Caregivers' representations of elders who drink too much alcohol: crossroads between professional home caregivers and hospitals nurses.

Abstract

Being old or having alcohol use disorders are two unfavorable conditions for receiving help or optimal care. When these two conditions are associated, professionals are even less attracted to work with old alcoholics. To address this issue, from the professionnals perspective, two studies based on research interviews were crossed, one was conducted with 17 professional home caregivers and the other with 29 hospital nurses. A double analysis of the collected speech was manually performed, then computerized by the Alceste® software. This qualitative research, may have indirectly selected the most favorable agents concerned by the issue: those who agreed to answer. Professional home caregivers have negative and demeaning representations of older drinkers (manipulative, nasty, violent...), which generate feelings of powerlessness when faced with them and deleterious identifications. Despite an expressed lack of training and a lack of support for their activities, these agents are able to develop skills in their caregiving interventions, and find professional satisfaction by accompanying them. Nurses also have an initial negative impression of elders misusing alcohol, but these professionals rapidly consider them as less violent and more approachable than younger adults with alcohol use disorder. The exchanges with these old alcoholic patients, often resort to humor, in a possible attempt for proximity, while the same agents report only very few skills to care for elderly alcoholics. Despite all these negative precedents, care is possible and develops itself in daily practice. Beyond initial and spontaneous adverse reactions, while they feel very isolated and little supported in their actions, professional home caregivers as well as nurses, develop daily assistance and care with elders misusing alcohol. The professional home caregivers' expectancy for training and the nurses' expectancy for support could help improve the first approach of these elders and the quality of care offered to them.