Shared decision-making on drinking alcohol in older adults living in residential care facilities: care professionals' perspectives

Introduction: Older adults living in residential care facilities (RCFs) may wish to drink alcohol, despite adverse outcomes. Shared decision-making (SDM) could support care professionals in balancing residents' autonomy and well-being with the ad-verse outcomes to all residents and staff. This study aims to assess factors that could affect shared decision-making (SDM) and care professionals' behaviour regarding residents' alcohol use in residential care facilities (RCFs).

Methods: A quantitative cross-sectional study and explorative analyses were chosen to answer the research question. Care professionals working in psychogeriatric or in somatic units of RCFs were included (N = 332) and filled out a survey. The main variables studied in this research are shared decision-making, behaviour (facilitating or limiting residents' alcohol use), care professionals personal alcohol use and their attitudes, person-centred care and organisational culture. t-tests, regression analyses and ANOVA analyses were conducted using SPSS.

Results: Care professionals' attitudes towards residents' alcohol use are significantly associated with personal alcohol use; the level of SDM; and the level of enabling residents to drink alcohol. SDM is associated with person-centred care (PCC) and significantly differs between somatic units and psychogeriatric units.

Conclusion: SDM could be used in dilemmas regarding residents' alcohol use. Care professionals' personal alcohol use and attitudes towards residents' alcohol use could affect whether they discuss and facilitate this use. This may cause inconsistencies in care towards residents' alcohol use, which endangers PCC.

Implications for Practice: SDM could support care professionals in dilemmas regarding residents' alcohol use. Care professionals should learn about the possible role of their personal alcohol use and attitudes regarding this topic. Finally, organizations should consider potential complicating factors when developing and implementing organizational policies regarding residents'alcohol use.