Alcohol use amongst older adults: Knowledge and beliefs of occupational therapists working in physical health care settings

Abstract

Introduction There is little discussion in the United Kingdom occupational therapy literature surrounding the topic of older people and alcohol, despite the growing prevalence of alcohol-related health problems in older adults resulting from an ageing population and changing patterns of consumption. Occupational therapists in physical health care settings are likely to work with older people whose drinking pattern may not be alcohol dependent, but may put their physical or psychological health at risk. Method A survey methodology was employed using open and closed questions, recruiting occupational therapists (band 5 to 9) (n = 122) working with older people (65+ years) in physical health care settings across all, except one, National Health Service Regional Health Boards in Scotland. Results Responses highlight gaps in occupational therapists’ knowledge around alternative ‘safe limits’ of alcohol intake for older people. Belief in professional role was evident, but the perception was that this was not supported by undergraduate education. Occupation focused theory and assessment were not prioritized when considering alcohol in the older adult. Conclusion This study has highlighted a need to develop pre- and post-qualification education for occupational therapists, to enhance understanding of theory, assessment and knowledge of alcohol with older adults in physical health care settings.

Use of occupation-focused language by occupational therapists in physical health care settings when considering older people and alcohol use

“…In a recently completed study (Maclean et al, 2015), the authors of this study surveyed occupational therapists working in physical health care settings about their knowledge and beliefs relating to alcohol misuse amongst older adults (aged over 65 years). Knowledge of theory and assessment is essential for health care professionals working within the context of ageing and alcohol misuse (Wallace et al, 2010).…”

“…This provided us with an opportunity to 'listen' to the language being used in these practice settings and contribute to the ongoing discussion about occupation-focused practice. Having previously identified themes (Maclean et al, 2015), we returned to our data to look in more detail at therapists' word choice. As the question did not pre-determine a specific conceptual model of practice, we were able to explore more generally the relationship between the language of practice, and the language used by current occupational therapy models.…”

“…Guided by McNaught and Lam (2010), we 'cleaned' the data by removing conjunctions (for example, 'a', 'the') and conversation fillers (for example, 'you know'), corrected spelling and combined plural and singular words. Parameters were set to display the 50 most frequently used words and the generated word clouds were checked against the enumerative content analysis of the original transcript (Maclean et al, 2015) to ensure consistency. We recognise that frequency does not necessarily equate to importance; however, by focusing on word choice we were able to compare the use of occupational language between those therapists who did and those who did not claim to use conceptual models in their practice.…”

“…The other notable word that features prominently across both word clouds is 'alcohol'; however, this is understandable given that our practice language analysis was based upon a segment of data from a larger survey of occupational therapists' knowledge and beliefs about alcohol use amongst older people. For more information, the authors direct the reader to the full presentation of our findings in Maclean et al (2015).…”

Can we talk about it? A qualitative study exploring occupational therapists’ decision making in judging when to ask an older person about drinking alcohol

“…Drawing on the theoretical perspective of person-centredness (McCormack and McCance 2017) and collective occupation (Kantartzis and Molineux 2017), this paper examines when occupational therapists in an acute hospital setting will initiate a conversation with older people (65+ years) about their drinking and how this can contribute to a wider multisystems approach. This paper builds on our prior research in the field, including a recent survey of occupational therapists in Scotland (n = 122) who indicated that they were hesitant to ask older people about their alcohol consumption when admitted to an acute hospital setting (Maclean et al 2015).…”