Alcohol Use in an Older Adult Referred to a Consultation-Liaison Psychiatry Service: A Case Report

Nursing Knowledge of Alcohol and Other Drugs (AOD) in a Regional Health District: An Exploratory Study

Nurses remain at the forefront of direct patient care due to the nature of their role; they are in a position to provide assessment, response and referral of individuals in healthcare settings with problematic alcohol and other drug (AOD) use. We aim to determine the AOD knowledge of nurses in a regional health district in Australia and the awareness of an AOD service operating in the clinical environment. We employed a cross-sectional online survey, with descriptive and correlational analysis performed to explore relations between knowledge and both assessment and referral practices for individuals with problematic AOD use. Results indicate good knowledge of the AOD service, with confidence to refer to the service associated with recent contact. Lower satisfaction levels with the AOD service were found in nurses who had no recent contact with the service. Awareness of the service was also positively associated with completion of the electronic AOD assessment. These results indicate that the presence of experienced AOD clinicians may increase familiarity with AOD services and increase screening. Given the link between familiarity and comfort with the AOD service and referral, establishing specialised AOD nursing positions remains an important strategy. We argue that the presence of specialised AOD nurses has a flow on effect in maintaining continuing screening and encouraging nurses to refer individuals with problematic AOD use for ongoing care and treatment.

The Experiences of Clinicians Caring for Older Adults with Dual Diagnosis: An Exploratory Study

Dual diagnosis has been identified as a significant challenge to mental health services, resulting in higher rates of psychiatric relapse and greater illness severity. Much research explores dual diagnosis in the adult mental health cohort, however little research attention has been paid to older adults with dual diagnosis. Far from being a trivial issue, preliminary studies have shown that dual diagnosis in older adults is under diagnosed and poorly identified by clinicians with few specific treatment options available. In addition, studies of the ageing baby boomer cohort demonstrate a potential for dual diagnosis presentations to increase in the coming years. This article explores the experiences of a clinical team providing care to older adults with dual diagnosis in Melbourne, Australia, through a semi-structured interview process. The participants described a number of systemic barriers to providing care to the older adults with dual diagnosis presenting to the mental health service, in addition to feeling poorly prepared and expressing a degree of clinical helplessness. Additionally, the participants described service improvement, which included a strong dual diagnosis culture in the leadership team of the mental health service and role modelling dual diagnosis competent practice among clinicians.