Printer friendly version

ID: 917

Type of submission: Oral

Conference track: Research

Topics: Innovative Harm Reduction Programmes; Key Populations and Harm Reduction

Presenting author: Michelle McCann

Presenting author biography:

Michelle McCann is a Research Fellow from SMART Substance MIisuse and Ageing Research Team, University of Bedfordshire, UK.

A non-abstinence based care home for older people with alcohol problems in the UK

Michelle McCann


As the number of older adults in the world’s population is growing, alcohol misuse in older adults is becoming an increasingly important issue. A significant number of older adults drink heavily until the end of their lives. Many reach a stage when they require permanent residential care because they are no longer able to care for themselves. However, most care homes for older adults are neither accessible nor suitable for older adults who continue to drink heavily. This presentation describes a progressive care home for older adults who are unable or unwilling to stop drinking where the purpose is harm reduction rather than abstinence.


Methods comprised document analysis, observations of verbal exchanges, experiences and routines in communal areas, field notes taken during staff rounds, interviews with residents and family members, focus groups with staff, interviews with Doctor/General Practitioner and other professionals based in the home.


Each resident has an agreed allocation of alcohol given out by staff. Staff often purchase alcohol and tobacco for residents. Residents can drink in their rooms, in the lounge, in the grounds and outside the home. The home provides a stable environment and access to regular nutrition, improved management of medication, avoidance of injuries caused by falls due to intoxication, prevention of physiological withdrawals, protection of money and management of residents to prevent fighting and aggression. Medication is dispensed and monitored. Most of the residents have experienced significant losses in their lives and are estranged from their families. They have complex physical and mental health problems and some can be aggressive and abusive to staff.


The home provides a safe and stable place for residents to live (and die) with dignity and is likely to lead to a significant reduction in the use of public services.