The document summarizes key learnings from the Drink Wise, Age Well programme, which aimed to raise awareness of harmful drinking in older adults aged over 50 and reduce associated harms. It discusses four main themes of impact: 1) Increasing knowledge and awareness of alcohol issues in older adults, 2) Increasing resilience, 3) Supporting changes to alcohol use, and 4) Reducing stigma. For each theme, it outlines the programme activities and findings from evaluation data, including increased knowledge among professionals and the public, improved resilience, reductions in alcohol use and first-time access to support among participants. It proposes next steps like online workshops and advocacy to continue the legacy of the programme.

1. Drink Wise, Age Well
Sharing our learning

2. Drink Wise, Age Well Legacy Workshop 1:
Sharing our Learning
Objectives of workshops:
● Raise awareness of DWAW’s approach to community-based alcohol harm
reduction for the over 50s
● Share key findings from the programme evaluation
● Provide insights based on DWAW learning and stories of lived experience
● Engage stakeholder organisations to the issue of harmful drinking in the
over 50’s
● Collectively explore further actions that could be taken at a system level

3. Drink Wise, Age Well Legacy Workshop 1:
Sharing our Learning
Agenda for today
● Welcome, intros, frame
● Key learnings from the DWAW programme
● Advocacy group: insights from lived experience
● Where we are now: 2021 and beyond
● The “Calling Time” Charter: assessing what’s being done

4. Why is alcohol and ageing an issue
In both England and Scotland, 55-64 year olds drink more on average than any
other age group and are the most likely to exceed the UK drinking guidelines.
In England adults aged 65+ are most likely to drink everyday
In England, alcohol-specific death rates have risen since 2001, with these rises
occurring almost exclusively between the ages of 55 and 85. In 2018 the
highest rate of alcohol-specific deaths was in ages 55-64

5. Why older adults are at risk of alcohol harm
Less able to metabolise alcohol and more likely to have underlying health issue
that may be exacerbated
More likely to be on medications which alcohol can affect
Greater structural and cognitive changes caused by alcohol
More susceptible to imbalance leading to increased risk of falls
Can have an impact on menopausal symptoms
Increased risk of social isolation and drinking at home alone

6. Programme model and locations

7. Evaluation design and methodology
The findings are based on an approach called Contribution Analysis
Contribution Analysis helps to assess the impact (contribution) of programmes
where changes are likely to be the result of multiple contributory factors
We examined reports, literature and routinely collected data produced by
Drink Wise, Age Well and the data we had gathered from service users, staff
and professional stakeholders

8. Four themes of impact
Increasing knowledge, awareness and profile of the issue
Increasing Resilience
Supporting people to make changes to their alcohol use
Reducing stigma and discrimination

9. Increasing knowledge, awareness and profile of the issue: Background
Our baseline community survey found low levels of knowledge
about alcohol in people aged over 50
For example, 74% of people were unable to correctly identify
the UK government drinking guidelines and 23% wouldn’t
know where to get help if they were experiencing an alcohol
problem
Other research has demonstrated that professionals may lack
the knowledge and skills to identify and respond to alcohol use
in this age group

10. Increasing knowledge, awareness and profile of the issue: Activities
Media advocacy, social media campaigns and digital
engagement to raise awareness and encourage
behaviour change
Development of knowledge and skills in frontline
professionals (e.g. the police, fire and rescue, NHS,
social care workers) to recognise and respond to
problem drinking in the over 50’s
Delivering alcohol awareness workshops to over 50’s
in multiple community settings

11. Increasing knowledge, awareness and profile of the issue: key findings
15 million people were potentially exposed to media messaging about the
DWAW survey. In the month that followed there was a 187% increase in
people seeking help
90% of professionals who received training said they planned to make
changes to their practice
92% workshop attendees were able to correctly identify the
recommended drinking guidelines and 93% said they would know where
to get help
However, people from minority ethnic groups were underrepresented

12. The session facilitator gave out the
measures … so there was wee measuring
glasses … I still use that for my wine. You
can keep a better track of what you’re
drinking. You think you’re only having one
glass of wine but…”
Workshop participant

