Falls, tremors and memory loss are considered part of the typical aging process, but they can also signal that an older loved one is suffering from alcohol use or abuse: All-too-common conditions among our elderly that today border on epidemic in the nation’s nursing homes.

According to the National Institute on Alcohol Abuse and Addiction, 6% to 11% of the elderly admitted to hospitals in the United States show signs of alcoholism. That number jumps to 14% for emergency room visits. And if those numbers aren’t eye-popping enough, 49% of all nursing home residents exhibit symptoms of alcoholism.

Unfortunately, it is not often easy for caregivers to distinguish between the signs of aging and alcoholism. For example, falls, tremors and memory loss can indicate either condition.  “Where two or more beers a day might have been fine at a younger age, that same amount can become a problem as one ages,” says Stephan Arndt, Ph.D., director of the Iowa Consortium for Substance Abuse.

Why are older adults so vulnerable to the negative effects of alcohol? First, as we age our bodies have less tolerance to alcohol. In the aging process, body fat increases while lean muscle mass decreases, creating a drop in total body water. Alcohol travels undiluted through the body, resulting in higher levels of blood alcohol concentration. Also as we grow older, we produce less of the enzyme need to metabolize alcohol so more alcohol moves through the stomach directly into the liver.

For all these reasons, older adults who consume two or more alcoholic drinks daily are at risk for developing a number of health problems including stroke, heart disease, high blood pressure, various forms of cancer and diabetes.

At even higher risk are individuals over the age of 65 who use prescription or over-the-counter drugs such as tranquilizers, pain killers, sleeping pills or antihistamines. These older adults risk becoming “accidental addicts” or experiencing injury or death either by accident or suicide. With 30% of all Americans over the age of 65 taking eight or more prescription drugs daily, it’s obvious why high numbers of the elderly end up in hospitals, emergency rooms or nursing homes with alcohol-related problems.

First, learn the facts and myths surrounding alcoholism. “One of the biggest myths is that no one can help another person to quit drinking unless that person wants help,” says Debra Jay, co-author of Aging and Addiction (Hazelden Publishing 2002). That kind of thinking often means we end up doing nothing. Instead of thinking there is nothing we can do, we need to ask ourselves: “What will make Mom accept help?”

Jay, who advocates a “Love First” approach, says, “For the older adult, there’s a lot of shame around being an alcoholic. They may refuse help out of fear of what others will think. To the adult child, this may not matter, but it matters quite a bit to the older adult. It can be very helpful to say something like “Alcohol is taking away your good reputation but recovery can give it back.”

“What you don’t want to do as a family member is to wait until the older adult hits bottom,” says Jay. “For the older adult, hitting bottom can too often result in death.”

If your loved one does indicate that he or she wants to quit drinking, it’s wise to seek the advice of a physician. Withdrawal from alcohol places tremendous stress on the heart, which may lead to stroke or death. A physician may advise your loved one to enter a detox center or hospital to ensure safety.

The next step may be admission to a treatment center. While some treatment centers specialize in the care of the elderly, many do not. If your loved one is admitted to a treatment center, be sure to ask what kinds of adaptations can be made to meet the needs of your older loved one. Day treatment is another option.

“Remember that once someone is out of treatment or is sober, they are not cured,” says Jay. “This is a chronic illness.”

Many people turn to Alcoholics Anonymous for help. In fact, one third of those currently attending AA meetings are over age 50. This means an older person is likely to find others there who will understand their particular concerns.

Regardless of whether a parent is willing to seek help, family caregivers can themselves attend Al-Anon meetings, seek out counseling, or enroll in the family care program of a treatment center.

“Though it may take repeated attempts before a loved one is ready to seek help, this disease unfortunately always gives the family another chance to step in,” says Jay. Some new crisis — a fall, a missed appointment or a hospital admission — will give family caregivers the opportunity to once again intervene on behalf of a loved one.

Jay says, “It’s worth it to keep trying. We can give our parents the gift of sobriety so they can share all the gifts they have to offer us. We lose out when we lose the older generation to alcoholism, and they lose out on the chance to leave a different legacy than the legacy of alcoholism for their families.”