Balancing individual rights and risks: a systematic review of qualitative studies of perspectives on older adults’ alcohol use in residential care setting
“Balancing individual rights and risks: a systematic review of qualitative studies of perspectives on older adults’ alcohol use in residential care settings” a review by Nichol and associates (2025) explored how alcohol consumption among older adults in residential care (RC) is perceived and managed. It highlights the tension between respecting residents’ autonomy and addressing health and safety concerns. Alcohol use is often linked to dignity, social inclusion, and personal freedom, yet it also poses risks, especially for individuals with cognitive or physical impairments. The review emphasizes the need for staff training to identify and manage problematic alcohol use and national guidelines to ensure consistent, ethical, and person-centered care practices. These measures aim to support residents’ rights while safeguarding their wellness. While the ethical balance between autonomy and risk in alcohol use is acknowledged, how frontline staff navigate these decisions in real-time—especially with residents experiencing cognitive decline—remains underexplored. This includes 1) subjective thresholds staff use to define “problematic” use; 2) the influence of institutional culture and personal beliefs on care decisions and 3) the impact of these decisions on residents’ quality of life and health outcomes. This review offers implications for addiction and healthcare research aimed at fostering development of evidence-based training that reflects real-world ethical dilemmas; informing policy frameworks that are both rights-based and risk-aware and enhancing an understanding of addiction in aging populations, a growing yet understudied demographic.