Councils and healthcare authorities are slowly coming to terms with the widespread problem of alcoholism among the elderly; lewd overtures, fondling and verbal abuse are daily experiences for many home care workers in Denmark, according to a new study.
In the study of working conditions for over 800 home care nurses and social workers undertaken by the trade union FOA, 40 percent of the workers reported encountering drunk and alcoholic elderly on a daily basis. Another 35 percent reported the same experience once or several times per week, reports Ugebrevet A4.
“Wiping up vomit – being groped – sexual propositions – drunk man’s talk,” was one survey respondent’s description of her working day helping elderly charges with alcohol problems.
“Residents who won’t let us change their clothes, even if there is faeces and urine on them. They won’t allow their bed sheets to be changed, even if the bed is soaked in urine and faeces,” another respondent described.
All told, 40 percent of the home care workers surveyed reported that they were regularly offended and that they sometimes felt uncomfortable doing their jobs because of their elderly charges’ drunken behaviour.
Those statistics and personal stories are leading public health authorities and trade union leaders to rethink their strategies concerning how to serve home help-dependent seniors with alcohol problems.
“We don’t talk nearly enough about the fact that alcohol abuse is a widespread problem in our society and, of course, that it also affects the healthcare workers in their jobs,” Anette Søgaard Nielsen, the leader of the alcohol treatment programme in the city of Odense, told Ugebrevet A4.
Anny Winther (Venstre), the chairman of the social and healthcare committee for the national association of local councils (KL), agreed it was unacceptable that social and healthcare workers are regularly exposed to abusive language and inappropriate behaviour stemming from high rates of alcoholism.
“The councils are aware of the problem. There may still be a need for extra training and a clear agreement with residents that the home care workers will only come to them if they behave properly – as long as skipping the visit won’t entail a health risk for the resident.”
The national board of health, Sundhedsstyrelsen, estimated in 2010 that 18 percent of Danes between the ages of 65 and 74 had a “problematic” alcohol consumption. More than 14 alcoholic drinks per week for women and more than 21 for men is how Sundhedsstyrelsen defines "problematic" alcohol intake.
Karen Stæhr, the chairman of FOA’s department for social and healthcare workers, told Ugebrevet A4 that alcohol abuse among the elderly was “a bloody big taboo that – ugh – we still can’t talk about”.
Her comment was seconded by Ulrik Becker, a doctor at Hvidovre Hospital who specialises in alcoholism. To make matters worse, he added, the medications many elderly people take often exacerbate the effects of the alcohol.
To address the problems associated with alcohol abuse among the elderly FOA and local councils have begun looking at ways to treat it from both ends: through therapy programmes for the elderly, and specialized education for the home care professionals who work with them.
Some councils have already introduced guidelines to help home care workers determine and maintain reasonable boundaries. One such guideline is a ban on buying or serving alcohol to someone who is drunk or whom they suspect may have an alcohol problem. Another guideline permits home care workers to leave someone who is drunk and has fallen on the floor, if the individual is still too drunk to stand or sit on their own and is too belligerent to be helped.
Nevertheless, Margrethe Kähler, a lawyer and senior advisor to the retirees’ association Ældre Sagen, argued that the councils had no right to meddle or pass judgement if a help-dependent elderly person chooses to drink a couple of glasses of wine per day.
“But if they lose all control, as many of these people do, then we think the social authorities have the right to tell them ‘no’ – that they won’t go and buy them 15 beers, for example.”
Becker pointed out that home care workers are faced with an ethical problem, as well. If a resident relies on home care workers to buy groceries, do the workers really have the right to refuse to buy alcohol?
“As far as the law goes they definitely don’t, but we could also advise home helpers to buy a small bottle of schnapps instead of a big one. Or they could content themselves with buying them a single beer, instead of a whole case,” Becker said. “There are lots of things you can do that are still ‘faithful’. It’s just a matter of approach.”
