Alcohol misuse in older people: the role of home carers

Abstract

Research on problems associated with alcohol use in older people is scant and contradictory. The 'greying' of the population and the current emphasis on care in the community, mean that it is increasingly important to understand patterns of alcohol use which may incur risk in elderly people, and to develop appropriate prevention and early intervention approaches. This paper begins with a brief overview of the literature on alcohol misuse in older people, and discusses some of the problems of identifying and responding to problem drinking in the elderly. The paper then examines the potential role of one group of workers, home carers who, for many elderly people, are a crucial link to the world beyond their homes. It is suggested that home carers are well placed to respond to risky drinking among elderly people but that they experience both structural and personal barriers to adopting a more active role. The provision of appropriate information and training may go some way towards encouraging carers to remain alert to alcohol related problems in elderly clients but supportive, accessible services are also required.

Alcohol use in later life – older people's perspectives

“…There have been a number of studies which have focused on the extent to which older people who receive services may have a problem with alcohol, the difficulties in recognising problem drinking in older service users and how health and social care practitioners should respond (Herring and Thom, 1997a, b; Klein and Jess, 2002; Simpson et al , 1994). Findings from these studies indicate:The prevalence of problematic drinking is unclear due to the sensitivity of the topic and stigma leading to under‐reporting.The lack of awareness of the possibility of alcohol problems, in part due to medication and other health conditions masking the effects of alcohol consumption.A lack of appropriate referral agencies for treatment.Reluctance among professionals to broach the topic directly with service users.A dilemma between awareness of the need for support where a person is vulnerable and a reluctance to judge.A tension between rights and risks – the wish to respect privacy, autonomy and choices even if this puts the older person at risk.A lack of specialist training, uncertainty about how to include problematic alcohol use in the context of assessment and in the management of problematic use in residential settings.None of these issues which relate specifically to older people's alcohol use feature in the policy response to recent increases in alcohol‐related hospital admissions.…”

Alcohol and older people

“…Abuse of alcohol in the elderly may be more common than previously thought, but accurate detection is hampered by, among other things, lack of information about the most suitable screening or detection methods for this group (Mears & Spice, 1993). Herring and Thom (1997) highlight the limitations of previous research, including the fact that the problems surrounding the varying definitions for old age and alcohol abuse make comparisons difficult. Other explanations offered for differences in consumption among the older population include surveys finding an increasing prevalence in problematic alcohol use when conducted in health care settings rather than in community settings.…”

“…Policies that include the needs of older people are required to provide the older generation with access to alcohol services (Klein & Jess, 2002). Herring and Thom (1997) suggest that home carers are well placed to respond to risky drinking among elderly people but that they (ie. home carers) experience both structural and personal barriers to adopting a more active role.…”