13. Increasing Resilience: Background
Resilience is the ability to adapt positively to stressful life
circumstances
Being resilient is especially important in older age which can
be a challenging time of life, and includes changes such as
retirement, bereavement or reduced physical mobility
There are three domains of resilience: Individual (personal
resilience) Social (having empowering relationships with
others) Environmental (having access to adequate
resources, including care and material resources)

14. Increasing resilience: activities
A structured resilience group course Live Wise, Age Well to
increase individual resilience in people aged over 50
One-to-one support for individuals and their families with a
focus on building coping strategies and self-worth
A wide range of social activities and mutual aid groups to build
connections and strengthen community involvement
Recruiting volunteers aged over 50, many with lived
experience, to develop their own skills and support others

15. Increasing resilience: key findings Live Wise, Age Well Group
The majority of participants entered and exited with the same
level of resilience
But of those reporting a low level of resilience at entry,
48% reported normal levels of resilience by the end
One quarter of those who were higher risk drinkers, reduced
their alcohol use at the end of the group intervention

16. Increasing resilience: key findings
For those participating in social activities there were improvements in
Emotional health 79% Sense of Purpose 82% Relationships 80%
Of those who drank alcohol, 38% reported that their alcohol use had
reduced
Only a quarter of people who took part in the resilience interventions
were men
Some not comfortable with group or unable to attend

17. When I was by myself and secret drinking,
you do feel extremely lonely. Very, very
lonely and you feel as though you’re the
only person that’s going through it. So to
be able to get out and about, meet people
with shared experiences, it’s what’s
helped me the most.”
Resilience Participant

18. Before I started doing this voluntary work
[running a Drink Wise, Age Well crafts group],
I suffered really badly with depression.
Some days I never used to go out of house
or anything. In fact I didn't even bother
getting ready and I stayed in bed most of
the time.”
Resilience Participant

19. Supporting people to make changes in their alcohol use: background
Research suggests that:-
Alcohol problems are less likely to be identified in older adult’s
Older adults have better outcomes in alcohol services specifically for
their age group and some people prefer them
Older adults with alcohol problems have high levels of undiagnosed
cognitive impairment which can make it difficult for them to engage and
benefit from alcohol treatment

20. Supporting people to make changes in their alcohol use: activities
Screening and alcohol brief intervention in wider community
and public settings
Alcohol interventions focus on age-related factors, provide
flexibility with location and times
Cognitive screening to provide participants with the suitable
level of support
Support for families to adopt positive coping strategies and
to assist their loved ones to make positive changes
Age-specific peer support sessions

21. Supporting people to make changes in their alcohol use: findings
75% had a score indicating hazardous or harmful alcohol use
Two thirds of those who received SBI hadn’t been asked about alcohol
in the last 12 months
43% said they intended to make changes to their drinking
Among those who received the alcohol intervention service, more than
a third said it was the first time they had received alcohol treatment
The majority of people who received the online webchat service said it
was their first time accessing any support

22. Supporting people to make changes in their alcohol use: findings
Alcohol Interventions:
76% reduced their alcohol consumption but almost half were still
drinking above the recommended drink limits at discharge compared to
80% at assessment
No difference in outcomes between DWAW and generic alcohol service
however only 3% disengaged from DWAW compared to 10% in alcohol
services
74% improved their wellbeing
45% reduced their anxiety and depression and there were marked
improvements in cognitive functioning

23. She [alcohol intervention service worker] used to
come to the house and take me down to [peer
support group meetings] at that time because I
wouldn’t go on a bus, or [I was] frightened to go
outside … I feel as if, through their help … I’m getting
more confident, and I was starting to go on a bus
myself and go to the [peer support group]
meetings.”
Programme participant

24. In rough terms, I would possibly do 60-70 units a
week… I'm now down to sort of 25-30 units, which is
still over the recommended issue… I do want to
reduce that… and the way I’ve reduced it, I don’t
have foggy mornings anymore… [and I don’t] get up
in the morning and have a drink…”
Programme participant

25. Reducing stigma and discrimination: background
Stigma and discrimination occurs across a range of settings
including health and social care, employment, housing and policing,
as well as in relationships with family and friends and in the general
community
Fear of stigma and discrimination can prevent people seeking social
support, help or treatment for the problems they are experiencing
with alcohol
Older adults may be subject to additional stigma because of their
age, resulting in overlapping layers of discrimination

