Health professionals’ experience of nursing home residents‘ consumption of alcohol and use of psychotropic drugs

Background: Nursing home (NH) residents are in most cases in older ages and use prescription drugs. As alcohol interacts with many commonly prescribed drugs, NH residents may be more vulnerable to the effects of alcohol. Aim: To investigate the experiences of health professionals in Norwegian NHs when it comes to residents' alcohol consumption and use of psychotropic drugs, and the facilitation of such use in the NH. Method: Focus-groups and individual interviews with NH health professionals were performed in 2017 and 2018. The data were analysed using content analysis. Findings: Two main themes emerged: (1) the balancing of alcohol consumption, and (2) the use of psychotropic drugs. Each of these themes involved reasoning, which revealed that the informants in general had little attention regarding alcohol consumption among residents, and few institutions had policies regarding serving and consumption of alcohol. The informants reported an increased attention regarding use of psychotropic drugs and a tendency towards less use of psychotropic drugs among the residents than before, but few informants reported use of standardised observations tools of symptoms related to prescribing and discontinuation of drugs. Conclusion: Alcohol policies or procedures related to alcohol consumption were uncommon at the NH that the interviewees of this study represented, and the professionals regarded infrequent serving and consumption of alcohol among the residents as a part of everyday life. In cases when residents frequently consumed alcohol, the professionals used dialogue to underpin the adherent risks and they also tried to control the consumption of the resident in different ways. The interviewees were aware of various side-effects of psychotropic drugs; they were also aware of their effects in combination with alcohol

Coping and Social Resilience during the COVID-19 Pandemic: A Qualitative Follow-Up Study among Healthcare Workers in Norwegian Public In-Home Services

Background: Healthcare workers (HCWs) are central and serve in the frontlines when epidemics threaten public health. Thus, certain communities may be hardest hit by these challenges. Interventions supporting HCWs are important, and to develop these, understanding their experiences is essential. Aim: To explore how HCWs in Norwegian public in-home services experienced work during the COVID-19 pandemic over time. Method: A longitudinal qualitative study with two data collections approximately one year apart (2021 and 2022) was performed. Individual interviews were conducted with HCWs. Results: The analysis resulted in six main themes: Changing everything, Redefining ‘necessary tasks’, Distancing and loneliness, Cooperation and coordination, More infections and fewer worries and Lessons for the future. These indicate capabilities and processes, how they are evolving over time, and outcomes. The first two themes focus on the first period of the pandemic, the next two on the ongoing intermediate period, and the final two cover the last period. Conclusion: The HCWs’ narratives have demonstrated their collective coping based on adaptive and transformative capacities. Further, they have enlisted experienced social resilience in their strategies for coping with the COVID-19 challenges

Family’ members experiences of their older relative’s alcohol and substance misuse

Background Alcohol consumption in Norway and much of the western world has increased during the past decades, in particular among older adults (> 65 years). Although living with a family member’s alcohol misuse has been shown to have a significant deleterious health impact, research on this topic is both lacking and urgently needed to develop targeted health services. Aim To generate knowledge of how family members are affected by their older relatives’ alcohol and other substance misuse problems. Method In 2020, 17 individual interviews were carried out with the wives and adult children of older adults with alcohol and other substance misuse problems. Data were analysed using content analysis. Findings Analyses revealed two main themes; the impact of living with psychological stress over time, and the impact over time on family relationships and functioning. Both included four subthemes, representing different dimensions of participants’ experiences of the impact of their older relative’s alcohol and substance misuse. Conclusion The challenges family members experienced through ongoing exposure to their relatives’ alcohol and/or other substance misuse increased over time. These experiences had significant negative consequences for their health and life situation

Additional file 1 of A systematic review of prevalence of pain in nursing home residents with dementia

Additional file 1: S1 Table. PRISMA 2020 Checklist

Health professionals’ experience of nursing home residents‘ consumption of alcohol and use of psychotropic drugs

Background:Nursing home (NH) residents are in most cases in older ages and use prescriptiondrugs. As alcohol interacts with many commonly prescribed drugs, NH residents may be morevulnerable to the effects of alcohol.Aim:To investigate the experiences of health professionals inNorwegian NHs when it comes to residents’ alcohol consumption and use of psychotropic drugs,and the facilitation of such use in the NH.Method:Focus-groups and individual interviews withNH health professionals were performed in 2017 and 2018. The data were analysed using contentanalysis.Findings:Two main themes emerged: (1) the balancing of alcohol consumption, and (2)the use of psychotropic drugs. Each of these themes involved reasoning, which revealed that theinformants in general had little attention regarding alcohol consumption among residents, and fewinstitutions had policies regarding serving and consumption of alcohol. The informants reported anincreased attention regarding use of psychotropic drugs and a tendency towards less use ofpsychotropic drugs among the residents than before, but few informants reported use of stan-dardised observations tools of symptoms related to prescribing and discontinuation of drugs.Conclusion:Alcohol policies or procedures related to alcohol consumption were uncommon atthe NH that the interviewees of this study represented, and the professionals regarded infrequentserving and consumption of alcohol among the residents as a part of everyday life. In cases whenresidents frequently consumed alcohol, the professionals used dialogue to underpin the adherentrisks and they also tried to control the consumption of the resident in different ways. Theinterviewees were aware of various side-effects of psychotropic drugs; they were also aware oftheir effects in combination with alcohol

Factors associated with alcohol consumption and prescribed drugs with addiction potential among older women and men – the Nord-Trøndelag health study (HUNT2 and HUNT3), Norway, a population-based longitudinal study

