IFF - Implementation of F+F (early detection and early intervention) for problematic alcohol and drug consumption by older people

The "FFF" project surveyed the experiences of institutions on the topic of old age and alcohol consumption (high-risk consumption, early detection, areas of conflict, use of screening instruments). The survey also addressed the need and associated challenges among the following: nursing service providers of Spitex, retirement homes and nursing homes, and general practitioners and nursing home doctors* (Schaaf et al., 2019). The results were discussed with relevant stakeholders (Curaviva, Spitex, family doctors, addiction specialists) with regard to relevance and, above all, feasibility. Finally, priorities for the implementation process were defined (ibid.). The comprehensive survey showed that carers are increasingly confronted with people with alcohol problems of varying degrees of severity. In addition, overmedicalization among the elderly, mixed consumption, and interaction of alcohol and medication (including side effects, such as increased risk of falling) are described as a major problem.

Early detection and early intervention (F+F) were considered useful in various discussions. However, institutions and doctors often only act when there are concrete incidents in which the clients endanger themselves, harass roommates or when carers are impaired in terms of their work and the workflow in the company is disrupted. The appropriate handling of clients who drink while simultaneously maintaining their self-determinations to the greatest possible extent creates discrepancies for the carers. This repeatedly leads to uncertainty, specifically when a situation is not yet problematic enough to justify intervention. Early detection – a method to improve the quality of life – is occasionally feared as impairment of self-determination. Therefore, sensitization and training in the field of early detection are important in the understanding of health promotion. The aim is to facilitate, the use and access to proven interventions, skills and instruments for nursing home doctors and general practitioners*, Spitex employees and employees of old people's and nursing homes by means of participatory and tailor-made packages of measures.

Retirement and nursing homes: The introduction of an F+F concept combined with appropriate training and anchoring in the companies, provides the homes with the security they need to act and react appropriately in concrete situations, thereby contributing to the promotion of the health and quality of life of the residents. Together with “CURAVIVA Bern Weiterbildung”, the ISGF is developing a program for nursing professionals (courses) and one for home management/nursing services (workshops). The implementation of F+F is monitored and evaluated by local addiction prevention centers and the ISGF. 

Spitex companies: Information on “F+F alcohol/medicines for the elderly” to sensitize Spitex employees is to be intergrated to existing training programs. Tailored in-house training courses on F+F are held in Spitex companies. In analogy to the workshop for home management/nursing services, “CURAVIVA Bern Weiterbildung” is planning a training program for Spitex companies. 

“Ärtzliche Qualitätszirkel” (Quality Circle - General Practitioners and Nursing home doctors): Within the framework of existing QZ meetings, the basics of problematic alcohol consumption in old age (interaction of drugs) as well as effective and practicable techniques of short interventions are taught.