Facts, Figures, and General Information

Centers for Disease Control and Prevention (CDC)—Alzheimer's Disease and Healthy Aging Data Portal

www.cdc.gov/aging/agingdata/index.html

Resource summary: This website provides consumers with self-reported data on health indicators in adults over 50. It contains a database of overall health indicators (e.g., ratings of sufficient sleep) and chronic conditions reported by participants in CDC's Behavioral Risk Factor Surveillance System. It also tracks other reported dimensions of health collected by this CDC survey, including cognitive decline, screenings and vaccinations, nutrition, activity level, mental health, and caregiving efforts. This information can be used by healthcare policy stakeholders to gauge the level of health risk behaviors, health conditions, and use of preventive services among the aging population.

The website also provides links to relevant online content and related publications. Instructions are included for using the portal to create custom reports, but the site also allows for creating reports using standard templates that show data by state or U.S. region based on age level, year, and health dimension.

Referral, Treatment, and Support Group Locators

Association of Recovery Community Organizations (ARCO)

https://facesandvoicesofrecovery.org/arco/

Resource summary: ARCO's mission is to grow and sustain the recovery movement, both nationally and internationally, in three main ways. First, ARCO vets nonprofit recovery organizations for acceptance as ARCO affiliates and provides training and technical assistance to further their reach in local communities. Second, ARCO engages in advocacy efforts aimed at the general public and policymakers that involve education against stigma and for acceptance of the recovery community. Third, the organization helps people realize long-term recovery by supporting clients' transitions from treatment to recovery services.

Department of Veterans Affairs (VA)—SUD Program Treatment Locator

www.va.gov/directory/guide/SUD.asp

Resource summary: The VA treatment locator can be searched by state for VA Medical Centers that offer specialized SUD treatment.

Eldercare Locator

https://eldercare.acl.gov

Resource summary: Sponsored by the Administration on Aging (AoA), this website provides information on support services for older adults and caregivers and valuable information on elder rights, housing, health conditions and wellness, insurance benefits, transportation, and long-term care planning. Users can search for information and referrals for assistance through federal, state, and local resources, as well as health insurance counseling agencies. The site is user friendly and offers many options for finding assistance at the community level. Consumers also may request help by phone, online chat, or email. Consumer publications and outreach materials can be ordered for free, but there may be shipping and handling costs.

Faces & Voices of Recovery—Guide to Mutual Aid Resources

https://facesandvoicesofrecovery.org/resources/mutual-aid-resources

Resource summary: Faces & Voices of Recovery offers information on mutual-help organizations based on the following categories: 12-Step, alcohol, co-occurring health conditions, faith-based, family-/friend-focused, gender-specific, medication-assisted, secular, and youth.

FindTreatment.gov

https://findtreatment.gov

Resource summary: People seeking treatment for SUDs can use this federal locator maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA) to find treatment facilities based on location, availability of treatment for co-occurring mental disorders, availability of telemedicine care, payment option, age, languages spoken, and access to medication for OUD. The site also links to information on understanding addiction, understanding mental illness, and paying for treatment.

NIAAA (National Institute on Alcohol Abuse and Alcoholism) Alcohol Treatment Navigator

https://alcoholtreatment.niaaa.nih.gov

Resource summary: This site offers comprehensive information on alcohol use disorder (AUD) and AUD treatment. It describes the need for professional assessment and individualized treatment plans and explains the recovery process, including the possibility of relapse and ways to overcome it. Access is available for clients, family, friends, and clinicians to information sources, mutual-support groups, and resources for older adults who are using alcohol.

Readers can learn about the different types of treatment available, how to find treatment, costs of treatment, insurance coverage, and options for support throughout recovery. The site provides a toolkit that can be downloaded and used by clients, therapists, and treatment providers to “navigate” the process of finding the right kind of help at different stages of recovery and treatment. It includes worksheets that can be individualized to track progress and lists of important questions for clients to ask of providers and treatment programs.

Substance Abuse and Mental Health Services Administration (SAMHSA)—Behavioral Health Treatment Services Locator

https://findtreatment.samhsa.gov

Resource summary: This online resource provides users with a confidential, easy-to-use tool for finding local behavioral health service facilities that offer treatment for substance use and mental disorders. The site includes tutorials for using the interactive tool to search for both inpatient and outpatient programs in a given area.

SAMHSA— National Directory of Drug and Alcohol Abuse Treatment Facilities, 2020

https://www.samhsa.gov/data/sites/default/files/reports/rpt23267/National_Directory_SA_facilities.pdf

Resource summary: This document contains a comprehensive list of state-certified substance use and mental disorder treatment facilities that responded to the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS). The directory provides a list of state behavioral health agencies and individual treatment facilities broken out by city and state.

Each facility is coded for primary focus, type of care, treatment setting, treatment approaches, payment and funding assistance options, language services, ancillary services, age groups and genders served, and targeted programs for special populations such as active and retired military; court-ordered clients; trauma victims; and lesbian, gay, bisexual, or transgender (LGBT) individuals.

This directory supplements FindTreatment.gov, which is updated more frequently. The directory, however, contains more detailed information about each facility.

SAMHSA's National Helpline

www.samhsa.gov/find-help/national-helpline

Resource summary: SAMHSA's National Helpline provides free treatment referral and relevant information for individuals who need help dealing with substance misuse or mental illness. The phone lines (1-800-662-HELP [4357]; 1-800-487-4889 [TTY]) are staffed 24 hours a day by information specialists who can respond in English or Spanish. All calls to the helpline are free and confidential.

The helpline website features free publications on substance use and mental disorder awareness, plus family treatment approaches, interventions, and self-help for achieving recovery from these disorders.

Government Agencies and Departments

Administration for Community Living (ACL)

www.acl.gov

Resource summary: ACL, part of the Department of Health and Human Services (HHS), provides funding and support services to community-based organizations that promote independent living and full community participation among older adults and people with disabilities. The website offers information and educational resources about behavioral health and aging issues, chronic disease management, and healthy aging geared toward people with disabilities, older adults, and their family and friends.

National Institute on Aging (NIA)

www.nia.nih.gov

Resource summary: NIA is part of the National Institutes of Health (NIH). Its primary focus is to support a broad scientific effort to understand the nature of aging and the health and wellness of older adults. The website has consumer-oriented information on a wide variety of topics, including caregiving, cognitive health, and doctor-patient communication.

The site also contains training for researchers, clinicians, and students; grants and funding opportunities; clinical practice tools; publications; and health information for the Spanish-speaking community.

Groups and Organizations

AARP

www.aarp.org

Resource summary: AARP is a nonprofit organization that works to address the needs and interests of older adults in the United States. The AARP website provides information and resources in English and Spanish on substance misuse, health, and wellness for older adults, among other topics. The AARP Foundation (www.aarp.org/aarp-foundation/find-help/?intcmp=FOU-R2-C2-SRVCS) offers an online local assistance directory that helps older adults with limited resources search for free or reduced-cost services in their area, including healthcare and food programs.

Faces & Voices of Recovery

https://facesandvoicesofrecovery.org

Resource summary: Faces & Voices of Recovery is a recovery advocacy organization promoting science-based addiction treatment and recovery-focused policies that emphasize health and well-being and reduce discrimination against people with addiction. The website contains a library of resources related to recovery advocacy and education, reports, toolkits, and recovery stories, as well as links to recovery research, recovery data, capacity building, training, and ideas for getting involved in your community.

National Association of Area Agencies on Aging

www.n4a.org

Resource summary: This website provides or links to information for consumers and professionals on a variety of older adult-related topics, including health care, housing, transportation, Medicare savings programs, low-income subsidies, health assistance, health insurance, and home-and community-based services. Consumers can access information on aging services, advocacy, initiatives, and resources.

National Association of Social Workers—Aging

www.socialworkers.org/practice/aging

Resource summary: This webpage offers guidance on practice standards and professional growth for social workers who work with older adults. It provides members with access to professional development opportunities, practice and advocacy tools, and other resources to enhance social workers' capacity to support older adults and family caregivers.

