Giving alcohol to a resident

[fournee]

I have been working at an Asst Living Facility for 1 month part time and really love it. A resident's son gave the wellness office a bottle of Brandy to give to her at night. The instructions are to give her a 'shot' of brandy with 7up or another clear soda. The drink is suppose to help her sleep at bedtime. The other nurse have no problem wth this, I on the other hand, feel very weird. As far as I know, the Director of the building has no knowledge of this. The resident will abuse it if she kept it in her apartment, as I was told. I don't know what to do. Suggestions please.

[nurseprnRN, BSN, RN]

Have the son bring in nips instead of a big bottle, and issue her one a day, to open at whatever time she chooses. She could also have one of those big 30-day automated pill dispensers, he could fill it once a month, and it could dispense her one a day at HS.

[joanna73, BSN, RN]

That's the reason for a Doctor's order for alcohol. The physician is aware of each residents medication profile, and whether or not alcohol is contraindicated. As long as I have an order, and I'm also using my nursing judgment with each resident, I'm not concerned. As an aside, millions of people probably take meds and drink.

[traumaRUs, MSN, APRN]

Its not the ETOH thats the issue, it seems to be whether this resident is paying to have her meds dispensed. At least in the ALFs I'm familiar with, there are different levels of care; all of which must be paid for. This nurse identified that this resident is not on the "nursing" side of care but only paying for PRN meds.

So, without any type of order, even one for a prn ETOH drink, this resident should not be receiving it - at least that's how I see it....

[amoLucia]

Its not the ETOH thats the issue, it seems to be whether this resident is paying to have her meds dispensed. At least in the ALFs I'm familiar with, there are different levels of care; all of which must be paid for. This nurse identified that this resident is not on the "nursing" side of care but only paying for PRN meds.

So, without any type of order, even one for a prn ETOH drink, this resident should not be receiving it - at least that's how I see it....

Thank you ... I thought that I was reading the original post the same way. I'm not too familiar with ALF, just LTC. I question that the nitecap is 'covered up' in a CLEAR liquid. Like trying to slip her a 'mickey'? Is she making phone calls to her son at nite, hence his request??? I've known things like this to happen!

OP subsequently comments that the resident has a dementia diagnosis, so she obviously would not be capable of independent control. Her behaviour 'behind closed doors' may be problematic at nitetime and may necessitate a higher level of care for her (that her family seems to want to hide)!!!

I think a re-evaluation care conference is in order so the MD can write orders, and the building administrator is also apprised for legal and risk mgt reasons (and safety & financial).

Just IMHO and 2 cents.

[nancysymonsblod]

It is not unusual for residents to have a drink or two in long term care, especially an assisted living. Lets face it at that age your not there to be their mother or father. Nothing wrong at all as long as the physician is aware. Been in long term care for 35 years and have seen this practice many times. It is their home. Besides it has less side effects than a nasty dose of xanax or another sedative for sleep. Also initiates appetite. Im a long term care nurse not a police officer or drug and alcohol rehab nurse. If they have had a drink for years before bed witholding it can cause more problems than not.

[Asystole RN]

When I worked in LTC I had a patient who, by order, could receive a double shot of any liquor she chose or her Ambien/Vicodin combo.

Slept like a baby everytime she took the booze.

But because you are an agent of the company, follow the company rules.

[CapeCodMermaid, RN]

Amolucia.....a diagnosis of dementia does not necessarily mean the resident must give up independent control.

[mappers]

Its not the ETOH thats the issue, it seems to be whether this resident is paying to have her meds dispensed. At least in the ALFs I'm familiar with, there are different levels of care; all of which must be paid for. This nurse identified that this resident is not on the "nursing" side of care but only paying for PRN meds.

So, without any type of order, even one for a prn ETOH drink, this resident should not be receiving it - at least that's how I see it....

Exactly! If the resident isn't paying for nursing services, then the nurse should not be in charge of her nightly drink. If the son thinks she can't control her drinking, but is OK with giving herself medication, I'd say there is something fishy in Denmark.

[amoLucia]

Amolucia.....a diagnosis of dementia does not necessarily mean the resident must give up independent control.

I agree generally, but there is safety issue here with her & liquor. Son doesn't want her to have the bottle herself, so maybe he knows something we don't.

I have no problems with supervised alcohol for pts (have given it out); in fact, I'm surprised it's not ordered more often than I've seen. But this particular pt has given me concern from what I've read in this thread. Unless I've misinterpreted OP.

[sharpeimom]

I agree generally, but there is safety issue here with her & liquor. Son doesn't want her to have the bottle herself, so maybe he knows something we don't.

I have no problems with supervised alcohol for pts (have given it out); in fact, I'm surprised it's not ordered more often than I've seen. But this particular pt has given me concern from what I've read in this thread. Unless I've misinterpreted OP.

I just reread the OP and what occurred to me reading it again is that maybe the mom is simply forgetful sometimes and could forget she's already had her drink and have another.

To me, that's more misuse than abuse. I'd like to think he wouldn't have brought the brandy in the first place if his mom had had a real problem or were alcoholic.

[vonxojn]

I worked in a long term facility that had a resident that had an order on her MAR for Vermouth every night. I used my own judgement as far as giving it to her. I often worry about her getting up at night and falling. Even thou it was s small amt.

[NurseCard, ADN]

It's amazing that I've worked in two different LTC facilities, and have not had one single

resident with an order to give them any alcoholic beverages, nor have I seen any stored

in any of the refridgerators.

As a matter of fact, the ENTIRE time that I have worked as a nurse, I have had exactly

ONE patient, in the hospital, who had an order for any alcoholic beverages. This was

actually a fellow that my husband and I bowled with. He was only in the hospital for

about three days. He had an order for three beers a day.