Drinking in Assisted Living - The New York Times

How likely is an assisted living resident to have a drinking problem?

The short answer is: nobody really knows. But a study by a University of Pittsburgh team, recently published in Research on Aging, provides some useful clues. More than 800 aides working in assisted living facilities in Pennsylvania were asked in a questionnaire about behaviors they had observed, or had evidence of, in the elderly people they cared for. Their responses suggested that:

-Nearly 70 percent of assisted living residents drank alcohol.
-More than a third drank daily.
-Twelve percent had abused alcohol (defined as drinking enough to cause “physical or psychosocial harm”) in the past three months.
-Almost 20 percent had experienced an apparent influence on their health from alcohol use in the past three months.

You might ask why the researchers relied on reports from nursing aides, who provide the bulk of hands-on care in assisted living, instead of asking residents themselves. One reason, admitted Nicholas Castle, a leading health policy researcher at the University of Pittsburgh, is that the team didn’t have the money to train and pay interviewers for an extensive multistate investigation that would provide a deeper understanding of this largely overlooked issue. That’s one limitation of this approach.

But as many readers pointed out the last time we talked about drinking and aging, denial is not just a river. “People tend to underestimate their consumption,” Dr. Castle said. He was not sure that residents would provide more accurate information than nursing aides, who are deeply involved with residents. “They tend to know what’s going on,” he said.

Alcohol misuse or abuse does not appear to increase with age, but it may have more serious consequences for people in their 80s, as the great majority of assisted living residents are. Their tolerance for alcohol changes; the amount they have drunk daily for years can become more intoxicating, more apt to cause falls, depression, high blood pressure and other accidents and illnesses.

In assisted living, too, most people take multiple medications and also show at least some cognitive decline. “With their changing metabolism and the possible interactions with prescription drugs, they may not need to drink a lot to have problems with alcohol,” Dr. Castle said.

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