Supporting healthier alcohol use amongst older people within community care settings: Insights from a qualitative exploration of older people’s and care providers’ perspectives

Problem

Within the United Kingdom, 87% of the older population consume alcohol and 20% of this group report drinking at levels which may put them at risk. Older people are likely to experience harm from their drinking, due to the combination of alcohol with the multiple health conditions and medications that are common in later life. Drinking also plays a central role in many older people’s social and leisure lives, making a positive contribution to their quality of life. Primary care and other community based staff are ideally placed to understand factors shaping older people’s drinking and to promote healthier alcohol use. However, the majority of older people at risk have never discussed their drinking with any care provider. This study aimed to explore the factors that influence the decisions of older people and their community health and social care providers about late-life drinking. This paper will also explore how primary care providers can be supported to meet the needs of older people relating to their drinking.

Approach

Twenty-four older adults (aged 65+) and 35 care providers working with older people in the community (general practitioners, district and practice nurses, health care assistants, pharmacists, home carers, social workers and dentists) were involved in semi-structured interviews and focus groups addressing our research questions. Data were analysed thematically, applying principles of constant comparison.

Findings

Drinking occasions contribute to developing routines and structure in later life, potentially increasing older people’s consumption. Older people prioritise quality over length of life, and see alcohol as a positive contribution towards pleasure in retirement, creating a conflict with providers’ judgement of risk. Older people base their perceived susceptibility to harm from their drinking around their personal experiences and their identity as more responsible drinkers. Consequently, older people and their care providers may overlook risks attached to drinking.

Consequences

Care providers can support older people to recognise risks in their drinking patterns and develop healthier day-to-day routines. Older people can be supported to recognise the importance of health to their quality of life and primary care has a key role in addressing alcohol intake in clinical settings. Care providers should be supported to recognise misuse in older people and adopt appropriate communication techniques to address risky drinking.