National Council on Aging (NCOA)

www.ncoa.org

Resource summary: NCOA promotes the health and economic security of older adults. Its website maintains a collection of resources on healthy aging for providers, older adults, advocates, and caregivers. Topics covered include fall prevention, chronic disease management, and aging mastery.

Cultural Diversity

American Psychological Association (APA)—Multicultural Competency in Geropsychology

www.apa.org/pi/aging/programs/pipeline/multicultural-competency.pdf

Resource summary: This report, developed by the APA Committee on Aging, provides recommendations for increasing multicultural competencies among psychologists who work with older adults. The report provides guidelines for improving and maintaining cultural competence in psychological practice and recognizes training modules designed to help providers and organizations develop multicultural standards in geropsychology. It also contains information on key issues facing the multicultural aging population.

APA—Lesbian, Gay, Bisexual and Transgender Aging

www.apa.org/pi/lgbt/resources/aging

Resource summary: This webpage provides information and links to publications, organizations, and media coverage with a focus on LGBT aging issues.

National Asian Pacific Center on Aging (NAPCA)

www.napca.org

Resource summary: NAPCA is dedicated to diversity and advocacy efforts to promote the capacity of employers and mainstream service providers to support Asian Americans and Pacific Islanders. Website topics for consumers include self-management of chronic diseases, preventing Medicare fraud, healthy eating, brain health, and Medicare Part D enrollment assistance. The website also contains information on dementia, elder abuse prevention, family caregiving, healthy aging, and mature workers.

National Caucus and Center on Black Aging, Inc. (NCBA)

https://ncba-aging.org

Resource summary: NCBA is a national organization focusing on issues affecting minority adults ages 50 and older. Consumers can access on its website information on health and wellness services, employment services, housing services, and other topics.

National Hispanic Council on Aging (NHCOA)

www.nhcoa.org

Resource summary: NHCOA is a national organization concerned with improving the health, economic security, and housing of Hispanic older adults, their families, and their caregivers. The organization's health-related work includes local health education and promotion and cultural competency training for healthcare providers.

National Indian Council on Aging (NICOA)

https://nicoa.org/

Resource summary: NICOA is concerned with improving the health, social services, and economic well-being of American Indian and Alaska Native elders. It is involved with advocacy issues, networking with aging organizations and community service providers, and technical assistance for Native American communities. The website offers information on policy issues, health and wellness for elders, and caregiver support.

National Resource Center on Native American Aging (NRCNAA)

www.nrcnaa.org

Resource summary: Funded by ACL, NRCNAA provides education, training, and technical assistance to help develop community-based solutions to improve the delivery of support services to the Native American aging population. Its aim is to improve their health and social conditions through free projects and services and to empower them to live their best over the lifespan. The site contains educational tools for service providers, caregivers, and community members. Consumers can access factsheets, reports, presentations, and articles on policy activities as well as service locators for aging Native Americans, long-term planning information, programs for balancing health and well-being, and the Native Aging Visions newsletter.

SAGE (Advocacy & Services for LGBT Elders)

www.sageusa.org/

Resource summary: The SAGE website provides advocacy, training, programming, and resource development to improve aging for LGBT people nationwide. Older adults and their caregivers can sign up for the SAGE newsletter to get action alerts, event invites, and the latest news on LGBT aging issues. Through its sister sites, the National Resource Center on LGBT Aging and SAGECare, SAGE provides cultural competency training and education for aging services providers.

Understanding Issues Facing LGBT Older Adults

www.lgbtmap.org/file/understanding-issues-facing-lgbt-older-adults.pdf

Resource summary: This report from the Movement Advancement Project and SAGE helps providers and others better understand the social isolation and health challenges that affect many LGBT older adults.

SAMHSA Publications

All publications listed in this section are available at no cost from SAMHSA's publications ordering webpage (https://store.samhsa.gov) or from1-877-SAMHSA-7 (1-877-726-4727).

Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784

Resource summary: This brochure explores the role of family therapy in recovery from mental illness, SUDs, or both. It explains how family therapy sessions are run and who conducts them. It also provides information on how effective family therapy sessions are in supporting recovery.

Get Connected: Linking Older Adults With Resources on Medication, Alcohol, and Mental Health

https://store.samhsa.gov/product/Get-Connected-Linking-Older-Adults-with-Resources-on-Medication-Alcohol-and-Mental-Health-2019-Edition/SMA03-3824

Resource summary: Developed in collaboration with NCOA, this resource includes a program coordinator's guide and program support materials. The latter are education curriculums for program staff, factsheets and handouts, and forms and resources. This resource is designed for health and aging services providers. The main goal of this resource is to improve the lives of older adults who may be misusing alcohol or medications and who may need the help of mental health services. Content was designed to increase awareness and educate providers about the significant effects of alcohol and medication misuse and mental illness in the older adult population and the steps to take for mitigating problems. The program support materials will help guide providers to adopt effective practices for screening and referral to community-based resources and support services in the areas of substance misuse and mental health.

Medication for the Treatment of Alcohol Use Disorder: A Brief Guide

https://store.samhsa.gov/product/Medication-for-the-Treatment-of-Alcohol-Use-Disorder-A-Brief-Guide/SMA15-4907

Resource summary: This document provides guidance on the use of FDA-approved medications for treating AUD in clinical practice. It includes a section on assessing and treating older adults. The document discusses developing a treatment plan and selecting a medication, initiating treatment with medication, and monitoring patient progress.

Treatment of Depression in Older Adults

https://store.samhsa.gov/product/Treatment-Depression-Older-Adults-Evidence-Based-Practices-EBP-Kit/SMA11-4631

Resource summary: The authors of this guide note that depression is widely underrecognized and undertreated in older adults and offer important tips for working with older adults in terms of communication, privacy, and assessment. This booklet describes how practitioners—such as psychiatrists, psychologists, physicians, nurses, social workers, and aging services providers—can provide effective care for older adults who have depression. It discusses evidence-based approaches for screening and diagnosis, treatment, and outcomes evaluation.

TIP 27: Comprehensive Case Management for Substance Abuse Treatment

https://store.samhsa.gov/product/TIP-27-Comprehensive-Case-Management-for-Substance-Abuse-Treatment/SMA15-4215

Resource summary: TIP 27 describes case management as an interdisciplinary approach to addiction treatment that includes coordination of health, substance use, mental health, and social services. This TIP provides guidance and resources to help keep clients engaged in treatment and moving toward recovery, which requires periodically assessing clients and facilitating service delivery across different levels of care, particularly for clients with other disorders and conditions who require multiple services over extended periods of time and who face difficulty in gaining access to those services.

TIP 34: Brief Interventions and Brief Therapies for Substance Abuse

https://store.samhsa.gov/product/TIP-34-Brief-Interventions-and-Brief-Therapies-for-Substance-Abuse/SMA12-3952

Resource summary: TIP 34 documents the components of and criteria for the use of brief cognitive-behavioral therapy (CBT), brief strategic and interactional therapies, brief humanistic and existential therapies, brief psychodynamic therapy, short-term family therapy, and time-limited group therapy. Each of these therapies can be used to treat select subpopulations of people with SUDs and those at risk of developing them. These therapies are intended for clients who may not have the time or money to dedicate to traditional therapy or for clients who are functioning in society but who misuse substances. These therapy approaches can be used in a variety of settings and can be useful for reaching a greater number of people than more traditional approaches (e.g., for clients who are on waiting lists for specialized programs). The publication discusses the effectiveness of each approach. It also provides historical background, outcomes research, rationale for use, and case scenarios for implementation of brief interventions and therapies for a range of problems related to substance misuse.

TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment

https://store.samhsa.gov/product/TIP-35-Enhancing-Motivation-for-Change-in-Substance-Use-Disorder-Treatment/PEP19-02-01-003

Resource summary: This updated TIP describes the elements of motivational interventions, the five principles of motivational interviewing, catalysts for changing behavior, and the stages of change that a client will go through while working toward recovery from substance use. Readers will learn how to integrate motivational approaches into treatment programs, and how to measure client motivation. The TIP provides guidance on how to develop a therapeutic relationship that respects and builds on the client's autonomy, how to tailor treatment to a client's stage of readiness for change, and how to address client resistance or ambivalence by asking open-ended questions and using other motivational strategies. The information in this TIP will help equip clinicians with the necessary skills for enhancing client motivation at different stages of the change process. Content includes a description of proven motivational techniques, research results, case studies, and multiple screening and assessment tools to assist providers in guiding their clients toward positive treatment outcomes.

TIP 54: Managing Chronic Pain in Adults With or in Recovery From Substance Use Disorders

https://store.samhsa.gov/product/TIP-54-Managing-Chronic-Pain-in-Adults-With-or-in-Recovery-From-Substance-Use-Disorders/SMA13-4671

Resource summary: TIP 54 discusses the physiological, social, and mental impact of chronic noncancer pain; the cycle of chronic pain and addiction; the importance of ongoing assessment; and the complexity of managing pain in clients with active addiction. This manual is intended for primary care providers, addiction specialists, psychiatrists, pharmacists, and nurses who treat or are likely to treat adult patients with or in recovery from SUDs who present with chronic noncancer pain. It offers guidance on chronic pain management, treating patients in recovery, managing addiction risks in patients treated with opioids, using patient education and treatment agreements and tools for assessing dimension and level of pain, and talking with patients about complementary and alternative treatments.

TIP 57: Trauma-Informed Care in Behavioral Health Services

https://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816

Resource summary: The audience for this guide includes healthcare and behavioral health service providers, prevention specialists, program administrators, community service providers, criminal justice system support workers, and researchers. The TIP covers trauma awareness, the impact of trauma, trauma-informed screening and assessment, implementation of trauma-informed care, and development of a trauma-informed workforce.

TIP 59: Improving Cultural Competence

https://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

Resource summary: TIP 59 provides an introduction to cultural competence in behavioral health services targeted to treatment counselors, clinical and programmatic staff, and program administrators. The guide identifies core competencies necessary for culturally responsive evaluation and treatment planning and discusses the need for cultural competence of support service organizations and behavioral health services for different racial and ethnic groups. The appendixes include cultural resources and clinical tools for screening, assessment, and treatment.

TIP 63: Medications for Opioid Use Disorder

https://store.samhsa.gov/product/TIP-63-Medications-for-Opioid-Use-Disorder-Full-Document/PEP20-02-01-006

Resource summary: TIP 63 provides an introduction to the three FDA-approved medications for opioid use disorder (OUD) treatment and explains their use in addressing OUD in medical settings. These medications—methadone, naltrexone, and buprenorphine—have proven effective in rigorous scientific studies for treating OUD, particularly when administered alongside individualized psychosocial supports and other recovery services. The TIP includes practical guidelines and clinical tools for OUD screening, assessment, diagnosis, treatment planning, and referral to recovery support services. It also contains resources for finding medical and behavioral health service providers who specialize in treating OUD.

General Information

SAMHSA—Addiction Technology Transfer Center (ATTC) Network

https://attcnetwork.org

Resource summary: The ATTC Network is a multidisciplinary resource for professionals in the addiction treatment and recovery services field. The network's 10 U.S-based centers, 2 national focus area centers, and network coordinating office provide access to news, tools and other resources, and free and low-cost training programs in the addiction field. For example, the Mid-America ATTC in 2019 released BHMEDS-R3, the latest version of its app on medications prescribed for SUDs and mental disorders. The app is meant to be a quick reference for nonprescribing behavioral health service professionals and for consumers. See https://attcnetwork.org/centers/mid-america-attc/product/bhmeds-r3-app.

APA Guidelines for Psychological Practice with Older Adults

www.apa.org/pubs/journals/features/older-adults.pdf

Resource summary: This APA resource updates the 2003 Guidelines for Psychological Practice with Older Adults. It provides information to psychologists on evaluating their own readiness for working with older adults. It also offers information on clinical issues, assessment, intervention, consultation, professional issues, and continuing education and training related to working with the older adult population.

Council on Social Work Education— Gero-Ed Center

www.cswe.org/Centers-Initiatives/CSWE-Gero-Ed-Center.aspx

Resource summary: This resource, aimed at social work faculty, students, practitioners, and program managers, offers free resources, educational materials, and curriculums to enhance the competencies of social work providers caring for older adults. Webinar topics include patient-centered medical homes, social work in integrated settings, and how to become a certified application counselor to facilitate patient enrollment in the healthcare marketplace.

Users can access educational resources, such as the Specialized Practice Curricular Guide for Gero Social Work Practice, information on workforce development projects, and specialized curriculums on age-friendly community initiatives, caregiver well-being, elder justice, rural aging, and LGBT older adults.

NAADAC, The Association for Addiction Professionals—Institute Webinar Series

www.naadac.org/webinars

Resource summary: NAADAC provides free training and low-cost continuing education credits for addiction professionals. Webinars may be viewed live or on demand. Topics include SUD treatment, supervision, workforce development, veterans, families, trauma, and peer recovery support.

NCOA—Resources

www.ncoa.org/audience/professional-resources/?posttype=ncoaresource

Resource summary: This webpage serves as a searchable database of more than 2,000 resources, including articles, webinars, and manuals, for providers who work with aging adults. Topics include fall prevention strategies and the role of self-management in chronic diseases.

Alcohol Misuse and Drug Use

SAMHSA—A Guide to Preventing Older Adult Alcohol and Psychoactive Medication Misuse/Abuse: Screening and Brief Interventions

www.ncoa.org/wp-content/uploads/SBIRT-Older-Adult-Manual-Final.pdf

Resource summary: This document is an evidence-based practice manual for guiding behavioral health service providers and administrators in designing, implementing, and delivering screening and brief intervention programs to prevent substance misuse in older adults. It also includes a collection of resources.

American Society of Addiction Medicine (ASAM)

www.asam.org/asam-home-page

Resource summary: The website offers information and education and training resources for medical providers in the field of addiction medicine. The site also offers articles on advocacy issues and addiction news, among other resources. The information presented on the website is free, but training and education courses may require payment.

Drug Interactions Checker

www.drugs.com/druginteractions.html

Resource summary: This site features an interactive tool for consumers and clinicians that checks for drug interactions with other drugs, including over-the-counter (OTC) medications medications; foods; alcohol and other beverages; herbal products, and some medical conditions.

Readers can search for information on drugs and have access to a searchable pill identifier, FDA alerts, news, and other resources for preventing unexpected consequences from medication use.

National Institute on Drug Abuse (NIDA)— NIDAMED: Clinical Resources

www.drugabuse.gov/nidamed-medical-health-professionals

Resource summary: The NIDAMED website lists resources for healthcare professionals to learn about the effects of substance misuse on clients' health and describes how to identify drug use early and prevent it from turning into misuse or addiction. Resources are tailored to emergency physicians, dentists, pharmacists, family physicians, nurse practitioners, physician assistants, pediatricians, osteopathic physicians, and addiction medicine specialists.

Visitors to the site can access news; education and continuing medical education activities; information for patients, teens, and parents; and a clinician resource and quick reference guide for drug screening.

NIAAA—Professional Education Materials

www.niaaa.nih.gov/publications/clinical-guides-and-manuals

Resource summary: This site is geared toward clinicians, physicians, social workers, and other providers who work with people who misuse alcohol. It offers access to screening, treatment planning, and general information. The site also provides links to related resources on such topics as medications for treating AUD, the impact of alcohol use on families, and epidemiologic data on alcohol use.

NIDA— Screening for Drug Use in General Medical Settings: Resource Guide

www.drugabuse.gov/sites/default/files/resource_guide.pdf

Resource summary: This NIDA three-step resource guide describes how providers can use the NIDA Quick Screen and NIDA-modified Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) tools to determine clients' risk of substance misuse. The NIDA Quick Screen can assess clients' past-year drug use and alcohol misuse, and the ASSIST measures lifetime drug use and prescription medication misuse. The resource guide instructs providers on how to score these measures and how to follow up with clients based on their results.

