Understanding Rehabilitation Providers: Knowledge, Attitudes, and Practices Toward Older Adults with Substance Use Disorders
Abstract
1. Introduction
1.1. Overview of Substance Use
1.2. Barriers to Treatment
1.3. Substance Use and Older Adults
1.4. Outcomes of Treatment for Older Adults
2. Materials and Methods
2.1. Participants
2.2. Measures
2.2.1. Knowledge, Attitudes, and Practices
2.2.2. Ageism
2.3. Procedures
2.4. Analysis
3. Results
3.1. Knowledge, Attitudes, and Behaviors
3.2. Expectations Regarding Aging
4. Discussion
5. Limitations and Suggestions
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Survey Tool
- Q1. How old are you?________________________________________________________________
- Q2. What county do you live in?________________________________________________________________
- Q3. With which racial/ethnic group do you identify?
- ◦
- Caucasian (1)
- ◦
- African American (2)
- ◦
- Latino or Hispanic (3)
- ◦
- Asian (4)
- ◦
- Native American (5)
- ◦
- Native Hawaiian or Pacific Islander (6)
- ◦
- Two or more (7)
- ◦
- Other/Unknown (8)
- ◦
- Prefer not to say (9)
- Q4. With which gender do you identify?
- ◦
- Male (1)
- ◦
- Female (2)
- ◦
- Other: (3)
- ◦
- Prefer not to say (4)
- Q5. What is the highest level of education you have completed?
- ◦
- Some High School (1)
- ◦
- High School (2)
- ◦
- Some College (3)
- ◦
- Associate’s Degree (4)
- ◦
- Bachelor’s Degree (5)
- ◦
- Master’s Degree (6)
- ◦
- Doctorate or higher (7)
- ◦
- Trade School (8)
- ◦
- Prefer not to answer (9)
- Q6. What is your occupational title?________________________________________________________________
- Q7. How many years of experience do you have in this occupation?________________________________________________________________
- Q8. What is the highest level of training or certification you have received?________________________________________________________________
- Q9. How many years of experience do you have working with adults aged fifty-five years and older?________________________________________________________________
- Q10. What is your employment status?
- ◦
- Employed, working 1–39 h per week (1)
- ◦
- Employed, working 40 or more hours per week (2)
- Q11. I feel confident in my ability to treat adolescents.
- ◦
- Strongly agree (1)
- ◦
- Agree (2)
- ◦
- Neither agree nor disagree (3)
- ◦
- Disagree (4)
- ◦
- Strongly disagree (5)
- Q12. I feel confident in my ability to treat adults.
- ◦
- Strongly agree (1)
- ◦
- Agree (2)
- ◦
- Neither agree nor disagree (3)
- ◦
- Disagree (4)
- ◦
- Strongly disagree (5)
- Q13. I feel confident in my ability to treat older adults.
- ◦
- Strongly agree (1)
- ◦
- Agree (2)
- ◦
- Neither agree nor disagree (3)
- ◦
- Disagree (4)
- ◦
- Strongly disagree (5)
- Q14. I feel confident in my knowledge of older adults.
- ◦
- Strongly agree (1)
- ◦
- Agree (2)
- ◦
- Neither agree nor disagree (3)
- ◦
- Disagree (4)
- ◦
- Strongly disagree (5)
- Q15. I understand older adults have specialized needs compared to younger adults.
- ◦
- Strongly agree (1)
- ◦
- Agree (2)
- ◦
- Neither agree nor disagree (3)
- ◦
- Disagree (4)
- ◦
- Strongly disagree (5)
- Q16. I have completed training that expanded my knowledge of older adults.
- ◦
- Strongly agree (1)
- ◦
- Agree (2)
- ◦
- Neither agree nor disagree (3)
- ◦
- Disagree (4)
- ◦
- Strongly disagree (5)
- Q17. I have difficulty understanding the needs of older adults.
- ◦
- Strongly agree (1)
- ◦
- Agree (2)
- ◦
- Neither agree nor disagree (3)
- ◦
- Disagree (4)
- ◦
- Strongly disagree (5)
- Q18. How would you rate the training of healthcare professionals in identifying and addressing substance use disorders in older adults?
