Handling Harmful Use of Alcohol and Drugs in Elderly Homes

An increasing challenge in elderly care
Harmful use of alcohol and drugs among the elderly is an often overlooked but growing issue. Many residents have a long history of abuse, while others develop risk behaviors in connection with loneliness or mental health issues. Handling these situations requires knowledge, compassion, and clear procedures.

Why is it particularly challenging?

Late onset abuse
- Retirement or loss of loved ones can trigger new use
- Harder to detect as symptoms resemble dementia

Interaction with medication
- Alcohol can exacerbate the side effects of common medications
- Risk of dangerous combinations with painkillers

Stigma and underreporting
- Many elderly people are ashamed and hide their use
- Staff may be unaccustomed to addressing the problem

How elderly homes can work preventively

Early identification and assessment

The nurse's role
- Testing at intake with validated tools
- Document suspected use in the journal

The doctor's responsibility
- Medical assessment in case of suspicion of harmful use
- Adjust medication at demonstrated risk

Individualized measures

For residents with active addiction
- Include addiction competence in care planning
- Regular doctor checks for medication monitoring

Documentation of deviations
- Always write deviation report at risk behaviors
- Include information about drug interactions

When the crisis arises - procedures to follow

Acute effect or withdrawal
- Immediate doctor contact for serious symptoms
- Clear documentation in the journal and deviation register

Informant obligation
- Serious events must be reported to both doctors and relatives
- Clearly describe what risks have been identified

Reflection Questions - Addiction Problems

Care staff
- How can you become better at detecting early signs?
- Which conversation techniques work best to get through?

Manager, nurse, occupational therapist, and physiotherapist
- Are there sufficient procedures for doctor information?
- How do you ensure follow-up of deviations?

Residents and relatives
- What information do you need about your rights?
- How can you support without taking over responsibility?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day