Finding a fair deal: Policies on alcohol and drugs at "wet" eldercare facilities

"Wet" eldercare facilities for people who age with long-term substance use problems and complex needs exist in several countries. Residents are accepted as active users of alcohol and drugs, and while the media has presented the permissive policies of the facilities in a positive light, others have described these policies as harmful. The aim of this article is to analyze residents' and staff members' understanding of alcohol and drug policies in wet eldercare facilities. Is there a shared understanding? What reasons do they give in support or criticism of the policies? The study is based on qualitative interviews with 42 residents and 21 staff members at four Swedish eldercare facilities for people who are aging with long-term substance use problems. The research team identified central themes using qualitative content analysis. The analysis shows that both residents and staff cite self-determination and the need for pragmatic trade-offs as the reasons for a policy whereby residents can consume alcohol in the privacy of their own rooms but not in common areas. The analysis did not support claims that the permissive approach resulted in reduced consumption of alcohol, and this demonstrates the need to balance self-determination with the risk of harm. Residents' general appreciation of their facility colored their views on alcohol and drug policies, which shows how important it is to provide residents with positive conditions and experiences so that they can balance the rules that make the facilities tolerable places to live.