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Michigan Alcoholism Screening
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Hearing Handicap Inventory for the Elderly-Screening Version (HHIE_S)
Yes No
1. After drinking, have you ever noticed an increase in your heart rate or beating in your chest? 
2. When talking with others, do you ever underestimate how much you actually drink?
3. Does alcohol make you sleepy so that you often fall asleep in your chair?
4. After a few drinks, have you sometimes not eaten or been able to skip a meal because you don't feel hungry?
5. Does having a few drinks help decrease your shakiness or tremors?
6. Does alcohol sometimes make it hard for you to remember parts of the day or night?
7. Do you have rules for yourself that you won't drink before a certaintime of day or night? 
8. Have you lost interest in hobbies or activities you used to enjoy?
9. When you wake up in the morning, do you ever have trouble remembering part of the night before? 
10. Does having a drink help you sleep?
11. Do you hide your alcohol bottles from family members?
12. After a social gathering, have you ever felt embarrassed because you drank too much?
13. Have you ever been concerned that drinking might be harmful to your health?
14. Do you like to end an evening with a nightcap?
15. Did you find your drinking increased after someone close to you died?
16. In general, would oyu prefer to have a few drinks at home rather than go out to social events?
17. Are you drinking more now than in the past?
18. Do you usually take a drink to relax or clam your nerves?
19. Do you drink to take your mind off your problems?
20. Have you ever increased your drinking after experiencing a loss in your life?
21. Do you some time drive when you have had too much drink?
22. Has a doctor or nurse ever said they were worried or concerned about your drinking?
23. Have you ever made rules to manage your drinking?
24. When you feel lonely does having a drink help?
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Aging & Health Issues: The Family Physician's Role - American Academy of Family  Physicians
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