VA—Brief Addiction Monitor

www.mentalhealth.va.gov/communityproviders/docs/bam_continuous_3-10-14.pdf

Resource summary: This questionnaire collects information from patients in recovery on drug and alcohol use, emotional and physical well-being, income needs, and risk activities. This screening tool may be downloaded at no cost.

VA/Department of Defense (DoD) Clinical Practice Guideline: Management of Opioid Therapy for Chronic Pain

www.healthquality.va.gov/guidelines/Pain/cot

Resource summary: This publication, cosponsored by DoD and the VA, provides practitioners with the most current recommendations on prescribing opioid therapy for chronic pain throughout the DoD and VA healthcare systems. The webpage with the link to this publication also contains patient-provider tools for identifying risks associated with opioid use, managing side effects, and tapering and discontinuing opioids.

VA—Opioid Safety Initiative

www.va.gov/PAINMANAGEMENT/Opioid_Safety_Initiative_OSI.asp

Resource summary: The VA Opioid Safety Initiative page features a toolkit for clinical practice. It includes an updated patient education guide, an acute pain provider guide, a quick pain reference guide, as well as medication guidelines, forms, and a treatment manual. Clinical teams caring for older veterans with chronic pain may find this information useful.

The page also provides information on opioid therapy risks, resources on opioids for veterans and providers, and access to the National Library of Medicine Opiate Addiction Portal and Opioid Safety Initiative materials.

World Health Organization (WHO)—The ASSIST Screening Test Version 3.0 and Feedback Card

www.who.int/substanceabuse/activities/assist_test/en/

Resource summary: This validated interview tool is used to screen clients for all types of substance misuse. A computer version and a shorter version (ASSIST-Lite) are available. The full version of WHO's ASSIST screener, scoring system, and client feedback guidance can be downloaded and is available in multiple languages.

Dementia and Other Cognitive Disorders

Alzheimer's Association—2018 Dementia Care Practice Recommendations

www.alz.org/professionals/professional-providers/dementia_care_practice_recommendations

Resource summary: These recommendations provide guidance to healthcare and social service providers who work with individuals living with dementia and their families in residential and community-based care settings. They aim to inform and influence dementia care standards, training, practice, and policy.

The document contains review articles on the fundamentals of person-centered care for individuals with dementia, person-centered assessment and care planning, evidence-based nonpharmacological practices to address behavioral and psychological symptoms of dementia, and evidence-based interventions for transitions in care for individuals living with dementia. The guide also discusses supportive and therapeutic environments for people living with dementia, practice principles for quality dementia care, progressive support activities of daily living for people living with dementia, ongoing medical management of dementia, and information on meeting the informational, educational, and psychosocial support needs of people living with dementia and their caregivers.

Association for Frontotemporal Degeneration— For Health Professionals

www.theaftd.org/for-health-professionals

Resource summary: This webpage provides educational resources for healthcare professionals about frontotemporal degeneration (FTD), including clinical presentations of the various subtypes of FTD, approaches for diagnosing FTD, and methods for treating symptoms of FTD. It also links to support resources for those living with FTD and their families, and to research and clinical trials.

NIA—Alzheimer's and Dementia Resources for Professionals

https://www.nia.nih.gov/health/alzheimers-dementia-resources-for-professionals

Resource summary: This NIA webpage offers free clinical practice tools for diagnosis, treatment, and management; training materials and professional curriculums; articles on patient care; and other resources on cognitive impairment for medical and behavioral health service providers who see older adults.

The site also contains a section for caregivers and patients as well as links to e-alerts, news, funding announcements, and options for ordering free publications.

Counseling Approaches

A Clinician's Guide to CBT With Older People

www.uea.ac.uk/documents/246046/11919343/CBT_BOOKLET_FINAL_FEB2016%287%29.pdf/280459ae-a1b8-4c31-a1b3-173c524330c9

Resource summary: This workbook explores age-sensitive strategies for adapting CBT for older adults. It includes an overview of fundamentals required for increasing treatment access for older people, the problems of depression and anxiety in later life, age-appropriate augmentations to CBT, working with complex comorbidity issues, and the challenges of ageism in general and in the treatment field itself. The workbook contains practical exercises and case studies illustrating how to use CBT to help older people reduce their symptoms of concern.

Dialectical Behavior Therapy (DBT) Research and Training

http://depts.washington.edu/uwbrtc/research/treatment-development-clinic/

Resource summary: This webpage, for the Behavioral Research & Therapy Clinics (BRTC) at the University of Washington, explains that DBT incorporates mindfulness practices to help people manage overwhelming emotions. It is a skill-building approach that shows promise in treating older adults who experience emotional dysregulation and have poor interpersonal skills.

The page provides links to research and training areas, BRTC research, the treatment development clinic, publications, and a subscription area for receiving related news.

Dulwich Centre—A Gateway to Narrative Therapy and Community Work

https://dulwichcentre.com.au

Resource summary: This site provides information and educational resources on narrative therapy, a link to collective projects, and access to the subscriber page of the International Journal of Narrative Therapy and Community Work.

Motivational Interviewing Network of Trainers (MINT)

https://motivationalinterviewing.org

Resource summary: The MINT website provides users with information about the network, how to join, and a library of MI publications. The site includes references, articles, videos, and links to training opportunities in the theory and practice of MI. Users can search the site for trainings and events, information about MI, MI in the news, news about MINT, MI research, and other resources.

NIAAA— Twelve Step Facilitation (TSF) Therapy Manual

https://pubs.niaaa.nih.gov/publications/projectmatch/match01.pdf

Resource summary: The TSF manual provides step-by-step instruction on using TSF for treating alcohol misuse. Its practical rules are applicable across a variety of outpatient treatment settings and it is flexible enough to allow for individual treatment interventions that are consistent with the 12 Steps of Alcoholics Anonymous.

Tobacco Use

CDC—Smoking & Tobacco Use

www.cdc.gov/tobacco

Resource summary: This webpage provides free resources and information for clients and clinicians for reducing cigarette smoking, tobacco dependence, and related consequences of tobacco use. The site also offers tools and resources; data and statistics; multimedia options; state and community resources; stories and tips from former smokers; and information on global tobacco control activities, tobacco-related disparities, and special populations.

HHS—Million Hearts® Initiative: Tobacco Use

https://millionhearts.hhs.gov/tools-protocols/tools/tobacco-use.html

Resource summary: Providers can use the tools on this webpage to improve the tobacco use interventions they undertake as part of clinical care.

National Cancer Institute (NCI)—Smokefree.gov

https://smokefree.gov

Resource summary: Smokefree.gov explains the journey from wanting to quit to taking action and offers free support to help clients quit tobacco. The site provides tips for how to cope with stress without smoking, steps for preparing to quit, and ideas for managing cravings. It discusses withdrawal symptoms, triggers, and the health benefits of quitting and offers a variety of ways for smokers to reach their goals, including the use of nicotine replacement therapy, smoke-free apps, social media support, and smoke-free texting programs. The site offers links to other Smokefree.gov pages specific to the needs of women, veterans, teens, Spanish speakers, and people over 60.

Health and Wellness

SAMHSA—Treating Sleep Problems of People in Recovery From Substance Use Disorders: In Brief

https://store.samhsa.gov/product/Treating-Sleep-Problems-of-People-in-Recovery-From-Substance-Use-Disorders/sma14-4859

Resource summary: This publication offers tips for healthcare providers on how to help clients in recovery from SUDs who have sleep problems. It discusses the potential impact of poor sleep on recovery and offers recommendations on screening and treatment.

American Geriatrics Society—Complementary and Integrative Medicine

(https://geriatricscareonline.org/FullText/B030/B030_VOL001_PART001_SEC002_CH012)

Resource summary: This webpage offers a useful summary of complementary and integrative medicine approaches. The page also includes a table listing natural products and their interactions with prescribed medications, as well as a summary of the evidence base for complementary and integrative medicine approaches as they relate to different health conditions common in aging.

