Substance use and misuse of older adults living in residential care facilities: a scoping review from a person-centred care approach

Abstract

Person-centred care (PCC) in residential care facilities (RCFs) is valuable but creates challenges for care professionals balancing involvement and a partnership approach for residents while considering the health and safety outcomes of all residents. This review evaluates what is known about the substance use and misuse of residents living in RCFs and what is important to study in future research to enhance PCC, especially in cases in which residents wish to choose unhealthy behaviours. A scoping review was conducted and exclusion criteria were set. The included papers were assessed on methodological quality using the Mixed Methods Appraisal Tool and the results were qualitatively analysed. The included papers consisted of studies regarding alcohol, tobacco and illicit drugs. The results showed that care professionals are involved in facilitating and regulating alcohol and tobacco. The focus of the included papers is on alcohol and tobacco. Five of the 16 papers assessed the residents’ perspective. This review highlights the importance of incorporating the perspectives of residents, care professionals and the organisation to enhance PCC and enable residents to make shared and well-informed decisions in dialogue with care professionals. Future research should also assess the distinction between substance use and misuse, and how this affects implementing PCC in RCFs.

Cannabis use in a Canadian long-term care facility: a case study

“…While residents’ autonomy must be respected, as well as their own expertise with regards to medical cannabis use, the value of standardized medication protocols to ensure the safety of residents as well as to inform care decisions must be acknowledged. The tension experienced in balancing LTC residents’ autonomy with health and safety concerns in the context of substance use has been cited in a recent scoping review [ 48 ] as well as prior research that has examined the use of tobacco in residential care settings [ 49 ].…”

“…Lessons can be drawn from literature that has examined the use of other legal substances, such as alcohol and tobacco in LTC [ 48 , 60 ], and the need to develop person-centered care plans that ensure the safety of the individual, fellow residents, and the healthcare team.…”

An Introduction to Silver Empowerment

“…autonomy, informal care, quality of care, participatory research, technological innovation, palliative care and dementia care). PhD studies are, for example, about intimacy and sexuality of older persons with dementia living in a nursing home (Roelofs et al, 2019a(Roelofs et al, , 2019b, autonomy (Van Loon, Janssen et al, n.d.;Van Loon, Luijkx et al, 2019), access to care (Schipper et al, 2015a(Schipper et al, , 2015b, and the use of tobacco and alcohol by residents who live in a nursing home (de Graaf et al, 2021). Care organisations contribute to conducting the PhD studies of the science practitioners by enabling them to work on the research during contract hours.…”