‘Wet’ eldercare facilities: three strategies on the use of alcohol and illicit substances

Abstract

ABSTRACT Wet eldercare facilities constitute a type of harm reduction arrangements where goals of abstinence are abandoned in favour of goals of increased wellbeing for older people with long-term substance use disorder. The fact that residents are acknowledged as being active in their substance use results in challenges; harmful activities are witnessed by the staff in a context that has actually been created by a social service agency. The aim of this article was to explore what professionals in wet eldercare facilities considered problematic in relation to residents’ consumption of alcohol and illicit substances and what strategies they used to address these ‘problems’. Particular attention was paid to approaches and strategies that addressed the challenge of being present at a facility where destructive behaviour and consumption of alcohol and illicit substances were part of everyday life. Data for the study consists of 12 interviews with managers and staff at five eldercare facilities with different sizes, organizational styles, and approaches. Qualitative content analysis was used to identify strategies that were used to handle the presence of alcohol and drugs under a ‘cap of acceptance’ deemed to be necessary for a wet eldercare facility. Three main strategies were identified and referred to as a) looking away, b) intervention and prohibition and c) intervention and distribution. In the final analysis, findings were brought into a typology for strategies, based on the two variables of acceptance and control, and the use of different strategies was critically discussed.