Habits, rituals, and addiction: an inquiry into substance abuse in older persons

Older people enter the final phases of their lives with well-established habits and rituals, some of which might be or become substance abuse. This inquiry focused on the relationship between habits, rituals, and the compulsive addictive behaviours evident in older persons' substance abuse. Habits and rituals, examined as adaptive and limiting functions in older persons, revealed changes in autonomy, social inclusion, and emotional responses to such changes as older persons experience declining energy reserves and physical debilities. Older persons' ebbing sense of control and passionate responses to change illustrate the perennial struggle between the will and emotions when habits and rituals transform to compulsive addictive behaviours. Two concepts, germane to this struggle both in older persons' addictive behaviours and nurses' response, emerged from this inquiry: temperance, a balance between the will's freely chosen actions and passionate desire, and discipline, the means to achieve such balance. The focused attention demanded in discipline can be realized in spiritual exercises and daily care of the soul. Disciplined actions engage the older persons' imaginative capacities to manage and abandon the self in goals consistent with end-of-life issues: meaningful fulfillment of human potential and the need for daily joy and pleasure in living the final years.