- ◦
- Satisfactory (1)
- ◦
- Somewhat satisfactory (2)
- ◦
- Neither satisfactory nor unsatisfactory (3)
- ◦
- Somewhat unsatisfactory (4)
- ◦
- Unsatisfactory (5)
- Q19. How familiar are you with the specific challenges and risk factors associated with substance use disorders in the older adult population?
- ◦
- Not familiar at all (1)
- ◦
- Slightly familiar (2)
- ◦
- Moderately familiar (3)
- ◦
- Very familiar (4)
- ◦
- Extremely familiar (5)
- Q20. How satisfied are you with your training or credentialing process regarding education of older adult patients?
- ◦
- Extremely dissatisfied (1)
- ◦
- Somewhat dissatisfied (2)
- ◦
- Neither satisfied nor dissatisfied (3)
- ◦
- Somewhat satisfied (4)
- ◦
- Extremely satisfied (5)
- Q21. How confident are you in the awareness of healthcare providers regarding potential interactions between commonly prescribed medications for older adults and substances of abuse?
- ◦
- Very confident (1)
- ◦
- Confident (2)
- ◦
- Neutral (3)
- ◦
- Not confident (4)
- ◦
- Very unconfident (5)
- Q22. How frequently do you encounter older adults with substance use disorders in your rehabilitation practice?
- ◦
- Rarely (1)
- ◦
- Occasionally (2)
- ◦
- Often (3)
- ◦
- Very often (4)
- Q23. Which of the following challenges do you believe older adults with substance use disorders face in accessing and engaging with rehabilitation services?
- ◦
- Stigma associated with aging and substance use (1)
- ◦
- Lack of awareness about available services (2)
- ◦
- Physical health limitations (3)
- ◦
- Mental health comorbidities (4)
- ◦
- Financial constraints (5)
- ◦
- Transportation difficulties (6)
- ◦
- Other (please specify) (7)
- Q24. Rate the effectiveness of the following strategies or interventions when working with older adults with substance use disorders: (1 being the highest, 6 being the lowest)
- ______ Individual counseling (1)
- ______ Group therapy (2)
- ______ Medication-assisted treatment (3)
- ______ Harm reduction approaches (4)
- ______ Family therapy (5)
- ______ Other (please specify) (6)
- Q25. How do you adapt your approach when working with older adults compared to younger individuals with substance use disorders?
- ◦
- I use the same approach for both age groups (1)
- ◦
- I modify my approach slightly for older adults (2)
- ◦
- I significantly modify my approach for older adults (3)
- ◦
- I use a completely different approach for older adults (4)
- Q26. What barriers, if any, do you perceive in effectively addressing the unique needs of older adults with substance use disorders?
- ◦
- Lack of specialized training in geriatric substance use disorders (1)
- ◦
- Limited availability of age-appropriate treatment programs (2)
- ◦
- Resistance to change or treatment adherence issues (3)
- ◦
- Ageism within the healthcare system (4)
- ◦
- Other (please specify) (5)
- Q27. Which resources or training do you believe would enhance your ability to support older adults with substance use disorders in rehabilitation?
- ◦
- Continuing education workshops/seminars (1)
- ◦
- Online courses/modules (2)
- ◦
- Mentorship programs (3)
- ◦
- Clinical guidelines specific to older adults with substance use disorders (4)
- ◦
- Access to specialized geriatric addiction counselors (5)
- ◦
- Other (please specify) (6)
- Q28. How do you believe attitudes towards substance use disorders in older adults impact the effectiveness of rehabilitation efforts?
- ◦
- Positively (1)
- ◦
- Negatively (2)
- ◦
- No impact (3)
- ◦
- Unsure (4)
- Q29. When people get older, they need to lower their expectations of how healthy they can be.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q30. The human body is like a car: When it gets old, it gets worn out.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q31. Having more aches and pains is an accepted part of aging.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q32. Every year that people age, their energy levels go down a little more.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q33. I expect that as I get older, I will spend less time with friends and family.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q34. Being lonely is just something that happens when people get old.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q35. As people get older, they worry more.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q36. It’s normal to be depressed when you are old.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q37. I expect that as I get older, I will become more forgetful.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q38. It’s an accepted part of aging to have trouble remembering names.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q39. Forgetfulness is a natural occurrence just from growing old.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
- Q40. It is impossible to escape the mental slowness that happens with aging.