CDC—Timed Up & Go (TUG) Test

www.cdc.gov/steadi/pdf/TUG_Test-print.pdf

Resource summary: The TUG test is part of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Program from CDC. The test assesses a client's ability to stand from a sitting position, walk a short distance (10 feet), turn around, and walk back to where he or she was sitting. Several parameters are measured during the exercise, such as gait, arm swinging, shuffling, posture, stride, and time to completion of the task. Results are used to gauge the person's risk for falling or to indicate a possible need for further clinical evaluation.

CMS— Annual Wellness Visit

www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AWV_chart_ICN905706.pdf

Resource summary: This document is targeted to Medicare fee-for-service providers to help them provide covered services to their patients during annual wellness visits. It can be printed out in hard copy but also contains links to resources such as the CMS Initial Preventive Physical Examination sheet, CDC's health risk assessment framework, Medicare's coverage of SUD treatment services, and Medicare's claims processing manual, which contains coding for rural health clinics and federally qualified health centers.

NCOA—Center for Healthy Aging

www.ncoa.org/center-for-healthy-aging

Resource summary: The Center for Healthy Aging collaborates with national, state, and community partners to improve the lives of aging adults. It supports expansion and sustainability efforts aimed at health promotion and disease prevention among this population. It provides educational resources on health and wellness, disease management, nutrition, exercise, and fall prevention for older adults.

The center houses the National Chronic Disease Self-Management Education Resource Center and the National Falls Prevention Resource Center, both funded by ACL. These resources are for clinicians and consumers.

NCOA—Engaging American Indian/Alaska Native Elders in Falls Prevention Programs

www.ncoa.org/resources/engaging-american-indianalaska-native-elders-falls-prevention-programs

Resource summary: This NCOA webpage has a link to a tip sheet with culturally sensitive, practical strategies for engaging American Indian and Alaska Native elders in fall prevention efforts. Users can download a tip sheet that discusses the issue of falls among the elderly and related impacts, risk factors, the needs of aging tribal members, intervention approaches that leverage existing resources, and ways to ensure a culturally competent workforce.

NIA—Health Information

www.nia.nih.gov/health

Resource summary: This page of the NIA site offers easy-to-read information on a broad range of health topics specific to older adults, including healthy eating, exercise, and fall prevention. Users can search for such topics as Alzheimer's disease, caregiving, cognitive health, physical activity, healthy eating, doctor-patient communication, menopause, hyperthermia, shingles, heart health, depression, Lewy-body dementia, and advance care planning. They can also order print publications, find opportunities to participate in clinical trials, and contact NIA for more specific information.

Self-Management Resource Center

www.selfmanagementresource.com

Resource summary: The center makes available a variety of small-group self-management programs for chronic illness. The programs are available online or through licensed local organizations. In addition to the core program for groups with multiple chronic illnesses, several condition-focused programs are offered, including ones for diabetes, chronic pain, and HIV. These programs were originally developed by and housed at the Stanford Patient Education Research Center. The site provides information about provider training as well as licensing for organizations that would like to offer one or more of the self-management programs. The site also provides access to implementation tools, trainer certification guidelines, administrative manuals in English and Spanish, and facilitator videos, and it links to a locator for finding local programs.

General

NCOA

www.ncoa.org

Resource summary: NCOA promotes the health and economic security of older adults. Its website maintains a collection of resources on healthy aging for providers, older adults, advocates, and caregivers, including news on related topics of interest; innovations in the field; and information on economic security, healthy living, and public policy affecting older adults. The site also provides links to interactive tools for determining benefits, getting financial tips, and finding the best Medicare plan.

NCOA—Resources

www.ncoa.org/audience/older-adults-caregivers-resources/?posttype=ncoaresource

Resource summary: This webpage contains a searchable database of articles and webinars on topics ranging from behavioral health issues to fall prevention.

Alcohol Misuse and Drug Use

SAMHSA— Finding Quality Treatment for Substance Use Disorders

https://store.samhsa.gov/product/Finding-Quality-Treatment-for-Substance-Use-Disorders/PEP18-TREATMENT-LOC

Resource summary: This one-page downloadable factsheet provides useful guidelines for finding a quality SUD treatment provider. It identifies steps for accessing care and the five signs of quality treatment: program and staff accreditation, availability of FDA-approved medications, use of evidence-based practices, promotion of family involvement, and provision of ongoing support (e.g., ongoing counseling, help with meeting basic needs like sober housing).

A.A. for the Older Alcoholic—Never Too Late

www.aa.org/assets/en_US/p-22_AAfortheOlderAA.pdf

Resource summary: This booklet presents stories from men and women who became involved with AA as older adults. It recreates the narrative approach of AA speakers at meetings in a large-print format. The stories briefly describe the individuals and the transformation to sobriety that they achieved through attending AA meetings.

How Do You Talk to Older Adults Who May Be Addicted?

www.hazeldenbettyford.org/articles/how-to-talk-to-an-older-person-who-has-a-problem-with-alcohol-or-medications

Resource summary: This easy-to-read online article can be used by family members and others concerned about an older adult's use of alcohol or drugs. It offers information about how to identify signs that an older adult may be misusing alcohol or drugs, how to talk with the older person nonconfrontationally, and how to get help. The article presents practical approaches and specific language for talking with older adults in the case of risky alcohol or medication use.

Interactive Alcohol Misuse Screener

www.alcoholscreening.org

Resource summary: AlcoholScreening.org is a free service of the Center on Addiction. The screening tool is designed to help people determine whether their alcohol use is harmful to their health or if it increases their risk for future harm. Depending on the results of the screener, the site offers guidance on lowering a person's risks of harm from drinking and urges those with hazardous drinking patterns to take positive action. Note that the site's discussion of drinking in moderation is not specific to older adults.

MedicareInteractive.org—Treatment for Alcoholism and Substance Use Disorder

www.medicareinteractive.org/get-answers/medicare-covered-services/mental-health-services/treatment-for-alcoholism-and-substance-abuse

Resource summary: This webpage discusses Medicare coverage of treatment for SUDs.

NIAAA Alcohol Treatment Navigator

https://alcoholtreatment.niaaa.nih.gov

Resource summary: This website helps consumers understand AUD and take steps for finding the best treatment options based on individual needs and preferences. It explains the different types of treatment available, associated costs, and ways to identify quality treatment.

The site offers a downloadable toolkit to help users organize and simplify their search process.

NIAAA—Rethinking Drinking: Alcohol & Your Health

www.rethinkingdrinking.niaaa.nih.gov

Resource summary: This interactive website from NIAAA provides consumers with accurate information about what a standard drink is and how to calculate their level of alcohol consumption based on the types and quantity of alcoholic beverages they consume. See the Drink Size Calculator (www.rethinkingdrinking.niaaa.nih.gov/Tools/Calculators/Drink-Size-Calculator.aspx) and the Cocktail Content Calculator (www.rethinkingdrinking.niaaa.nih.gov/Tools/Calculators/Cocktail-Calculator.aspx). Note that guidelines at this website are for all adults; they are not specific to older adults. Users can download publications in English-or Spanish-language versions.

NIA—Alcohol Use or Abuse

www.nia.nih.gov/health/topics/alcohol-use-or-abuse

Resource summary: This webpage provides readers with tips on discussing sensitive topics with their healthcare providers, including alcohol use. It also provides information on how to help someone who misuses alcohol, recognize when drinking has become a problem, and understand the relationship between alcohol and drug use. Consumers can find facts about aging and alcohol, such as how alcohol may affect older people differently than younger people, and how heavy drinking can cause health problems, make some health problems worse, and affect safety in general.