Background Little is known about factors associated with alcohol consumption and use of drugs with addiction potential in older adults. The aim of this study was to explore the association between socio-demographic variables, physical and mental health and the later (11 years) use of frequent drinking, prescribed drugs with addiction potential and the possible combination of frequent drinking and being prescribed drugs with addiction potential in older adults (≥ 65 years). Methods In this longitudinal study, we used data from two surveys of the Nord-Trøndelag Health Study (HUNT2 1995–1997 and HUNT3 2006–2008), a population based study in Norway. We totally included 10,656 individuals (5683 women) aged 54 years and older when they participated in HUNT2. Frequent drinking was defined as drinking alcohol 4 days or more per week. Data on prescribed drugs with addiction potential were drawn from the Norwegian Prescription Database. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009. Results The typical frequent drinker in HUNT3 was younger, more educated, lived in urban areas, and reported smoking and drinking frequently in HUNT2 compared to the non-frequent drinker in HUNT3. The typical user of prescribed drugs with addiction potential in HUNT3 was an older woman who smoked and was in poor health, suffered from anxiety, had been hospitalized in the last 5 years and used anxiety or sleep medication every week or more often in HUNT2. The typical individual in HUNT3 with the possible combination of frequent drinking and being prescribed drugs with addiction potential had more education, smoked, drank frequently and used anxiety or sleep medication in HUNT2. Conclusion Individuals who were identified as frequent drinkers in HUNT2 were more likely to be frequent drinkers in HUNT3, and to have the possible combination of frequent drinking and being prescribed drugs with addiction potential in HUNT3. Health care professionals need to be aware of use of alcohol among older adults using drugs with addiction potential

Family' members experiences of their older relative's alcohol and substance misuse.

BACKGROUND: Alcohol consumption in Norway and much of the western world has increased during the past decades, in particular among older adults (> 65 years). Although living with a family member's alcohol misuse has been shown to have a significant deleterious health impact, research on this topic is both lacking and urgently needed to develop targeted health services. AIM: To generate knowledge of how family members are affected by their older relatives' alcohol and other substance misuse problems. METHOD: In 2020, 17 individual interviews were carried out with the wives and adult children of older adults with alcohol and other substance misuse problems. Data were analysed using content analysis. FINDINGS: Analyses revealed two main themes; the impact of living with psychological stress over time, and impact over time on family relationships and functioning. Both included four subthemes, representing different dimensions of participants' experiences of the impact of their older relative's alcohol and substance misuse. CONCLUSION: The challenges family members experienced through ongoing exposure to their relatives' alcohol and/or other substance misuse increased over time. These experiences had significant negative consequences for their health and life situation

Health professionals’ experiences regarding alcohol consumption and its relation to older care recipient’s health and well-being

Background: Alcohol consumption among older people is expected to increase in the years ahead. Health professionals’ experiences of, and reflections on, alcohol consumption and its relation to well-being are thus important to the provision of adequate and high-quality treatment and care. Aim: To investigate health professionals’ experiences and reflections about alcohol consumption among older people and how it is related to their health and well-being. Methods: A case study design approach was adopted, incorporating three qualitative studies involving Norwegian health professionals. The health professionals interviewed included workers in nursing homes, home care professionals and general practitioners. Results: The study revealed a diversity of views and reflections on alcohol consumption, its facilitation, and the impact on the health and well-being of older patients and care recipients. Six themes were revealed by the three studies: (i) the facilitation of alcohol consumption to promote and normalize life in nursing homes, (ii) the restriction of unhealthy alcohol consumption, (iii) attempts to discuss alcohol consumption with care recipients, (iv) the initiation of collaboration with informal caregivers in restricting alcohol consumption, (v) minimalizing the dialogue regarding alcohol consumption to guard patient privacy and (vi) a desire for joint action and a national political strategy. Conclusion: Health professionals working in NHs, in-home and GPs find it difficult to discuss the use and elevated use of alcohol with older people for whom they have care and treatment responsibilities. In general, they are concerned that such conversations infringe on the principles governing an individual’s autonomy. However, because they are aware that elevated alcohol intake may have a negative impact on health and well-being, they also express a need for guidelines how they in a better and open minded way can discuss the use and elevated use of alcohol with the patients they care for

Health professionals’ experiences regarding alcohol consumption and its relation to older care recipient’s health and well-being

Background: Alcohol consumption among older people is expected to increase in the years ahead. Health professionals’ experiences of, and reflections on, alcohol consumption and its relation to well-being are thus important to the provision of adequate and high-quality treatment and care. Aim: To investigate health professionals’ experiences and reflections about alcohol consumption among older people and how it is related to their health and well-being. Methods: A case study design approach was adopted, incorporating three qualitative studies involving Norwegian health professionals. The health professionals interviewed included workers in nursing homes, home care professionals and general practitioners. Results: The study revealed a diversity of views and reflections on alcohol consumption, its facilitation, and the impact on the health and well-being of older patients and care recipients. Six themes were revealed by the three studies: (i) the facilitation of alcohol consumption to promote and normalize life in nursing homes, (ii) the restriction of unhealthy alcohol consumption, (iii) attempts to discuss alcohol consumption with care recipients, (iv) the initiation of collaboration with informal caregivers in restricting alcohol consumption, (v) minimalizing the dialogue regarding alcohol consumption to guard patient privacy and (vi) a desire for joint action and a national political strategy. Conclusion: Health professionals working in NHs, in-home and GPs find it difficult to discuss the use and elevated use of alcohol with older people for whom they have care and treatment responsibilities. In general, they are concerned that such conversations infringe on the principles governing an individual’s autonomy. However, because they are aware that elevated alcohol intake may have a negative impact on health and well-being, they also express a need for guidelines how they in a better and open minded way can discuss the use and elevated use of alcohol with the patients they care for