- ◦
- Definitely true (1)
- ◦
- Somewhat true (2)
- ◦
- Somewhat false (3)
- ◦
- Definitely false (4)
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Variable | n = 25 |
---|---|
M (Range) | |
Age of participants | 40.9 (24–74) |
Race | n (%) |
Caucasian | 20 (80.0%) |
African American | 3 (12.0%) |
Latino or Hispanic | 1 (4.0%) |
Two or more | 1 (4.0%) |
Gender | |
Female | 20 (80.0%) |
Male | 5 (20.0%) |
Education | |
Bachelor’s Degree | 3 (12.0%) |
Master’s Degree | 20 (80.0%) |
Doctorate or Higher | 2 (8.0%) |
Employment | |
Employed, working 1–39 h per week | 3 (12.0%) |
Employed, working 40 or more hours per week | 22 (88.0%) |
Years of experience | |
In reported occupation | 13.9 (1–40) |
Working with older adults | 13.0 (0–40) |
Job Title | |
Social worker | 6 (30%) |
Licensed therapist/counselor | 5 (25%) |
Registered nurse | 4 (20%) |
Program supervisor | 4 (20%) |
Clinical director | 3 (15%) |
Physician | 2 (10%) |
Care manager | 1 (5%) |
Item | n (%) Indicating Frequency of Encounters |
---|---|
Rarely | 4 (16.0%) |
Occasionally | 9 (36.0%) |
Often | 10 (40.0%) |
Very often | 2 (8.0%) |
Response | Strongly Agree n (%) | Agree n (%) | Neither Agree nor Disagree n (%) | Disagree n (%) | Strongly Disagree n (%) | |
---|---|---|---|---|---|---|
Item | ||||||
I feel confident in my ability to treat adolescents. | 7 (28.0%) | 6 (24.0%) | 3 (12.0%) | 9 (36.0%) | 0 (0.0%) | |
I feel confident in my ability to treat adults. | 18 (72.0%) | 6 (24.0%) | 1 (4.0%) | 0 (0.0%) | 0 (0.0%) | |
I feel confident in my ability to treat older adults. | 10 (40.0%) | 12 (48.0%) | 1 (4.0%) | 2 (8.0%) | 0 (0.0%) | |
I feel confident in my knowledge of older adults. | 9 (36.0%) | 11 (44.0%) | 3 (12.0%) | 2 (8.0%) | 0 (0.0%) | |
I understand older adults have specialized needs compared to younger adults. | 9 (36.0%) | 14 (56.0%) | 2 (8.0%) | 0 (0.0%) | 0 (0.0%) | |
I have difficulty understanding the needs of older adults. | 0 (0.0%) | 2 (8.0%) | 4 (16.0%) | 14 (56.0%) | 5 (20.0%) |
Item | n (%) Indicating This Item Is a Challenge |
---|---|
Stigma associated with aging and substance abuse | 17 (21.8%) |
Lack of awareness about available services | 16 (20.5%) |
Physical health limitations | 15 (19.2%) |
Transportation difficulties | 11 (14.1%) |
Mental health comorbidities | 10 (12.8%) |
Financial constraints | 8 (10.3%) |
Other | 1 (1.3%) |
Strategy | n (%) Rank 1 | n (%) Rank 2 | n (%) Rank 3 | n (%) Rank 4 | n (%) Rank 5 | n (%) Rank 6 |
---|---|---|---|---|---|---|
Individual counseling | 9 (42.9%) | 7 (33.3%) | 2 (9.5%) | 2 (9.5%) | 1 (4.8%) | 0 (0.0%) |
Group therapy | 5 (23.8%) | 7 (33.3%) | 4 (19.0%) | 3 (14.3%) | 2 (9.5%) | 0 (0.0%) |
Medication-assisted treatment | 2 (9.5%) | 6 (28.6%) | 5 (23.8%) | 4 (19.0%) | 4 (19.0%) | 0 (0.0%) |
Harm reduction approaches | 4 (19.0%) | 0 (0.0%) | 3 (14.3%) | 9 (42.9%) | 5 (23.8%) | 0 (0.0%) |
Family therapy | 1 (4.8%) | 1 (4.8%) | 7 (33.3%) | 3 (14.3%) | 9 (42.9%) | 0 (0.0%) |
Other | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 21 (100.0%) |
