psychological or related to addiction and negative interactions between alcohol and medication. The misuse of alcohol does not disappear with age, but it takes different forms, sometimes atypical, depending on the co-morbidities, the circumstances and the living or care environment.

[Addictive behavior among the elderly].

Addictive behavior still persists among the elderly, mainly concerning substance abuse, such as alcohol, tobacco or psychotropic drugs and addictive practices such as gambling. Illegal substances or cyber-addictions appear much less often. The environment (place of residence or care) and/or economic factors may influence behavior and practices.

[Elders of 75 and over at an emergency service].

Context: Elderly patients represent an important and growing part of the emergency department activity.

Purpose: To describe population aged of 75 and over admitted in an emergency department without programming and then compare patients addressed with a letter of referral or not.

Methods: A prospective transversal study was carried out over one month in the emergency department of the hospital of Mâcon.

[A joint committee to fight against pain].

The crucial need to take into account the pain felt by elderly people is sometimes difficult to implement on the scale of small or medium-sized institutions. The pooling of resources which a joint committee to fight against pain could offer is an interesting avenue to explore.

[The place of alcohol in hospital meals].

Wine and other types of alcohol are generally seen as an important part of French tradition. A study was carried out at Mâcon hospital to reflect on the place of alcohol in meals served on short stay medical-surgical wards. The results show that the consumption of wine, which was already modest ten years ago, had almost disappeared by 2010, without the offer having been restricted.

[Life-events incidence in Alzheimer disease: preliminary study on the ABORD program].

Introduction: Alzheimer disease has been studied according to several approaches: neurological, cognitive, or psychodynamic. Investment in the latter is sparse although it provides an essential clinical overview for global understanding of the disease.

Objectives And Methods: This study followed the Alzheimer Observation Bank of Research and Data (ABORD) programme, which began in the 1980s.

[Acute alcoholic intoxication at the hospital: a clinical stake. A prospective study of one year in a general hospital].

Introduction: Acute alcoholic intoxications (AAI) are frequent in hospitals. This entails some difficulties to caregivers and their clinical approach is little developed in France. This study aimed at estimating perception of alcohol consumption of hospitalized people with positive alcohol blood test at admission.

[Acute alcoholic intoxication in subjects over 75 years of age: a clinical situation far to be uncommon].

Acute ethylic intoxication (AEI) or alcoholic drunkenness is not only a youth-specific disorder. It also occurs at advanced ages of life. Diagnosis is not easy, at times made in excess, but more often underestimated, then leading to the negligence of a risk situation and suffering.