NIA— Older Adults and Alcohol: You Can Get Help

https://order.nia.nih.gov/sites/default/files/2018-01/older-adults-and-alcohol.pdf

Resource summary: This publication is for older adults and their family members, friends, and caregivers. It provides free, easy-to-read information and answers to common questions about how alcohol affects the body as people age and how to get help if drinking is negatively affecting health. The document explains how the aging body becomes more sensitive to the effects of alcohol and how heavy drinking can make some health problems worse. It also discusses the harmful effects of drinking alcohol while taking medicines, as well as the benefits of social supports for cutting down or quitting drinking.

Alcohol and Medication Interactions

Drugs.com—Drug Interactions Checker

www.drugs.com/drug_interactions.html

Resource summary: Consumers can access information that explains what drug-drug interactions are, how they occur, how to check for them, and what other factors can cause interactions with certain medications. Consumers can also check medication-alcohol interactions and download the website's mobile app for information on the go. The app is compatible with Android and iOS devices.

FDA—My Medicine Record

www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM095018.pdf

Resource summary: My Medicine Record is a form that clients can use to keep track of all of their medications and record any adverse reactions that occur. It includes sections for recording emergency contact information, primary care physician, and pharmacy. The form also provides a list of questions to ask providers about medications and dietary supplements. Clients can enter information electronically or print the form and write on it.

NIAAA— Harmful Interactions: Mixing Alcohol With Medicines

https://pubs.niaaa.nih.gov/publications/Medicine/Harmful_Interactions.pdf

Resource summary: This 10-page pamphlet discusses commonly used prescription and OTC medications and how they interact with alcohol. After giving a brief explanation of the dangers involved, such as reduced effectiveness of the medication or toxicity, the document displays a multipage table that contains a list of commonly used medications, by brand names and generic names, and identifies the reactions that might occur when drinking alcohol and taking a given medication.

Tobacco Use

NIA—Quitting Smoking for Older Adults

www.nia.nih.gov/health/quitting-smoking-older-adults

Resource summary: This webpage provides free information to help older adults quit smoking. It contains a list of federal resources and their associated quit lines and discusses the dangers of traditional cigarettes, cigars, pipes, hookahs, chewing tobacco, snuff, and secondhand smoke, and the benefits of quitting at any age. Some of the dangers are increased risks for lung disease, heart disease, cancer, respiratory disease, osteoporosis, eye disease, and diabetes.

NCI —Clear Horizons: A Quit-Smoking Guide for People 50 and Older

https://smokefree.gov/sites/default/files/pdf/clear-horizons-accessible.pdf

Resource summary: Clear Horizons serves as both a self-help guide for older smokers who want to quit and an addiction counseling protocol for clinicians who work with this population. The document contains information on the health benefits of quitting smoking, step-by-step guidance for preparing to quit, and tips for remaining smoke free.

Content addresses the issues of individual triggers, craving, withdrawal, and “slips.” The guide says that slipping back into the smoking habit is common but emphasizes that this does not indicate failure. The guide recommends getting back on track after a slip by following the 4 D's: Distract yourself, Deep breathing, Drink water, and Do something else. Information about quit-smoking medication, consumer resources, and a sample quit journal can also be found in the guide.

Mutual-Help Groups

Al-Anon

https://al-anon.org/

Resource summary: Al-Anon family group meetings allow friends and family members of people who misuse substances to share their experiences and learn how to apply the principles of the Al-Anon program to their individual situations. Sponsorship gives members the chance to receive personal support from more experienced individuals in the program. Many Al-Anon members benefit by hearing about situations and relationships that are similar to their own.

Al-Anon literature is available in more than 40 languages. The Al-Anon/Alateen Service Manual is available in Spanish and French, and the Al-Anon website is available in English, Spanish, and French.

Alcoholics Anonymous (AA)

https://aa.org/

Resource summary: The AA website offers information about alcohol misuse and links to local resources that provide lists of AA group meetings for people who misuse alcohol and want to stop. AA sponsors provide members with more personal support from experienced individuals.

Information is provided for clinicians, AA members, and the general public. Local resources can be obtained by entering in your ZIP Code. The site showcases a number of public service announcements (available in English, Spanish, and French), as well as AA literature, e-books, self-support resources, the press page, General Service Board, General Service Office newsletters, regional forums information, and international AA activities.

Narcotics Anonymous (NA)

www.na.org

Resource summary: NA is a global community-based organization with a multilingual, multicultural membership that supports addiction recovery via a 12-Step program, including regular group meeting attendance. It is an ongoing support network for maintaining a drug-free lifestyle.

The website features information for the public, literature and other products, a link to events, resources and updates for NA members, and an interactive database to search for local helplines and meetings.

Secular Organizations for Sobriety (SOS)

www.sossobriety.org

Resource summary: SOS is a network of support groups focused on helping people achieve sobriety from SUDs or compulsive eating using meeting support in a secular setting. Consumers who want to find a meeting must send a message and provide their name, phone number, and email address.

Seniors In Sobriety (SIS)

www.seniorsinsobriety.com

Resource summary: SIS is an offshoot of AA and has been actively reaching out to older adults with AUD since 1990. Its outreach efforts include encouraging local meetings to designate themselves as senior friendly and starting SIS meetings.

This website provides information about SIS's history, focus, and annual conference. It also has a list of meetings where older adults who misuse alcohol can meet for fellowship, help with cutting down or quitting alcohol consumption, and education on the unique problems alcohol misuse causes their age group.

SMART (Self-Management and Recovery Training) Recovery

www.smartrecovery.org

Resource summary: The SMART Recovery website provides information about its program, training opportunities, and a searchable database of local and online meetings in the United States and abroad. The SMART Recovery program supports people who are trying to break free from addictive activities of all kinds. It provides education and tools to help clients change their behaviors and thinking. The site's SMART Recovery Toolbox includes quick reference worksheets, homework exercises, and literature resources that focus on confidence building, coping with anxiety, decision making, and relapse prevention.

Women for Sobriety (WFS)

https://womenforsobriety.org

Resource summary: WFS is a recovery program based on women's unique emotional needs that focuses on helping women with SUDs enter into and maintain recovery. The WFS New Life Program is based on 13 Acceptance Statements that encourage emotional and spiritual growth. WFS has certified moderators and chat leaders facilitating mutual-help groups online and in person, as well as phone volunteers available for one-on-one support.

Consumers have access to information on the program, an interactive meeting finder, online and phone support, the annual conference, a signup page for the email list, and articles.

Caregiver Resources

Alzheimer's Association—Support Groups

www.alz.org/care/alzheimers-dementia-support-groups.asp

Resource summary: This webpage describes group meetings that provide a safe place for caregivers, family, and friends of people with dementia to meet and develop a mutual support system. The page provides a 24/7 helpline and a searchable database of caregiver support groups.

Caregiver Self Assessment Questionnaire

www.healthinaging.org/tools-and-tips/caregiver-self-assessment-questionnaire

Resource summary: Originally developed and tested by the American Medical Association, this questionnaire is hosted on the HealthinAging.org website and is available in multiple languages. The questionnaire is available as an interactive online assessment tool or can be downloaded as a PDF. Questions are related to physical, emotional, and mental conditions.

ElderLaw Answers

www.elderlawanswers.com

Resource summary: ElderLaw Answers provides free tools and indepth information for consumers and elder law attorneys. The website maintains resources on financial and legal services related to caring for an older adult with healthcare and other needs. Consumers can search for information on estate planning, Medicaid, probate matters, long-term care insurance, nursing homes and other support care options, senior living, retirement planning, and veterans' benefits, as well as answers to common questions and statistics on related issues.

Family Caregiver Alliance (FCA)

www.caregiver.org

Resource summary: FCA works to address the needs of caregivers for family members. The site has information on complex caregiver challenges and provides education resources on chronic illnesses, a research registry, and advocacy tools. It also offers an information line for caregivers of adults with chronic medical illnesses living at home, online caregiver support groups, and an online Family Care Navigator that provides a state-by-state list of services and assistance for caregivers.

mmLearn.org

https://training.mmlearn.org/video-library

Resource summary: mmLearn.org maintains a library of free videos for caregivers who seek practical ways to meet the physical, emotional, and spiritual needs of the older adults in their care. Videos are available on specific topics, including substance misuse, Alzheimer's disease, assistive devices, wound care, depression, and fall prevention. This resource also offers free continuing education for practitioners.

