Out of the ordinary: Media reports on wet eldercare facilities

Abstract

The aim of this article was to investigate presentations of “wet” eldercare facilities in Sweden, a type of facility that provides care for older people with long-term alcohol problems and where the consumption of alcohol is allowed. Wet eldercare facilities challenge traditional Swedish policy on alcohol treatment, and their approach constitutes a breach of mainstream policies on alcohol and treatment, where abstinence is a goal. Data for the study consisted of articles that reported on two nursing homes in the City of Gothenburg during 1995–2017, a total of 65 articles. Qualitative content analysis was used to identify relevant themes. The study revealed that with the exception of a media scandal at one of the facilities in 2017, reports were mostly positive. Residents were portrayed as “chronic” alcoholics (kroniker) who were resistant to treatment, but in need of the type of permissive approach and care that was provided at the facilities. In the article we refer to this as a framework of matched arrangements. Readers of several media reports were invited to see the person behind the scruffy addict and the approach was in some cases developed into a critique of unrealistic ambitions of mainstream treatment. This critique was, however, not developed into a coherent framework. A conclusion was that the surprisingly positive portrayal of residents and descriptions of the facilities as “different” should be understood in relation to the way the media creates interest by reporting on events and arrangements that appear as out of the ordinary.

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

“…Although interviewees tended to justify their own actions, some of them, when referring to the looking away response, questioned if they in fact facilitated continued abuse and caused additional harm, rather than a dignified life. Such accusations were actually part of a 2017 media scandal when the Cloverdale facility was described as law-less territory (Jönson and Harnett, 2019). Given this, it is perhaps not surprising that the manager at Victoria Lodge dismissed the 'competing' control response of the Danish facility as irresponsible while the manager at Cloverdale/Mountainview described it as 'interesting' and a response to possibly learn from.…”

“…From researchers' point of view, harm reduction has been described as humane and pragmatic and as means to improve health and reduce societal costs (Stenius 2007;Lindgren 2008;Aceijas 2012;Maremmani et al 2015). In both Sweden and Denmark a positive view has been particularly present in relation to older individuals with a long-standing history of substance use disorder and homelessness (Jönson and Harnett 2019;Thiesen 2007). To provide housing in special eldercare facilities has been suggested as a reasonable harm reduction intervention for this particular group (Palm 2009).…”

“…Staff at wet eldercare facilities are present 24/7 and may witness residents' consumption of destructive, sometimes lethal, amounts of alcohol and illicit substances, but their role is to provide care and accept residents as being active 'addicts'. The accepting approach may not only pose a moral challenge for the staff, but also clashes with policies of social services, according to which staff generally are regarded as having a legal imperative to act if they are aware that destructive behaviour is going on (Jönson and Harnett 2019).…”

“…Wet eldercare facilities have been described in a favourable light by implicit referrals to the lack of real alternatives (cf. Andersen and Järvinen 2007;Jönson and Harnett 2019), for instance by stating that they target people with 'long-term alcohol problems' who are 'unable to live in their own home' (the website of a Danish wet eldercare facility). These accounts are part of a justification repertoire proving that a wet facility is the last and only solution for people who have been through the entire system of treatments and failed (Emerson 1981).…”

Where is “society”?

“…Societal inclusion and exclusion mechanisms are discussed by von Greiff, Skogens, and Berlin (2019) , who account for a follow-up study with clients treated for substance abuse in Sweden in the 1980s. In a piece on how the media portray eldercare facilities which serve alcohol or allow alcohol use, Jönson and Harnett (2019) unfold a depiction of residents and descriptions of the facilities as “different” in surprisingly positive notions. In both of these articles, the subjects of the study or the account of them in the media are related to their place in society as part of an institutional service provision (substance abuse treatment and elderly care).…”