Item | n (%) Indicating Familiarity with Challenges |
---|---|
Not familiar at all | 0 (0.0%) |
Slightly familiar | 5 (20.0%) |
Moderately familiar | 8 (32.0%) |
Very familiar | 11 (44.0%) |
Extremely familiar | 1 (4.0%) |
Item | n (%) Indicating Satisfaction with Training |
---|---|
Extremely dissatisfied | 0 (0.0%) |
Somewhat dissatisfied | 3 (12.0%) |
Neither satisfied nor dissatisfied | 12 (48.0%) |
Somewhat satisfied | 8 (32.0%) |
Extremely satisfied | 2 (8.0%) |
Item | n (%) Indicating Adapting Approaches |
---|---|
I use the same approach for both age groups | 0 (0.0%) |
I modify my approach slightly for older adults | 16 (64.0%) |
I significantly modify my approach for older adults | 7 (28.0%) |
I use a completely different approach for older adults | 2 (8.0%) |
Item | n (%) Indicating This Item Is a Barrier |
---|---|
Lack of specialized training in geriatric substance use disorders | 17 (34.0%) |
Limited availability of age-appropriate treatment programs | 12 (24.0%) |
Resistance to change or treatment adherence issues | 11 (22.0%) |
Ageism within the healthcare system | 7 (14.0%) |
Other | 3 (6.0%) |
Item | n (%) Indicating Item Would Be Beneficial |
---|---|
Continuing education workshops/seminars | 17 (30.9%) |
Online courses/modules | 10 (18.2%) |
Mentorship programs | 4 (7.3%) |
Clinical guidelines specific to older adults with substance use disorders | 11 (20.0%) |
Access to specialized geriatric addiction counselors | 11 (20.0%) |
Other | 2 (3.6%) |
Item | n (%) Indicating Effects of Attitudes |
---|---|
Positively | 5 (20.0%) |
Negatively | 12 (48.0%) |
No impact | 0 (0.0%) |
Unsure | 8 (32.0%) |
Scale | M (SD) |
---|---|
Physical health | 52.8 (18.7) |
Mental health | 72.2 (22.0) |
Cognitive function | 60.0 (25.8) |
Overall (Combined domain scores) | 61.5 (18.9) |
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Share and Cite
Johnson, M.; Cathorall, M.L.; Newsham, T.M.K.; Fugate-Whitlock, E. Understanding Rehabilitation Providers: Knowledge, Attitudes, and Practices Toward Older Adults with Substance Use Disorders. J. Ageing Longev. 2025, 5, 41. https://doi.org/10.3390/jal5040041
Johnson M, Cathorall ML, Newsham TMK, Fugate-Whitlock E. Understanding Rehabilitation Providers: Knowledge, Attitudes, and Practices Toward Older Adults with Substance Use Disorders. Journal of Ageing and Longevity. 2025; 5(4):41. https://doi.org/10.3390/jal5040041
Chicago/Turabian StyleJohnson, Marybeth, Michelle L. Cathorall, Tina M. K. Newsham, and Elizabeth Fugate-Whitlock. 2025. "Understanding Rehabilitation Providers: Knowledge, Attitudes, and Practices Toward Older Adults with Substance Use Disorders" Journal of Ageing and Longevity 5, no. 4: 41. https://doi.org/10.3390/jal5040041
APA StyleJohnson, M., Cathorall, M. L., Newsham, T. M. K., & Fugate-Whitlock, E. (2025). Understanding Rehabilitation Providers: Knowledge, Attitudes, and Practices Toward Older Adults with Substance Use Disorders. Journal of Ageing and Longevity, 5(4), 41. https://doi.org/10.3390/jal5040041