Alcohol is one of the most widely available psychoactive substances globally. Many accept the risks associated with alcohol consumption for reasons such as social engagement and feelings of pleasure. Alcohol consumption in a nursing home setting highlights the moral and logistical challenges of balancing the need for a safe living and working environment with the dignity of risk (DoR) and personal autonomy of residents.
Under the public health framework include the medical risks associated with alcohol consumption, whether residents with impaired cognitive functioning have the capacity to make a decision about alcohol consumption and the practice and ethical implications of supplying alcohol to residents. Under a legal framework, nursing homes must consider the legal imperative to respect residents’ rights, the possibility of liability in negligence, duties owed to employees, the existence of substitute decision-makers and liquor licensing laws. Fundamental considerations under the human rights framework include the damaging psychological effects of risk-avoidance and the importance of inclusive risk assessment processes.
Alcohol policies should incorporate elements from all 3 frameworks. There is limited data publicly available about alcohol policies in nursing homes. Further research is needed to establish current practice and to evaluate the merits and disadvantages of different policies. Establishing inclusive and thorough decision-making processes is key to achieving better consumer-directed care.
As the global population continues to age, the need for robust, comprehensive, and transparent decision-making policies surrounding alcohol consumption in nursing homes will become increasingly urgent. A holistic approach must be taken to ensure the complexities and controversies surrounding nursing home alcohol consumption are adequately addressed. This is best achieved through consideration of public health, legal, and human rights frameworks.Stay the course, stay well, mask up, get vaccinated, and stay tuned!