National Caregivers Library

www.caregiverslibrary.org

Resource summary: This website contains an extensive online library for caregivers that includes useful articles, forms, checklists, and links to topic-specific external resources. It offers free resources specific to caregiving activities and support, self-care for the caregiver, employer support, nutrition, safety, disaster preparedness, elder abuse, and caregiving ministries.

Topics discussed include disabilities, diseases, emotional issues, end-of-life issues, government resources, legal and money matters, and transportation. Users can find details on advanced directives, consumer protection, senior care options, and new research.

VA—Caregiver Support

www.caregiver.va.gov/Care_Caregivers.asp

Resource summary: The VA offers a number of free services to support family caregivers of veterans, including the online workshop Building Better Caregivers, which gives caregivers information and tools to help them learn more effective caregiving strategies, as well as ways to manage their own stress and emotions. The webpage also offers links to many other caregiver resources, such as the VA's Caregiver Support Line—an information and referral center staffed by licensed healthcare professionals; the Caregiver Support Website; the VA's Peer Support Mentoring Program; a telephone-based coaching program for caregivers; a suicide prevention toolkit for caregivers; and a secure video-based tool that allows veterans and their caregivers to meet with VA healthcare providers through a computer or mobile phone application. In addition, caregivers can obtain help from the local VA Medical Center's Caregiver Support Coordinator, a licensed professional who can provide valuable information and match caregivers with services for which they are eligible.

The website provides or links to tips and tools on managing medicines, talking with providers, caring for oneself, staying organized, and other topics. It also has links to a hospital locator, health programs for veterans, long-term and community-based care, A-Z health topics, the National Center for PTSD, and the National Resource Directory.

Health and Wellness

ACL —Expand Your Circles: Prevent Isolation and Loneliness As You Age

https://eldercare.acl.gov/Public/Resources/Brochures/docs/Expanding-Circles.pdf

Resource summary: This easy-to-read brochure offers tips for older adults on how to expand their social networks and remain socially engaged with others. It provides statistics related to social isolation among older adults; lists negative health effects associated with isolation and loneliness; and links to resources for connecting with other people.

NIA—A Good Night's Sleep

www.nia.nih.gov/health/good-nights-sleep

Resource summary: This NIA webpage focuses on the importance of a good night's sleep. It discusses sleep apnea, movement disorders in sleep, and the effects of Alzheimer's disease on sleep patterns, and tips for falling asleep safely. It also provides access to outside resources and articles on related topics, such as fatigue in older adults, sleep problems and menopause, and ways to manage sleep problems for older adults with Alzheimer's disease.

NIMH —Older Adults and Depression

www.nimh.nih.gov/health/publications/older-adults-and-depression/19-mh-8080-olderadultsanddepression_153371.pdf

Resource summary: This NIMH brochure discusses depression among older adults. The publication describes the most common types of depression, depression signs and risk factors, treatment options, and steps to take in addition to treatment. It also offers tips on how to help someone with depression and tells the reader what to do if he or she is having suicidal thoughts.

Silver Sneakers—Health Fitness for Older Adults

www.silversneakers.com

Resource summary: Silver Sneakers is a flexible health and fitness program for adults ages 65 and older. It is covered under some Medicare Advantage Plans. Classes are held in a variety of settings, such as gyms and community centers. Consumers can search the website for locations across the United States.

Silver Sneakers fitness programs offer beginner-and experienced-level classes. Consumers can browse the different classes offered on the website, including cardio fitness lessons, low-impact water activities, and balance training. If unable to attend classes in person, Silver Sneakers members can access online exercise videos on the website or use an online app to tailor their exercise program and track healthy living goals.

The website also has links to articles and information about healthy living for seniors, including tips on preparing meals, beating the winter blues, volunteering, and maintaining interests.

Technology and Social Media

Lifeline Support

www.lifelinesupport.org

Resource summary: This federal program lowers the monthly cost of phone and Internet service for eligible customers who use a participating phone or Internet provider. The website explains eligibility requirements and the application process, and includes a locator for participating companies.

Staying Connected: Technology Options for Older Adults

https://eldercare.acl.gov/Public/Resources/Brochures/docs/N4A_Tech_Brochure_P06_high.pdf

Resource summary: This brochure introduces older adults to types of social media options and their benefits. It contains information on text messaging, Internet, email, Facebook, Skype, YouTube, instant messaging, Twitter, blogging, cell phones, and other technologies used to receive information and communicate with family and friends. The brochure briefly explains how and when to use social media, and gives privacy and etiquette tips.

Dementia and Other Cognitive Disorders

Alzheimer's Association—Resources

www.alz.org/help-support/resources

Resource summary: This webpage has caregiver training resources in English and Spanish; a virtual library of publications, databases, and social media tools; information for children and teens; tips for handling holidays and resolving family conflicts surrounding the disease; and other resources. Users can link to their local Alzheimer's Association chapter, community resources, and message boards.

Association for Frontotemporal Degeneration (AFTD)—Newly Diagnosed

www.theaftd.org/living-with-ftd/newly-diagnosed

Resource summary: This webpage has information on and links to AFTD's Helpline, a detailed guide for people diagnosed with FTD, online and local support groups, printable FTD awareness cards, FTD FAQs, and caregiver resources.

NIA—Dementia

www.nia.nih.gov/health/topics/dementia

Resource summary: This webpage provides health information about dementia—the different types of dementia, assessment and diagnosis, mixed dementia, end-of-life care for people with the disease, biomarker research, and support services. The page also contains links to other information on the NIA site, such as research and funding, news and events, and a free app for understanding medical scans.

General

Box

Alcohol Use Quantity and Frequency Guidelines.

Alcohol Misuse and Drug Use

Treatment Planning

Alcohol Health-Related Risk and Treatment Response Pyramid^{1461,1462,1463}

Resource summary: The Alcohol Health-Related Risk and Treatment Response Pyramid illustrates how to apply clinical interventions to corresponding levels of health-related risk associated with drinking. It can be used to assess older adults' risks.

Box

Alcohol Health-Related Risk and Treatment Response Pyramid.

Alcohol Use Agreement and Drinking Diary Cards

Resource summary: Providers can use these sample forms to develop an alcohol consumption agreement with clients and help them track their daily drinking.

Alcohol Use Agreement and Drinking Diary Cards (PDF, 1.4M)

Behavioral Health and Cognitive Impairment Screening and Assessment Tools

Generalized Anxiety Disorder (GAD-7) Screening Tool

Resource summary: This well-established diagnostic tool diagnoses anxiety and measures its severity. It is a self-report scale that asks individuals to rate symptoms over the past 2 weeks. The GAD-7 has been validated with older adults with a cutoff score of 5 for older adults indicating a need for further assessment.¹⁴⁶⁵ For more on the GAD-7 and its questions, see the article “A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7” by Spitzer and colleagues at https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/410326.¹⁴⁶⁶

Geriatric Anxiety Scale (GAS)

www.uccs.edu/agingandmentalhealthlab/scale

Resource summary: The Geriatric Anxiety Scale is a 30-item measure developed for and validated in older adult populations.¹⁴⁶⁷ It is a self-report measure that assesses somatic, affective, and cognitive symptoms of anxiety over the past 7 days. A shorter 10-item version is also available; it is also valid and reliable for older adults.¹⁴⁶⁸

Geriatric Anxiety Scale (GAS) (PDF, 1.4M)

Penn State Worry Questionnaire (PSWQ)

Resource summary: The PSWQ is a 16-item self-report questionnaire that measures worrying (e.g., how much a person worries, the effects of worrying on a person).

