We have a couple of alcoholics and a fair few more who enjoyed the odd tipple in our place. We have a group who always chip in on a few bottles of wine and snacks and gather in the lounge on a Saturday evening.
Wrt medication it depended upon whether they managed their own mediction and how drunk they were.
For people who managed their own medication there was nothing we could do. They were adults with full capacity and it was their choice to make.
If we were in charge of their medication it meant they had been assesed as not having the capacity to be in charge of their own medication. Legally, we had to follow the medication instructions to the letter. We could not administer medication if they had consumed alcohol without a qualified, medical professional (we had no nurses - only carers) telling us in writing that we could or 111 telling us over the phone that we could.
We were advised to operate common sense. If someone had a can of lager before bed or a small wine with dinner and a glass of sherry before bed we still gave them their medication. If they were obviously intoxicated we had to phone 111 for advice each and every time. Usually we were advised to wait four hours and then give them their medication or skip a dose but there were some that could be given with alcohol.
Under no circumstances were we allowed to take alcohol away from anyone unless a deprivation of liberty order was in place. Ditto medication. If the resident was in charge of their own medication we could not take it away unless they were deemed as being an immediate danger to themselves and we could only do this with the say so of the crisis team.
If I took Alcoholic Bob on a shopping call and he decided he wanted to buy three bottles of gin I could not legally stop him. I could encourage him not to. I could contact his family and social worker but I could not deny him his choice to buy gin. He is an adult and they are always deemed as having the capacity to make their own choices unless a DOLs is in place.
It's the same with dementia and leaving the premises. We can encourage them not to leave, we can follow them, we can contact the police if we are worried for their immediate safety. We can contact their family and social worker but we cannot physically prevent them from leaving if they are adamant that they want to leave.
This was in a semi independent living complex. We sadly, had lots of people who could have benefitted from full nursing care in a secure dementia unit but could not secure the funding or had families who were blinkered to their detoriating mental state and wanted to protect their own inheritance. I have lost count of the number times I have chased someone with dementia down the road begging them to come back home. The majority of the time they happily comply when you offer them a cuppa and biscuit and promise to go out later and do whatever errand it was they thought they were running on their behalf.
Often they just wanted a wander in the hopes of finding someone to chat to.
I'm pretty shocked at the number of care homes mentioned on here who are overstepping the law. It is not legal to deny an adult the choice to drink, smoke or eat too much cake.