26. Reducing stigma and discrimination: activities
Creating a UK wide social media campaign to reduce stigma
and to highlight age-related factors that can lead to
increased alcohol use
Support people via 1-2-1 and groups to challenge their own
self-stigma and wider discrimination
Ensuring that the voices of people with lived experience are
heard in policy discussions about issues that directly affect
their lives
Publication of a report on age discrimination in alcohol
policy practice and research

27. Reducing stigma and discrimination: key findings
Training challenged stereotypes that some professionals held of people with
alcohol problems
The most successful stigma-reduction activities targeted people with alcohol
problems - new sense of purpose and self-identity outside their alcohol
problem
No evidence that the programme reduced stigma among family members
Stigma-reduction impact may be short-term
Public Health England removed age cuts offs from its online alcohol rehab
directory

28. The public anti-stigma
campaign reached > 1
million people
83% believe society
should treat older adults
with alcohol problem with
more tolerance

29. Experts by experience
John Nelson
Sarah Lowton

30. The Covid Effect
0ver 50% are drinking at a level that could cause health
problems now or in the future, with nearly one in four
classed as high risk or possibly dependent.
1 in 3 children with parent aged over 50 worried about
their alcohol use since lockdown
Remote service provision should be provided in addition to,
rather than instead of, face-to-face support for older
adults.

31. Legacy
Online Knowledge Exchange Workshops to nearly
500 participants offering pledges to improve
practice
Advocacy group: workshops, research, social cafes
We Are With You digital tools- alcohol health
checker
Age Inclusive Model Service (AIMS) audit toolkit for
services
Launched our over 50s Alcohol Helpline

32. 5 MIN BREAK

33. Calling Time for Change four nation charters- recommendations for
providers, commissioners, policy makers

34. We believe
Everyone has a human right to age well with dignity.
Older adults should be able to live the best life they can, free from
the negative effects and harms caused by alcohol.
Everyone should have access to factual and credible information to
make informed choices about their alcohol use as they age.
Alcohol treatment and support must be easily accessible for all ages
and stages in life.

35. Charter for England - Four themes
PREVENTION: life events in later life can be a trigger
WORKING TOGETHER: communities are at the heart of reducing alcohol harm
PROVIDING TREATMENT: it’s never too late to change
NATIONAL STRATEGIES and best practice

36. Group exercise

37. Prevention
Targeted public health campaigns that will help older adults and their families
to understand how life events can lead to increased alcohol use, and how
alcohol use can affect healthy ageing.
A wider social prescribing model that ensures older adults are given
opportunities to make social connections in their communities to enhance
their health and wellbeing.
Recognition that carers for dependent family members can become very
isolated,
The roll-out of a brief interventions skills programme

38. Communities working together
Workplaces to promote alcohol-free social events and wellbeing initiatives
Pubs and local clubs to offer alternative alcohol -free spaces
Community projects such as older adults day centres or dementia cafes to
host alcohol prevention and awareness events to normalise the conversation
in wider settings.
Recognition that older adults living in rural communities may find it particularly
difficult to access suport

39. Providing treatment - part 1
Alcohol treatment services to embed a social prescribing model into their provision to
tackle the issues that might lead to increased alcohol use as people age.
Alcohol services to embrace meaningful co-production and develop pathways for
volunteering and employment opportunities
Alcohol services to be designed in a way that makes them accessible to older adults
and is person-centred, and not time bound.
Alcohol treatment services to offer peer support meetings for older age groups to
increase confidence and mutual support.

40. Providing treatment part 2
Health and wellbeing boards to conduct joint strategic needs assessments
Commissioners and funders to monitor access to alcohol services by age.
The treatment workforce to access value based training. It is important that
workers explore their feelings and attitudes around older adults.
Unjustified age cut-offs or ageist practice in alcohol projects, and treatment
services to be challenged on the grounds of age discrimination.

41. National strategies
National prevention strategies and interventions that raise awareness around
alcohol across the life course.
NICE to develop best practice guidelines for supporting older adults with
substance misuse problems.
Department of Health and Social Care and the Home Office to ensure that the
needs of our ageing population are specifically recognised with tailored
solutions in the UK Government Alcohol Strategy