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Discussion

Happy Hour

I remember a time when it was not unusual for the physician to prescribe a glass of wine or a mixed drink for patients at their evening meal or HS. Often this stimulated their appetite or promoted sleep. The bottles of alcohol were labeled with the individuals name and kept in the locked medicine cabinet. I have always felt, with the occasional exception, this was a much better route to take rather than loading them with pills to get the same results. Is this still done?

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    • Featured Replies

    I've heard of this but not seen it, although I've heard of it more for prevention of DTs than the reasons you've named.

    I do remember patients being prescribed beer while in the hospital to prevent DTs (was Milwaukee's Best, then Heineken) before the newer CIWA protocol was started, but that stopped in 2009.

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    • Experts

    My maternal grandfather was prescribed 1 beer each day for lunch -- so that he wouldn't have to take a diuretic for his kidney problems. My grandmother was a total non-drinker (daughter of alcoholic) and she always assured us grandkids that PopPop's beer was medicine prescribed by his doctor. I doubt she would have let him drink it if it wasn't a doctor's order. He had a wise doctor. PopPop lived to be 96 -- and didn't enter a nursing home until he had a stroke 2 weeks before his death. I doubt the beer did him any harm.

    My father (a physician) wrote a prescription for his mother to get a glass of Irish Whiskey each evening before supper in the LTC. It wasn't medicinal, it was just to prevent her from pitching a fit if she didn't have her usual pre-dinner cocktail. It was just as much for the benefit of the staff as it was for grandma.

    Whatever happened to such good ol' common sense?

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    • Author

    I did occasional agency work in the 90's at a Catholic LTC facility in Baltimore that had a cocktail and social hour each evening for the residents. The med or charge nurse would pour and the NA's serve. This also included no salt pretzels and different light snacks along with the wine and booze. Of course those attending had a doctor's order to allow them to do so, this activity went a long way in promoting harmony on the unit and in making the residents feel a bit more 'human' vs being a log.

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    I've worked several nsg homes where pts had orders for nitecaps. Families provided the drinks and we stored them securely. We had some TOP SHELF beverages.

    Even had the occ order for a "may repeat one time" on 11-7. And I served bar.

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    I think our cardiac transplant unit sometimes prescribes a beer. You don't want an open heart patient going into DTs. I think it should still be done. We give nicotine patches to smokers, why not alcohol to drinkers? Instead, I end up pushing Ativan every so often so they don't go into DTs and A-Fib.

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    I have seen this available especially in nursing homes. I have even seen it in the hospital setting. While it is not a common thing, if discussed with the provider, and there are no contraindications, it is often more agreeable to have that 2-4oz of wine versus a drug.

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