Routine screening for alcohol misuse in older people with cognitive impairment receiving services in memory clinics is feasible and acceptable. The process of completing alcohol screening tools with older adults receiving services at memory clinics may increase awareness of the potential impact of alcohol on cognitive functioning and provide practitioners with an opportunity to educate service users about the ways that their drinking is affecting their memory. Several techniques to facilitate completion of screening tools were identified. Future research should evaluate the reliability and validity of alcohol screening tools with older people through corroborating screening results with other assessment methods.

Substance misuse in older adult populations is a significant social and health issue. This area requires urgent attention from researchers, clinicians, commissioners, and society as a whole. This article provides a discussion of the literature and important aspects of clinical practice.

Purpose – The purpose of this paper is to explore current practice, barriers and facilitators to identifying and responding to alcohol problems in memory clinics. Design/methodology/approach – A questionnaire sent to professionals in 55 memory clinics in England, Wales and the Isle of Wight and two focus groups with professionals from three memory clinics in England. Findings – Only 1/35 clinics that responded to the questionnaire was using a standardised alcohol screening tool but all attempted to gain some information about alcohol use. Without screening tools, practitioners found it difficult to determine whether alcohol use was problematic. Barriers to identification/intervention included cognitive impairment, service-user being “on guard” during assessment, presence of family members/carers, time constraints and a perception that brief interventions were not within the remit of memory clinics. Facilitators were obtaining visual clues of problem drinking during home visits and collateral information from family members/carers. Research limitations/implications – Focus group participants were recruited through convenience sampling and a small number of professionals took part. This means that the findings may be subject to selection bias and limits the generalisability of the findings. Practical implications – Memory clinics should provide guidance and training for practitioners on how to intervene and respond to alcohol misuse. Further research is required to determine the most effective way to identify alcohol problems in people with cognitive impairment and how to deliver brief alcohol interventions that take account of cognitive deficits. Originality/value – This is the first study to examine alcohol screening and interventions in memory clinics and identifies a need for guidance, training and further research.

BackgroundThere is limited literature on security and access for social care settings despite policy highlighting importance, and no published research exploring facial recognition lock technology (FRLT) for potential improvements. This study explored FRLT device implementation, use, barriers and benefits.MethodsOne residential care home with 43 older adults and 68 staff members (Site A), and one supported living facility caring for six individuals with mental health issues with 18 staff members (Site B) were provided with FRLT for six months. Nine pre-implementation staff interviews explored existing access and security perceptions. Ten post-implementation staff interviews and one staff focus group were conducted; all were analysed using content analysis to understand, alongside process mapping, the use and impact of the FRLT. Interview participants included site care staff and other visiting healthcare professionals. We additionally report feedback from the technology developers to demonstrate impact of industry-academia collaboration.ResultsPre-implementation interviews highlighted issues with current pin-pad or lock-box systems, including; code sharing; code visibility, ineffective code changes, security issues following high staff turnover, lack of efficiency for visitors including NHS staff and lack of infection control suggesting requirement for innovation and improvement. Pre-implementation interviews showed openness and interest in FRLT, although initial queries were raised around cost effectiveness and staff skills. Following implementation, good levels of adoption were achieved with 72% and 100% (49/68 and 18/18) of staff members uploading their face at the two sites, and 100% of residents at Site B using the system (6/6). Additionally, Site B made a positive procurement decision and continues to discuss wider rollout. Post implementation interviews suggested FRLT was useful and acceptable for improving security and access. Benefits identified included staff/visitor time saving, enhanced security, team ease of access, resident autonomy and fewer shared touch points. Integration was suggested including with fire alarm systems, staff clocking in/out, and Covid monitoring to improve usefulness. The developers have since responded to feedback with design iterations.ConclusionWe identified concerns on security and access in social care settings, which warrant further exploration and research. FRLT could increase resident autonomy and reduce staff burden, particularly considering frequent multi-agency health and care visits.