In this research update, Kathryn Waldegrave, lecturer in community nursing at the University of Leeds, summarises the evidence for making the not-so-straightforward assessment of ‘responsible’ drinking in older adults.
Tolerance to alcohol diminishes over the life course and brings increased risk when used at levels previously considered to be ‘safe’ in younger years. In considering alcohol consumption in an older adult population, the narrative tends towards the negative aspects – the impact on health and the increase in mortality, underpinned by evidence of a lack of engagement in targeted public health campaigns to reduce alcohol intake.
A recent study aimed to synthesise evidence exploring the views and perceptions of older people as they relate to alcohol consumption, with the aim of enhancing and targeting policies and interventions to promote both healthy ageing and alcohol harm reduction.
The review recognised the multifaceted role that alcohol plays in the lives of the older adult population, highlighting positive elements alongside some more negative aspects. Drinking was recognised as an activity to maintain and sustain social interactions after retirement, and was identified as holding an important role in supporting cultural identity. The review also acknowledges how drinking habits and routines can become firmly established over the life course and recognises the subsequent challenges faced by healthcare professionals in promoting behaviour changes to reduce a risk when patients do not see the activity as being problematic to health.
A commentary notes that interventions focusing solely on the negative aspects of alcohol are unlikely to change established behaviours. It is suggested that incorporating alcohol health promotion into routine health checks would support the identification of ‘responsible drinkers’ and proposes this is where public health interventions should be focused. In the case of needing to plan personalised interventions to manage unsafe levels of drinking, nurses should take into account the positive role that social and cultural aspects of drinking may provide for the patient and consider seeking alternative ways of maintaining these through new social and leisure opportunities.
Reference: Bareham BK, Kaner E, Spencer LP, Hanratty B. Drinking in later life: a systematic review and thematic synthesis of qualitative studies exploring older people’s perceptions and experiences. Age Ageing 2019; 48:134-146
Commentary: Alfred L. Routine health checks can provide opportunities for alcohol health promotion in older adults who identify as responsible drinkers. Evid Based Nurs 2019, online first 11 April 2019
Kathryn Waldegrave is a lecturer in community nursing at the University of Leeds