Penn State Worry Questionnaire (PSWQ) (PDF, 1.4M)

Geriatric Depression Scale (GDS)-Short Form

https://web.stanford.edu/~yesavage/GDS.html

Resource summary: The GDS-Short Form is one of the most popular depression screeners for older adults. The version of the GDS that should be given to clients is shown first below, followed by the scoring version. Clients with a GDS score of 6 or greater need further assessment and may need treatment for major depressive disorder (MDD).¹⁴⁷² Clients with a GDS score below 6 should be screened again in 1 month if symptoms of depression are still present.¹⁴⁷³ If a client's depressive symptoms are no longer present in 1 month, give the depression screener again in 6 months.¹⁴⁷⁴

Geriatric Depression Scale (GDS)-Short Form (PDF, 1.4M)

Patient Health Questionnaire (PHQ-9)

https://cde.drugabuse.gov/instrument/f226b1a0-897c-de2a-e040-bb89ad4338b9

Resource summary: The PHQ-9 is a nine-item screener for depression in adults of any age. It is tested and approved for use with older clients.¹⁴⁷⁶ The screener is also useful for monitoring depression severity and treatment response in clients who have already screened positive for or been diagnosed with depression. A two-item version of the PHQ-9 is available (the PHQ-2) that includes only the first two questions from the PHQ-9. However, compared with the PHQ-9, the PHQ-2 has a higher likelihood of giving older adults a false positive (that is, incorrectly rating a person as depressed when they are not).¹⁴⁷⁷ To get more reliable results, you should give the full PHQ-9. If you give the PHQ-2, be sure to give the full PHQ-9 to older adults who have a total score of 3 or higher.¹⁴⁷⁸

Scoring: The total score for the PHQ-9 is derived by first summing each column (e.g., each item chosen in column “More than half the days” = 2), then summing the column totals. Total scores range from 0 to 27 and indicate the following levels of depression severity:

0–4: None-minimal

5–9: Mild depression

10–14: Moderate depression

15–19: Moderately severe depression

20–27: Severe depression

In addition to the total score, review responses to Question #9 (suicidality) and the unnumbered question below it (the effect of symptoms on the client's daily functioning) when determining whether to initiate or refer for further assessment and treatment.^{1479,1480,1481}

PTSD Checklist for DSM-5 (PCL-5)

www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp

Resource summary: The PTSD Checklist for DSM-5 has been approved for use with older adults.¹⁴⁸² The VA gives instructions on how to use the tool. A score of 50 often means PTSD is present.¹⁴⁸³ However, in older clients a score of 50 may be too high and might not catch all older people with possible PTSD.¹⁴⁸⁴ Because of this, a cutoff score of 34 is better for adults ages 50 to 64, and a cutoff score of 24 is better for adults ages 65 to 81.¹⁴⁸⁵

PTSD Checklist for DSM-5 (PCL-5) (PDF, 1.5M)

Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)¹⁴⁸⁷

www.ptsd.va.gov/professional/assessment/documents/pc-ptsd5-screen.pdf

Resource summary: The PC-PTSD-5 is used to screen clients for PTSD. A score of 3 or more “yes” responses is considered cause for more indepth screening.

Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) (PDF, 1.4M)

Health and Wellness

Health and Wellness Screening and Assessment Tools

Elder Abuse Suspicion Index© (EASI©)¹⁴⁸⁹

www.mcgill.ca/familymed/research/projects/elder

Resource summary: The EASI© is a short questionnaire about abuse of older people. You should ask Questions 1 through 5 directly to the client. Questions apply to the last 12 months. You can answer Question 6 yourself. A “yes” response on one or more questions (other than on Question 1) is considered a positive screen. This tool is available and validated in English and French.

Elder Abuse Suspicion Index© (EASI©) (PDF, 1.4M)

Revised Iowa Pain Thermometer (IPT-R)

Resource summary: The IPT-R is easy for older patients to understand and to use. It is approved for use in older adults, including those from diverse racial and ethnic populations.¹⁴⁹⁰ The IPT-R can also be used with older adults with cognitive impairment.¹⁴⁹¹

Revised Iowa Pain Thermometer (IPT-R) (PDF, 1.5M)

Revised Faces Pain Scale

Resource summary: The revised Faces Pain Scale is easy for older adults to understand and to use. It is approved for use in older adults, including those from diverse racial and ethnic populations.¹⁴⁹³

In the following instructions, say “hurt” or “pain,” whichever seems right for a particular client. “These faces show how much something can hurt. This face [point to face on far left] shows no pain. The faces show more and more pain [point to each from left to right] up to this one [point to face on far right]—it shows very much pain. Point to the face that shows how much you hurt [right now].”

Score the chosen face 0, 2, 4, 6, 8, or 10, counting left to right. Therefore, “0” = “no pain” and “10” = “very much pain.” Do not use words like “happy” or “sad.” This scale is intended to measure how a client feels inside, not how his or her face looks.

Figure

Revised Faces Pain Scale.

Faces Pain Scale – Revised, ©2001, International Association for the Study of Pain [www.iasp-pain.org/FPSR]

Katz Index of Independence in Activities of Daily Living (Katz ADL)^1494,1495

Resource summary: The Katz ADL is one of the most commonly used instruments for measuring a client's functional status in relation to ADLs. It assesses performance in six areas: bathing, dressing, toileting, transferring, continence, and feeding. A person's ability or inability to perform ADLs and instrumental ADLs (IADLs) is used to gauge the need for care.

Katz Index of Independence in Activities of Daily Living (Katz ADL) (PDF, 1.4M)

Barthel Index

Resource summary: The Barthel Index is a brief, widely used screener for ADLs.^{1497,1498,1499} It measures a person's abilities to perform the following: feeding, bathing, grooming, dressing, toileting, bladder and bowel control, transfers, mobility, and using the stairs.

Functional Activities Questionnaire

Resource summary: This tool is used for older adults with normal cognition; mild cognitive impairment; or mild, moderate, or advanced dementia. It is used to measure IADLs.¹⁵⁰⁰ The questionnaire should be completed by a person who knows the client well (usually a caregiver or adult family member), has observed his or her behavior, and can assess the client's ability to complete IADLs and how much assistance they need, if any.

Lubben Social Network Scale (LSNS)

www.bc.edu/content/bc-web/schools/ssw/sites/lubben/description.html

Resource summary: The LSNS is designed for use with older adults. It is intended to gauge the level of a person's social support from family and friends and to determine whether that person's score indicates social isolation, which can contribute to increased mental and physical problems in older adults. Older clients can easily complete the six-item short version (LSNS-6), a self-report questionnaire available at the same website.

Social Network Map

www.researchgate.net/publication/232542443_The_Social_Network_Map_Assessing_Social_Support_in_Clinical_Practice

Resource summary: The Social Network Map is a client-centered tool that collects information on the composition of the older adult's social network, the extent to which network members provide different types of support, and the nature of relationships in the network.¹⁵⁰¹ The version below is adapted for older adults in recovery.

Figure

Social Network Map for Older Adults in Recovery.

Adapted from Tracy & Whittaker (1990).¹⁵⁰²

The following strategies¹⁵⁰³ will help you and your older clients develop a social network map:

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Create a pie chart with the seven domains. Health, behavioral health service, social service, and peer recovery support providers may be part of the support network clients identify.

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Ask older clients to identify members of their social networks by first name or initials only.

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Ask clients to describe how available (e.g., rarely, sometimes, often) each member of the network is to give emotional, instrumental, or informational support. Give examples and be specific:

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“Who is available to give you emotional support like comforting you if you are upset or listening if you are stressed?” “How often does this person give you that kind of support?”

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“Who is available to help you out in a concrete way like giving you a ride or helping with a chore?” “How often does this person give you that kind of support?”

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“Who would give you information on how to do something new or help you make a big decision?” “How often does this person give you that kind of support?”

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Note the type and frequency of support each person listed in each domain can offer.

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Ask clients to describe how close they are to each member of their network, how long they have known them, and how frequently they see them.

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Ask clients to review the map and identify types of support that may be lacking and strategies for adding new network members to beef up their social support.